The rate of failure to thrive among children aged 2 months - 5 years in Kanaan sub-district / Diyala province

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1 The rate of failure to thrive among children aged 2 months - 5 years in Kanaan sub-district / Diyala province Mehdi SH. Al-Zuheiry (M.B.Ch.B., F.I.C.M.S.Ped.) College of Medicine-Diyala University Background: Failure to thrive (FTT) is a common pediatric problem particularly in developing countries. The prevalence of FTT varies according to the different populations. Objectives: to determine the rate of FTT among children aged 1-5 years in Kanaan district / Diyala province. Subjects and methods: This study was conducted in the primary health care center of Kanaan district / Diyala province over a period of 6 months (November 2007 to April 2008). Hundred children aged 1-5 years were chosen randomly and each child was subjected for measurement of body weight, mid-arm circumference (MAC), and hemoglobin (Hb) level. Results: The rate of FTT was 47% according to the body weight and 21% according to MAC. The majority of cases of FTT according to the body weight were mild cases (80.8%) while the moderate cases represent 19.2% from the total cases. The study also revealed that the rate of FTT increases as the level of maternal education decreases. Furthermore, increasing rate of FTT among children with exclusive breast feeding, as well as among children with unemployed mothers were found. There were more cases of anemia among children with FTT. Conclusion: It was concluded that FTT is highly prevalent in the studied area & possibly in Iraq (although most cases were mild), and the main causes of FTT are failure of breast feeding & low maternal education. Keywords: Failure to thrive, Body weight, Children. Published in Diyala Journal for applied researches / Vol. (5), No. (1) Iraq.

2 Urinary tract infections and failure to thrive among children aged 2 months - 5 years in Diyala province Mehdi SH. Al-Zuheiry (M.B.Ch.B., F.I.C.M.S.Ped.) *, Abdul-Razzaq SH. Hassan (ph.d) **, Shefa M. Hamza (M.B.Ch.B., F.I.C.M.S.Ped.) *** * Department of Pediatrics, College of Medicine-Diyala University, ** Department of Microbiology, College of Medicine-Diyala University, *** Department of Pediatrics, Baladrooz General Hospital-Diyala Health Directorate Background: Urinary tract infections (UTI) are common pediatric problems. They are most commonly caused by Escherichia coli (E.coli). Failure to thrive (FTT) is a term given to malnourished infants & younger children who fail to meat the expected standards of growth. Poor growth can be an important clue to a chronic illness as UTI. Objectives: to determine the rate of UTI among children 2 months-5 years of age with FTT, risk factors, relevant causative bacterial agents, and their antibiotic susceptibility in Diyala province. Subjects and methods: This study was carried out in Al-Batool Hospital of Pediatrics and Gynecology in Baquba city during a 9-month period from 1 November 2008 to 1 August One hundred forty children (2 month - 5 year of age) with FTT and 90 children with normal body weight ( served as controls ) were evaluated for UTI by culture and sensitivity of urine prior to antibiotic therapy. Results: This study reveals that of the total number of 140 patients with FTT, 38 (27%) of them had UTI; and of 90 control children without FTT, 7 (7.8%) of them had UTI. The commonest causative bacterial agent recovered from urine cultures was E.Coli, followed by Klebsiella aerugines. In this study, bacterial isolates were mostly sensitive to trimethoprim-sulphamethaxasole (TMP-SMX), gentamicin, cefotaxime and nalidixic acid. The rate of UTI in children with FTT was more in females (40.6%) compared with males (15%) and more in uncircumcised males (22.9%) compared with circumcised males (3.6%).

3 Conclusion: UTI is significantly prevalent in children with FTT in Diyala province and female sex and uncircumcised male are among the risk factors for UTI. Key words: Urinary tract infections, Children, failure to thrive Published in the activities of the 1 st scientific conference of Diyala university 13-14/12/2009 The prevalence of rotavirus infection in Baquba- Diyala province Abdul-Razak SH. Hasan (Ph.D.), College of Vet. Med. Diyala University Abbas A. Al-Duliami (Ph.D.), College of Education. Diyala University Mehdi SH. Al-Zuheiry (F.I.C.M.S.Ped.), College of Medicine, Diyala University Abdul-Kadir Y. Al-Azawi (B.Sc.), College of Education, Diyala University Background: Rotavirus infection is the leading single cause of severe diarrhea among infants and young children. More than 500,000 children under 5 years of age die from rotavirus infection each year, and almost 2 million more become severely ill. Objectives: To determine the prevalence of rotavirus infection among patients with diarrhea in Baquba- Diyala province, and to explore the effect of certain relevant factors. Materials and methods: The present study was extended from 1/July/2007 to 1/September/ 2008 in Baquba city. A total of 300 fecal specimens were collected from patients suffering from acute diarrhea. The patients include 136 (45.3%) females with mean age (7.8 ± 4.7) years, and 164 males with mean age (5.3± 3.4) years. Demographic information regarding the patient's age, sex, residence, type of water supply, and type of feeding (for those below 2 years of age) were collected through a special questionnaire prepared for this study. BioRad-Rota kit is a highly sensitive agglutination test was used for detection of rotavirus in fecal specimens. All data were statistically analyzed. Results: The results showed that the overall infection rate by rotavirus among patients was 20.3%, and the highest infection rate was among those below 5 years of age. Rotavirus infection among adult patients was also recorded. Females had an insignificantly higher infection rate compared to males (22.1% vs 18.9%). Patients consuming river's water had significantly higher infection rate compared to those used municipal or tank water (34.5%, 14.1% and 18.5%) respectively. Patients (below 2 years) feed artificially had higher infection rate compared to those on breast or mixed feeding (28.2%, 19.1% and 18.8%) respectively. Although, the rotavirus

