Health care workers' exposure to blood-borne pathogens in Lebanon.

BACKGROUND: Accidental exposure to blood-borne pathogens (BBPs) is a risk for health care workers (HCWs). AIM: To study the pattern of occupational exposure to blood and body fluids (BBFs) at a tertiary care hospital. METHODS: This study reports a 17-year experience (1985-2001) of ongoing surveillance of HCW exposure to BBFs at a 420-bed academic tertiary care hospital. RESULTS: A total of 1,590 BBF exposure-related accidents were reported to the Infection Control Office. The trend showed a decrease in these exposures over the years with an average +/- standard error of 96 +/- 8.6 incidents per year. In the last 6 years, the average rate of BBF exposures was 0.57 per 100 admissions per year (average of needlestick injuries alone was 0.46 per 100 admissions). For 2001, the rates of exposure were found to be 13% for house officers, 9% for medical student, 8% for attending physicians, 5% for nurses, 4% for housekeeping, 4% for technicians and 2% for auxiliary services employees. The reason for the incident, when stated, was attributed to a procedural intervention (29%), improper disposal of sharps (18%), to recapping (11%) and to other causes (5%). CONCLUSIONS: The current study in Lebanon showed that exposure of HCWs to BBPs remains a problem. This can be projected to other hospitals in the country and raises the need to implement infection control standards more efficiently. Similar studies should be done prospectively on a yearly basis to study rates and identify high-risk groups.

Prevalence of hepatitis B in a presumably healthy Lebanese population.

OBJECTIVE: Policy makers need data on the prevalence of infection with HBV in order to determine the cost effectiveness of universal immunization against hepatitis B. This study aims at determining the prevalence rate of infection with HBV in a basically healthy group of Lebanese adults. METHODS: Sera from 2634 presumably healthy Lebanese individuals, mean age 32.1 years, obtained between 1995-1997, were tested for hepatitis B surface antigen (HBsAg). The sample was composed of subjects residing in different areas in Lebanon. Detection of HBsAg was performed utilizing the ELISA technique. The analysis took place in the Clinical Microbiology Laboratory, Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon. Chi-square test was used to examine statistical associations. RESULTS: The prevalence of HBsAg among the samples was 1.6%. Blue-collar employees, smokers and those living in the South of Lebanon were significantly more likely to be infected with hepatitis B virus. CONCLUSIONS: The data presented indicates that Lebanon has a low prevalence of HBV infection. Costeffective studies are needed to justify universal iminunization against hepatitis B especially in countries where budgets are tight.

Reversible encephalopathy secondary to paratyphoid infection and concomitant acute Hepatitis A.

Reversible encephalopathy has been described in association with typhoid fever as well as nontyphoidal salmonella infections. A diagnostic dilemma as to the cause of encephalopathy may arise when there is coexistent acute viral hepatitis and suspicion of fulminant liver failure. The authors report a patient who presented with acute icteric hepatitis A infection and a concomitant febrile illness due to Salmonella paratyphi associated with progressive encephalopathy and coma. The young man developed high-grade fever and coma. Concomitant infection with S. paratyphi was diagnosed and the patient's encephalopathy resolved rapidly with antibiotic therapy. This is the first report of a putative association of S. paratyphi infection and reversible encephalopathy. Salmonella and hepatitis A virus infection are both transmitted via the fecal-oral route, and awareness of this association is important in the management of such patients.

Intestinal parasites among presumably healthy individuals in Lebanon.

OBJECTIVE: To determine the prevalence period of intestinal parasites among presumably healthy subjects in Lebanon. METHODS: One stool specimen from 2634 presumably healthy Lebanese subjects, mean age 32.1 years with a range of 14-71 years, resident of different areas in Lebanon was examined for the presence of parasites. The analysis took place in the Clinical Microbiology Laboratory, Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon, over 25-months between 1995-1997. RESULTS: The prevalence of intestinal parasites was 12.4%. The most common parasites identified were Entamoeba coli (38%), Giardia lamblia (3.1%) and Entamoeba histolytica (2.3%) [corrected]. CONCLUSION: The data presented shows the need to improve hygienic conditions to contain the problem of intestinal infections with parasites in Lebanon.

Evaluation and management of selected sexually transmitted diseases.

Sexually transmitted diseases (STDs) represent some of the oldest and most prevalent infectious diseases of humans. Currently and with changes in lifestyles, the short list of STDs has grown to currently comprise 21 different infections and infestations. In this review, we concentrate on those infections that are common and which require special approach and handling. Gonorrhea and nongonococcal urethritis comprise more than half of STDs. The approach and management of these patients is briefly outlined. The important role contact tracing and education play in improving preventive practices of these infections is emphasized. Syphilis is presented in a simplified approach touching on presentation, diagnosis and treatment.

Knowledge, attitude, and behavior of students regarding 'mad cow disease'.

The aim of the current study is to assess the knowledge, attitude and behavior of students enrolled at the American University of Beirut (AUB) in Lebanon, towards mad cow disease (MCD). Three hundred and fifty-six students (199 males and 157 females), ranging in age between 17 and 25 years were randomly selected from various majors and were asked to fill out a self-administered questionnaire. It was found that 99.7% of students had heard about MCD and 85.8% knew that the cow is the host for bovine spongiform encephalopathy (BSE). Seventy five percent reported that animals contract the disease through the consumption of meat and bone meal. Thirty-seven percent wrongly believed that MCD cases were reported in Lebanon and 89% were not satisfied with the measures undertaken by the Lebanese government to curb the disease. Eighty four percent were concerned about the disease and 72% stated having modified their eating habits accordingly. Moreover, students majoring in biology and other health-related majors knew significantly more about MCD compared with students majoring in non-health related majors. A surprising finding was that females were more likely to modify their eating habits than males. Hence, this study provides an insight into the knowledge, attitude, and behavior of AUB students towards MCD. A limitation of this study is that our sample is not representative of all university students in Lebanon. Future surveys should also target students enrolled in other universities in the country.