See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/299538413

Orthodontic Treatment Need (DAI) in Iraq

Article · June 2005

CITATION READS
1 263

1 author:

Akram Faisal Alhuwaizi

University of Baghdad
56 PUBLICATIONS   60 CITATIONS   

SEE PROFILE

Some of the authors of this publication are also working on these related projects:

Properties of coated arch wires View project

Audit: Diagnosis, Records, and finishing View project

All content following this page was uploaded by Akram Faisal Alhuwaizi on 29 April 2016.

The user has requested enhancement of the downloaded file.

6 ____________________________________________________________________________________ Iraqi Orthod J 1(1) 2005

Orthodontic Treatment Need (DAI) in Iraq

Akram Faisal Alhuwaizi a

Abstract: About seven thousand 13 year olds with no history of orthodontic treatment were selected from
six governorates (Baghdad the capital, Ninevah, Basrah, Diyala, Anbar and Najaf). Orthodontic treatment
need was assessed by the use of the dental aesthetic index (DAI).
The DAI scores registered in this study ranged between 13 and 65 with a mean of 24.247. Of the
sample 65.8% were found to have no or slight treatment need, 16.8% with treatment elective, 10.2% with
treatment highly desirable and 7.2% with very severe (handicapping) malocclusion and treatment
mandatory.
Highly desirable or mandatory treatment need (DAI≥31) was found significantly more in Anbar, followed
by Diyala, Basrah, Baghdad, Najaf, and lastly Ninevah; being significantly more in the rural sample than in
the urban sample, but insignificantly related to gender.
In conclusion, it was estimated that in Iraq roughly about 34,000 children aged 13 years have very
severe malocclusion that requires urgent treatment and must be treated annually to control handicapping
malocclusion.
Keywords: Orthodontic treatment need, DAI, Iraq (Iraqi Orthod J 2005; 1(1): 6-13)