4 infections were recorded around the year, the highest infection rate was during spring and winter seasons (22.5% vs 21.4%). Conclusion: Rotavirus infection as a cause of acute diarrhea was common in Baquba, and particularly affects children below 5 years of age. Keywords: Rotavirus, acute diarrhea, gastroenteritis Published in Iraqi Journal of Community Medicine / Vol. (24), No. (3) July Iraq. Sero-epidemiological study of outbreak of measles among children in Diyala Ismail I. Latif (MBChB, phd) *, Mehdi SH. Al-Zuheiry (MBChB, DCH, FICMSPed) **, Nadhim GH. Noaman (MBChB, DCM, MSC, phd) *** * Department of Anatomy, College of Medicine-Diyala University, ** Department of Pediatrics, College of Medicine- Diyala University, *** Department of Community Medicine, College of Medicine-Diyala University Measles is a serious infectious disease in children. Despite reaching global measles vaccination coverage of 80% of individuals, measles virus remains the fifth leading cause of death and the most common cause of vaccine-preventable death in children under 5 years of age. This article aimed to assess the sero-epidemiological characteristics of the outbreak of measles among children in Diyala province in This study was done during the outbreak of measles in Diyala provinc ( spring and summer of 2009) in Al-Batool hospital of Pediatrics and Gynecology in Baquba city during a 2-month period from first of April 2009 to first of June A sample of 103 pediatrics patients presented with clinically suspected measles was studied by thorough history and physical examination with a determination of immunoglobulin M antibodies in serum by enzyme-linked immunosorbent assay testing for measles. There was 58.3% (66 out of 103) positive blood samples for immunoglobulin M of measles in children with clinically evident measles. The present study showed that there was no significant difference in the distribution of children with measles positive by immunoglobulin M according to their age, sex, residency, mothers previous vaccination status and previous measles. On the other hand, the study revealed that the distribution of immunoglobulin M positive measles cases was

5 significantly higher (p<0.05) among unvaccinated children, and in children with low and medium economic status. It was concluded that the single serum assay of immunoglobulin M antibodies by enzymelinked immunosorbent assay testing has medium sensitivity in the diagnosis of measles in children, and there is an increasing susceptibility of infection with measles for infant less than one year of age and for children with poor family economic status. Key words: Measles, IgM, serology, Children, Diyala Published in Tikrit Medical Journal / Vol. (16), No. (2) December Iraq. Clinico-epidemiological trends of Visceral Leishmaniasis in Diyala Governorate during the year Dr.Falah Mkhaber Al- Zubaidi (MBChB, FICMSPed) Diyala health directorate/ministry of health Assistant prof. Dr.Nadhim Ghazal Noaman (MBChB, DCM, MSC, phd) Community medicine department/college of medicine/ Diyala university Assistant prof. Dr.Mehdi SH. Al-Zuheiry(MBChB, DCH, FICMSPed) Pediatrics department/college of medicine/ Diyala university Background: Visceral leishmaniasis (kalazar) is a disease caused by intracellular protozoa related to Leishmania affected children under five years, endemic in countries of Eastern Mediterranean Region, jackals and foxes were considered as reservoirs, sand fly act as a vector. The patients present with different symptoms and signs. Objectives: To evaluate the size of this public health problem in Diyala governorate and to study the clinical and epidemiological aspects of this problem. Patient and Method:The study was descriptive cross sectional study done during the period between first of October 2009 to the thirteenth of September 2010, in Al- Batul teaching hospital for maternity and pediatric in Baquba city- Diyala. The data was collected by direct interviews by researchers with the patients using special questionnaire form, in addition to the results of examination and investigations. Results: The number of patients was 243 including (49%) below one year, (34%) below two years, (52%) males and (48%) females. The patients were presented with fever for less than 15 days (58%), splenomegaly& hepatomegaly (93%), sweating (40%), bleeding (14%), chest infection (35%), diarrhea (53%) and vomiting (79%). The patients also presented with anemia (96.5%) and those who need blood transfusion were (47%),

6 the death rate was (2%) only. The number of the patients was more in the months November and December than other months of the year and higher during the year than the previous years. Conclusions: Visceral leishmaniasis still a major public health problem affecting mostly children under five years presented with different signs and symptoms, blood transfusion was needed in about half of the patients. Active case detection and regular surveillance by screening is needed with health education and improving the environment is important in Diyala. Key words: Clinico- epidemiological, Visceral leishmaniasis, Diyala. Published in International Journal for Sciences and Technology / Vol. (6), No. (3) September Jordan