Iraq - Iraq has one of the highest tuberculosis (TB) prevalence rates in the region, with more than 15,000 individuals infected annually, according to Iraq Ministry of Health. In response, IOM Iraq is providing urgent medical support to TB patients across the country.

Since 2014, IOM’s Emergency Health Program has been supporting the Iraqi Ministry of Health’s National Tuberculosis Program (NTP), focused on assistance to displaced Iraqis, Syrian refugees, and vulnerable host community members, in cooperation with WHO and Health Cluster partners. In the last three months alone, IOM provided initial screening for more than 2,400 presumptive TB cases.

IOM Iraq’s TB in emergencies activities were initially carried out in the Kurdistan Region of Iraq (KRI), and in Kirkuk governorate. This year, working hand in hand with health authorities, IOM expanded its TB activities to operate in 12 governorate across the country: Anbar, Baghdad, Basra, Diyala, Duhok, Erbil, Kerbala, Kirkuk, Najaf, Ninewa, Salah al-Din and Sulaymaniyah. 

“The conflict in Iraq has created enormous humanitarian challenges, including placing additional strain on the health system, and the exacerbation of health needs,” said IOM Iraq’s Chief of Mission, Thomas Lothar Weiss. “IOM Iraq is pleased to work together with Iraq’s Ministry of Health and humanitarian partners to educate vulnerable populations about the risk of Tuberculosis and to support prevention and treatment.”

In 2017 IOM was selected as the principal recipient of the Global Fund to provide support for the Iraqi NTP, through which IOM and NTP designed a major TB program intervention. This program aims for tuberculosis control in Iraq, especially among IDPs, returnees and Syrian refugees.

Efforts include awareness raising, medical staff training, support to screening facilities, and early detection and diagnosis of TB cases among IDPs in emergency sites and camps.

IOM carries out initial screening at camps and in host communities; diagnostic tests to confirm cases are carried out at NTP laboratories. Between 2014 and 2017, IOM supported detection of more than 300 TB cases by NTP health facilities among IDPs and Syrian refugee populations in the KRI and Kirkuk.

Within the last four months, more than 50,000 IDPs, refugees and host community members have been visited by IOM mobile medical teams to raise their awareness about TB. 

According to Iraq’s NTP, in 2016, 7,246 TB cases were identified -- 47% male and 53% females -- with age groups ranging between one to four years old (164 cases) and upwards to 65 and older (1,075 cases).  Of the total 305 individuals were IDPs.

In 2015, of the total number of patients, which reached over 8,000, 29% were cured, 62% successfully completed treatment, and 3% (240 individuals) died; other cases were transferred, or did not complete treatment.

This year, NTP has confirmed a rise in the number of TB cases identified; this is mostly due to TB patients coming from Mosul, and IDPs in remote areas or hard to reach locations, for whom there has been a delay in diagnosis and treatment, or interruption of treatment due to difficulty accessibility to reach health services.

IOM’s TB project involves several steps, starting with awareness campaigns in IDP camps and informal settlements. In coordination with NTP, IOM performs initial screening for all IDPs, who come forth, believing they have symptoms of diseases. An IOM TB team then offers transportation to suspected TB patients from the camp or informal settlement to a NTP center.

At the NTP center a specialist provides patients with a comprehensive physical examination, radiological investigation, tuberculin skin test, sputum smear or culture.

When results are received, NTP identifies those with TB. This year with Global Fund support, IOM is providing anti-TB medication to patients through NTP’s pharmaceutical department.

TB patients are put on a strict 6-month medication plan. Directly observed treatment (DOT) is applied for some patients in need of guidance. Selected vulnerable patients receive high protein TB food packages to enhance their physical strength. 

After two months, IOM brings the patient back to the NTP center for another round of tests. If the results are negative, the patient is deemed cured. If however the results are positive, then the patient will be subjected to NTP treatment protocol. IOM, in coordination with NTP, continues follow up through the entire duration until the patient demonstrates complete recovery.

Due to the Mosul conflict, after months of grinding urban warfare, 824,034 individuals (137,339 families) are still in displacement. 

After a nine-month assault to oust ISIL from the once 2-million strong city, the Government of Iraq declared on Sunday that Mosul has been retaken. Military operations in Mosul led to the displacement of more than one million individuals to camps and out-of-camp locations.

Some IOM Iraq activities in Emergency Sites Qayara and Haj Ali in Ninewa governorate, were temporary paused at the end of last week due to security concerns. As of this week, activities have fully resumed. The two sites together host nearly 80,000 displaced Iraqis.

IOM Iraq’s Displacement Tracking Matrix (DTM) is now weekly releasing figures of IDPs who transit through Hammam al-Aleel screening site —from the beginning of West Mosul operations. The cumulative figure of IDPs from West Mosul, who transited in Hammam al-Aleel (since 25 February 2017), stands at 695,677 individuals.

IOM’s DTM actively monitors displacement across Iraq. The latest DTM Emergency Tracking figures on displacement across Iraq are available at: http://iraqdtm.iom.int/EmergencyTracking.aspx  

All DTM products and information about the DTM methodology can be found on the DTM portal: http://iraqdtm.iom.int/  

For further information, please contact IOM Iraq:

Hala Jaber, Tel: +964 751 740 1654, Email: hjaberbent@iom.int

Raber Aziz, Tel: +964 750 465 9204 Email: raziz@iom.int

Sandra Black, Tel: +964 751 234 2550 Email: sblack@iom.int