C
ons et al.1 approached the index problem from
purely the appearance standpoint and developed
the DAI. They generally used the opinions of the
lay public as to what constituted unacceptable dental
arrangements from the aesthetic standpoint.
The DAI has two components: a clinical component
and an esthetic component. It links the clinical and
esthetic components mathematically to produce a single
score that combines the physical and the esthetic aspects
of occlusion.
After an individual’s score has been calculated, it
can be placed on a scale to determine the point at which
the score falls between most and least socially
acceptable dental appearance. The further a DAI score
falls from most acceptable dental appearance the more
likely the occlusal condition is both socially and
physically handicapping.2
The DAI has decision points along the DAI scale
defining case severity levels that approximate the
judgment of orthodontists. The DAI scores of 25 and
below represent normal or minor malocclusions with no
or slight treatment need. The DAI scores of 26 through
30 represent definite malocclusions with treatment
elective. The DAI scores 30 through 35 represent severe
malocclusions with treatment highly desirable. The DAI
scores 36 and higher represent very severe or
handicapping malocclusions with treatment considered
mandatory.3
Although the DAI scale has decision points
separating different levels of orthodontic treatment
need, DAI scores can be rank ordered on a continuous
scale from 13 to 80 or higher. This continuous scale
makes the DAI sensitive enough to differentiate cases
a
B.D.S., M.Sc., Ph.D.; Assistant Professor at the Department of
Orthodontics, College of Dentistry, University of Baghdad.
with greater or lesser need for treatment within severity
levels. Decision points for eligibility to receive
treatment in publicly funded programs can be modified
to meet available resources.4
Although the DAI is particularly sensitive to
occlusal conditions that have the potential for causing
psychological or social dysfunction it also predicts the
clinical judgments of orthodontist in separating
handicapping from non-handicapping malocclusions.
The DAI can be useful in both epidemiological surveys
and as a screening device to prioritize subsidized
orthodontic treatment in public programs where
resources are insufficient to meet the demand.
Epidemiologists need a method for determining unmet
need for orthodontic care in populations. 2 The DAI is
currently being employed by the World Health
Organization (WHO) as an epidemiological tool to
assess unmet need for orthodontic care in its
International Collaborative Study of Oral Health
Outcomes ICS II.5
The DAI has also been used to evaluate orthodontic
treatment by comparing occlusion before and after
orthodontic treatment.6
A DAI score can be obtained intraorally without the
use of radiographs in about 2 minutes by trained dental
auxiliaries. The reliability of dental auxiliaries in
measuring DAI scores was assessed by Cons et al.1 and
Spencer et al.7 to find that auxiliaries are highly reliable
in obtaining DAI scores.
Studies in the United States as well as
internationally, showed the validity of the DAI. 7-10
Since the DAI is based on perceptions of dental
aesthetics in the USA, it can be used without
modification on other ethnic groups only where
perceptions of dental aesthetics are similar to those in
the USA. Studies were performed to determine whether
Orthodontic treatment need (DAI) in Iraq ________________________________________________________ Al-Huwaizi
perceptions of dental aesthetics as rated by students in
eleven diverse groups are similar to those of students in
the USA and concluded that these perceptions were very
similar to the perceptions of USA students. Therefore
the standard DAI can be used internationally without
modification.11-14
MATERIALS AND METHODS
The sample included a total of 7176 intermediate
school students 13 years of age. These students were
taken from 6 governorates (cities and environs) in Iraq
selected to cover the whole country geographically
(Baghdad the capital, Ninevah, Basrah, Diyala, Anbar
and Najaf) according to a multi-stage stratified sampling
technique. Details of the geographic distribution and
sampling technique are given in Alhuwaizi.15
After excluding the invalid case sheets and isolating
the students with some sort of orthodontic treatment, the
number of casesheets which entered the statistical
analysis dropped to 6957.16-17
The DAI is an equation or formula in which ten
measured components are multiplied by their regression
coefficients (weights). The addition of their products
and the addition of a constant number ‘13’ to the total
gives the DAI score as shown in table 1.
After the students’ scores were calculated, they were
rank-ordered on a continuous scale from 13 and above.
The higher the DAI score, the more likely the occlusal
condition is both socially and physically handicapping.
The DAI has decision points along the DAI scale
defining case severity levels that approximate the
judgment of orthodontists (Table 2). All the DAI scores
were classified according to these decision points.
The DAI has the following components:
1. Missing visible teeth: This is the number of missing
permanent incisor, canine and premolar teeth on the
maxillary and mandibular arches. A history of all
missing anterior teeth was obtained to determine
whether extractions were performed to improve
aesthetics.
If spaces are closed, the missing teeth were not be
counted. If a primary tooth was still in position and its
successor was not yet erupted, the missing tooth was not
counted. If a missing incisor, canine or premolar tooth
was replaced by a fixed prosthesis; the missing tooth
was not be counted.
2. Crowding in the incisal segments of the arch: Both
maxillary and mandibular incisal segments were
examined for crowding. Crowding in the incisal
segment was the condition in which the available space
between the right and left canine teeth was insufficient
to accommodate all four incisors in normal alignment.
Teeth might have been rotated or displaced out of
alignment in the arch (Figure 1). The number of incisor
segments (each incisal segments consists of four
incisors in either the maxillary or mandibular arch) with
7
crowding was recorded as: 0 (no segment crowded), 1
(1 segment crowded), or 2 (2 segments crowded).
When in doubt the lower score was assigned. If the
four incisors were in proper alignment but either or both
canines were displaced, the incisal segment was not
marked as crowded.
3. Spacing in the incisal segments of the arch: Both
maxillary and mandibular incisal segments were
examined for spacing. Spacing in the incisal segment
was the condition in which the available space between
the right and left canine teeth exceeds that required to
accommodate all four incisors in normal alignment. If
one or more incisor teeth had proximal surfaces without
any interdental contact the segment was recorded as
having space. The number of incisal segments in both
arches with spacing was recorded as either: 0, 1 or 2.
When in doubt the lower score was assigned.
4. Maxillary central diastema: The measurement was
made at any level between the mesial surfaces of the
central incisors to the nearest whole millimeter.
5. Largest anterior irregularity on the maxillary
arch: Irregularities may be either rotations out of, or
displacements from, normal alignment (Figure 1). The
four incisors were visually scanned to locate the greatest
irregularity between adjacent teeth and it was measured
using a metric ruler to the nearest whole millimeter
(Figure 2).
Irregularities may occur with or without crowding. If
there was sufficient space for all four incisors in normal
alignment but some were rotated or displaced that
segment was not be marked as crowded, only the largest
irregularity was recorded.
6. Largest anterior irregularity on the mandibular
arch: Measurement was the same as on the maxillary
arch except that it was done on the mandibular arch.
The greatest irregularity between adjacent teeth on the
mandibular arch was located and measured as described
before.
7. Anterior maxillary overjet: The largest maxillary
overjet was recorded with a metal ruler or vernier to the
nearest whole millimeter as mentioned before. This trait
was not recorded if all maxillary incisors are missing or
in lingual crossbite.
8. Anterior mandibular overjet (negative overjet):
This trait was recorded when any mandibular incisor
protruded labially to the opposing maxillary incisor
(inverted). The largest negative overjet of any of the
incisors in the mandibular arch was recorded to the
nearest whole millimeter.
If a mandibular incisor was rotated so that one part
of the incisal edge was in crossbite (was labial to the
maxillary incisor) but another part of the incisal edge
was not in crossbite negative overjet was not measured.
9. Vertical anterior open bite: The largest lack of
vertical overlap between the opposing pairs of incisors
8 ____________________________________________________________________________________ Iraqi Orthod J 1(1) 2005

