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PubMedDate not supplied

The current status of hepatitis B in Lebanon.

The current status of hepatitis B infection in Lebanon is unknown due to the scarcity of published studies on the subject. This study was conducted to summarize the available information on hepatitis B in Lebanon since 1966, as well as to determine the current status of the problem, by analyzing the prevalence of positive hepatitis B surface antigen (HBsAg) reported from different laboratories of major hospitals covering the six districts of Lebanon in the year 2000. The overall HBsAg carrier rate among 61,271 tested individuals was 2.2%, being 13% among 30,809 blood donors, and 3.6% among 13,669 tested individuals in serology laboratories. There were marked geographical variations in the HBsAg carrier rate being 0.8% in Mount Lebanon, 1.9% in each of Bekaa and Greater Beirut, 2.2% in North Lebanon, 2.4% in Nabatiyeh, reaching up to 4.7% in South Lebanon. These findings are comparable to the previously reported studies on pregnant women and children, thus confirming that Lebanon is moderately endemic for hepatitis B. Such information stresses the urgent need for efficient national public health surveillance campaigns, and mass vaccination programs. In addition, the universal screening of pregnant women for HBsAg, and the implementation of universal newborn vaccination against hepatitis B virus (HBV) should be the standard of medical care for the control and eradication of HBV in Lebanon.

Hepatitis B↗
PubMedDate not supplied

Age distribution of breast cancer in Lebanon: increased percentages and age adjusted incidence rates of younger-aged groups at presentation.

BACKGROUND: Breast cancer is the most common cancer in Lebanese women. Lebanon has no national cancer registry and the American University of Beirut Medical Center (AUBMC) is one of the largest hospitals in Lebanon and has a fully operational cancer registry. Earlier studies showed that it sees about one third of all cancer cases in Lebanon. METHODS: All female breast cancer patients recorded at AUBMC between 1983 and 2000 were evaluated. We used the sex-specific age distribution of 1995 Lebanese Population and Housing Survey to estimate the age-specific incidence of breast cancer in Lebanon. The results were calculated as number and proportion of cases, 10-year age-specific incidence rates, crude rates and age standardized rates (ASR) per 100,000 population. The ASR per 100,000 population was estimated by the direct method with the use of the World Standard Population. RESULTS: Between 1983 and 2000, there were a total of 16421 cancers of which 8007 were in women. There were 2673 female breast cancers, averaging 148 cases per year (Range:94-202). Almost half of cases (49.1%) were in women below the age of fifty. The mean age was:49.8 years +/- 13.9 years. Ten-year age groups distribution showed that 4.7% were below 30 years of age, 16.1% were 30-39 years, 28.3% were 40-49 years, 26.3% were 50-59 years, 16.9 % were 60-69 years, 6.1% were 70-79 years and 1.6% were 80 years of age or older. Twenty-two patients (0.9 %) had their age missing in the records. Overall ASR was 30.6, for a crude rate of 27.7. Age adjusted incidence rate had its peak in women aged 50-59, followed by women 40-49 then 60-69 with values of 96.3, 79.9 and 77.4 per 100,000 respectively. We also noted 19 male breast cancer cases corresponding to 0.7% of the 2692 combined total. CONCLUSIONS: The percentage of women with breast cancer in Lebanon seen at AUBMC in pre-menopausal and younger-aged groups is higher than those reported from western countries. Our results emphasize the need to search for possible environmental, lifestyle and/or genetic risk factors in Lebanon. Our study also shows the importance of implementing early detection and screening programs which, along with high quality mammography and medical care, can have a positive impact on survival, especially in younger-aged women.

Adult↗
PubMed2006

Prevalence and treatment of mental disorders in Lebanon: a national epidemiological survey.

BACKGROUND: Mental disorders are believed to account for a large portion of disease burden worldwide. However, no national studies have been undertaken to assess this assumption in the Arab world. METHODS: As part of the WHO World Mental Health (WMH) Survey Initiative, a nationally representative psychiatric epidemiological survey of 2857 adults (aged 18 years) was done in Lebanon between September, 2002, and September, 2003, through a study called LEBANON (Lebanese Evaluation of the Burden of Ailments and Needs Of the Nation). 12-month prevalence and severity of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) disorders, and treatment were assessed with the WHO Composite International Diagnostic Interview (CIDI, version 3.0). Information was also obtained for sociodemographics and exposure to traumatic events in the Lebanon wars. FINDINGS: 308 (17.0%) of respondents met criteria for at least one 12-month DSM-IV/CIDI disorder, 108 (27.0%) of whom were classified serious and an additional 112 (36.0%) moderate. Nearly half of respondents had a history of exposure to war-related traumatic events. Significantly elevated odds ratios (OR) of mood, anxiety, and impulse-control disorders were associated with two (OR 2.0-3.6) or more (2.2-9.1) war-related traumatic events, resulting in substantially higher proportions of moderate and severe 12-month mental disorders in respondents exposed to multiple war-related traumata (16.8-20.4%) compared with other respondents (3.3-3.5%). Only 47 (10.9%) respondents with 12-month disorders obtained treatment. 85% of people were treated in the general medical sector and the mental-health-care system, and the rest by religious or spiritual advisers, counsellors, herbalists, or fortune-tellers. INTERPRETATION: Mental disorders are common in Lebanon, with a prevalence equivalent to that in Western Europe. However, the number of individuals with mental disorders who are not receiving treatment is considerably higher in Lebanon than in Western countries.

