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PubMed1986

The epidemiology of infant deaths in the Armenian parish records of Lebanon.

It is difficult to study time trends in mortality from most developing countries due to the lack of an appropriate data base. The present investigation is based on data from parish records of the Armenian Apostolic churches in Lebanon. Death and baptismal registers have been regularly maintained in these churches from 1863. Infant deaths were identified in the registers of the 13 churches. Available data on these deaths were abstracted, coded and analysed. Denominators for the different periods of study and for the various churches were calculated from baptismal records. The study shows that there has been a constant drop in the infant deaths over the review period. Infant mortality rates were higher in the parishes located in refugee camp areas. The most important recorded causes of death included diarrhoea and pneumonia. A study of clustering of deaths by time and place revealed a major epidemic of measles with high fatality in 1926. This epidemic had been previously unrecorded. The present study demonstrates the use of non-traditional data sources to assess long-term secular trends of mortality.

Armenia↗
PubMed1987

A case-control study of rheumatoid arthritis in Lebanon.

A case-control study was conducted to investigate the risk factors contributing to the development of rheumatoid arthritis (RA) in Lebanon. One hundred cases of classical and definite RA were identified from various care facilities in Beirut. Each case was matched with another patient of the same age and sex and free from any arthritic problem. Data on demographic, socioeconomic, genetic and psychosocial factors were collected. Histories obtained from both case and control groups showed a significant difference as to their family history of RA (odds ratio = 2), their past history of trauma (OR = 4) and their history of tonsillitis (OR = 2.2). A significantly higher proportion of cases reported the occurrence of major life events prior to the onset of their disease (OR = 2.5). The perception of the nuclear family environment was compared in both case and control groups. More RA patients were brought up in a family of high conflict (OR = 5), low cohesion (OR = 2) and low expressiveness (OR = 3.5).

Adult↗
PubMed2004

Agreement between husband and wife reports of domestic violence: evidence from poor refugee communities in Lebanon.

BACKGROUND: This paper compares husband and wife reports of wife beating using household survey data collected from poor Palestinian refugee communities in Lebanon. METHODS: The analyses are based on a matched data file of 417 currently married couples, drawn from a unique multi-purpose living conditions sample survey of about 3600 Palestinian refugee households interviewed in the spring and summer of 1999. Four outcomes (ever beaten, last year beating, beating during pregnancy, and injuries caused by beating) were analysed using Kappa statistics and per cent agreement. Logistic regression was used to analyse discordant reporting of wife beating during the year preceding the survey. RESULTS: Husband and wives' reports of the four different outcomes are in 'good' agreement as judged by Kappa coefficients, ranging from 0.62 for 'beaten during pregnancy' to 0.69 for 'injuries resulting from beating'. Prevalence estimates of domestic violence are also remarkably similar. However, findings from a multivariate logistic regression model on agreement regarding 'last year beating' show that only age of men was a significant predictor of agreement, controlling for education level, marital duration, region of residence, household size, health status, and consanguinity. CONCLUSIONS: Our findings show that men's self-reports of their violent behaviour against their wives are fairly congruent with those of their spouses, implying that the perpetrators, men, can be 'trusted' in providing basic information on 'beating histories' in epidemiological and demographic population-based investigations in contexts similar to ours. However, care should be taken in studies of young men's current beating behaviour using only their self-reports.

Adolescent↗
PubMed1996

Antimicrobial resistance of clinical isolates of Streptococcus pneumoniae in Lebanon.

A total of 61 clinical isolates of Streptococcus pneumoniae from Lebanon were tested for their susceptibility to penicillin G and seven other antibiotics by the agar dilution technique. All penicillin-susceptible isolates were also susceptible to chloramphenicol, ceftriaxone and erythromycin. Penicillin-resistant isolates were consistently susceptible only to erythromycin.

Amoxicillin↗
PubMed1987

Widowhood and mortality in an Armenian church parish in Lebanon.

