Prevalence of pulmonary tuberculosis in Al-Najaf governorate, Iraq

Saleem Khteer Al-Hadraawy; Kais Khudhair Alhadrawi; Israa Abduljabbar Jaloob Aljanaby; Ahmed Abduljabbar Jaloob Aljanaby; Rahman S Zabibah

doi:10.12688/f1000research.121881.1

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Research Article

Prevalence of pulmonary tuberculosis in Al-Najaf governorate, Iraq

[version 1; peer review: 2 not approved]

Saleem Khteer Al-Hadraawy¹, Kais Khudhair Alhadrawi², Israa Abduljabbar Jaloob Aljanaby³, Ahmed Abduljabbar Jaloob Aljanaby ¹, Rahman S Zabibah²

Saleem Khteer Al-Hadraawy¹, Kais Khudhair Alhadrawi², [...] Israa Abduljabbar Jaloob Aljanaby³, Ahmed Abduljabbar Jaloob Aljanaby ¹, Rahman S Zabibah²

PUBLISHED 20 Jun 2022

Author details Author details

¹ Biology, Faculty of Science, University of Kufa, AL-Najaf, Iraq
² Radiology Techniques, College of Medical Technology, The Islamic University, Najaf, Iraq
³ Microbiology, Faculty of Pharmacy, University of Kufa, AL-Najaf, Iraq

Saleem Khteer Al-Hadraawy
Roles: Data Curation, Methodology

Kais Khudhair Alhadrawi
Roles: Software, Writing – Original Draft Preparation

Israa Abduljabbar Jaloob Aljanaby
Roles: Conceptualization, Methodology, Writing – Original Draft Preparation

Ahmed Abduljabbar Jaloob Aljanaby
Roles: Methodology, Project Administration, Writing – Review & Editing

Rahman S Zabibah
Roles: Methodology, Software

OPEN PEER REVIEW

REVIEWER STATUS

Abstract

Background: pulmonary tuberculosis (PTB) is one of the most global dangerous infectious diseases worldwide, particularly in developing countries. Mycobacterium tuberculosis (Mtb) is the most infectious agent that caused PTB transferred by air droplets from one person to other. In the present epidemiological study, we aimed to record the total numbers and percentages of patients infected with PTB caused by Mtb during 12 months in AL-Najaf Governorate, Iraq.
Methods: This study has been done in 2019 from January to the end of December in the north and south region of AL-Najaf Governorate, Iraq. Sputum of PTB-patients has been stained by Ziehl–Neelsen to Mtb diagnosis according to World Health Organization (WHO) recommendation.
Results: We recorded 174 PTB-patients in AL-Najaf Governorate 2019; 89 male and 85 female; 101 and 73 in the north and south sections respectively. The age group 16-24 was the highest infected. Quarter two recorded the highest numbers of PTB-patients; 33 (60%) in the north section and 22 (40%) in the south section.
Conclusion: There was low PTB incidence in AL-Najaf Governorate 2019 but the Youngers were the most susceptible to infection. Infection in the north section was higher than in the south section and there were no high differences between genders. Seasons have no high effect on the number of infections.

Keywords

Pulmonary tuberculosis, Mycobacterium tuberculosis, AL-Najaf Governorate, North section, South section, 2019, Iraq.

Corresponding author: Ahmed Abduljabbar Jaloob Aljanaby

Competing interests: No competing interests were disclosed.

Grant information: The author(s) declared that no grants were involved in supporting this work.

Copyright: © 2022 Al-Hadraawy SK et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to cite: Al-Hadraawy SK, Alhadrawi KK, Aljanaby IAJ et al. Prevalence of pulmonary tuberculosis in Al-Najaf governorate, Iraq [version 1; peer review: 2 not approved]. F1000Research 2022, 11:675 (https://doi.org/10.12688/f1000research.121881.1) First published: 20 Jun 2022, 11:675 (https://doi.org/10.12688/f1000research.121881.1) Latest published: 20 Jun 2022, 11:675 (https://doi.org/10.12688/f1000research.121881.1)

