Hyperreactive airway disease in adults Data from a national study in Lebanon

Background: Asthma and hyperreactive airway [HRA] disease are a major cause of health resource utilization and poor quality of life worldwide; its prevalence in adults may widely vary according to the definition used. It is mainly a childhood disease, but its natural history till adulthood is not well known. This is due to other confounding factors such as smoking and environmental factors that may lead to misdiagnose asthma as chronic obstructive pulmonary disease. Correct and timely diagnosis of asthma and HRA is important because it can be treated successfully and affected individuals may achieve good control of their disease

Objective: To evaluate the prevalence of asthma and HRA in Lebanese adults, their symptoms and predictors

Methods: A cross-sectional study using a multi- stage cluster sample was carried out in Lebanon, between October 2009 and September 2010. Lebanese residents aged 40 and above participated to the study; a post-bronchodilator spirometry was performed to con- firm diagnosis

Results: Out of 2201 individuals, 218 [9.9%] were considered to have HRA. The following factors were found associated with HRA in the Lebanese population: Northern [ORa: 3.54] and Bekaa Plain [ORa: 2.44]] ver- sus other regions; occupational exposure to toxic gases and fumes [ORa: 2.08]; heating home with wood [ORa:1.75]; having a family history of chronic respiratory dis- ease [ORa: 2.19], a history of childhood lung problem [ORa: 5.53], and father smoking during childhood [ORa:1.47]. Added to these factors, HRA was also predicted by female gender [ORa: 1.81]; lower education [ORa: 1.20]; older age [ORa: 1.28] and low birth weight [ORa: 3.14]

Conclusion: This is the first epidemiological study in Lebanon that determined physician diagnosed asthma prevalence and hyperreactive airway disease and their associated factors among Lebanese adults. It also provides useful contributions that local health organizations may use for national programming and a foundation for health researchers to pursue further study in asthma research. Public awareness about the increased risk of asthma associated with heating homes with wood and exposure to passive smoking should be raised; Lebanese policy makers should also generate higher efforts to implement and reinforce the smoking ban law in public places

Lung cancer correlates in Lebanese adults: a pilot case-control study

Lung cancer is one of the most prevalent types of cancers. However, there are no epidemiological studies concerning lung cancer and its risk factors in Lebanon. This study was carried out to determine the association between lung cancer and its most common risk factors in a sample of the Lebanese population. A hospital-based case - control study was conducted. Patients were recruited in a tertiary health care center. A questionnaire in Arabic was designed to assess the possible risk factors for lung cancer. For females, cigarette smoking [ORa = 9.76] and using fuel for heating [ORa = 9.12] were found to be the main risk factors for lung cancer; for males, cigarette smoking [ORa = 156.98], living near an electricity generator [ORa = 13.26], consuming low quantities of fruits and vegetables [ORa = 10.54] and a family history of cancer [ORa = 8.75] were associated with lung cancer. Waterpipe smoking was significantly correlated with lung cancer in the bivariate analysis. In this pilot study, it was found that in addition to smoking, outdoor and indoor pollution factors were potential risk factors of lung cancer. Additional studies would be necessary to confirm these findings

Cigarette smokers' profile in Lebanese adults

The objective of this study was to describe cigarette smoking prevalence among adults in Lebanon and to evaluate the profile of light cigarette smokers compared to never and heavy smokers. Data were taken from a cross-sectional study carried out from October 2009 to Septem-ber 2010, using a multistage cluster sampling all over Lebanon. Lebanese residents aged 40 years and above were enrolled in the study with no exclusion criteria. After an oral informed consent, subjects answered a questionnaire, including detailed smoking history and cigarette dependence. SPSS version 17.0 was used for data analysis. Out of 2201 individuals, 1320 [60.0%] had ever smoked cigarettes, out of whom 10.1% were light cigarette smokers. The adjusted odds ratio estimate of cigarette smoking was 3.08 for males compared to females [P<0.001], 1.13 for lower education [P=0.016], 1.87 and 3.12 for re-tired and jobless compared to working [P=0.001 and P<0.001] respectively, 1.17 for older age [P<0.001], 1.68 for presence versus absence of a family history of chronic respiratory disease [P<0.001], and 5.27 and 1.99 for presence compared to absence of at least one smoker at home [P<0.001] and at work [P < 0.001] respectively. This is the first epidemiological study in Lebanon that determined cigarette smoking prevalence at the national level. In Lebanon, males of the older generation seem to have higher smoking prevalence and dosing.

Symptoms, severity and asthma control in 5-14 Y-old lebanon school children

This study addressed symptoms' profile, severity and determinants of asthma control in school-aged patients [5-14 y] across Lebanon. It is a cross-sectional study, applied on school children with physician-diagnosed asthma [PDA], divided into two groups: those who were on controllers [C+] and those who were not [NC. Out of 5544 children, 275 [4.96%] had PDA. The C+ group [32.7%] had higher mother's education than the NC group [45.9%] [p = 0.037]. NC children were more frequently found in public versus private schools [p = 0.0001]. Higher frequencies of regular visits to the doctor were noted in the C+ compared to NC group. In C+ group, 90% were on reliever and controller, and 10% just on one controller. A trend for more severity in the C+ group was noted compared to the NC group. An impact of asthma on daily activities was reported by 40% in the C+ group versus 34% in the NC group. Treatment of PDA in 5-14 y school children was quite adapted according to the recom-mendations. However, total control was reported in low percentages of patients reflecting universal discrepancy between evidence base medicine and real life

Asthma, allergic rhinitis and eczema in 13-14-year-old schoolchildren across Lebanon

Childhood asthma is one of the most important diseases of childhood. There is no known prevalence of asthma and allergic diseases in Lebanon. This study was conducted with a primary objective of finding the prevalence of asthma, allergic rhinitis and eczema in Lehanese children. It is a descriptive cross-sectional study on children in Lehanese public and private schools. A sample of 22 schools participated in the study, where standardized ISAAC written core questionnaires were distributed. 13-14-year-old students filled in the questionnaires in class. 1613 individuals were analyzed. The prevalence of diagnosed asthma [5.6%] is the lowest in Lebanon compared to the eastern Mediterranean countries. Prevalence of ever wheezing [21.4%] last 12 months wheezing [19.9%] wheezing on effort [12.7%] night cough [22.8%] * allergic rhinitis [32.7%] and eczema [11.5%] is on the medium prevalence trend noted all over the world, referring to ISAAC study. It also showed marked variations and differences across the governates in Lebanon, the lowest prevalence of diagnosed asthma [1.9%] but the highest prevalence of asthma symptoms like ever wheezing being in the Bekaa governate [26.8%]. Undiagnosed asthma, rhinitis and eczema have medium prevalence in Lebanon. Differences exist between Lebanese governates. Further studies are needed to understand the environmental, climate and socioeconomic causes of these discrepancies