was recorded to the nearest whole millimeter as on the presence of malocclusion especially the effect of
described before. modernization/ industrialization.26
10. Antero-posterior molar relation: This assessment DAI scores of 31 and more (severe malocclusion
most often was based on the relation of the permanent and highly desirable or mandatory treatment) were
maxillary and mandibular first molars. If the assessment found more in Anbar (19.5%), followed by Diyala
cannot be based on the first molars because one or both (19.3%), Basrah (17.0%), Baghdad (16.8%), Najaf
are absent, not fully erupted, or misshaped because of (16.8%), and Ninevah (15.5%) as shown in table 5. This
extensive decay or fillings, the relations of the is coincident with the finding of Al-Alousi et al.27 who
permanent canines and premolars are assessed. found that the central area had a higher prevalence of
The right and left sides are assessed with the teeth in students with functionally and/ or aesthetically
occlusion as described before (Figure 3) and only the unacceptable occlusion than in the north or south areas.
side with the largest deviation from normal molar Considering the mean DAI score, Anbar showed the
relation was recorded. The score was as follows: highest mean (24.751) followed by Diyala (24.688),
0 =Normal molar relation Basrah (24.664), Baghdad (24.243), Najaf (24.153), and
1 =Mandibular first molar on either side is half cusp Ninevah (23.969) as shown in table 5. These differences
either mesial or distal to the maxillary first molar were found to be statistically significant (F=3.058,
2 =Mandibular first molar on either side is one full cusp d.f.=5, 6951, p<0.01) and table 6 displays the results of
or more either mesial or distal to the maxillary first inter-governorate t-tests.
molar Considering gender differences, males showed
When in doubt the lower score was assigned. comparable means DAI score (24.377) to that of
females (24.397) as shown in table 7. This was
RESULTS AND DISCUSSION statistically insignificant for the urbans, rurals and total
Results of the individual DAI components have been sample (Table 8).
published in earlier reports.18-23
The distribution of the scores of the dental aesthetic
index (DAI) for the total sample is displayed in table 3
and figure 4. The lowest DAI score recorded was 13 and
the highest DAI score registered was 65 and the most
commonly registered DAI score was 20 (9.3%). The
(a) Rotation
only published study presenting detailed DAI score
distribution was Jenny et al.24 published in more detail
in a later paper.10 In the latter study, the lowest DAI
score registered was 15 and the highest was 66, and the
most commonly registered DAI score was 19 (9.3%)
followed by 21 (6.6%). This result showed that the Iraqi
and American samples had comparable median, lower (b) Displacement
and upper limits on the DAI scale showing that the DAI Figure 1: Examples of anterior intra-arch
score can be used on the Iraqi population with relatively irregularities.
the same precision as on the American population on
whom it was constructed.
According to the DAI scores, normal or minor
malocclusion with no treatment need or slight need
(DAI 13-25) was found in 65.8% of the sample, definite
malocclusion with treatment elective (DAI 26-30) in
16.8%, severe malocclusion with treatment highly
desirable (DAI 31-35) in 10.2%, and very severe
(handicapping) malocclusion with treatment mandatory
(DAI ≥36) was found in only 7.2% of the sample
(Figure 5). When comparing these results with those
found by others (Table 4 and Figure 6) our Iraqi sample
seems to have lower orthodontic treatment need than
that of samples taken from American Whites, Native
Americans, New Zealanders or Japanese. However,
Otuyemi et al.25 presented that his Nigerian sample had Figure 2: Measuring irregularities with a metric
a lower treatment need than that of the present sample. ruler or vernier.
These results support the theory of environmental effect
Orthodontic treatment need (DAI) in Iraq ________________________________________________________ Al-Huwaizi 9