Introduction

Health awareness is one of the most important reasons to avoid different infection such as pulmonary-TB and COVID-19.¹ The developing countries are the most infected with these types of infections.²^,³ Pulmonary-TB considered as the most infection caused by Mtb and can cause many dangerous complicated in the lung lead to death in many times.⁴ Pulmonary-TB is a contagious disease that is a major cause of illness and one of the top causes of mortality around the world and was the biggest cause of mortality from a single infectious agent until the COVID-19 pandemic, ranking ahead of many infections such as acquired immunodeficiency syndrome (AIDS).⁵^,⁶ More than 80% of pulmonary-TB patients can be successfully treated with a six to nine-month drug regimen. Many factors can lead to PTB progress such as smoking, malnutrition, diabetes, poverty and absent of health awareness.⁷^,⁸ In 2020, milestone of about more than 30% reduction in the absolute number of PTB deaths between 2015 and 2020.⁹ Al-Najaf Governorate is one of the most important holy cities in Iraq, about 180 kilometers south of Baghdad capital of Iraq and its estimated population about 1,500,000 people and it is crowded Governorate as compared with other because of highly percentage of visitors came to it from inside and outside of Iraq over the year.² This feature may be lead to fast transmit of different pandemic diseases in population such as COVID19 and PTB.¹⁰^,¹¹ According to important features above, the main goal of this study is to detect the prevalence of numbers and percentages of PTB-patients caused by Mtb in AL-Najaf Governorate during one year to find the most important ways to avoid this deadly disease in future.

Methods

Research ethics

The authors confirm that they are getting verbal agreement from Mtb-patients in this study. We confirm that we have obtained all the original approvals from Specialized Center for Chest and Respiratory Disease in AL-Najaf Governorate (23895/2019) in order to collect samples and follow up on patients and all data that related with research.

Study design

This epidemiological study has been performed under supervisor of Specialized Center for Chest and Respiratory Disease in AL-Najaf Governorate during one year from the first January to end of December 2019. In this study, two main sections have been studied; north and south section. According to seasonal variation, study was divided to four quarters as follow: quarter one include January, February and March. Quarter two; April, May and June July. Quarter three; July, August and September. Quarter four; October, November and December.

Diagnosis of Mtb in PTB-patients

Sputum has been collected from all suspected patient infected with PTB as follows; fasting sputum were collected from the same patient in three days respectively, and made slide stained with Ziehl-Neelsen. Appearance of red bacilli has been considered as positive infection with Mtb.¹²^,¹³

Statistical analysis

Graph-Pad Prism computer software has been used to detect the numbers and percentages of PTB-patients caused by Mtb according to ages, gender and seasonal variation.¹⁴^–¹⁶

Results

Total PTB-patients

The results indicated in Table 1 there were 174 PTB-patients in AL-Najaf Governorate; 89 male 51.1% and 85 female 48.9%. Out of total 174, there were 101(58%) in north section and 73(42%) in south section of the Governorate. According to age groups, Table 2 shows the age group 16-24 was the most infected with PTB that recorded 52 patients 29.9% followed by 55-64 which recorded 45 patients 25.9%.

Table 1. Total PTB-patients caused by Mtb in AL-Najaf Governorate 2019.

AL-Najaf Governorate	Male (100%)	Female (100%)	Total (100%)
North section	49 (48.5)	52 (51.5)	101 (58)
South section	40 (54.8)	33 (45.2)	73 (42)
Total (No. %)	89 (51.1)	85 (48.9)	174 (100)

Table 2. Total distribution of PTB-patients caused by Mtb according to age groups in AL-Najaf Governorate 2019.

Age group (year)	16-24	25-34	35-44	45-54	55-64	Total (100%)
North section	32	16	11	18	24	101 (58)
South section	20	10	12	10	21	73 (42)
Total (100%)	52 (29.9)	26 (15)	23 (13.2)	28 (16)	45 (25.9)	174 (100)

Seasonal infections

Thirty eight PTB-patients have been recorded in quarter one distributed as follows: 22 patients 57.9% in north section and 16 in south section 42.1%. Age group 16-24 was the highest infected with 13 cases 34.2% while the 25-34 was the lowest which recorded 5 cases 13.2% only (Table 3). Quarter two recorded the highest numbers of PTB-patients; 33 (60%) in north section and 22 (40%) in south section. Also, the age group 16-24 was the highest infected with 17 patients 31% while the 35-44 was the lowest which recorded 6 cases 11% (Table 4). As shown in Table 5 there were 44 PTB-patients in quarter three; 23 patients 52.3% and 21 patients 47.7% has been recorded in north and south section respectively, while the age group 55-64 registered 15 infections 34.1%, on the contrary, the age group 35-44 was the lowest infected with 4 cases 9.1%. The results proved in Table 6 there were 37 PTB-patients in quarter four; 23 (62.1%) and 14 (37.9%) in north and south section of Governorate respectively, age group 16-24 recorded 11 patients 29.7% while the 25-35 registered 3 cases 8.1%.

