Seroprevalence of brucellosis in sheep and goats from Al Jufrah district in Libya.

Introduction: brucellosis is a global neglected zoonotic disease affecting mainly livestock, causing communicable and zoonotic infections. This study aimed to investigate the seroprevalence and determine epidemiological risk factors associated with Brucella infection in sheep and goats in Al Jufrah central district of Libya. Methods: sera samples from 555 animals (goats (n=320) and sheep (n=235)) sheep) were obtained and subjected to the Rose Bengal Plate Test (RBPT) then further confirmed by a validated Enzyme Linked Immunosorbent assay (ELISA). Collected data was analyzed using Statistical Package for the Social Sciences (SPSS). Results: in total, 2.7% were ELISA seropositive for brucellosis with the highest seropositivity rate among the studied animals from Sokna with 5.8% (n=13/225) followed by 0.7% (n=2/285) in Waddan and 0% (n=0/45) in Houn. Only location was identified as a significant risk and no significant differences were identified between seropositivity and the age studied groups, species of animals, gender, and size of farms (p-value>0.05). Conclusion: the present study provides important information on the epidemiological status of Brucella infection in an important region in North Africa. Prevention control systems adopting "One Health" concept, and regional and international collaboration are important to control brucellosis and other zoonotic and transboundary diseases.

Epidemiological manifestations and impact of healthcare-associated infections in Libyan national hospitals.

BACKGROUND: Healthcare-associated infection is a serious global problem, particularly in developing countries. In North African countries, comprehensive research on the incidence and effects of such infections is rare. This study evaluated the epidemiology and determined the impact of healthcare-associated infections in Libyan national teaching hospitals. METHODS: A prospective longitudinal study was carried out in Libya's four largest teaching and referral hospitals (Tripoli Medical Center, Tripoli-Central Hospital, Benghazi Medical Center, and Sabha Medical Center) from November 1, 2021, to October 31, 2022. The epidemiological events and the parameters incorporated in this study were based on the data published by the Libyan Centers for Disease Control. The surveillance was carried out on all patients admitted to the wards of medicine, surgery, intensive care, gynecology & obstetrics, and pediatrics in all four hospitals. Trained staff reviewed the medical records and compared the percentages of patients with healthcare-associated infections. Bio-statistical and multivariable logistic regression analyses were carried out to test the variables associated with healthcare-associated infections and the resulting deaths. RESULTS: A total of 22,170 hospitalized patients in four hospitals were included in the study. Hospital-acquired infection was reported in 3037 patients (13.7%; 95% CI: 12.9-14.4%). The highest incidence was in Benghazi Medical Center (17.9%; 95% CI: 16.9-18.7%), followed by Sabha Medical Center (14.8%; 95% CI:14.9-16.51%). Surgical site infection was the most prevalent (31.3%), followed by ventilator-associated pneumonia (29.3%), urinary tract infection (26.8%), and bloodstream infection (12.6%). Patients with healthcare-associated infections experienced severe morbidity requiring intervention. New antimicrobial regimens were needed for 1836 patients (93%), and 752 patients (34%) required admission to intensive care. Surgical intervention, respiratory support, and inotropes were also needed as a consequence of HAI events. CONCLUSIONS: The high incidence of healthcare-associated infections in Libyan hospitals should be considered a major problem and a serious burden. This should alert healthcare authorities at the national and hospital levels to the urgent need for preventive and control strategies to combat hospital-acquired infections.

The Impact of Armed Conflict on the Prevalence and Transmission Dynamics of HIV Infection in Libya.

The interrelationships between HIV/AIDS and armed conflict are a complex phenomenon, and studies are rarely devoted to this area of research. Libya is the second-largest country in Africa that has been evoked with war since the NATO intervention in 2011. The country has also experienced one of the largest HIV outbreaks associated with the Bulgarian nurse's saga. The effect of the armed conflict on the dynamic spread of HIV is not yet well-known. The objectives of this study were to determine the impact of armed conflict on the epidemiological situation of HIV infection in Libya and to analyze the transmission dynamics of HIV strains during the conflict. We investigated the movement of people with HIV during the Libyan armed conflict, analyzed the HIV subtypes reported from 2011 to 2020, and followed up the infected cases all over the country. The patterns of HIV spread within the Libyan regions were traced, and the risk factors were determined during the conflict period. A total of 4,539 patients with HIV/AIDS were studied from the four regions during the Libyan conflict. Our data analysis indicated that Benghazi, the biggest city in the Eastern region, was the significant exporter of the virus to the rest of the country. The viral dissemination changes were observed within the country, particularly after 2015. A major virus flows from the Eastern region during the armed conflict associated with internally displaced people. This resulted in the dissemination of new HIV strains and accumulations of HIV cases in western and middle regions. Although, there were no significant changes in the national prevalence of HIV/AIDS. Our data highlight the factors that complicated the spread and dissemination of HIV during the armed conflict, which provide a better understanding of the interaction between them. This could be used to plan for effective preventive measures in tackling the spread of HIV in conflict and post-conflict settings.

The epidemiological characteristics of COVID-19 in Libya during the ongoing-armed conflict.

COVID-19 can have even more dire consequences in countries with ongoing armed conflict. Libya, the second largest African country, has been involved in a major conflict since 2011. This study analyzed the epidemiological situation of the COVID-19 pandemic in Libya, examined the impact of the armed conflict in Libya on the spread of the pandemic, and proposes strategies for dealing with the pandemic during this conflict. We collected the available information on all COVID-19 cases in the different regions of Libya, covering the period from March 25th to May 25th 2020. The cumulative number of cases and the daily new cases are presented in a way to illustrate the patterns and trends of COVID-19, and the effect of the ongoing armed conflict was assessed regionally. A total of 698 cases of COVID-19 were reported in Libya within a period of three months. The number of cases varied from one region to another and was affected by the fighting. The largest number of cases were reported in the southern part of the country, which has been severely affected by the conflict in comparison to the eastern and western parts of the country. This study describes the epidemiological pattern of COVID-19 in Libya and how it has been affected by the ongoing-armed conflict. This conflict seems to have hindered access to populations and there by masked he true dimensions of the pandemic. Hence, efforts should be combined to combat these consequences.

Current problematic and emergence of carbapenemase-producing bacteria: a brief report from a Libyan hospital.

A collection of 94 Gram-negative bacteria isolates, showing different antimicrobial resistance phenotypes including to the carbapenem classes was investigated. Strains were originated form clinical sources from a single hospital in Tripoli, Libya during 2015 and were identified based on cultural and phenotypic characteristics, and fully characterized by the VITEK automated system. Forty-eight percent (48%) of the collection was identified as Acinetobacter baumannii, 50% Klebsiella pneumoniae and 2% Escherichia coli. Resistance to the carbapenem classes was reported in 96% of the A. baumannii strains and 94% of the K. pneumonia strains. Seventy-eight percent (78%) of the isolates showed different multidrug-resistant (MDR) phenotypes, of which K. pneumoniae expressing the highest rates of MDRs(i.e. 91%). Emergence of resistance to carbapenems in the Gram-negative bacteria is a challenging global problem, particularly for Africa. Surveillance of these pathogens and appropriate actions are urgently required in Libyan healthcare settings.