A nonconcurrent cohort study was conducted in Lebanon by using the parish records of an Armenian Apostolic Orthodox church. Included in the study were 1,529 married couples. The observation period extended from 1949-1980 with follow-up information available on 90% of the subjects based on a review of burial registers, parish census records, and neighborhood inquiries. Identified during the observation period were 152 widowers and 623 widows. Three analytic procedures were used to compare the mortality of widowed to married subjects: person-years, matched-pair, and life table analyses. The results showed an increased risk of mortality for widowed compared with married subjects, although this excess in risk was not overall statistically significant. Most important was the result that among widowers as opposed to widows the higher risk of mortality acted at approximately ages 66-75 years. The suggested hypotheses to explain this finding include changes in the network size as well as social support systems which act in a particular way in this culture for men at the age of retirement. The results of this initial study of a specific community in a Middle Eastern society parallel findings in studies of Western industrial societies; they also tend to give additional evidence for the association of increased risk when widowhood is accompanied by increased stress caused by other life changes such as retirement.

Actuarial Analysis↗
PubMed1985

Thoracic wounds in Israeli battle casualties during the 1982 evacuation of wounded from Lebanon.

During the first 3 weeks of the operation "Peace for Galilee" (O.P.G.) 938 wounded soldiers were evacuated from Lebanon to the Rambam Medical Center in Haifa, Israel. Of these, 64 (6.8%) had chest wounds with or without other wounds. The characteristics of these wounds, the treatment given in the field and at the hospital and their results, are examined and a review of the literature of chest war wounds are summarized. A rapid and efficient in-field medical aid was the most important contributing factor to the low mortality and morbidity rates achieved. As far as we know, this is the first time computerized tomography was used in the diagnosis of war wounds of the chest.

Adolescent↗
PubMed2006

Reactions to combat stress in Israeli veterans twenty years after the 1982 Lebanon war.

During the war or shortly thereafter, the most common manifestation of combat induced psychopathology is combat stress reaction (CSR). The long-term consequences of CSR have so far received little scientific attention. The aim of this study was to examine whether CSR is a marker for long-term PTSD and other psychiatric comorbidities. Two groups of veterans from the 1982 Lebanon war were assessed 20 years after the war: one comprised 286 CSR casualties and the other comprised 218 matched non-CSR soldiers. Participants were assessed for PTSD, psychiatric symptomatology, social functioning, physical health, and postwar life events. Twenty years after the war, veterans with antecedent CSR reported more PTSD, psychiatric symptomatology and distress, social dysfunction, and health problems than did non-CSR veterans. We conclude that CSR should be seen as a marker for long-term psychiatric distress and impairment. In addition, the implications of combat-related trauma are broad and varied, and go beyond the narrow scope of PTSD.

Aging, Premature↗
PubMed2004

The sociocultural context of condom use within marriage in rural Lebanon.

Prevalence rates for condom use are low across the Middle East despite limited alternate contraceptive options and growing awareness of sexually transmitted diseases (STDs) and HIV/AIDS. Virtually no research exists to explain this situation and to guide policy development or effective interventions. An analysis of 25 focus-group discussions with married women and men, interviews with service providers, and a survey of 589 women of childbearing age in a rural district of southern Lebanon reveal that a broad and complex set of sociocultural factors influence condom use. In the study area, 7 percent of married women currently use condoms, 24 percent reported ever use, and inconsistent use is common. Condoms are preferred primarily for their lack of physiological side effects. Five factors were found to impede method adoption and sustained use. These include various encumbering beliefs, reduced sexual pleasure, adverse experiences, gender-related fears and tensions, and a residual social stigma attached to condoms. Several strategies are suggested to increase and improve condom use. These issues will assume greater importance as fertility declines further in the region, demand for contraception continues to increase, and STDs and HIV/AIDS become more deeply rooted, as has occurred in other parts of the world.

Adolescent↗
PubMed2006

Application of Multi Locus Sequence Typing to the analysis of the biodiversity of indigenous Saccharomyces cerevisiae wine yeasts from Lebanon.

