Resilience-promoting factors in war-exposed adolescents: an epidemiologic study.

Studies of war-exposed children have not investigated a comprehensive array of resilience-promoting factors, nor representative samples of children and adolescents. A representative sample of N = 710 adolescents was randomly selected from communities recently exposed to war. All those who had experienced war trauma were administered questionnaires measuring war exposure, family violence, availability of leisure activities, school-related problems, interpersonal and peer problems, socialization, daily routine problems, displacement, availability of parental supervision and contact and medical needs as well as coping skills related to religious coping, denial, self-control, avoidance and problem solving. Mental health was measured by the Strengths and Difficulties Questionnaire (SDQ) and the Child-Revised Impact of Events Scale (CRIES). Resilient adolescents were defined as those who experienced war trauma, but did not manifest any symptoms on the SDQ or CRIES. Resilience was related to being male, using problem-solving techniques, having leisure activities, and having parents who spent time with their adolescents and who supported them with school work. Interventions designed for war-traumatized youth must build individual coping skills of children and adolescents, yet at the same time target parents and teachers in an integrated manner.

Compiling comprehensive national health statistics in a fragmented health information system: lessons learned from Lebanon.

In view of the rapid health transition faced by the country and a highly dominant private sector, the issue of obtaining reliable health statistics is becoming a priority for Lebanon. This paper reviews the process of compiling and disseminating national health statistics from the multitude of public, private and nongovernmental partners in the country. The lessons learned from preparing two editions of the National health statistics report in Lebanon allow identification of some challenges and strengths of the current health information system in Lebanon. The experience emphasizes the need for a close partnership with all stakeholders, an efficient management system, adequate human resources and predefined systems and procedures. The process would benefit from having an interactive website for exchange of data and information among stakeholders and the public. The existence of clear guidelines with consistent definitions and standardized forms would also facilitate the collection and analysis of data.

Housing quality and ill health in a disadvantaged urban community.

OBJECTIVES: This study examined the association between housing quality and chronic illness among household members in the little investigated, underserved urban communities in Hay el Sellom, one of the largest informal settlements on the outskirts of Beirut, Lebanon. STUDY DESIGN: A population-based cross-sectional survey. METHODS: Face-to-face interviews were conducted to obtain the required information on 3881 individuals of all age groups in 788 households. Housing quality was measured using infrastructure and services, and housing conditions. Ill health was measured by the reporting of chronic illnesses. A multivariate regression model using the Generalized Estimation was used to analyse the association between ill health and housing quality, controlling for other covariates. RESULTS: Fifty percent of studied households reported chronic illnesses. Approximately two-thirds of individuals lived in households with more than four problems relating to housing conditions. The results of the study showed a significant positive association between housing conditions and chronic illness. CONCLUSION: These findings highlight the need for immediate action as they suggest that health in poor urban communities could be improved with better planning of housing needs.

Drug-related hospitalization at a tertiary teaching center in Lebanon: incidence, associations, and relation to self-medicating behavior.

OBJECTIVE: In Lebanon there is very limited restriction on drug use. Accordingly, self-medication is highly prevalent. This study examined the influence of these factors on the development of drug-related illnesses that lead to hospitalization. METHODS: Patients admitted to the medical and pediatric wards of a tertiary teaching center in Beirut, Lebanon, over a period of 6 months were interviewed and their charts were reviewed. Admissions attributable to adverse drug reactions or therapeutic failures were identified and characterized with respect to demographic factors, medical history, drug intake, and self-medicating behavior. The influence of these variables on the development of drug-related illnesses was examined by logistic regression. RESULTS: Of 1745 adults and 457 children, there were 177 (10.2%) and 36 (7.9%) drug-related illnesses, respectively. Adverse drug reactions accounted for 7.0% and 5.7% and therapeutic failures for 3.2% and 2.2% of adult and pediatric admissions, respectively. Self-medication was commonly practiced (52.6% of adults and 41.6% of children). Logistic regression analysis revealed that female sex increased the risk of adverse drug reaction in adults, whereas self-medication decreased the risk. In children, the risk of adverse drug reaction was increased in lower socioeconomic groups, whereas the risk of therapeutic failure was increased by a positive history of atopy or drug reaction. CONCLUSIONS: These results provide the first detailed analysis of the problem of drug-related illnesses in a developing country and identify a number of related or risk factors. Despite the lack of regulation of drug dispensing and the unchecked access to drugs in Lebanon, the incidence of drug-related illnesses is not different from that in Western nations. This finding may have relevance to policies of drug regulation in other countries.

Compiling comprehensive national health statistics in a fragmented health information system: lessons learned from Lebanon

نظراً للتحول الصحي السريع التي تواجهه الباد ولوجود قطاع خاص شديد الهيمنة أصبح الحصول عى إحصاءات صحية موثوقة مسألة ذات أولوية بالنسبة للبنان. ويستعرض هذا البحث عملية تجميع ونر الإحصائيات الصحية الوطنية من العديد من الركاء في القطاع العام والخاص وغر الحكومي في الباد. إن الدروس المستفادة من إعداد طبعتن من "تقرير الإحصائيات الصحية الوطنية في لبنان" تتيح التعرف عى نقاط القوة وكذلك بعض التحديات التي يواجهها نظام المعلومات الصحية الراهن في لبنان. فهذه التجربة تؤكد الحاجة إلى إقامة شراكة وثيقة بن جميع الأطراف المعنية، وإلى وجود نظام إدارة كفء، وموارد بشرية كافية، ونظم وإجراءات محددة مسبقاً. ومن شأن هذه العملية أن تستفيد من وجود موقع إلكروني تفاعي لتبادل البيانات والمعلومات بن الأطراف المعنية والجمهور. كا أن وجود دلائل إرشادية واضحة ذات تعريفات محددة وناذج موحدة من شأنه أن يسهل جمع البيانات وتحليلها

In view of the rapid health transition faced by the country and a highly dominant private sector, the issue of obtaining reliable health statistics is becoming a priority for Lebanon. This paper reviews the process of compiling and disseminating national health statistics from the multitude of public, private and nongovernmentalpartners in the country. The lessons learned from preparing two editions of the National health statistics report in Lebanon allow identification of some challenges and strengths of the current health information system in Lebanon. The experience emphasizes the need for a close partnership with all stakeholders, an efficientmanagement system, adequate human resources and predefined systems and procedures. The process would benefit from having an interactive website for exchange of data and information among stakeholders and the public. The existence of clear guidelines with consistent definitions and standardized forms would also facilitate the collection and analysis of data.

Face à la transition sanitaire rapide dans le pays et à un secteur privé fortement dominant, l’obtention de statistiques de santé fiables devient une priorité au Liban. Le présent article analyse le processus de compilation et de diffusion des statistiques de santé nationales fournies par une multitude de partenaires publics, privés et non gouvernementaux dans le pays. Les enseignements tirés de la préparation de deux éditions du rapport sur les statistiques sanitaires nationales au Liban ont permis d’identifier certaines forces et faiblesses du systèmed’information sanitaire actuel dans le pays. L’expérience souligne la nécessité d’un partenariat étroit entre les parties prenantes, d’un système de gestion efficace, de ressources humaines adéquates ainsi que de systèmes et de procédures prédéfinis. La création d’un site Internet interactif pour l’échange de données et d’informationsentre les parties prenantes et le public constituerait un avantage pour le processus. En outre, l’existence de recommandations claires, de définitions cohérentes et de formulaires normalisés faciliterait également le recueil et l’analyse des données.