Table 3. Total distribution of PTB-patients caused by Mtb in AL-Najaf Governorate in quarter one 2019.

Age group (year)		16-24	25-34	35-44	45-54	55-64	Total	Total (100%)
North section	Male	3	1	0	3	2	9	22 (57.9)
North section	Female	5	3	1	1	3	13	22 (57.9)
South section	Male	1	1	2	3	1	8	16 (42.1)
South section	Female	4	0	3	0	1	8	16 (42.1)
Total (100%)		13 (34.2)	5 (13.2)	6 (15.8)	7 (18.4)	7 (18.4)	38 (100)	38 (100)

Table 4. Total distribution of PTB-patients caused by Mtb in AL-Najaf Governorate in quarter two 2019.

Age group (year)		16-24	25-34	35-44	45-54	55-64	Total	Total (100%)
North section	Male	4	4	3	3	2	16	33 (60)
North section	Female	7	1	1	3	5	17	33 (60)
South section	Male	4	3	2	1	2	12	22 (40)
South section	Female	2	2	0	1	5	10	22 (40)
Total (100%)		17 (31)	10 (18.1)	6 (11)	8 (14.5)	14 (25.4)	55 (100)	55 (100)

Table 5. Total distribution of PTB-patients caused by Mtb in AL-Najaf Governorate in quarter three 2019.

Age group (year)		16-24	25-34	35-44	45-54	55-64	Total	Total (100%)
North section	Male	5	2	1	2	2	12	23 (52.3)
North section	Female	2	4	1	1	3	11	23 (52.3)
South section	Male	2	1	2	2	6	13	21 (47.7)
South section	Female	2	1	0	1	4	8	21 (47.7)
Total (100%)		11 (25)	8 (18.2)	4 (9.1)	6 (13.6)	15 (34.1)	44 (100)	44 (100)

Table 6. Total distribution of PTB-patients caused by Mtb in AL-Najaf Governorate in quarter four 2019.

Age group (year)		16-24	25-34	35-44	45-54	55-64	Total	Total (100%)
North section	Male	2	0	4	4	2	12	23 (62.1)
North section	Female	4	1	0	1	5	11	23 (62.1)
South section	Male	2	1	2	2	0	7	14 (37.9)
South section	Female	3	1	1	0	2	7	14 (37.9)
Total (100%)		11 (29.7)	3 (8.1)	7 (18.9)	7 (18.9)	9 (24.4)	37 (100)	37 (100)

Discussion

Al-Najaf is a tourist governorate in Iraq, attracting millions of tourists from within Iraq and abroad annually and inhabited by a high percentage of the population. Therefore, it is necessary to study the most important epidemic diseases that may be dangerously and quickly transmitted in this type of crowded population.¹⁷^,¹⁸ In this epidemiological study we divided Al-Najaf Governorate in two sections: north and south (Table 1), the results demonstrated that north section was higher than south section according to total infection in 2019, this result is may be due to the increase in the population and the large number of rural and crowded areas in north section more than south section.²^,¹⁹ Also, Table 1 proved that there was approximately equal frequency in numbers of male and female infected with PTB; 89 and 85 respectively, while other researchers proved that PTB rates are significantly higher in male than in female.²⁰^–²² In this study, the equal numbers of male and female infected with PTB may be due to there have their equal involvement in society and public life.²³ Therefore, man and women are vulnerable to PTB in equal percentage. Male and female have different combinations of risk factors for PTB but the main reason still not fully unclear.²⁴ Out of five age groups, we documented in Table 2 the age group 14-26 was the highest infected with 52 patients 29.9%. We think this is dangerous indicator in young age groups and the reason may be due to low health awareness, malnutrition and hookah smoking.²⁵^,²⁶ Martinez et al. (2017)¹² recommended that focusing PTB preventive efforts on home contacts is extremely beneficial. However, beyond the family, a significant portion of transmission may occur at the communal level.²⁷ Therefore, we must increasing health awareness among young people and holding seminars to focus on the seriousness of this deadly disease to protecting children at risk for tuberculosis transmission in communities and households should be recommended. Poor health system development, scarcity of medical care and socio-economic factors and have been linked with increased risk of PTB on individual and population levels in developing countries.²⁸^,²⁹ These factors cannot account for the seasonality of PTB incidence, which has been seen in many parts of the world. According seasonal variation, quarter two recorded 55 cases it is the highest numbers of PTB-patients. Much research recorded a high numbers in infections in the warm seasons.³⁰^,³¹ Al-Najaf Governorate has hot climate in most of year with hot shiny sun, therefore, most peoples try avoiding the sun light that lead to decrease in vitamin D that support innate immune responses to Mtb.³²^,³³ Skin is the important source for Vitamin D synthesis dependent upon sunlight exposure. The low exposure to sunlight during summer and winter could lead to vitamin D deficiency and subsequent that leads to low innate immune response and may be increase to Mtb infection.³⁴^,³⁵

