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Volume 32, Number 7—July 2026

Research

Prognostic Value of PCR Cycle Threshold Value in Crimean-Congo Hemorrhagic Fever, Iraq, 2022–2023

Raghad I. Khaleel, Ihab R. Aakef, Riyadh A. Al-hilfi, Hussein A. Hasan, Iman M. Aufi, Hawraa A. Shakir, Ahmed A. Hussein, Noora A. Abdulhadi, Zainb A. Mohsin, Amal A. Raheem, Sarah W. Ahmed, Ghazwan A. Baghdadi, Chiori Kodama, Antoine Chaillon, Anaïs LegandComments to Author , Pierre Formenty, Sinan G. Mahdi, and Adnan Khamasi
Author affiliation: Central Public Health Laboratory, Baghdad, Iraq (R.I. Khaleel, H.A. Hasan, I.M. Aufi, H.A. Shakir, A.A. Hussein, N.A. Abdulhadi, Z.A. Mohsin, A.A. Raheem, S.W. Ahmaed); Communicable Disease Control Center, Baghdad (I.R. Aakef, G.A. Baghdadi, S.G. Mahdi); Directorate of Public Health, Ministry of Health, Baghdad (R.A. Al-hilfi); World Health Organization Eastern Mediterranean Regional Office, Cairo, Egypt (C. Kodama); World Health Organization Emergencies Programme, Geneva, Switzerland (A. Chaillon, A. Legand, P. Formenty); World Health Organization Country Office, Baghdad (A. Khamasi)

Main Article

Table 1

Characteristics of CCHF-confirmed patients in study of prognostic value of PCR cycle threshold for Crimean-Congo hemorrhagic fever, Iraq, 2022–2023

Characteristic Values
 p value†
2022 2023
Age 0.10
<15 17/380 (4.5) 16/575 (3)
15–24 99/380 (26) 133/575 (23)
25–34 61/380 (16) 131/575 (23)
35–44 85/380 (22) 130/575 (23)
45–54 73/380 (19) 92/575 (16)
>55 45/380 (12) 73/575 (13)
Median (range)
 35 (1–90)
 35 (2–80)
Sex 0.35
F 149/380 (39) 243/575 (42)
M
 231/380 (61)
 332/575 (58)
Residency status 1.00
Rural 1/1 (100) 262/575 (46)
Semiurban 0/1 (0) 81/575 (14)
Urban 0/1 (0) 232/575 (40)
Ct value, median (range)
 25.8 (11.4–36.9)
 27.4 (12.9–38.9)
 <0.001
Exposures and clinical features <0.001
Median time from onset to admission, d (range) 3 (0–13) 4 (0–20)
Fever 359/380 (94) 567/575 (99) <0.001
Contact with confirmed case 18/375 (5) 15/567 (3) 0.08
Contact with animals 212/375 (57) 297/575 (52) 0.14
Slaughtering 127/375 (34) 315/574 (55) <0.001
Contact with raw meat 207/375 (55) 359/575 (63) 0.02
Tick bite 134/374 (36) 42/575 (7) <0.001
Hemorrhagic 145/380 (38) 195/575 (34) 0.18
Ecchymosis 104/380 (27) 134/575 (23) 0.16
Bleeding at injection site 109/379 (29) 145/575 (25) 0.23
Injected eyes 1/1 (100) 41/575 (7) 0.07
Ribavirin
 1/1 (100)
 190/535 (36)
 0.36
Outcome 0.02
Cured 305/380 (80) 494/575 (86)
Death 75/380 (20) 81/575 (14)

*Values are no. (%) except as indicated, Percentages may not sum to 100% due to rounding. Ct, cycle threshold †Determined by Pearson χ2 test, Wilcoxon rank-sum test, or Fisher exact test.

Main Article

Page created: May 21, 2026
Page updated: June 11, 2026
Page reviewed: June 11, 2026
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