Adult↗
PubMed2000

Epidemiology of human immunodeficiency virus and acquired immunodeficiency syndrome in Lebanon from 1984 through 1998.

OBJECTIVE: To identify the epidemiologic characteristics of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) in Lebanon during the period between January 1, 1984, and December 31, 1998. MATERIALS AND METHODS: This report presents a descriptive analysis of HIV and AIDS surveillance data. The subjects of this study were all notified HIV and AIDS cases in Lebanon reported to the Epidemiological Surveillance Unit of the Department of Preventive Medicine at the Ministry of Public Health in Lebanon. RESULTS: The HIV epidemic started in Lebanon in 1984 with the first diagnosed AIDS cases. The number of cases slowly but steadily increased, to reach, by 1998, 529 cases, of which 147 were AIDS cases. The average age of infected persons was 31 years, with a ratio of men to women close to 3.6:1. The most frequent mode of transmission is sexual (71.9% of all cases; heterosexual, 53.9% of all cases), which consequently increases the perinatal transmission of the disease (4.3% of all declared cases). Data on high-risk groups (intravenous drug users, homosexuals, prostitutes, and prisoners) are incomplete, although the problem does exist. The safety of blood products is relatively well controlled in the country. No new cases of HIV infections through blood transfused in Lebanon have been reported since 1993 (8.5% of all cases). CONCLUSION: The continuously increasing number of HIV and AIDS cases shows an urgent need for targeted interventions in the general population to stop any further spread of HIV infections in the years to come.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Health care for older persons: a country profile--Lebanon.

Lebanon is a small country, comparable in size to New Hampshire. It is currently estimated that 8% of the population is age 65 and older. The Lebanese population has witnessed a clear demographic transition in the past few decades. Our culture demands respect for older people and values highly the natural bonds of affection between all members of the family. The healthcare system in the country is an adaptation of the European model. Despite the large number of physicians (approximately 10,000) there is a shortage of primary care and geriatric physicians. There are 36 nursing homes in Lebanon, with a total of 6,000 beds, but most of them are understaffed, with the exception of three nursing homes that offer relatively comprehensive services including rehabilitative, preventive, and curative services. The Ain Wizen Elderly Care Centre is well recognized for the program it operates for older people, which is a good model for the region and for Lebanon in terms of services, training, and research. Demographic changes and social and economic developments in Lebanon have created new realities in the unprecedented growth of the older population. Lebanon, like other developing countries, needs to define the policies and programs that will reduce the burden of an aging population on its society and economy. There is a need to ensure the availability of health and social services for older persons and to promote older persons' continuing participation in a socially and economically productive life.

Aged↗
PubMed1999

Epidemiology of tuberculosis in Lebanon.

OBJECTIVE: To identify the epidemiological characteristics of tuberculosis (TB) in Lebanon; a review covering the period from 1 January 1995 to 31 December 1996. DESIGN: Descriptive analysis of surveillance data of all new cases of active TB reported to the Epidemiological Surveillance Unit of the Department of Preventive Medicine at the Ministry of Public Health in Lebanon. RESULTS: A total of 1111 patients were males and 832 patients were females; 5 % of the patients were below the age of 5 years and 19% below the age of 15. The geographical distribution of TB patients shows that 38.4% of the patients were residents of Beirut, and 27.2% residents of North Lebanon. CONCLUSIONS: This study shows the existence of a potentially large TB reservoir in Lebanon, especially in the areas of Beirut and North Lebanon. Health workers should be alerted to the importance of continual case finding, effective treatment, control of infection transmission and the continued abatement of the tuberculosis problem in the years to come.

Adolescent↗
PubMed2006

The providers of health services in Lebanon: a survey of physicians.