Conclusion

There were low PTB-patients numbers in AL-Najaf Governorate in 2019 but the Youngers were the most susceptible to infected. Infection in north section was higher than south section and there were no high differences between genders. Seasons have no high effect on the number of infections.

Data availability

All data has been included in this manuscript.

Raw data of patients infected with tuberculosis/2019

Sputum No.	Gender of patient	Age group/Year
Sputum No.	Gender of patient	16-24	25-34	35-44	45-54	55-64
1	Male	X
2	Male	X
3	Male	X
4	Male	X
5	Male		X
6	Male		X
7	Male			X
8	Male			X
9	Male				X
10	Male				X
11	Male				X
12	Male				X
13	Male				X
14	Male				X
15	Male					X
16	Male					X
17	Male					X
18	Male	X
19	Male	X
20	Male	X
21	Male	X
22	Male	X
23	Male	X
24	Male	X
25	Male	X
26	Male		X
27	Male		X
28	Male		X
29	Male		X
30	Male		X
31	Male		X
32	Male		X
33	Male			X
34	Male			X
35	Male			X
36	Male			X
37	Male			X
38	Male				X
39	Male				X
40	Male				X
41	Male				X
42	Male					X
43	Male					X
44	Male					X
45	Male					X
46	Male	X
47	Male	X
48	Male	X
49	Male	X
50	Male	X
51	Male	X
52	Male	X
53	Male		X
54	Male		X
55	Male		X
56	Male			X
56	Male			X
58	Male			X
59	Male				X
60	Male				X
61	Male				X
62	Male				X
63	Male					X
64	Male					X
65	Male					X
66	Male					X
67	Male					X
68	Male					X
69	Male					X
70	Male					X
71	Male	X
72	Male	X
73	Male	X
74	Male	X
75	Male		X
76	Male			X
77	Male			X
78	Male			X
79	Male			X
80	Male			X
81	Male			X
82	Male				X
83	Male				X
84	Male				X
85	Male				X
86	Male				X
87	Male				X
88	Male					X
89	Male					X
90	Female	X
91	Female	X
92	Female	X
93	Female	X
94	Female	X
95	Female	X
96	Female	X
97	Female	X
98	Female	X
99	Female		X
100	Female		X
101	Female		X
102	Female			X
103	Female			X
104	Female			X
105	Female			X
106	Female				X
107	Female					X
108	Female					X
109	Female					X
110	Female					X
111	Female	X
112	Female	X
113	Female	X
114	Female	X
115	Female	X
116	Female	X
117	Female	X
118	Female	X
119	Female	X
120	Female		X
121	Female		X
122	Female		X
123	Female			X
124	Female				X
125	Female				X
126	Female				X
127	Female				X
128	Female					X
129	Female					X
130	Female					X
131	Female					X
132	Female					X
133	Female					X
134	Female					X
135	Female					X
136	Female					X
137	Female					X
138	Female	X
139	Female	X
140	Female	X
141	Female	X
142	Female		X
143	Female		X
144	Female		X
145	Female		X
146	Female		X
147	Female			X
148	Female				X
149	Female				X
150	Female					X
151	Female					X
152	Female					X
153	Female					X
154	Female					X
155	Female					X
156	Female					X
157	Female	X
158	Female	X
159	Female	X
160	Female	X
161	Female	X
162	Female	X
163	Female	X
164	Female		X
165	Female		X
166	Female			X
167	Female				X
168	Female					X
169	Female					X
170	Female					X
171	Female					X
172	Female					X
173	Female					X
174	Female					X

Acknowledgment

Special thanks to Specialized Center for Chest and Respiratory Disease in AL-Najaf Governorate for all assistance and all information that introduced to researchers to finish this study.