AIMS: To assess suitability of Multi Locus Sequence Typing (MLST) for investigating the biodiversity of wine yeast strains. This method was compared with established ones like microsatellite analysis or amplification of genomic regions flanked by repeated (delta) elements. METHODS AND RESULTS: DNA fragments were amplified and sequenced for 26 loci representing housekeeping genes, open reading frames (ORFs) of unknown functions or intergenic regions. A set of seven loci was tested on 84 Saccharomyces cerevisiae strains, including 65 strains isolated from traditional wineries in Lebanon, commercial wine strains and Asian isolates. An overall sequence diversity of 2.05% was observed, consisting of single nucleotide polymorphisms, 60% of them occurring in a heterozygous state. The number of polymorphic sites per locus varied between 4 and 14. The same set of strains was analysed by microsatellite typing on six polymorphic loci and by interdelta amplification. CONCLUSIONS: Clustering of MLST profiles clearly differentiated the Asian group of strains from Lebanese and European commercial strains that appear closely related. The current MLST scheme appears less discriminatory (92.27%) on closely related wine yeasts than microsatellite or interdelta typing (>99%). SIGNIFICANCE AND IMPACT OF THE STUDY: MLST is a highly reliable method for relatedness inference and promising for wine yeast typing.

Biodiversity↗
PubMed2006

Onychomycosis in Lebanon: a mycological survey of 772 patients.

Accurate diagnosis of onychomycosis is based on clinical findings, direct microscopic investigation and mycological culture. If the diagnosis is not confirmed by culture and improvement does not occur, it is impossible to tell whether this represents treatment failure or an initial incorrect diagnosis. The aim of this study was to identify the major organisms involved in onychomycosis with emphasis on the importance of culture in treating onychomycosis. The study was performed at the Lebanese University, Beirut, Lebanon over a 5-year period (2000-2004). Clinically suspected patients were referred to our mycology laboratory for KOH test and culture. The study included 772 patients (520 women, 252 men). Cultures were positive in 54.3% of cases (predominantly male). The ratio of onychomycosis in toenails/fingernails was 1.9. In toenails, dermatophytes were found in 77.1% of cases, Candida in 18.9% and moulds in 4%. In fingernails, Candida was found in 81% of cases, dermatophytes in 18.1% and moulds in 0.9%. The most commonly isolated dermatophytes were Trichophyton mentagrophytes (36%), T. rubrum (27.5%) and T. tonsurans (26%). Pathogens involved in onychomycosis change according to each geographical area. Therefore, treatments should be based on studies carried out in the same region.

Candida↗
PubMed2006

The contact hypothesis revisited: status bias in the reduction of implicit prejudice in the United States and Lebanon.

Although 50 years of research demonstrate that friendly intergroup contact reduces intergroup prejudice, the findings are based solely on self-reported, explicit prejudice. In two parallel experiments examining intergroup contact and prejudice-between Whites and Blacks in the United States (Experiment 1) and between Christians and Muslims in Lebanon (Experiment 2)-we examined whether intergroup status differences moderate contact effects on implicit prejudice, as well as explicit prejudice. Both experiments replicated the standard effect of contact on explicit prejudice. They also demonstrated that intergroup contact reduces implicit prejudice among low-status groups. In Experiment 1, the implicit prejudice of Blacks toward Whites (but not Whites toward Blacks) was reduced as a function of friendly contact. In Experiment 2, the implicit prejudice of Muslims toward Christians (but not Christians toward Muslims) was reduced as a function of friendly contact.

Adult↗
PubMed1984

Acute viral hepatitis in Lebanon: evidence for a HAV-like non-A non-B hepatitis.

