COVID-19 vaccine acceptance in older Syrian refugees : Preliminary findings from an ongoing study

Funding source This work was supported by ELRHA’s Research for Health in Humanitarian Crisis (R2HC) Programme, which aims to improve health outcomes by strengthening the evidence base for public health interventions in humanitarian crises. R2HC is funded by the UK Foreign, Commonwealth and Development Office (FCDO), Wellcome, and the UK National Institute for Health Research (NIHR). The views expressed herein should not be taken, in any way, to reflect the official opinion of the NRC or ELRHA. The funding agency was not involved in the data collection, analysis or interpretation.Peer reviewedPublisher PD

The determinants of sustained adherence to COVID-19 preventive measures among older Syrian refugees in Lebanon

Acknowledgments The authors thank the participants at the Economic Research Forum annual conference in March 2022 for comments. Funding: SA and HG received the ELRHA Research for Health in Humanitarian Crises award (Number 51538) for "Tracking adherence of older refugees to COVID-19 preventive measures in response to changing vulnerabilities: A multi-level, panel study to inform humanitarian response in Lebanon". This work was supported by ELRHA’s Research for Health in Humanitarian Crisis (R2HC) Programme, which aims to improve health outcomes by strengthening the evidence base for public health interventions in humanitarian crises. R2HC is funded by the UK Foreign, Commonwealth and Development Office (FCDO), Wellcome, and the UK National Institute for Health Research (NIHR). The views expressed herein should not be taken, in any way, to reflect the official opinion of the NRC or ELRHA. The funding agency was not involved in the data collection, analysis or interpretation. ELRHA: https://www.elrha.org/programme/research-for-health-in-humanitarian-crises/ The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.Peer reviewedPublisher PD

Prevalence of Midwakh tobacco smoking in trend-setting Lebanon: an indicator of potential spread across the Arab world?

Background Alternative tobacco product (ATP) use is increasing in Lebanon. Dokha (or 'diziness') is an ATP smoked in a pipe called a midwakh. Research evidence suggests high nicotine content, with resultant physiologic effects. The objective of this study was to assess prevalence and correlates of midwakh tobacco use among 7 th -12 th grade students in Lebanon. Methods The analyses is based on one question included in the 2016 Lebanon Global School-based Student Health Survey (GSHS) that assessed past 30-day (current) use of midwakh in a representative sample of 5708 7 th -12 th graders sampled from public and private schools. All analyses were weighted accounting for the multi-stage cluster sampling design. Results Overall, 4.6% of students were current midwakh users, varying between 3.9%-5.4% across grade levels. A significantly higher percentage of males than females currently smoked midwakh (6.7% versus 2.7% respectively). Current use was higher in public versus private school students (6.3% vs. 3.6% respectively) but this difference was not statistically significant. Midwakh use was significantly associated with current smoking of cigarettes [OR: 16.61; 95%CI=12.21-22.58], as well as initiating cigarette smoking prior to 14 years of age among cigarette smokers [OR: 2.31; 95%CI=1.53-3.49]. Midwakh smoking was also statistically significantly related to ever smoking of waterpipe [OR: 9.89; 95%CI=6.78-14.45], current use of any tobacco products other than cigarettes [OR: 14.29; 95%CI=8.53-23.94], parental smoking [OR: 1.61; 95%CI=1.13-2.2], and with second-hand smoking [OR: 1.73; 95%CI=1.11-2.70]. Conclusions This study is one of the few that has provided prevalence rates and determinants of midwakh use outside of the Arabian Gulf, where it has been mostly confined. Although prevalence remains low, its consistency across grade levels is concerning. In addition, the pattern of associations is in line with evidence on other tobacco products. A trans-disciplinary research agenda for midwakh is urgently needed to understand use and effects, and contain its spread

The changing pattern of hepatitis A in Lebanese adults

Objective: A shift in the age of hepatitis A virus (HAV) infection from early childhood to adulthood has been observed in many developing countries. This epidemiological shift has been attributed to improved socioeconomic status and sanitary conditions resulting in growing cohorts of susceptible young people and hence an increased risk of HAV outbreaks. The aim of this study was to investigate the evolutionary trend of anti-HAV seroprevalence in Lebanon in a cohort of Lebanese adults. Methods: This was a cross-sectional study employing a convenience sample (voluntary blood donors) along with secondary data analysis. Sera from 283 healthy blood donors were tested for anti-HAV IgG antibodies. Moreover, we analyzed the national reports of HAV cases published by the Lebanese Ministry of Public Health since 2001. Results: Anti-HAV seropositivity increased steadily from 60% in the younger age group (19–29 years) to 91% in the older age group (50–59 years), leaving the younger group at higher risk of acquiring HAV. The national data show that the number of acute hepatitis A infections is higher in the age groups 5–9 and 10–19 years. Conclusion: Our seroprevalence data reveal that young adults are becoming more at risk of acquiring HAV infection. Thus the introduction of hepatitis A vaccine is highly recommended

The determinants of sustained adherence to COVID-19 preventive measures among older Syrian refugees in Lebanon

Introduction Lebanon has battled the COVID-19 pandemic in the midst of an economic crisis. The evolution of the pandemic and a fragile health system have meant that public health policy has had to rely heavily on non-pharmaceutical interventions for disease control. However, changes in disease dynamics, an unraveling economy, and pandemic fatigue have meant that disease control policies need to be updated. Methods Using recent and timely data on older (50 years and above) Syrian refugees in Lebanon, this paper uses multivariate linear probability models to explore the determinants of adherence to two non-pharmaceutical COVID-19 prevention measures (wearing a mask and avoiding social gatherings) among this high-risk subgroup in a vulnerable population. Among respondents who report adhering to these measures, the paper also investigates the determinants of sustained adherence over a period of 6 months. Results The findings suggest that no individual-level characteristics were robustly associated with mask wearing. For avoiding social gatherings, education was inversely associated with adherence to this preventive measure. Avoiding social gatherings was also significantly lower for residents of informal tented settlements (ITSs). Among initial adherents, and for both preventive practices, ITS dwellers were also significantly less likely to maintain adherence. Conclusion Identifying variables associated with adherence to non-pharmaceutical preventive practices, particularly for vulnerable groups, can help inform and refine interventions in the face of changing conditions. The material, physical, administrative and socio-economic constraints of life in an ITS suggest that avoiding social gatherings is hardly feasible. Yet despite the challenging conditions of ITSs, the indication to wear a mask is initially complied with, suggesting that tailoring policies to the limits and constrains of context can lead to successful outcomes even in very adverse settings