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VERSION 1 PUBLISHED 20 Jun 2022

Author details Author details

Saleem Khteer Al-Hadraawy
Roles: Data Curation, Methodology

Kais Khudhair Alhadrawi
Roles: Software, Writing – Original Draft Preparation

Israa Abduljabbar Jaloob Aljanaby
Roles: Conceptualization, Methodology, Writing – Original Draft Preparation

Ahmed Abduljabbar Jaloob Aljanaby
Roles: Methodology, Project Administration, Writing – Review & Editing

Rahman S Zabibah
Roles: Methodology, Software

Competing interests

No competing interests were disclosed.

Grant information

The author(s) declared that no grants were involved in supporting this work.

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https://doi.org/10.12688/f1000research.121881.1

© 2022 Al-Hadraawy SK et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Al-Hadraawy SK, Alhadrawi KK, Aljanaby IAJ et al. Prevalence of pulmonary tuberculosis in Al-Najaf governorate, Iraq [version 1; peer review: 2 not approved] F1000Research 2022, 11:675 (https://doi.org/10.12688/f1000research.121881.1)

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Reviewer Report 12 Sep 2022

Sarman Singh, Indian Institute of Science Education and Research (IISER), Bhopal, India; All India Institute of Medical Sciences, Bhopal, India; All India Institute of Medical Sciences, New Delhi, India

Not Approved

https://doi.org/10.5256/f1000research.133793.r149163

The study's aim is not clear.
The introduction section mentions that reduction in case numbers was a priority of the government, but without comparing the data of several years, how any trend

The study's aim is not clear.
The introduction section mentions that reduction in case numbers was a priority of the government, but without comparing the data of several years, how any trend can be forecasted?
Moreover, the methodology is extremely poor. The authors, on one hand, mention that sputum processing and reporting were done as per WHO criteria but in the same section they mention that 3 consecutive fasting samples were collected and stained with ZN staining. The authors seemingly are not aware of WHO's revised policy of 2 sputa (one morning and one spot).
The total population screened is not mentioned. So how without a numerator prevalence could be calculated?
Language is poor with numerous spelling, grammatical and syntax errors.

Is the work clearly and accurately presented and does it cite the current literature?

No
Is the study design appropriate and is the work technically sound?

No
Are sufficient details of methods and analysis provided to allow replication by others?

No
If applicable, is the statistical analysis and its interpretation appropriate?

No
Are all the source data underlying the results available to ensure full reproducibility?

No
Are the conclusions drawn adequately supported by the results?

No

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: Tuberculosis

I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above.

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Reviewer Report 08 Jul 2022

Edinson Dante Meregildo Rodriguez, Escuela de Medicina, Universidad César Vallejo, Trujillo, Peru; Hospital Regional Lambayeque, Chiclayo, Peru

Not Approved

https://doi.org/10.5256/f1000research.133793.r142258

The entire manuscript needs extensive and in-depth English language revision by a professional language-editing service. Otherwise, it should be rejected.

Abstract

Background: "pulmonary tuberculosis (PTB) is one of the most global dangerous infectious diseases worldwide...".
Comment: This sentence is redundant because global and worldwide have similar meanings. It would be better to say: "pulmonary tuberculosis (PTB) is one of the most dangerous infectious diseases worldwide...".

Introduction
Please define each abbreviation when it first appears. For example, Mtb, PTB, etc.

“The developing countries are the most infected with these types of infections”.
Comment: This sentence is redundant: It would be better to say: “The developing countries are the most affected by these types of infections”.

“Pulmonary-TB considered as the most infection caused by Mtb and can cause many dangerous complicated in the lung leads to death in many times”.
Comment: This expression doesn't make much sense. Please check your correctness.

"...the main goal of this study is to detect.."
Comment: "...the main goal of this study was to detect..."

"... they are getting verbal agreement from Mtb-patients in this study."
Comment: It would be better to say that informed consent was obtained.

Study design
"This epidemiological study has been performed under supervisor of..."
Comment: "This epidemiological study has been performed under the supervision of..."

