Evidence map›Paper›PMID 42201098›Full record

ArticleInfectious disease reports2026

Clinical Characteristics, Risk Factors, and Predictors of Fatal Outcomes and Prolonged Hospitalization of Crimean-Congo Hemorrhagic Fever Cases in Basrah, Iraq.

Mohammed H Al-Maliki, Celine Tabche, Alaa K Mousa, Ali R Hashim, Zeenah Atwan, Hassan A Farid, Maitham G Yousif, David Rawaf, Nazik Haikaz Hasrat, Murtadha Almusafer and 8 more

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Article in Infectious disease reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Mohammed H Al-MalikiBasrah Teaching Hospital, Basrah Health Directorate, Basrah 61004, Iraq.
Celine TabcheWHO Collaborating Centre for Public Health Education and Training, School of Public Health, Department of Primary Care and Public Health, Imperial College London, London W12 0BZ, UK.ORCID 0000-0001-7690-6368
Alaa K MousaDepartment of Internal Medicine, College of Medicine and Basrah Teaching Hospital, University of Basrah, Basrah 61004, Iraq.
Ali R HashimDepartment of Internal Medicine, College of Medicine and Basrah Teaching Hospital, University of Basrah, Basrah 61004, Iraq.
Zeenah AtwanWHO Collaborating Centre for Public Health Education and Training, School of Public Health, Department of Primary Care and Public Health, Imperial College London, London W12 0BZ, UK.
Hassan A FaridManchester Centre for Clinical Neurosciences, Salford Royal Hospital, Salford, Greater Manchester M6 8HD, UK.
Maitham G YousifCollege of Science, Al-Qadisiyah University, Al Diwaniyah 58001, Iraq.
David RawafWHO Collaborating Centre for Public Health Education and Training, School of Public Health, Department of Primary Care and Public Health, Imperial College London, London W12 0BZ, UK.ORCID 0000-0003-1170-7039
Nazik Haikaz HasratTraining and Human Development Centre, Basrah Health Directorate, Basrah 61001, Iraq.
Murtadha AlmusaferDepartment of Surgery, College of Medicine, University of Basrah, Basrah 61004, Iraq.ORCID 0000-0002-0615-0179
Anees K NileCollege of Medicine, Al-Nahrain University, Alkadhimiya, P.O. Box 70076, Baghdad 10072, Iraq.
Riyadh Al-HilfiDirectorate of Public Health, Ministry of Health, Baghdad 10001, Iraq.ORCID 0000-0001-8147-6040
Azeem MajeedWHO Collaborating Centre for Public Health Education and Training, School of Public Health, Department of Primary Care and Public Health, Imperial College London, London W12 0BZ, UK.
Alessandra ScagliariniDepartment of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy.ORCID 0000-0003-1146-0101
Salman RawafWHO Collaborating Centre for Public Health Education and Training, School of Public Health, Department of Primary Care and Public Health, Imperial College London, London W12 0BZ, UK.ORCID 0000-0001-7191-2355
Roaa KhafajiIndependent Researcher, Chula Vista, CA 91910, USA.ORCID 0009-0006-9142-4483
Juan Carlos de la TorreDepartment of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA 92037, USA.ORCID 0000-0002-8171-8115
Haydar WitwitDepartment of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA 92037, USA.ORCID 0000-0002-0174-8454

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe impact of climate change on birds' migration and ticks' reservoir habits is contributing to the spread of Crimean-Congo hemorrhagic fever (CCHF), caused by CCHF virus (CCHFV), to new continents and countries. CCHF is endemic to the Eastern Mediterranean Region, including Iraq, and is witnessing a substantial surge in confirmed cases with considerable disparity and gaps in managing CCHF cases. The increasing CCHF spread across Asia, Africa, and Europe, including Spain and Turkey, highlights the danger of its expansion. Developing high-confidence diagnostic criteria, identifying risk factors, and accurate predictors of CCHF outcomes are critical to managing suspected and confirmed cases of CCHF and to reducing the current case fatality rate of CCHF, which is the goal of this study.

methodsWe completed a retrospective evaluation of 61 confirmed cases of CCHF in Basrah (Iraq). The cases were screened according to the clinical presentation, and CCHF cases were identified by ELISA and validated by PCR. Data was analyzed using SPSS version 22. T-tests, chi-square/Fisher exact tests, and Pearson's correlation were used, with significance set at

resultsWe found that repeated exposure to animals during animal slaughtering was a significant risk factor. In addition, 5% of the patients with confirmed CCHF, mainly from rural areas, reported exposure to rats. Clinical presentations included fever, headache, gastrointestinal problems, eye and orbital symptoms, and hemorrhagic complications. Predictors of death included advanced age, decreased platelet counts, and neuropsychiatric symptoms such as delusions and confusion.

conclusionsOur findings identify clinical and laboratory features of CCHF cases in Iraq, which will help to implement the most effective interventions to manage CCHF cases and protect the public in all Iraqi governorates. In summary, this study highlights a recent and significant rise in CCHF cases in Basrah Governorate, Iraq. Notably, 5% of confirmed cases reported contact with rats. The paper also proposes diagnostic criteria and identifies key predictors of mortality to support improved clinical management of CCHF. These findings underscore the urgent need for strengthened public health interventions, including enhanced infection prevention and control measures, increased awareness, and improved surveillance systems. The findings have important implications for improving control procedures, guiding therapeutic development, informing vaccine strategies, and supporting evidence-based policy alongside future research efforts.

Indexed as

clinical presentationCrimean–Congo hemorrhagic fever (CCHF)disease outbreakinfectious diseasesIraq

Identifiers

PMID42201098
PMCPMC13214867

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.