GEOGRAPHIC VARIATION OF NOTIFICATION SCABIES RATES IN IRAQ: A NATIONAL SURVEILLANCE STUDY, 2016–2023

Background: Scabies remains a neglected tropical disease that spreads in environments and conditions where access to healthcare is difficult, which may affect disease transmission and reporting. There is no national surveillance data for Iraq, where millions of people were displaced between 2014 and 2017.
Objective: To describe national and directorate-level trends in notification rates across Iraq between 2016 and 2023.With a focus on governorates most affected by the 2014-2017 displacement crisis.
Methods: We conducted a descriptive study using notification data from the Iraqi Ministry of Health annual reports for 2016, 2019, 2020, 2021, 2022, and 2023 (reports for 2017–2018 were unavailable). Covering 18 governorates. The report summarized scabies cases and rates per 10,000 population nationally and across health directorates, and compared them between directorates affected by the displacement crisis.
Results: The national reported scabies rate increased from 2.1 per 10,000 population in 2016 to 13.9 in 2019, then declined to 7.38 in 2022 before rising to 8.36 in 2023. Nineveh had the highest rate in 2021- 2023; Salah al-Din and Kirkuk fell from 39.3 and 33.0 in 2019 to 7.6 and 9.8 in 2023, and Anbar stayed below the national rate.
Conclusion: Reported scabies rates in Iraq varied substantially over time and across health directorates, with Nineveh persistently highest. These findings highlight the importance of continued surveillance and targeted prevention efforts. As the data are passive notifications with no information for 2017–2018, they cannot show whether these changes reflect transmission or reporting.