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Background: The B.1.1.7 SARS-CoV-2 variant results in spike gene target failure (SGTF) in reverse transcription-quantitative polymerase chain reaction (RT-PCR) assays. Few studies have been published on the clinical impact of B.1.1.7/SGTF. Aim(s): To assess the incidence of B.1.1.7/SGTF and its associated clinical characteristics among hospitalized COVID-19 patients. Method(s): This observational, single-centre, cohort study was conducted between December 2020 and February 2021 and included 387 hospitalized COVID-19 patients. The Kaplan-Meier method was used for survival analysis, and logistic regression to identify risk factors associated with B.1.1.7/SGTF. Result(s): By February 2021, B.1.1.7/SGTF (88%) dominated the SARS-CoV-2 PCR results in a Lebanese hospital. Of the 387 eligible COVID-19 patients confirmed by SARS-CoV-2 RT-PCR, 154 (40%) were non-SGTF and 233 (60%) were B.1.1.1.7/SGTF;this was associated with a higher mortality rate among female patients [22/51 (43%) vs 7/37 (19%);P = 0.0170]. Among patients in the B.1.1.7/SGTF group, most were aged >= 65 years [162/233 (70%) vs 74/154 (48%);P < 0.0001]. Independent predictors of B.1.1.7/SGTF infection were hypertension (OR = 0.415;CI: 0.242-0.711;P = 0.0010), age >= 65 years (OR = 0.379;CI: 0.231-0.622;P < 0.0001), smoking (OR = 1.698;CI: 1.023-2.819;P = 0.0410), and cardiovascular disease (OR = 3.812;CI: 2.215-6.389;P < 0.0001). Only non-SGTF patients experienced multi-organ failure [5/154 (4%) vs 0/233 (0%);P = 0.0096]. Conclusion(s): There was a clear difference between the clinical features associated with B.1.1.7/SGTF and non-SGTF lineages. Tracking viral evolution and its clinical impact is crucial for proper understanding and management of the COVID-19 pandemic.Copyright © Authors 2023.
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This cross-sectional study evaluated digital health literacy (DHL) and web-based information-seeking behavior of Lebanese university students. A total of 602 students (60.1% female), 21.5 years (±4.1), participated in May-August 2020 in an online survey. We found that 76.2% used the Internet, in the past month, for COVID-19-related information. Those with a chronic health impairment more often had limited DHL for adding self-generated content (OR=0.448;95 % CI=0.185, 1.085) and for determining relevance (OR=0.276;95 %CI=0.114-0.670). Students in graduate studies had higher odds of having sufficient DHL for adding self-generated content (OR=2.328;95 % CI=1.104, 4.909) and evaluating reliability (OR=2.318;95 % CI=1.149, 4.679). Users of official sources of information had higher odds (OR=1.665;95 % CI=1.065, 2.605) of having sufficient DHL for adding self-generated content. Regular users of social media had lower odds (OR=0.576;95 % CI=0.358, 0.928) of having sufficient DHL for evaluating reliability. Self-efficacy, in this case one's potential to accomplish a search for reliable health information and adopt it in daily life, could improve with DHL. As such, health education needs to strengthen DHL competencies in university students, particularly among undergraduates, those relying on social media, and those with an existing health impairment © Copyright 2023 Author(s). This is an open access article distributed under the terms of the Creative Commons CC-BY 4.0 License (https://creativecommons.org/licenses/by/4.0/)
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Background: The World Health Organization has often reiterated its recommendations for the prevention of COVID-19, however, the success of these measures largely depends on public knowledge and attitudes. Aim(s): This study assessed the relationship between knowledge, attitude, behaviour and preventive measures for COVID-19 infection in a Lebanese population. Method(s): This cross-sectional study was conducted between September and October 2020 using the snowball sampling technique and an online self-administered questionnaire. The questionnaire had 4 parts targeting sociodemographic characteristics;medical history;knowledge, attitude and practices (preventive measures and behaviours related to COVID-19);and mental health variables such as psychological distress. Two models were derived using multivariable binomial logistic regression to optimize the picture of COVID-19 correlates. Result(s): Our sample comprised 1119 adults. Being older, female, a regular alcohol consumer, waterpipe smoker, having low level of education, low family income, and having contact with a COVID-19 patient correlated with increased odds of ever having been diagnosed with COVID-19. Participants who had ever been diagnosed with COVID-19 had a significantly better knowledge and a higher risky practice scale [adjusted odds ratio (ORa) = 1.49;95% CI 1.27-1.74;P < 0.001;and ORa = 1.04;95% CI 1.01-1.08;P = 0.024, respectively]. Conclusion(s): The most important predictors of COVID-19 infection appear to be generally well-known among the general population, however, their knowledge and adherence to preventive measures should be continuously re-evaluated. This study highlights the need for greater awareness to improve precautionary behaviours among the public.Copyright © Authors 2023.
