Acute flaccid paralysis incidence rate and epidemiology in children in Lebanon: a rise in numbers in the post-vaccination and refugee crisis era.

Background: Acute flaccid paralysis (AFP) is a clinical syndrome characterized by the acute onset of weakness and paralysis with reduced muscle tone. This study explored the incidence and different aspects of AFP in Lebanese children between 2009 and 2019. Methods: AFP data were collected from the Lebanese Ministry of Public Health. Incidence rate according to year, age groups, clinical data, follow-up, diagnosis, and vaccination status was analyzed in the 11-years period. Results: AFP incidence rates increased importantly from 0.63 per 100,000 in 2009 till 4.96 per 100,000 in 2019. Most of the patients were children under ten years of age, 40.6% of all cases were under five years old, and 37.9% were between 5 and 9 years old. Follow-up revealed that approximately two out of five patients experienced residual weakness. As for the final diagnosis, around 30% of cases were diagnosed as Guillain-Barre Syndrome (GBS). Most cases were children having received between 3 and 5 doses of polio vaccine. Conclusions: The rise in cases coincided with the Syrian refugee crisis in Lebanon and the progressively deteriorating economy in the country; yet, incidence rates were in the lower margin compared with other countries.

Ovarian cancer in Lebanese women: a 12-year comparative epidemiological study and trend analysis.

Purpose: Over the last decade, Lebanon has experienced an increase in the rate of cancer patients. The aim of this study is to investigate the incidence rates of ovarian cancer in Lebanese women over a period of 12 years and to compare them to other countries. Methods: Data were collected from the Lebanese National Cancer Registry for the time period 2005-2016 (inclusive). Data from other countries were retrieved from an online database 'Cancer Incidence in Five Continents'. The age-specific and age-standardised incidence rates (ASIR) were calculated and analysed using Joinpoint regression. Results: Ovarian cancer ranked seventh among the commonest cancers in Lebanese women in the studied time frame. Approximately 189 new cases were reported every year, with an average age-standardised incidence rate of 7.88 (per 100,000 women). Ovarian cancer showed a significantly decreasing trend in the 12 years of study. Lebanon had one of the highest ASIR for ovarian cancer among regional countries and randomly selected countries. Conclusion: Lebanon presented a high ASIR for ovarian cancer compared to regional countries, and was placed among the top ASIRs compared to countries worldwide. However, with the decreasing ovarian cancer trends, it is important to implement efficacious awareness in order to detect all OC cases.

Lebanese medical students' knowledge on and attitude toward xenotransplantation and its ethical issues: A cross-sectional study.

INTRODUCTION: Xenotransplantation is the transplantation of animal parts into humans. This study's aim is to assess the Lebanese medical students' attitude toward xenotransplantation and their knowledge of its related ethical issues. METHODS: A questionnaire was answered by 120 Lebanese medical students. Statistical analysis and ethical reflections were performed on the results. RESULTS: Out of the 120 participants, 100 already knew about xenotransplantation, and 61.7% of the students believe that it is applied clinically. Only 25% trust that the animals need to be genetically modified for the organs to be eligible for transplantation. About 25.8% and 46.7% of the students, respectively, strongly agree that the patients' and physicians' beliefs play an important role in agreeing to the procedure. Students were likely to accept the animal organ for transplantation if the transplant could completely cure or improve the course of an untreatable disease (86.6% and 75.0%) or if the outcomes and risks were the same as with a human transplant with a shorter waiting period (71.7%). Students who agreed that animal rights and welfare/wellbeing should be respected tended to disagree with the statement that it is acceptable to use animals for human ends (p = .026). CONCLUSION: Medical students proved to be knowledgeable on the ethical dilemmas related to xenotransplantation and showed a favorable attitude toward this procedure, which is crucial in its establishment as an absolute clinical reality in the near future and in the development and strengthening of research in this field.

Kidney cancer trends and risk factors in Lebanon: a 12-year epidemiological study.

