Iraq | Programme areas | Viral hepatitis

Viral hepatitis

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Hepatitis is an inflammation of the liver, most commonly caused by a viral infection. There are 5 main hepatitis viruses, referred to as types A, B, C, D and E. These five types are of greatest concern because of the burden of illness and death they cause and the potential for outbreaks and epidemic spread. In particular, types B and C lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer.

Hepatitis A and E are typically caused by ingestion of contaminated food or water. Hepatitis B, C and D usually occur as a result of parental contact with infected body fluids. Common modes of transmission for these viruses include receipt of contaminated blood or blood products, invasive medical procedures using contaminated equipment and for hepatitis B transmission from mother to baby at birth, from family member to child, and also by sexual contact.

Acute infection may occur with limited or no symptoms, or may include symptoms such as jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.

In Iraq, the number of hepatitis A cases has increased from 1802 in 2009 to 4473 in 2014 among nationals. The country is a low endemicity country for hepatitis B and C. The usual mode of transmission is blood transfusions or repeated exposure to blood and its derivatives (post-transfusion non-A non-B hepatitis). 

For hepatitis B, 3674 cases were reported; Hepatitis C 929 cases were reported and 199 cases were reported for hepatitis E. This was due to expansion of diagnosis in district labs. In the past, diagnosis was in public health laboratory in governorates. However, since 2013 diagnosis is conducted in district laboratories. Each district has an ELISA machine for hepatitis diagnostics. The major challenge for the programme is availability of funds, security situation in the country, overcrowding in the areas of migrants and refugees. The programme also suffers from lack of training and capacity-building and lack of availability of diagnostic kits.

The transmission of hepatitis type A and E is facilitated by poor infrastructure, poor quality of potable water, unsafe food and poor hygiene. A majority of health workers do not follow medical guidelines in dealing with blood and its derivatives, which has led to the spread of hepatitis B and C in communities. The priorities of the Ministry of Health are to establish an efficient hepatitis surveillance system, build the capacity of health personnel to manage patients, and provide medicines and diagnostic services at governorate level.

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Key health-related statistics

Total population (000s) 37 140
Total health expenditure on health (% of general government expenditure) 6.5
Maternal mortality ratio (per 100 000 live births) 50
Number of primary health care units and centres (per 10 000 population) 0.7
Total life expectancy at birth (years) 69.8

Source: Framework for health information systems and core indicators for monitoring health situation and health system performance, 2018

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