Assessment of Industrially Produced Trans Fatty Acids in Traditional Dishes, Arabic Sweets, and Market Food Products and Its Risks on Non-communicable Diseases in Lebanon.

Industrially produced trans fatty acids (IP-TFAs) are a major dietary contributor to non-communicable diseases worldwide. To address the industrially produced trans fatty acids food sources in Lebanon, a mapping exercise was enrolled between January 2019 and April 2021 to establish a national database. The 2019 survey was a pooled data from five separate sources and had relatively 30 types of traditional dishes. In contrast, the subsequent surveys in 2020 had a sample of 35 types of Arabic sweets and 80 types of market food products. The 2021 survey covered all types of butter and margarine available in the Lebanese markets. Our findings show that about 93% of the products tested in Lebanon, between 2019 and 2021, met the World Health Organization recommendations, while about 7% exceeded the limit. The mean level of the IP-TFAs elaidic and linolelaidic acids in most traditional dishes (0.9%), Arabic sweets (0.6%), butter, and margarine (1.6%), and market foods (0.52%) were relatively low compared with other countries. Although trans fatty acids have a small impact on heart disease mortality in Lebanon, they are unquestionably significant. The persistence of food products with high quantities of trans fatty acids poses a health risk to Lebanese citizens. Fortunately, proper laws in Lebanon can easily remedy this situation.

Vaccination coverage in Lebanon following the Syrian crisis: results from the district-based immunization coverage evaluation survey 2016.

BACKGROUND: Following the Syrian crisis, a substantial influx of Syrian refugees into Lebanon posed new challenges to optimal vaccination coverage for all children residing in the country. In 2016, the district-based immunization coverage evaluation survey (CES) assessed routine immunization coverage at the district level in Lebanon among children aged 12-59 months. METHODS: A cross-sectional multistage cluster survey was conducted in all of Lebanon (with the exception of the Nabatieh district) using the World Health Organization (WHO) recommended Expanded Programme on Immunization (EPI) methodology adapted to the local context. A survey questionnaire consisting of closed and open-ended questions concerning demographic information and the child's immunization status was administered to collect immunization status information. RESULTS: Among surveyed children aged 12-59 months, irrespective of nationality, vaccination coverage at the national level for any recommended last dose was below the targeted 95%. Generally, vaccination coverage levels increased with age and were higher among Lebanese than Syrian children. However, large variations were revealed when coverage rates were analyzed at the district level. Vaccination was significantly associated with nationality, age, mother's educational status and the place of vaccination. Common reasons for undervaccination included the child's illness at the time of vaccine administration, vaccination fees, lack of awareness or a doctor's advice not to vaccinate during campaigns. CONCLUSIONS: Substantial variability exists in vaccination coverage among children aged 12-59 months residing in different districts in Lebanon. Immunization coverage reached 90% or above only for the first doses of polio and pentavalent vaccines. A considerable dropout rate from the first dose of any vaccine is observed. Efforts to optimize coverage levels should include increased vaccination initiatives targeting both refugee children and children from vulnerable host communities, increased cooperation between public and private vaccine providers, improved training for vaccine providers to adhere to complete vaccine administration recommendations, and increased awareness among caregivers.

Influenza-associated severe acute respiratory infections in 2 sentinel sites in Lebanon-September 2015 to August 2016.

BACKGROUND: Given the sparse information on the burden of influenza in Lebanon, the Ministry of Public Health established a sentinel surveillance for severe acute respiratory infections (SARI) to identify the attribution of influenza to reported cases. We aim to highlight the proportion of influenza-associated SARI from September 1st, 2015 to August 31st, 2016 in 2 Lebanese hospitals. METHODS: The study was conducted in 2 sentinel sites located in Beirut suburbs and southern province of Lebanon. WHO's 2011 standardized SARI case definition was used. Data from September 1, 2015 to August 31, 2016 were reviewed, and all-cause hospital admission numbers were obtained. Nasopharyngeal swabs were collected and tested by RT-PCR. Descriptive and bivariate analyses were conducted using STATA 13. RESULTS: The 2 sentinel sites reported 746 SARI cases during the studied time frame: 467 from the southern province site and 279 from the Beirut suburbs site. SARI reports peaked between January and March 2016. All, except 4, cases were sampled, and a co-dominance of influenza B (43%) and influenza A (H1N1) (41%) was evident. A high proportion of cases was reported in children <2 years 274 (37%). The proportional contribution of influenza-associated SARI to all-cause hospital admissions was high in children <2 years in the south (4.5% [95% CI: 3.1-6.5]) and in children <5 years in Beirut (0.7% [95% CI: 0.6-0.8]). CONCLUSION: This is the first study to highlight the proportion of influenza-associated SARI in 2 hospitals in Lebanon. The findings will be beneficial for supporting respiratory prevention and immunization program policies.

Time Trends and Policy Gaps: The Case of Alcohol Misuse Among Adolescents in Lebanon.

BACKGROUND: Monitoring studies are crucial for informing and reforming local policies. OBJECTIVES: Using the Lebanon 2005 and 2011 Global School-based Student Health Surveys (GSHS), alcohol time trends were described, policy gaps were identified, and harm reduction policy recommendations were made. METHODS: In 2005 and 2011, 100 (n = 5109 students) and 44 (n = 2784 students) middle schools were surveyed, respectively. Self-reported cross-sectional data on alcohol use among 7-9th graders in private and public schools was collected including 30-day prevalence, lifetime drunkenness, alcohol-related problems, and sources of alcohol. RESULTS: In 2011, the majority (87%) had alcohol before turning 14. Between 2005 and 2011, past 30-day alcohol use had increased by 40% and lifetime drunkenness by 50% in the total sample (122% among females with a narrowing in the gender gap). Drinking was regular for more than a third of the past 30-day drinkers (drank two or more drinks on the days they drank). Male adolescents were more likely to obtain alcohol from "stores" or "through their friends" whereas females' main source was their "family." One in twenty reported experiencing alcohol-related problems (e.g., getting into fights with family/friends and skipping school). Conclusion/Importance: Evidence-informed policy implications include enforcing a minimum legal drinking age, regulating alcohol advertising, and marketing particularly those targeting youth and women, and ensuring the availability of youth-friendly services. Public messages to increase awareness among all stakeholders including youth, their parents, and larger community are also needed.