"Quarter two; April, May and June July."
Comment: "Quarter two; April, May, and June".

Diagnosis of Mtb in PTB-patients
"Sputum has been collected from all suspected patient..."
Comment: "Sputum was collected from all suspected patients..."

Results: Total PTB-patients
In Table 1 the authors present absolute and relative frequencies and state: "Out of total 174, there were 101(58%) in north section and 73(42%) in south section of the Governorate.".
Comment: It would be more useful and more clinically relevant if the authors showed (in the tables) some tests for comparison of proportions (also showing a level of significance and 95% CI) to specify whether these differences between the north and the south sections are statistically significant or not.

Discussion
The authors state: “…Table 1 proved that there was approximately equal frequency in numbers of male and female infected with PTB; 89 and 85 respectively…In this study, the equal numbers of male and female infected with PTB may be due to there have their equal involvement in society and public life”.
Comment: The authors should not make such an affirmation until they have applied a test to compare proportions and have shown that there are no statistically significant differences between the groups.

Conclusion
The authors state: “There were low PTB-patients numbers in AL-Najaf Governorate in 2019 but the Youngers were the most susceptible to infected”.
Comment: This statement is not true. The only thing the authors could say is that tuberculosis was more frequent in this age group. This is because tuberculosis infection and active tuberculosis are different stages of the same disease¹. What the researchers studied is active tuberculosis disease, but not primary infection or susceptibility to tuberculosis infection. Tuberculosis infection depends more on exogenous factors such as host exposure, while active tuberculosis depends more on endogenous factors, such as immunity ¹^,²^,³. In addition, in low-burden countries, a higher proportion of TB cases occurs due to reactivation of a latent focus of post-primary tuberculosis (remote infection among foreign-born residents); whereas worldwide, particularly in high-burden countries, most clinical TB reflects recently transmitted infection ²^,³.

Is the work clearly and accurately presented and does it cite the current literature?

Partly
Is the study design appropriate and is the work technically sound?

Partly
Are sufficient details of methods and analysis provided to allow replication by others?

Partly
If applicable, is the statistical analysis and its interpretation appropriate?

No
Are all the source data underlying the results available to ensure full reproducibility?

Yes
Are the conclusions drawn adequately supported by the results?

No

References

1. Smith I: Mycobacterium tuberculosis pathogenesis and molecular determinants of virulence.Clin Microbiol Rev. 2003; 16 (3): 463-96 PubMed Abstract | Publisher Full Text
2. Behr M, Edelstein P, Ramakrishnan L: Revisiting the timetable of tuberculosis. BMJ. 2018. Publisher Full Text
3. Dale K, Trauer J, Dodd P, Houben R, et al.: Estimating Long-term Tuberculosis Reactivation Rates in Australian Migrants. Clinical Infectious Diseases. 2020; 70 (10): 2111-2118 Publisher Full Text

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: infectious diseases, tropical diseases, tuberculosis, Covid-19, emergency medicine, critical care, chronic diseases, mental health, endocrinology, public health, systematic review, metanalysis

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Author Response 11 Jul 2022

ahmed abduljabbar jaloob aljanaby, Biology, Faculty of Science, University of Kufa, AL-Najaf, Iraq

11 Jul 2022

Author Response

Warm greetings
The research was subjected to an English language review. I think the scientific content is good. I respect your opinion, whatever it is. Please mention the scientific content, ... Continue reading Warm greetings
The research was subjected to an English language review. I think the scientific content is good. I respect your opinion, whatever it is. Please mention the scientific content, not the linguistic content
Thanks a lot
Warm greetings
The research was subjected to an English language review. I think the scientific content is good. I respect your opinion, whatever it is. Please mention the scientific content, not the linguistic content
Thanks a lot
Competing Interests: No competing interests were disclosed. Close
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Author Response 11 Jul 2022

ahmed abduljabbar jaloob aljanaby, Biology, Faculty of Science, University of Kufa, AL-Najaf, Iraq

11 Jul 2022

Author Response

Warm greetings
The research was subjected to an English language review. I think the scientific content is good. I respect your opinion, whatever it is. Please mention the scientific content, ... Continue reading Warm greetings
The research was subjected to an English language review. I think the scientific content is good. I respect your opinion, whatever it is. Please mention the scientific content, not the linguistic content
Thanks a lot
Warm greetings
The research was subjected to an English language review. I think the scientific content is good. I respect your opinion, whatever it is. Please mention the scientific content, not the linguistic content
Thanks a lot
Competing Interests: No competing interests were disclosed. Close
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Version 1