Ninety-three cases of acute viral hepatitis in adult Lebanese patients were followed-up prospectively for a period ranging from 6 to 18 months. These included 33 hepatitis A (HAV), 32 hepatitis B (HBV) and 21 non-A, non-B hepatitis (NANB) cases. The clinical and seroepidemiologic characteristics of the three types were evaluated. HAV was characterized by a short prodroma (less than 1 week) and a high IgM level. HBV did not differ from similar cases reported in the Western world except for a complete absence of male homosexuals and drug addicts as a possible route of transmission. NANB hepatitis in Lebanon is mainly a sporadic infection similar to HAV except that the prodromal phase is prolonged (greater than 14 days) and IgM levels are within normal limits. The failure to develop chronicity in NANB suggests that the virus of sporadic NANB may be different from that which causes post-transfusional (PTH) NANB.

Acute Disease↗
PubMed2006

Respiratory diseases and pesticide exposure: a case-control study in Lebanon.

STUDY OBJECTIVE: To evaluate the odds of being exposed to pesticides in asthmatic adults. DESIGN: A case-control study was performed in Lebanon. SETTING: People were approached when consulting physicians as outpatients. PATIENTS: Asthmatic patients and non-asthmatic controls in several Lebanese hospitals were interviewed. MAIN RESULTS: The study included 407 subjects from 10 medical centres. Any exposure to pesticides was associated to asthma (OR = 2.11 (1.47 to 3.02); p<10(-4)). Occupational use presented the highest association (OR = 4.98 (1.07 to 23.28); p = 0.02), followed by regional exposure (OR 3.51 (2.11 to 5.85); p<10(-4)). Results were confirmed by multivariate analysis, particularly for regional exposure (OR(a) = 2.78; p = 0.02) and house exposure (OR(a) = 2.17; p = 0.001). CONCLUSIONS: Results are comparable to those found in other studies; especially for occupational exposure. Pesticides toxicological effects may explain chronic respiratory symptoms and asthma associations found with all exposure types. Pesticide exposure was associated with asthma in Lebanese adults.

Adult↗
PubMed1982

Effect of urban versus rural residence and of maternal education on infant health in South Lebanon.

A sample of 253 women from rural and urban areas of south Lebanon were visited for 18 months after delivery. Information was collected on patterns of reproduction, infant feeding, and use of the health services. The findings indicate that educated women and women living in urban areas were better off in terms of family formation patterns, immunisation, and well-baby care. The importance of educating women, particularly in rural areas, as a policy that can be varied to improve child health and growth is thus emphasised. The study also indicates, however, the special need for health education programmes directed to all mothers to emphasise proper breast-feeding patterns and the importance of preventive health care for infants. The findings also indicate the need for a more diversified system of delivering health care in which properly trained paramedical personnel take part, particularly in rural areas.

Adult↗
PubMed2000

Impairments, disabilities and needs assessment among non-fatal war injuries in south Lebanon, Grapes of Wrath, 1996.

STUDY OBJECTIVE: To examine the impact of non-fatal war related injuries on physical disability in a group of war wounded civilians and to assess their needs. DESIGN: Cross sectional study. Home interviews were conducted using a structured interview schedule around one month after the injury, to assess impairments, disabilities, and needs. STUDY POPULATION AND SETTING: War wounded persons in towns and villages in South Lebanon during the attack "Grapes of Wrath" in 1996. RESULTS: The majority of the study population were young and in their productive age, mostly injured in the street or while hiding in open shelters. Around half of the injuries resulted in impairments, but, there were no age, gender or geographical differentials by severity of impairment. Almost one third (29%) of the students enrolled in schools at the time of the injury reported failure to continue their education and 42% of the working members lost their jobs with no potential for 34% of them to resume their former jobs. The impact of the injury on impairments, motor disabilities and physical independence was highest for injuries to the lower limbs (age and sex adjusted risk ratio (RR) 1.62, 95% confidence intervals (CI) 1.25, 2.10; 2.98, 95% CI 2.09, 4.23; and 2.13, 95% CI 1.39, 3.27, respectively). Despite the acute and early relief services provided by all those concerned at the time of the injury, when asked about unmet needs, the majority of the impaired (66%) reported the need for additional services, mostly medical in nature. The degree of disability was a salient factor for the need for rehabilitative services but not for medical services. CONCLUSIONS: The chronic and diverse needs of people with war injuries are often neglected and underestimated by the governmental institutions and relief agencies. Research funds as well as services should be allocated to tackle the long term and continuous health and social needs of those injured and their families.