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Intro: The COVID-19 pandemic remains a public health problem threatening national and global health security. Early during the pandemic, countries and governments including Lebanon declared states of emergency and imposed strict public health measures including national lockdowns and nonpharmaceutical interventions (NPIs) to reduce the spread of the virus. Lebanon has been struggling with plethora of challenges at the social, economic, financial, political and healthcare levels before the start of the pandemic in the country in February 2020. Method(s): The aim of this study is to advance the evolution of the COVID-19 epidemiology in Lebanon pre- and post-vaccination as well as the gaps and challenges affecting recovery and response. We will present the evolution of total number of cases, PCR positivity rates, case-fatality rates an hospitalizations. Finding(s): We present the evolution of the clinical and melocular epidemiology of COVID-19 in Lebanon, national response prior and following the introduction of COVID-19 vaccines and the impact of the latter on the course of the pandemic in Lebanon, national challenges and successes as well as the need to reimagine a national health strategy. The COVID-19 pandemic revealed the vulnerability, gaps and needs of the Lebanese health infrastructure including epidemiologic surveillance, genomic surveillance, integrated and concerted data sharing, diagnostic capacity, community mobilization and risk communication. Conclusion(s): The COVID-19 pandemic has been an eye opener about the need to invest in systemic and equal improvement in national health strategies. This is key to prevent future pandemics and to protect global health security. National and international coordinated strategies for emergency preparedness, response and recovery are critically needed in order to support the continuous monitoring of potential threats. The national commitment to these important inherent components of a rapid response requires investment in human and technical expertise to reduce inequality in access to information and care.Copyright © 2023
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Background: The One Health concept (OHC) seeks to improve the health of plants, animals, and humans because improving animal and plant health will increase the capacity for improving human health. Many risks such as plant and animal biotechnology applications have the potential to generate new diseases that can be transmitted to humans. In this way, the health of humans, animals, and plants is interrelated and depends on one another. However, it has been difficult to apply the OHC in some countries, such as those in the Middle East. The absence of financial support in the region is a major hindrance to applying this concept in the region. The application of the OHC requires the support of specialists who can advocate the government for support in launching OHC-related projects. Here, we discuss the OHC in the context of antimicrobial resistance, zoonotic diseases, and biosafety/biosecurity, which are important public health issues. Furthermore, we describe the current status of the OHC in the Middle East and recent research conducted related to this concept. There has been recent international solidarity in the application of the OHC to reduce risks that threaten the health of organisms. Several countries jointly launched the Global Health Security Agenda in 2014 with the aim of realizing a world that is free of infectious disease-related health risks. However, no previous review articles have examined the applications of the OHC in the Middle East region. This article discusses the OHC in terms of its needs and current applications in the Middle East. Methodology: The following keywords were used in the search: "One Health," "Middle East," "medicinal plants," "viruses," "rabies," "MERS," and "antimicrobial resistance." Related papers were obtained by searching for these keywords using available search engines, such as PubMed, Google Scholar, and Google search, as well as international organization websites. Conclusion(s): The concept of One Health is relatively new and has not been applied in most countries, possibly because the value of this concept for improving human health is not well understood. The key principle defining this concept and its importance is the interdependency of plants, animals, and human health. By applying the OHC, humans can benefit from healthy plants and animals by enhancing their growing conditions, medications, and environments. This would in turn improve general human health by allowing the safe extraction of therapeutics and food resources.Copyright © 2023
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Smartphone usage in Lebanon is increasing constantly. Lebanese population especially university students were described to be at a higher risk of smartphone addiction compared to the general population. To our knowledge there has been no study in the literature that investigated the mediating effect of self-esteem when assessing personality traits and smartphone addiction in young adults. The aim of our study was to assess factors associated with smartphone addiction and investigate the mediating role of self-esteem in the association between smartphone addiction and personality traits. A cross-sectional study was carried out between August and September 2020, during the lockdown period imposed by the government for the COVID-19 pandemic and that coincides with the summer season vacation for most Lebanese, using a sample of community-dwelling participants aged 18 to 29 years. The snowball technique was followed for participants' recruitment. The results showed that the mean age of the participants was 22.25 ± 2.87 years, with 70.9% females. The results showed that 216 (46.9%) of the participants had smartphone addiction. Higher negative emotionality (Beta = 0.17) was significantly associated with more smartphone addiction, whereas higher self-esteem (Beta = -0.37) and household crowding index (Beta = -1.58) were significantly associated with less smartphone addiction. Self-esteem mediated the association between negative emotionality and smartphone addiction. Lebanese young adults were found to be at a high risk of smartphone addiction. These results might serve as a first step towards implementing preventive measures to reduce smartphone addiction. Improving face to face communication, as well as setting specific time for cell phone usage might help reduce the development of addictive behaviors.