Table 1: Treatment needs registration form for the Dental Aesthetic Index (DAI).
DAI component Score Weight Sum.
0 Constant 13
Missing visible mandibular and maxillary incisor,
1 6
canine and premolar teeth (No. of teeth)
Crowding in the incisal segment
2 1
(Number of crowded segments 0, 1 or 2)
Spacing in the incisal segment
3 1
(Number of spaced segments 0, 1 or 2)
4 Maxillary diastema (in mm) 3
5 Largest maxillary anterior irregularity (in mm) 1
6 Largest mandibular anterior irregularity (in mm) 1
7 Anterior maxillary overjet (in mm) 2
8 Anterior mandibular overjet (in mm) 4
9 Vertical anterior open bite (in mm) 4
Antero-posterior molar relation
10 3
(0=normal, 1=½ cusp, 2=full cusp)
Total (add lines 0 through 10)

Table 2: Decision points on the DAI scale defining case severity levels that approximate the judgment of
orthodontists.
DAI scores Case sensitive level and relative treatment need
Normal or minor malocclusion;
13 – 25
No treatment need or slight need
Definite malocclusion;
26 – 30
Treatment elective
Severe malocclusion;
31- 35
Treatment highly desirable
Very severe (handicapping) malocclusion;
36 and higher
Treatment mandatory

 Distal Mesial 
Distal occlusion Normal occlusion Mesial occlusion
(D and D+) (N) (M and M+)

Figure 3: Classification or molar relation.