Adolescent↗
PubMedDate not supplied

Glucose-6-phosphate dehydrogenase deficiency in Kuwait, Syria, Egypt, Iran, Jordan and Lebanon.

A total of 3,501 male subjects from six Arab countries living in Kuwait were investigated for quantitative and phenotypic distribution of red cell glucose-6-phosphate dehydrogenase (G6PD). The ethnic origins of those investigated were Kuwait, Egypt, Iran, Syria, Lebanon and Jordan. The distribution of G6PD deficiency among the different ethnic groups varied widely, ranging from 1.00% for Egyptians to 11.55% for Iranians. The activity of the normal enzyme was remarkably similar, with values ranging from 6.1 +/- 0.8 to 6.5 +/- 1.1 IU/g Hb. A low frequency of the Gd(A) allele was found in two ethnic groups, Egyptians (0.019) and Iranians (0.014). Gd(A-) was present at the very low frequency of 0.006 in another two ethnic groups, Kuwaitis and Jordanians.

Adolescent↗
PubMedDate not supplied

Assessing procedural pain in children with cancer in Beirut, Lebanon.

This study describes the relationship between different indicators of pain, including self-reports, behavioral observations, and physiological measures, in children with cancer undergoing invasive procedures. Forty-five children between the ages of 4 and 10 years were evaluated while undergoing Port-a-Cath access. The study was conducted in the outpatient clinics of the Children's Cancer Center in Beirut, Lebanon. Children used 2 self-report measures of pain (the Wong-Baker FACES Pain Rating Scale and an adaptation of the FACES, the DOLLS). Parents and nurses assessed the child's pain on the FACES and the child's distress on the Observational Scale of Behavioral Distress-Revised. Nurses recoded behavioral observations as well as physiological responses to pain. There was a high degree of consistency between the self-reports and moderate to high correlations between self-reports, behavioral parameters, and physiological parameters, suggesting that accurate pain assessments can be made by both nurses and parents. The results also demonstrate adequate validity and reliability of the DOLLS scale in a Lebanese population, in addition to being the preferred assessment tool for all the children in the study.

Child↗
PubMed2003

Quality of life in rural and urban populations in Lebanon using SF-36 health survey.

BACKGROUND: Measuring health status in a population is important for the evaluation of interventions and the prediction of health and social care needs. Quality of life (QoL) studies are an essential complement to medical evaluation but most of the tools available in this area are in English. In order to evaluated QoL in rural and urban areas in Lebanon, the short form 36 health survey (SF-36) was adapted into Arabic. METHODS: SF-36 was administered in a cross-sectional study, to collect sociodemographic and environmental variables as well as self reported morbidity. We analysed a representative sample containing 1632 subjects, from whom we randomly picked 524 subjects aged 14 years and over. The translation, cultural adaptation and validation of the SF-36 followed the International Quality of Life Assessment methodology. Multivariate analysis (generalized linear model) was performed to test the effect of habitat (rural on urban areas) on all domains of the SF-36. RESULTS: The rate of missing data is very low (0.23% of items). Item level validation supported the assumptions underlying Likert scoring. SF-36 scale scores showed wide variability and acceptable internal consistency (Cronbach's alpha >0.70), factor analysis yielded patterns of factor correlation comparable to that found in the U.S.A and France. Patients resident in rural areas had higher vitality scores than those in urban areas. Older people reported more satisfaction with some domains of life than younger people, except for physical functioning. The QoL of women is poorer than men; certain symptoms and morbidity independently influence the domains of SF-36 in this population. CONCLUSION: The results support the validity of the SF-36 Arabic version. Habitat has a minor influence on QoL, women had a poor QoL, and health problems had differential impact on QoL.

Adolescent↗