Determining the bacterial and viral meningitis trend in Iraq from 2007 till 2023 using joinpoint regression

Hanan Abdulghafoor Khaleel; Riyadh Abdulameer Alhilfi; Salman Rawaf; Zeenah Atwan; Ameen Abdulhasan Al-Alwany; Mays Raheem; Celine Tabche

doi:10.1016/j.heliyon.2024.e30088

Determining the bacterial and viral meningitis trend in Iraq from 2007 till 2023 using joinpoint regression

Heliyon. 2024 Apr 22;10(9):e30088. doi: 10.1016/j.heliyon.2024.e30088. eCollection 2024 May 15.

Authors

Hanan Abdulghafoor Khaleel¹, Riyadh Abdulameer Alhilfi², Salman Rawaf³, Zeenah Atwan⁴, Ameen Abdulhasan Al-Alwany⁵, Mays Raheem³, Celine Tabche³

Affiliations

¹ Communicable Diseases Control Centre, Directorate of Public Health, Ministry of Health, Baghdad, Iraq.
² Directorate of Public Health, Ministry of Health, Baghdad, Iraq.
³ WHO Collaborating Centre, Department of Primary Care and Public Health, Imperial College London, UK.
⁴ Virology, Faculty of Medicine, University of Basrah, Iraq.
⁵ University of Bagdad College of Medicine, Iraq.

Abstract

Background: Acute meningitis is a disease with case fatality and disability rate that is dependent on the causative agent.

Objective: Determine the meningitis trend in Iraq from 2007 to 2023 using a joinpoint regression at national and sub-national levels and describe the epidemiology.

Methods: Joinpoint regression model was used on surveillance data from Jan 2007 until May 2023, to calculate annual and average annual percent changes to determine the trend. Meningitis total count was modelled by year of reporting and province using the log transformation and Poisson variance. Best-fit model was chosen based on the weighted BIC criteria as the final point.

Results: Bacterial meningitis was higher than viral meningitis from 2007 to 2018, then viral meningitis started to exceed till 2023. Meningococcal meningitis was lower than other bacterial and viral meningitis from 2007 to 2023. Most meningitis cases across the years were lower than 15 years, at almost 80 %, while 20 %-40 % were lower than one year. Across all years, 55 % of the cases were males; apart from 2019, 70 % were females.

Conclusion: In Iraq, viral meningitis has been the predominant type since 2018. Most meningitis patients were lower than 15-year-old males. The meningitis trend in Iraq was stable from 2007 till 2023.

Keywords: Communicable diseases; Infectious diseases; Iraq; Joinpoint regression; Meningitis; Trend; Viral meningitis.