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PubMed2026

Tracking the shifting landscape of SARS-CoV-2 variants in Lebanon among healthcare workers and hospitalized patients.

UNLABELLED: Genomic surveillance of SARS-CoV-2 is critical for tracking viral evolution and informing public health responses. This study characterized variants circulating among healthcare workers (HCWs) and hospitalized patients in Lebanon between January 2022 and September 2024. A total of 530 SARS-CoV-2-positive nasopharyngeal swabs were collected from five Lebanese governorates and subjected to whole-genome sequencing. Correlations between variant circulation and a number of demographic and clinical variables were assessed. Most HCWs were female (64%), young adults (20-30 years, 39%), and had no comorbidities (97%). In contrast, hospitalized patients were mostly older adults (>60 years, 55.6%) with underlying conditions (77%). Early 2022 was marked by BA.1- and BA.2-like Omicron variants, followed by the predominance of BA.5-like lineages. In 2023, recombinant XBB sublineages became widespread. By 2024, these were largely replaced by next-generation variants, including JN.1 and KP.3.1.1. Despite differences in demographics and exposure risk, both groups showed parallel variant evolution. These findings reflect global and regional patterns and highlight the dynamic nature of SARS-CoV-2 circulation in Lebanon. IMPORTANCE: This study provides a comprehensive snapshot of SARS-CoV-2 variant evolution in Lebanon between 2022 and 2024, focusing on healthcare workers and hospitalized patients. By combining genomic and clinical data, it reveals how successive Omicron subvariants emerged and spread within key population groups. The detection of diverse and evolving lineages, including XBB recombinants and next-generation variants such as JN.1, underscores the ongoing antigenic drift of SARS-CoV-2. These insights reinforce the value of continued genomic surveillance for pandemic preparedness, especially in regions where data remain limited. Understanding local variant dynamics can guide targeted vaccination strategies and health policy decisions.

Humans↗

PubMed2026

Molecular characterization of pESI-like megaplasmids in Salmonella Infantis from poultry in Lebanon.

UNLABELLED: Salmonella enterica serovar Infantis has emerged as a globally disseminated multidrug-resistant (MDR) pathogen, largely driven by the spread of the plasmid of emerging Salmonella Infantis (pESI)-like megaplasmid. In our study, we investigated the prevalence, antimicrobial resistance (AMR) phenotypes, and genomic features of S. Infantis isolates collected from poultry farms in Lebanon. A total of 72 isolates were recovered during a nationwide surveillance effort, among which 67 (93%) were MDR based on antimicrobial susceptibility testing (disk diffusion and broth microdilution) results, including resistance to critically important agents such as quinolones, and highly important classes such as tetracyclines and sulfonamides. Whole-genome sequencing was performed on 19 isolates selected through a stratified approach to encompass all identified AMR phenotypes; this analysis revealed a conserved pESI-like backbone together with MDR-associated determinants, including sul1, tet(A), and aadA. Plasmid marker analysis confirmed the presence of pESI in the majority of isolates, with plasmid-associated genes (ardA and trbA) and replicon markers (IncP and IncFIB(pN55391)) among the most prevalent. Comparative plasmid alignments with representative pESI sequences from Italy, Turkey, and the United States revealed strong conservation of the backbone alongside regional variation in AMR gene content. These findings highlight the role of poultry production systems in Lebanon as reservoirs for pESI-like megaplasmids and MDR S. Infantis, underscoring the zoonotic and public health risks posed at the human-animal-environment interface. Strengthened surveillance, antimicrobial stewardship, and biosecurity interventions are urgently needed to mitigate the spread of MDR S. Infantis within agriculture and beyond. IMPORTANCE: The emergence of plasmid of emerging Salmonella Infantis (pESI)-like megaplasmids has transformed Salmonella Infantis into a globally distributed multidrug-resistant (MDR) clone with the capacity to persist in livestock and disseminate resistance genes across ecological boundaries. Our study provides the first genomic characterization of pESI-positive S. Infantis from poultry farms in Lebanon, a region with high antimicrobial usage and limited stewardship frameworks. By integrating phenotypic susceptibility testing and whole-genome sequencing, we demonstrate that Lebanese isolates harbor conserved pESI-like backbone markers together with antimicrobial resistance determinants, aligning them with internationally circulating lineages. Comparative analysis with isolates from Italy, Turkey, and the United States highlights both the evolutionary stability and geographic diversity of pESI. These findings emphasize the urgent need for integrated surveillance and stewardship strategies to curb the spread of MDR S. Infantis and reduce the zoonotic risk at the human-animal-environment interface.