10 ___________________________________________________________________________________ Iraqi Orthod J 1(1) 2005
The rurals showed a higher mean DAI score
(24.669) than for the urbans (24.106) as shown in table
7. These differences were found to be statistically
significant and table 8 displays the results of t-tests.
Also, DAI scores where there is severe malocclusion
and treatment is highly desirable or mandatory were
found more in the rural sample (19.2%) than in the
urban sample (15.3%). This contradicts the findings of
Ansai et al.28 who found that in his sample urban
students had significantly higher DAI scores than rural
students and this may be attributed to racial differences.
CONCLUSIONS
In the year 2000, there were 471,880 Iraqis aged 13
years (students or not). About 7.2% of these children as
judged by the results of this study have very severe
handicapping malocclusion which needs mandatory
orthodontic treatment which means that roughly about
34,000 children aged 13 years must be urgently treated
every year to control handicapping malocclusion. This
is a very large number of orthodontic patients and hence
a program should be put by the Ministry of Health to
absorb this need with the following suggestions in mind:
1. Adopt the Dental Aesthetic Index to differentiate
those subjects with handicapping malocclusions and
give them a priority in treatment.
2. Better health education programs through the media
(television and radio) and visits to the schools to
encourage the students to demand orthodontic
treatment.
3. Training general practitioners to treat simple cases
and leave the specialists to treat the more
complicated case.
4. Continued support for general practitioners to obtain
higher studies and training courses in orthodontics
to assist in treating this large number of patients.
5. Provision of all the necessary equipment, material
and ancillaries to increase the productivity of the
already present orthodontists.
REFERENCES
1- Cons NC, Jenny J, Kohout FJ. The Dental Aesthetic Index:
Iowa City: Master Thesis, College of Dentistry,
University of Iowa, USA 1986.
2- Jenny J, Cons NC. DAI: the dental aesthetic index.
(Personal communication).
3- Jenny J, Cons NC. Establishing malocclusion severity
levels on the Dental Aesthetic Index (DAI) scale. Aust
Dent J 1996; 41(1): 43-6.
4- Jenny J, Cons NC. Comparing and contrasting two
orthodontic indices, the Index of Orthodontic Treatment
Need and the Dental Aesthetic Index. Am J Orthod
Dentofacial Orthop 1996; 110(4): 410-6.
5- World Health Organization. International collaborative
study of oral health outcomes (ICS II), document 2. Oral
data collection instrument and examination criteria.
Geneva: WHO 1989.
6- Lobb WL, Ismail AI, Andrews CL, Spracklin TE.
Evaluation of orthodontic treatment using the Dental
Aesthetic Index. Am J Orthod Dentofac Orthop 1994;
106(1): 70-5.
7- Spencer AJ, Allister JH, Brennan DS. Utility of the Dental
Aesthetic Index as an orthodontic screening tool in
Australia. Adelaide: University of Adelaide 1992.
8- Cons NC, Jenny J, Kohout FJ. Association of dental
aesthetics (DAI) with dental appearance, smile and desire
for orthodontic treatment. J Dent Res 1987; 66: abstr no
1081.
9- Jenny J, Cons NC, Kohout FJ, Jakobsen J. Relationship
between dental aesthetics and attributions of self-
confidence. J Dent Res 1990; 69: abstr no 761.
10- Jenny J, Cons NC, Kohout FJ, Jakobsen J. Predicting
handicapping malocclusion using the Dental Aesthetics
Index (DAI). Int Dent J 1993; 43: 128-32.
11- Cons NC, Jenny J, Kohout FJ, Freer TJ, Eismann D.
Perceptions of occlusal conditions in Australia, the
German Democratic Republic and the United States of
America. Int Dent J 1983; 33: 200-6.
12- Cons NC, Jenny J, Songpaisan Y, Jotikastira D. Utility of
the Dental Aesthetic Index in industrialized and
developing countries. J Publ Health Dentistry 1989;
49(3): 163-6.
13- Cons NC, Jenny J, Kohout FJ, Jakobsen J. Comparing
ethnic group-specific DAI equations with the standard
DAI. Int Dent J 1994; 44: 153-8.
14- Cons NC, Jenny J. Comparing perceptions of dental
aesthetics in the USA with those in eleven ethnic groups.
Int Dent J 1994; 44(5): 489-94.
15- Alhuwaizi AF. Occlusal features, perception of occlusion,
orthodontic treatment need and demand among 13 year
old Iraqi students (A national cross-sectional
epidemiological study). Ph.D. Thesis, College of
Dentistry, University of Baghdad, Iraq 2002.
16- Alhuwaizi AF, Al-Alousi WS, Al-Mulla AA. Orthodontic
treatment demand in Iraqi 13 year olds - A national
survey. J Coll Dentistry 2002; 13:134-9.
17- Alhuwaizi AF, Al-Mulla AA, Al-Alousi WS. Method of a
national survey on malocclusion. J Coll Dentistry 2002;
13: 12-23.
18- Alhuwaizi AF, Al-Mulla AA, Al-Alousi WS. Dental
crowding or spacing in 13 year olds. J Coll Dentistry
2002; 14: 126-36.
19- Alhuwaizi AF, Al-Alousi WS, Al-Mulla AA. The dental
midline at 13 year of age. J Coll Dentistry 2003; 15: 1-7.
20- Alhuwaizi AF, Al-Mulla AA, Al-Alousi WS. A survey on
anterior dental irregularities. J Coll Dentistry 2003; 15:
63-7.
21- Alhuwaizi AF, Al-Mulla AA, Al-Alousi WS. The overjet
of Iraqi 13 year olds (a national survey). Iraqi J Oral Dent
Sc 2004;3(1):40-6.
22- Alhuwaizi AF, Al-Alousi WS, Al-Mulla AA.
Anteroposterior dental arch relationship of adolescents. J
Coll Dentistry 2004; 16(1): 86-91.
23- Alhuwaizi AF. Open bite in Iraq (a national survey). J Coll
Dentistry 2005; 17(1): 81-85.
24- Jenny J, Cons NC, Kohout FJ, Jakobsen J. Differences in
need for orthodontic treatment between Native Americans
and the general population based on DAI scores. J Public
Health Dent 1991; 51(4): 234-8.
Comparison of force decay for different types of intermaxillary elastics… _______________________________ Al-Mathedi 11