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Objectives: Long COVID syndrome, the poorly defined illness, has been increasingly mentioned in recent studies yet is still poorly understood especially when it comes to precipitating and modulating factors, the high prevalence of mental health problems associated with the COVID-19 pandemic has brought to light the hypothesis of the existence of a psychological component associated with the persistence of symptoms and if vaccination may serve as a modulating factor. This study aims to examine the prevalence of somatization disorders and association between persistent COVID-19 symptoms and COVID-19 vaccine with somatization among a sample of the Lebanese general population. Methods: A cross-sectional study was carried out between September and October 2021. The snowball sampling technique was picked to choose a sample that addressed all Lebanese Mohafazat. Patient Health Questionnaire-15 (PHQ-15) was used to assess somatization. Results: A total of 403 participants was enrolled in this study, with a mean age of 32.76 ± 13.24 years, 108 (26.8%) had medium somatization symptoms (PHQ-15 scores ≥10). Having persistent COVID symptoms (ß=2.15) was significantly associated with more somatization, whereas the intake of COVID vaccine (ß=-1.17) was significantly associated with less somatization. Conclusion: Long lasting COVID-19 symptoms were closely related to somatization, although the administration of the COVID-19 vaccine was associated with less somatization. However, further studies are needed to provide a better understanding of the relationship between long COVID and somatization, on one hand, and the modulating factors on the other hand.
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BACKGROUND: In 2020, Lebanon has witnessed its worst economic crisis, exacerbated by the COVID-19 pandemic and a massive explosion of its capital. Amidst these stressors, this study aims at assessing the prevalence of depression, anxiety, suicidality, post-traumatic stress disorder (PTSD) and cognitive impairment in patients undergoing hemodialysis in an academic hospital destroyed by the explosion. METHODS: This cross-sectional study conducted 6 months after the blast included adults on hemodialysis, with no previous diagnoses of dementia or intellectual disability. It explores prevalence rates of psychiatric disorders, in addition to other medical and psychosocial variables such as frailty, malnutrition, sarcopenia, quality of life and religiosity. RESULTS: Forty two patients (mean age 66.1; SD: 11.2 years) undergoing hemodialysis for 6.12 years (SD:7.22 years) were included. Anxiety and depression rates reached 54.8% and 57.1% using cut-offs of 6 and 7 respectively on the Hospital Anxiety and Depression rating Scale. 9.5% of the patients reported being in the hospital at the time of the blast and 7.1% reported being injured. 33.3% screened positively for PTSD using a cut-off of 23 on the PCL-5. 26.2% had passive death wishes and 7.1% had suicide plans, however no one had attempted it. 23.8% were found cognitively impaired as shown by the Mini-Cog (<3). Around two-third of participants were moderately to severely malnourished per the GLIM criteria. One third suffered from frailty, according to the FRAIL screening tool. Around 60% suffered from sarcopenia, based on handgrip strength measures. These findings contrast with "acceptable to good" quality of life subjectively reported by participants on the Short Form 36 (SF-36) Health Survey. While one-third of participants participated in organizational religious activities, 88% reported significant subjective meaning of religion in their heart. CONCLUSIONS: Rates of depression, anxiety, PTSD, suicidality, and cognitive impairment were found to be alarming in the setting of an urban dialysis unit following a major explosion. Psychiatric disorders were found to be compounded with increased prevalence of malnutrition, frailty, and sarcopenia. These findings urge healthcare providers to implement early diagnostic and intervention strategies to improve both mental and physical wellbeing of this vulnerable population, in similar settings.