Animals↗

PubMed2026

'Sawa Aqwa' (Stronger Together): A multi-site randomized controlled trial of a brief family systemic intervention for adolescent mental health in Lebanon.

BACKGROUND: There are no evaluated family-based mental health and psychosocial support (MHPSS) interventions for adolescents in Southwest Asia (known as the Middle East), and few whole-family interventions in low- and middle-income countries, despite consistent evidence for the impact of family support on mental health and well-being. This study aims to evaluate the effectiveness of a brief family systemic mental health intervention, deliverable by non-specialists in mental health. METHODS: We conducted an assessor-blind type I hybrid effectiveness-implementation multi-site randomized controlled trial comparing the locally developed family intervention to a waitlist control group for randomly allocated families residing in North Lebanon and Beqa'a governorates. Eligible families presented with medium-to-high risk for child protection concerns (abuse, neglect, child labor, early marriage) and had at least one adolescent aged 12-17 who demonstrated psychological distress. Outcomes at the family, caregiver, and adolescent level were measured pre- and post-intervention, and at 3-month follow-up. RESULTS: Intent-to-treat analyses found a significant between-group effect of the intervention on adolescent-reported family functioning, caregiver mental health, and parenting. No change was found for adolescent psychological distress. Further analyses found effects on adolescent well-being for those who completed the intervention, and that father attendance was associated with better outcomes for adolescent well-being in the intervention group. No other significant moderators were found. At the 3-month follow-up for the intervention condition, family functioning and caregiver well-being significantly dropped from endline. CONCLUSIONS: The study demonstrates mixed results for a non-specialist-delivered family-systemic intervention developed in the context of humanitarian crises in Lebanon. While the intervention did not result in benefits in adolescent-reported symptoms of psychological distress, the intervention group did show greater improvements than the control group on a number of other outcomes, showing the potential impact of working with the wider family system to support adolescents in humanitarian settings.

Humans↗

PubMed2017

Smoking and Lung Cancer: A Geo-Regional Perspective.

Lung cancer is the leading cause of cancer-related deaths worldwide. Non-small cell lung cancer (NSCLC) represents the most frequently diagnosed subtype of this morbid malignancy. NSCLC is causally linked to tobacco consumption with more than 500 million smokers worldwide at high risk for this fatal malignancy. We are currently lagging in our knowledge of the early molecular (e.g., genomic) effects of smoking in NSCLC pathogenesis that would constitute ideal markers for early detection. This limitation is further amplified when considering the variable etiologic factors in NSCLC pathogenesis among different regions around the globe. In this review, we present our current knowledge of genomic alterations arising during early stages of smoking-induced lung cancer initiation and progression, including discussing the premalignant airway field of injury induced by smoking. The review also underscores the wider spectra and higher age-adjusted rates of tobacco (e.g., water-pipe smoke) consumption, along with elevated environmental carcinogenic exposures and relatively poorer socioeconomic status, in low-middle income countries (LMICs), with Lebanon as an exemplar. This "cocktail" of carcinogenic exposures warrants the pressing need to understand the complex etiology of lung malignancies developing in LMICs such as Lebanon.

early detection↗

PubMed2026

Whole exome sequencing identifies three novel variants and establishes the molecular diagnosis of ATP6V0A4-related distal renal tubular acidosis in a lebanese infant.

BACKGROUND: Distal renal tubular acidosis (dRTA) is a rare inherited disorder characterized by impaired urinary acidification, leading to metabolic acidosis, hypokalemia, nephrocalcinosis, and growth impairment. Pathogenic variants in ATP6V0A4 are among the most common genetic causes of autosomal recessive dRTA. METHODS AND RESULTS: We report a Lebanese infant presenting with failure to thrive, recurrent vomiting, severe hyperchloremic metabolic acidosis, hypokalemia, and bilateral nephrocalcinosis, in whom whole-exome sequencing (WES) was performed to establish the molecular diagnosis and perform a comprehensive genomic evaluation. WES identified three novel variants, including a novel homozygous likely pathogenic ATP6V0A4 variant, consistent with the patient's phenotype. Two additional novel variants in TTN and CEP290 were also detected. Family segregation analysis confirmed the inheritance pattern of all three variants and refined the interpretation of the additional genomic findings. The patient showed sustained clinical and biochemical improvement to alkali therapy, with normalization of biochemical abnormalities and improvement in growth during follow-up. CONCLUSIONS: This report expands the molecular spectrum of ATP6V0A4-related dRTA and illustrates the clinical utility of comprehensive WES combined with segregation analysis for accurate molecular diagnosis, variant interpretation, genetic counseling, and the evaluation of additional genomic findings in rare inherited disorders.

Humans↗