BACKGROUND: Emerging from civil distress carries with it major challenges to reforming a health system. One such challenge is to ensure an adequate supply of competent human resources. The objective of this study was to assess the supply of physicians in Lebanon in 1998, with an assessment of their practice patterns and capacity building. METHODS: Lists of members of physician's associations were examined to determine the number of physicians in Lebanon and their geographical distribution. A self-administered survey targeted 388 physicians (5%) randomly stratified by the five regions of Lebanon. Some 377 providers reported information on their demographic profile, practice patterns and development. Further, information on continuing education activities was acquired. RESULTS: In Lebanon, the overall physician-to-population ratio was 248 per 100, 000, characterized by an evident maldistribution at the intracountry regional level. Physicians worked 38 hours per week examining on average 21 patients per day, with an average time of 30 minutes spent per visit. They also reported spending 11% of their time waiting for patients. Respondents reported a very wide range of income, with 90% earning less than USD 2,000 per month. Moreover, the continuing education profile revealed a total of 43.7 hours per year, similar to that required for board certification in many developed countries. Conference attendance was the dominant continuing education activity (95% of respondents) and consumed most of the time allotted for continuing education, reported at 32 hours per year. DISCUSSION AND CONCLUSION: Various economic indicators point to an oversupply of physicians in Lebanon and a poor allocation of their time for capacity building. Therefore, it is crucial for decision-makers to closely monitor the increasing supply of providers and institute appropriate intervention strategies, taking into consideration appropriate provision of good-quality services and ensuring that continuing education activities are well established, organized and monitored.

Journal Article↗
PubMed2001

Validation of a 5-log10 reduction of Listeria monocytogenes following simulated commercial processing of Lebanon bologna in a model system.

Recently, numerous product recalls and one devastating outbreak that claimed 21 lives were attributed to Listeria monocytogenes in ready-to-eat meat products. Consequently, the Food Safety and Inspection Service published a federal register notice requiring manufacturers of ready-to-eat meat and poultry products to reassess their hazard analysis and critical control point plans for these products as specified in 9 CFR 417.4(a). Lebanon bologna is a moist, fermented ready-to-eat sausage. Because of undesirable quality changes. Lebanon bologna is often not processed above 48.9 degrees C (120 degrees F). Therefore, the present research was conducted to validate the destruction of L. monocytogenes in Lebanon bologna batter in a model system. During production, fermentation of Lebanon bologna to pH 4.7 alone significantly reduced L. monocytogenes by 2.3 log10 CFU/g of the sausage mix (P < 0.01). Heating the fermented mix to 48.9 degrees C in 10.5 h destroyed at least 7.0 log10 CFU of L. monocytogenes per g of sausage mix. A combination of low pH (5.0 or lower) and high heating temperatures (> or =43.3 degrees C, 115 degrees F) destroyed more than 5 log10 CFU of L. monocytogenes per g of sausage mix during the processing of Lebanon bologna. In conclusion, an existing commercial process, which was validated for destruction of Escherichia coli O157:H7, was also effective for the destruction of more than 5 log10 CFU of L. monocytogenes.

Animals↗
PubMed2001

Influence of sodium chloride on growth of lactic acid bacteria and subsequent destruction of Escherichia coli O157:H7 during processing of Lebanon bologna.

Due to undesirable quality changes, Lebanon bologna is often processed at temperatures that do not exceed 48.8 degrees C (120 degrees F). Therefore, it is important to study parameters that influence the destruction of Escherichia coli O157:H7 in Lebanon bologna. The objective of the present study was to determine the influence of curing salts (NaCl and NaNO2) on the destruction of E. coli O157:H7 during Lebanon bologna processing. Fermentation to pH 4.7 at 37.7 degrees C reduced populations of E. coli O157:H7 by approximately 0.3 log10, either in the presence or absence of curing salts. Subsequent destruction of E. coli O157:H7 during heating of fermented product to 46.1 degrees C was significantly reduced by the presence of 3.5% NaCl and 156 ppm NaNO2, compared to product without curing salts (P < 0.01). The presence of a higher level of NaCl (5%) in Lebanon bologna inhibited the growth of lactic acid bacteria (LAB), which yielded product with higher pH (approximately 5.0) and significantly reduced the destruction of E. coli O157:H7 even further (P < 0.05). Lower concentrations of NaCl (0, 2.5%) yielded Lebanon bologna with higher LAB counts and lower pHs, compared to product with 5% NaCl. When lactic acid was used to adjust pH in product containing different levels of NaCl, it was determined that low pH was directly influencing destruction of E. coli O157:H7, not NaCl concentration.

Colony Count, Microbial↗
PubMed2007

Dementia and depression among nursing home residents in Lebanon: a pilot study.

