Prevalence and Case Fatality Rate Among Crimean-Congo Hemorrhagic Fever Patients in Iraq from 2021 to 2023

Fatima Mohammed  Motashar; Buthaina Ateyah  Rashid; Kareem Ghadhban  Sajem

Fatima Mohammed Motashar Middle Technical University, Baghdad, Iraq
Buthaina Ateyah Rashid Middle Technical University, Baghdad, Iraq
Kareem Ghadhban Sajem Middle Technical University, Baghdad, Iraq

Keywords: CFR, CCHF, Iraq, Ribavirin, Hospital admission, Symptoms onset, Prevalence

Abstract

Crimean Congo Hemorrhagic Fever (CCHF), a zoonotic illness transmitted by ticks, has been present in Iraq since 1979. However, the incidence of CCHF has sharply increased since 2021, raising concerns about its public health impact. This study aims to estimate the prevalence and case fatality rate (CFR) of CCHF in Iraq for the years 2021, 2022, and 2023, and to examine the association of CFR with ribavirin administration and the interval between symptom onset and hospital admission. A retrospective cross-sectional analysis was conducted on 957 confirmed CCHF cases from across Iraq, excluding the Kurdistan region, with data provided by the Iraqi Communicable Disease Control Center. Results show a declining CFR of 47.4%, 19.5%, and 13.6% over the three years, with a statistically significant reduction in CFR (P=0.000). However, the study found no significant association between CFR and either ribavirin administration (P=0.422) or the interval from symptom onset to hospital admission (P=0.447). The findings suggest that while the CFR has significantly decreased, ribavirin administration and early hospital admission did not significantly influence patient outcomes during the study period. These results highlight the need for further investigation into other factors that may contribute to improving patient survival rates in CCHF cases.

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