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Article History

Received: 20 September 2025

Accepted: 28 January 2026

First Online: 2 February 2026

Declarations

:

: Independent institutional review boards or ethics committees are not formally established for public health surveillance activities in Iraq. For this study, ethical approval and a waiver of informed consent to participate were granted by the Director General of the Public Health Department, Ministry of Health, Baghdad, Iraq, who holds the official authority to approve public health research conducted using national surveillance data, and all patient information was anonymized and collected as part of routine public health surveillance. The research was conducted in full compliance with the principles of the Declaration of Helsinki (2013 revision). All data were fully anonymized prior to analysis, and no identifiable personal or clinical information was accessible to the research team.

: A waiver of informed consent to participate was granted by the Director General of the Public Health Department, Ministry of Health, Baghdad, Iraq, as the study was based exclusively on anonymized data collected as part of routine public health surveillance.

: Not applicable.

: The authors declare no competing interests.