VERSION 1 PUBLISHED 20 Jun 2022

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Version 1 20 Jun 22	read	read

Edinson Dante Meregildo Rodriguez, Universidad César Vallejo, Trujillo, Peru; Hospital Regional Lambayeque, Chiclayo, Peru
Sarman Singh, Indian Institute of Science Education and Research (IISER), Bhopal, India; All India Institute of Medical Sciences, Bhopal, India; All India Institute of Medical Sciences, New Delhi, India

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Reviewer Report

16 Views

12 Sep 2022 | for Version 1

16 Views Cite this report Responses(0)

Not Approved

The study's aim is not clear.
The introduction section mentions that reduction in case numbers was a priority of the government, but without comparing the data of several years, how any trend can be forecasted?
Moreover, the methodology is extremely poor. The authors, on one hand, mention that sputum processing and reporting were done as per WHO criteria but in the same section they mention that 3 consecutive fasting samples were collected and stained with ZN staining. The authors seemingly are not aware of WHO's revised policy of 2 sputa (one morning and one spot).
The total population screened is not mentioned. So how without a numerator prevalence could be calculated?
Language is poor with numerous spelling, grammatical and syntax errors.

Is the work clearly and accurately presented and does it cite the current literature?

No
Is the study design appropriate and is the work technically sound?

No
Are sufficient details of methods and analysis provided to allow replication by others?

No
If applicable, is the statistical analysis and its interpretation appropriate?

No
Are all the source data underlying the results available to ensure full reproducibility?

No
Are the conclusions drawn adequately supported by the results?

No

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Tuberculosis

Respond to this report

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Reviewer Report

30 Views

08 Jul 2022 | for Version 1

Edinson Dante Meregildo Rodriguez, Escuela de Medicina, Universidad César Vallejo, Trujillo, Peru; Hospital Regional Lambayeque, Chiclayo, Peru

30 Views Cite this report Responses(1)

Not Approved

Is the work clearly and accurately presented and does it cite the current literature?

Partly
Is the study design appropriate and is the work technically sound?

Partly
Are sufficient details of methods and analysis provided to allow replication by others?

Partly
If applicable, is the statistical analysis and its interpretation appropriate?

No
Are all the source data underlying the results available to ensure full reproducibility?

Yes
Are the conclusions drawn adequately supported by the results?

No

References

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

infectious diseases, tropical diseases, tuberculosis, Covid-19, emergency medicine, critical care, chronic diseases, mental health, endocrinology, public health, systematic review, metanalysis

Respond to this report

Responses (1)

Author Response

11 Jul 2022

ahmed abduljabbar jaloob aljanaby, Biology, Faculty of Science, University of Kufa, AL-Najaf, Iraq

Warm greetings
The research was subjected to an English language review. I think the scientific content is good. I respect your opinion, whatever it is. Please mention the scientific content, not the linguistic content
Thanks a lot

View more View less

Competing Interests

No competing interests were disclosed.

Alongside their report, reviewers assign a status to the article:

Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested

Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.

Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions

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Prevalence of pulmonary tuberculosis in Al-Najaf governorate, Iraq

Abstract

Keywords

Introduction

Methods

Research ethics

Study design

Diagnosis of Mtb in PTB-patients

Statistical analysis

Results

Total PTB-patients

Table 1. Total PTB-patients caused by Mtb in AL-Najaf Governorate 2019.

Table 2. Total distribution of PTB-patients caused by Mtb according to age groups in AL-Najaf Governorate 2019.

Seasonal infections

Table 3. Total distribution of PTB-patients caused by Mtb in AL-Najaf Governorate in quarter one 2019.

Table 4. Total distribution of PTB-patients caused by Mtb in AL-Najaf Governorate in quarter two 2019.

Table 5. Total distribution of PTB-patients caused by Mtb in AL-Najaf Governorate in quarter three 2019.

Table 6. Total distribution of PTB-patients caused by Mtb in AL-Najaf Governorate in quarter four 2019.

Discussion

Conclusion

Data availability

Raw data of patients infected with tuberculosis/2019

Acknowledgment

References

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