25- Otuyemi OD, Ogunyinka A, Dosumu O, Cons NC, Jenny
J. Malocclusion and orthodontic treatment need of
secondary school students in Nigeria according to the
dental aesthetic index (DAI). Int Dent J 1999; 49(4): 203-
10.
26- Corruccini RS. An epidemiologic transition in dental
occlusion in world populations. Am J Orthod Dentofac
Orthop 1984; 86(5): 419-26.
27- Al-Alousi W, Jamison HH, Legler DD. A survey of oral
health in Iraq. Population characteristics, occlusion and
enamel mottling of senior secondary school students.
Iraqi Dent J 1982; 9: 8-16.
28- Ansai T, Miyazaki H, Katoh Y, Yamashita Y, Takehara T,
Jenny J, Cons NC. Prevalence of malocclusion in high
school students in Japan according to the Dental
Aesthetic Index. Community Dent Oral Epidemiol 1993;
21(5): 303-5.
29- Johnson M, Harkness M. Prevalence of malocclusion and
orthodontic treatment need in 10-year-old New Zealand
children. Aust Orthod J 2000; 16(1): 1-8.

Table 3: Distribution of the total sample according to their DAI scores.

DAI DAI Cumulative DAI DAI Cumulative

n % n %
grade score % grade score %
13 3 0.04 0.04 36 65 0.93 93.78
14 8 0.11 0.16 37 46 0.66 94.44
Normal or minor malocclusion

15 139 2.00 2.16 38 87 1.25 95.69

16 115 1.65 3.81 39 53 0.76 96.45
17 422 6.07 9.87 40 47 0.68 97.13

Very severe (handicapping) malocclusion

18 386 5.55 15.42 41 45 0.65 97.77
19 600 8.62 24.05 42 49 0.70 98.48
20 644 9.26 33.30 43 26 0.37 98.85
21 613 8.81 42.12 44 13 0.19 99.04
22 524 7.53 49.65 45 23 0.33 99.37
23 448 6.44 56.09 46 17 0.24 99.61
24 378 5.43 61.52 47 9 0.13 99.74
25 299 4.30 65.82 48 5 0.07 99.81
26 202 2.90 68.72 49 3 0.04 99.86
malocclusion malocclusion

27 286 4.11 72.83 50 2 0.03 99.89

Definite

28 256 3.68 76.51 51 1 0.01 99.90

29 245 3.52 80.03 52 2 0.03 99.93
30 180 2.59 82.62 54 1 0.01 99.94
31 213 3.06 85.68 55 1 0.01 99.96
32 137 1.97 87.65 58 1 0.01 99.97
Severe

33 151 2.17 89.82 62 1 0.01 99.99

34 99 1.42 91.25 65 1 0.01 100.00
35 111 1.60 92.84

10%

8%

6%

4%

2%

0%
13 16 19 22 25 28 31 34 37 40 43 46 49 52 55 58 61 64
DAI score
12 ___________________________________________________________________________________ Iraqi Orthod J 1(1) 2005

Figure 4: Distribution of the total sample according to their DAI score.

