Awareness and intake of folic acid for the prevention of neural tube defects among Lebanese women of childbearing age.

Since the early 1990s, international recommendations have promoted folic acid supplementation during the periconception period as an effective way of preventing neural tube defects (NTDs). However, the adoption of this recommendation remains insufficient. To assess the awareness and actual intake of folic acid among married Lebanese women aged 18-45 years, a cross-sectional study was conducted among 600 women selected from all five administrative districts in Lebanon, using a multistage cluster sampling procedure. An anonymous questionnaire was completed which covered measures of knowledge and use of folate supplements, as well as demographic, socioeconomic and obstetrical factors. Sixty percent of surveyed women (60%; n = 360) had heard about folic acid. Doctors were the most frequent source of information (61.1%) but only 24.7% of women have been told of the correct period during which folic acid supplementation was useful. Overall, only 6.2% had taken folic acid tablets during the adequate period. Younger age, higher education level and stability/sufficiency of income appeared to be significant predictors of awareness among Lebanese women. Actual folic acid intake was significantly associated with younger age, higher number of pregnancies, planning the last pregnancy and having had that last one after 1990. In Lebanon, the level of folic acid awareness and adequate intake remain relatively low. Several approaches should be used to promote folic acid intake including awareness campaigns, and routine counseling by primary health care physicians on folic acid during preconception visits.

Efficacy versus abundancy: Comparing vaccination schemes.

We introduce a novel compartmental model accounting for the effects of vaccine efficacy, deployment rates and timing of initiation of deployment. We simulate different scenarios and initial conditions, and we find that higher abundancy and rate of deployment of low efficacy vaccines lowers the cumulative number of deaths in comparison to slower deployment of high efficacy vaccines. We also forecast that, at the same daily deployment rate, the earlier introduction of vaccination schemes with lower efficacy would also lower the number of deaths with respect to a delayed introduction of high efficacy vaccines, which can however, still achieve lower numbers of infections and better herd immunity.

The dynamics of COVID-19 spread: evidence from Lebanon.

We explore the spread of the Coronavirus disease 2019 (COVID-19) in Lebanon by adopting two different approaches: the STEIR model, which is a modified SEIR model accounting for the effect of travel, and a repeated iterations model. We fit available daily data since the first diagnosed case until the end of June 2020 and we forecast possible scenarios of contagion associated with different levels of social distancing measures and travel inflows. We determine the initial reproductive transmission rate in Lebanon and all subsequent dynamics. In the repeated iterations (RI) model we iterate the available data of currently infected people to forecast future infections under several possible scenarios of contagion. In both models, our results suggest that tougher mitigation measures would slow down the spread of the disease. On the other hand, the current relaxation of measures and partial resumption of international flights, as the STEIR reveals, would trigger a second outbreak of infections, with severity depending on the extent of relaxation. We recommend strong institutional and public commitment to mitigation measures to avoid uncontrolled spread.