BACKGROUND: The proportion of elderly in the Lebanese population is 7.1% and this is expected to increase to 10.2% by the year 2025. The nursing home (NH) population in Lebanon has not been studied. The aim of this study was to investigate the prevalence of dementia and depression among a portion of nursing home residents (NHR) in Lebanon and describe the characteristics of NHR afflicted with dementia and depression. METHOD: Of 200 NHR from three NH in Lebanon, 117 were selected by random sampling. Data on demographics and medical history were collected. An Arabic version of the Mini-Mental Status Examination and Geriatric Depression Scale (GDS) were administered. RESULTS: Our final sample consisted of 102 NHR. Sixty-one (59.8%) had dementia of some kind. Seventeen (27.9%) had mild dementia, 14 (22.9%) had moderate dementia, and 30 (49.2%) had severe dementia. Forty-five (57.7%) of the NHR tested had depression as measured by a GDS score of more than 10. CONCLUSIONS: Dementia and depression were present in more than half of the NHR in our sample. Our results have important implications, being the first to be collected in the Lebanese community. Screening NHR for dementia and depression on admission and at regular time intervals is a must. More studies targeting all aspects of the elderly population in Lebanon are needed.

Aged↗
PubMed2006

First nonavian dinosaur from Lebanon: a brachiosaurid sauropod from the Lower Cretaceous of the Jezzine District.

Two sauropod teeth from an Early Cretaceous (Neocomian) fluviodeltaic sandstone near Jezzine (Southern Lebanon) are the first nonavian dinosaur remains to be reported from Lebanon. Their distinctive character places them within Brachiosauridae. The sauropod teeth from Lebanon are a significant addition to the very scanty dinosaur record from the Levant, which hitherto consisted mainly of very poorly preserved and not easily identifiable specimens. The Basal Cretaceous Sandstone of Lebanon, thus, appears to be a potentially important source of fossil vertebrate material.

Animals↗
PubMed2004

Cancer incidence in postwar Lebanon: findings from the first national population-based registry, 1998.

PURPOSE: Cancer incidence rates in Lebanon have been lacking for over three decades. National data based on a total of 4388 cases diagnosed during the year 1998 were reviewed and analyzed. METHODS: Crude and age-standardized rates (ASRs) per 100,000 population were calculated and results were contrasted with estimates from developed and selected developing countries in the region. RESULTS: Among males, bladder (18.5%), prostate (14.2%), and lung cancer (14.1%) were the most frequently reported malignancies. Among females, breast cancer alone accounted for over a third of all cancers, followed by colon cancer (5.8%), and cancer of the corpus uteri (4.8%). Sex-differentials in incidence rates were highest for tobacco-related cancers (lung, larynx, and bladder). Compared with current estimates worldwide, ASRs for bladder cancer in Lebanon showed strikingly high rates. Whereas ASRs for breast and prostate cancer remained lower than those observed in developed countries, they were greater than those estimated from neighboring countries with a similar epidemiological transition as Lebanon. CONCLUSIONS: Findings of the comparative assessments most likely reflect differentials in prevalence of risk factors and lifestyle variables (e.g., lung and breast cancers) and can be partly explained by improvement in cancer detection rate in recent years (for prostate cancer). The implications of the results in light of primary prevention activities, screening practices, and research initiatives in Lebanon are discussed.

Adolescent↗
PubMed1987

Exposure to recurrent combat stress: combat stress reactions among Israeli soldiers in the Lebanon War.

This study examined the impact of repeated exposure to combat on combat stress reaction (CSR). Soldiers diagnosed with CSR during the Lebanon War (N = 382) were compared with a matched control group of soldiers who fought in the same units but did not manifest symptoms of CSR (N = 334). CSR in the Lebanon War was found to be related to the psychological outcome the soldier experienced in previous wars. The CSR rate in the Lebanon War was higher in soldiers who had experienced an episode of CSR in a previous war than in soldiers with no past combat experience. However, CSR rates were lower among soldiers who had not had an episode of CSR in a previous war than among soldiers with no prior combat experience. High intensity of combat in Lebanon was found to increase both the detrimental and favourable effects of prior combat experience.

Adaptation, Psychological↗
PubMed2005

A two-year survey on mosquitoes of Lebanon.

A total of 6,500 mosquitoes were identified during a two-year survey (1999-2001) in Lebanon, and these belonged to twelve species: Culex pipiens, Cx. laticinctus, Cx. mimeticus, Cx. hortensis, Cx. judaicus, Aedes aegypti, Ae. cretinus, Ochlerotatus caspius, Oc. geniculatus, Oc. pulchritarsis, Culiseta longiareolata and Anopheles claviger. Culex pipiens was the most predominant species in Lebanon, collected indoors and outdoors. It was continuously abundant and active throughout the year. Culex judaicus was a small and rare mosquito and it is reported to occur for the first time in Lebanon. On the coastal areas, Ochlerotatus caspius was very common, and proved to be a complex of species as two forms were detected. One of the vectors of malaria, Anopheles claviger, was collected from May to September, from eight sites in Lebanon. Its breeding sites were restricted to fresh, cool, and clean water in pools and wells. Most of these breeding sites were in the populated Metn County where a few indigenous cases of malaria were reported from 1997-2000. This shows that the reported malaria cases were not imported, but caused by the bites of locally infected Anopheles females.

Aedes↗