DAI 36-65
7.2%
DAI 31-35
10.2%

DAI 26-30
16.8% DAI 13-25
65.8%

Figure 5: Distribution of the total sample according to the severity of their DAI scores.

100%

80%
IRAQ
60% USA

40%

20%

0%
13 17 21 25 29 33 37 41 45 49 53 57 61 65
DAI score
Figure 6: Cumulative distribution of the total sample according to their DAI score of the present study and
Jenny et al. (24)

Table 4: Reported orthodontic treatment need using the DAI.

Sample DAI scores (%) Mean
Author DAI
Country Size Age 13-25 26-30 31-35 ≥36
score
American White 1337 15-18 46 26 15 13 26.53
Jenny et al. (1991) 24
Native Americans 485 12-17 19 26 25 30 31.82
Ansai et al. (1993) 28 Japan 409 15-18 32 21 25 22 30.5
Jenny et al. (1993) 10 America 1306 15-18 45.7 23.6 15.5 15.2
Jenny and Cons (1996) 3 America 7500 12-17 45.8 25.2 15 14
Otuyemi et al. (1999) 25 Nigeria 703 12-18 77.4 13.4 9.2
Johnson and Harkness (2000) 29 New Zealand 10 23 22 22 33
Present study Iraq 6957 13 65.8 16.8 10.2 7.2 24.25
 Comparison of force decay for different types of intermaxillary elastics… _______________________________ Al-Mathedi 13

Table 5: Distribution (%) and mean DAI score of the total sample by governorate.

DAI
Baghdad Ninevah Basrah Diyala Anbar Najaf Total
score
13-25 67.7 68.5 61.9 64.0 62.9 68.1 65.8
26-30 15.6 15.9 21.1 16.7 17.6 15.1 16.8
31-35 9.3 10.1 9.8 11.3 11.7 10.3 10.2
36-65 7.5 5.4 7.2 8.0 7.8 6.5 7.2
Total 100 100 100 100 100 100 100
Mean 24.247 23.969 24.664 24.684 24.756 24.146 24.247
Sem 0.137 0.183 0.193 0.200 0.199 0.190 0.137

Table 6: T-tests between the governorates for DAI score.

T-tests Najaf Anbar Diyala Basrah Ninevah
Baghdad NS * NS NS NS
Ninevah NS ** ** **
Basrah NS NS NS
Diyala NS NS
Anbar *

Table 7: Distribution (%) and mean DAI score of the total sample by governorate.
Urban Rural Total
DAI
Male Female Total Male Female Total Male Female Total
score
N=1739 N=1744 N=3483 N=1738 N=1736 N=3474 N=3477 N=3480 N=6957
13-25 68.6 67.4 68.0 63.2 64.1 63.6 65.9 65.7 65.8
26-30 16.2 16.6 16.4 17.5 16.8 17.2 16.9 16.7 16.8
31-35 8.6 9.0 8.8 11.4 11.8 11.6 10.0 10.4 10.2
36-65 6.6 6.9 6.7 7.8 7.3 7.6 7.2 7.1 7.2
Total 100 100 100 100 100 100 100 100 100
Mean 24.030 24.182 24.106 24.725 24.613 24.669 24.377 24.397 24.387
sem 0.142 0.144 0.101 0.151 0.149 0.106 0.104 0.104 0.073

Table 8: T-tests between both genders and residencies (urban and rural) for DAI score.
Gender difference Residency difference
Urban Rural Total Males Females Total
t value 0.755 0.527 0.137 3.362 2.083 3.849
d.f. 3481 3472 6955 3475 3478 6955
p level NS NS NS *** * ***

View publication stats