PURPOSE: Lebanon has witnessed an increase in the rates of several cancer subtypes over the last years. The aim of this study is to examine the incidence rates of kidney cancer in Lebanon over 12 years and to compare them to other countries. METHODS: Data were collected from the Lebanese National Cancer Registry (NCR) for the time period 2005-2016 (inclusive). Data from other countries were retrieved from an online database "Cancer Incidence in Five Continents." The age specific and age-standardized rates (ASR) were calculated and analyzed using Joinpoint regression. RESULTS: Kidney cancer ranked as the 10th commonest cancer among men and the 19th among women. An age-standardized rate of 3.54 (per 100,000) was obtained. The average ASR was 4.80 for men and 2.27 for women. Kidney cancer showed a significantly rising trend for both genders. Lebanon had the highest ASR for kidney cancer in men and the third highest in women among regional countries. CONCLUSION: Lebanon presented an average-to-high ASR for kidney cancer compared to regional countries. However, compared to countries worldwide, Lebanon had a below-average ASR. Nonetheless, with the rising kidney cancer trends, it is important to study the associated risk factors in order to develop proper preventive and screening measures and therefore decrease the incidence rates.

Familial Mediterranean fever research activity in the Arab world: the need for regional and international collaborations.

BACKGROUND: Familial Mediterranean fever (FMF) is an autoinflammatory, multisystem disease affecting the populations of the Mediterranean basin. AIMS: The aim of this study was to assess the research input of Arab countries on FMF between 2004 and 2019. METHODS: The Medline database (PubMed) was accessed for FMF-related publications. The number of publications was normalized to average: population size, GDP and number of physicians for every country. VOSViewer was used to create a co-occurrence bibliographic map. RESULTS: Between 2004 and 2019, 69 articles relating to FMF were published in the Arab world, accounting for 0.03% of the total number of publications originating in Arab countries, and 3.60% of all articles relating to FMF worldwide. After normalizing to average population size, GDP and number of physicians, Lebanon ranked first with 4.44, 0.64 and 1.99 publications per million persons respectively. Moderate positive correlations were found between number of publications and average population size (r = 0.385) and average number of physicians (r = 0.513). Half of the articles were published in journals ranked Q1 and Q2. An abundance of keywords relating to genetics hint at a main focus on the genetic aspect of the disease. CONCLUSION: The low number of publications could be a result of the absence of research funding and the political and military instability in the Arab world. Given that many articles were published in high quality journals, Arab countries should focus on providing a clinical aspect to their studies and working on regional and international collaborations.

Epidemiology of bacterial meningitis in Lebanon from 2011 to 2019.

BACKGROUND: Meningitis is a clinical syndrome, characterized by the inflammation of the meninges, the protective tissues that envelop the brain and spinal cord. It can be due to bacterial, viraland even fungal pathogens. OBJECTIVES: This study's aim is to investigate and observe the different aspects of meningitis in Lebanon between 2011 and 2019, specifically bacterial meningitis, and compare the incidence rates to different countries. MATERIALS AND METHODS: This study is a descriptive epidemiological study. Data were collected from the epidemiological surveillance unit of the Lebanese Ministry of Public Health. Incidence according to year, months, age groups, governorates and causative agents were analyzed in the 9-years period. RESULTS: With an incidence rate of approximately 7.56 cases a year per 100,000 individuals, bacterial meningitis accounted for most of the meningitis cases from 2011 to 2019. Four of the most commonly identified bacterial pathogens were studied: Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, and Mycobacterium tuberculosis, as well as other cases of meningitis with an identified or unidentified agent. The most common identifiable pathogen was S. pneumoniae (13.06%), followed by N. meningitidis (7.09%), and H. influenzae (0.56%). CONCLUSION: The data provided by the MOPH was evaluated in order to get a better understanding of the disease and improve the plans of action towards its control and treatment. Efforts should be made to preserve and ameliorate the existing surveillance system, and to ensure that all cases of meningitis are reported and investigated in compliance with the WHO guidelines.