Subject(s)
COVID-19 , Frailty , Sarcopenia , Stress Disorders, Post-Traumatic , Adult , Humans , Aged , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , Cross-Sectional Studies , Pandemics , Depression/diagnosis , Depression/epidemiology , Quality of Life , Frailty/epidemiology , Hand Strength , Sarcopenia/epidemiology , COVID-19/epidemiology , Anxiety/diagnosis , Anxiety/epidemiology , Renal DialysisABSTRACT
Background and Objectives: Due to their weakened immune response, hemodialysis (HD) patients with latent tuberculosis infection (LTBI) are at higher risk for active tuberculosis (TB) disease and are more subject to patient-to-patient transmission within dialysis units. Consequently, current guidelines advocate screening these patients for LTBI. To our knowledge, the epidemiology of LTBI in HD patients has never been examined before in Lebanon. In this context, this study aimed to determine LTBI prevalence among patients undergoing regular HD in Northern Lebanon and to identify potential factors associated with this infection. Notably, the study was conducted during the COVID-19 pandemic, which is likely to have catastrophic effects on TB and increase the risk of mortality and hospitalization in HD patients. Materials and Methods: A multicenter cross-sectional study was carried out in three hospital dialysis units in Tripoli, North Lebanon. Blood samples and sociodemographic and clinical data were collected from 93 HD patients. To screen for LTBI, all patient samples underwent the fourth-generation QuantiFERON-TB Gold Plus assay (QFT-Plus). Multivariable logistic regression analysis was used to identify the predictors of LTBI status in HD patients. Results: Overall, 51 men and 42 women were enrolled. The mean age of the study population was 58.3 ± 12.4 years. Nine HD patients had indeterminate QFT-Plus results and were therefore excluded from subsequent statistical analysis. Among the remaining 84 participants with valid results, QFT-Plus was positive in 16 patients, showing a positivity prevalence of 19% (95% interval for p: 11.3%, 29.1%). Multivariable logistic regression analysis showed that LTBI was significantly associated with age [OR = 1.06; 95% CI = 1.01 to 1.13; p = 0.03] and a low-income level [OR = 9.29; 95% CI = 1.62 to 178; p = 0.04]. Conclusion: LTBI was found to be prevalent in one in five HD patients examined in our study. Therefore, effective TB control measures need to be implemented in this vulnerable population, with special attention to elderly patients with low socioeconomic status.
Subject(s)
COVID-19 , Latent Tuberculosis , Male , Humans , Female , Aged , Middle Aged , Latent Tuberculosis/epidemiology , Latent Tuberculosis/complications , Latent Tuberculosis/diagnosis , Renal Dialysis , Prevalence , Cross-Sectional Studies , Pandemics , COVID-19/epidemiology , COVID-19/complicationsABSTRACT
AIM: On August 4, 2020, a massive explosion hit Lebanon's capital city, Beirut. The aim of this study was to explore the effect of the Beirut blast on the COVID-19 situation in the country. SUBJECT AND METHODS: Data on COVID-19 were retrieved from the Lebanese Ministry of Public Health (LMOPH), where all the COVID-19 positive cases were reported. The study was divided into two periods, considering the incubation period of the COVID-19 virus: (July 27-August 9, 2020) and (August 10-23, 2020). Information obtained included daily number of cases, tests, deaths, hospitalized patients, intensive care unit (ICU) patients, and mode of acquisition (local vs. expat). Daily positivity rates were reported per 100 tests. An independent sample t-test and a Joinpoint regression analysis were used to determine significance. A p value less than 0.05 was considered significant. RESULTS: A total of 201,010 tests were conducted during our studied period, with 8993 positive cases, constituting a total positivity rate of 4.5 per 100 tests. Case fatality rate over the studied period was 0.8%. The positivity rate of the period prior to August 10, 2020, was 2.7 per 100 tests, significantly less than that of the period following the explosion, which was 6.4 per 100 tests (p < 0.001). During our studied period, daily positivity rates were significantly increasing at a slope of 0.29 (p < 0.001). A significant increase in slope was noted on August 13, 2020 (p < 0.001). The number of hospitalized patients increased from 139 patients on July 27 to 266 on August 23, 2020, and that of ICU patients increased from 36 to 75. CONCLUSION: The port of Beirut explosion resulted in a significant increase in the daily number of positive COVID-19 cases. The aftermath of the explosion, the damage to healthcare facilities, and the overcrowding due to emergency efforts were contributing factors to that increase.