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Prevalence of infectious diseases in the population of United Nations soldiers in Lebanon.

INTRODUCTION

In recent decades an escalation of armed conflicts has been observed in Asia, particularly in the Middle East and Central Asia. Interventions of international organizations have led to an establishment of a series of peacekeeping and stabilization missions. The UN and NATO military contingents consist of soldiers coming from different countries and different continents. Each region of the deployment of Multi-National Forces has its own specific characteristics. A many-thousand population of soldiers, who represent a group of immigrants, are temporarily deployed in the territory of a country characterized by environmental conditions different to the ones prevailing in their home countries. The population of peacekeepers differs considerably in many respects. Common existence of representatives of different races, religions and nationalities, people of different culture, habits and attitude towards personal hygiene, feeding and accommodation all contribute to an increased occurrence of various contagious and parasitic diseases. (1,2) There is a clear correlation between increasing incidence of infectious diseases and disregard of basic principles of hygiene and prophylaxis, aimed at reducing the risk of falling ill. (3,4) Issues concerning prophylaxis gain particular importance in hot climate areas.

The major risk factors which influence morbidity rates and prevalence of diseases in hot climate areas are high temperatures, humidity, poor sanitary and hygienic standards of a region, especially low standards of public sanitation, lack of safe sources of drinking water or domestic sewage treatment facilities as well as widespread use of excrement as manure to irrigate cultivated fields. The factors mentioned above influence both the occurrence of endemic infectious and parasitic diseases and also increase the risk of cosmopolitan infectious diseases. (5)

Apart from water- and food-borne diseases, which pose a major epidemiological threat, particular attention should paid to other ways of transmission, among which respiratory, vector-borne illnesses and sexually transmitted diseases are the centre of attention of sanitary services. (6) Regions such as the Middle East and the peacekeeping mission in Lebanon, where thousands of UNIFIL (United Nations Interim Force in Lebanon) soldiers have been deployed, require expertise in the existing risks and preventive medicine procedures which could put a stop to the occurrence and spread of infectious diseases, particularly within the domain of importing disease entities to home countries. The subject matter mentioned above is one of the primary tasks to be dealt with by medical services of military missions in the world. (7)

The aim of this article is to assess the prevalence of infectious diseases in the population of soldiers of different nationalities treated in the Hospital of the United Nations Interim Force in Lebanon. Much attention has been paid to the frequency of incidence of the afore-mentioned diseases and the morbidity structure. Risk factors influencing the incidence of contagious and parasitic diseases, including environmental factors, have been discussed.

MATERIAL AND METHODS

Upon compiling the epidemiological analysis of infectious diseases occurring in the examined population of soldiers treated in the Hospital of United Nations Interim Force in Lebanon the data included in hospital documentation were used. The conducted analysis was based on medical records of 2.054 patients of different nationalities treated from 1993 to 2000. This retrospective study was designed to determine the rate of morbidity, the rate of transmission dynamics on constant and inconstant bases and the rate of morbidity structure of the studied group.

The examined population was selected out of 38.434 people, military personnel of particular contingents, in the UNIFIL service from 1993 to 2000. The composition of the studied population was random. In total 2.054 soldiers in the UNIFIL service were hospitalized in the UN Hospital in Lebanon from 1993 to 2000. Each of the soldiers treated in the UNIFIL Hospital within the given period was subjected to complete clinical examination, epidemiological and statistical assessment.

The Chi-square test was used to look at the statistical significance of the obtained results. p values <0.05 were considered significant.

RESULTS

Contagious and parasitic diseases accounted for 10.6% of all health problems treated within the analyzed period (Figure 1, Table 1). The groups of the most frequently hospitalized patients were those of Irish, Nepalese, Fijian and Polish nationalities (Figure 2, Table 2).

Contagious diseases

Contagious diseases accounted for 5.8% of all hospitalizations (139 patients) from 1993 to 2000. The highest rate of morbidity structure within the analyzed period was registered in 1996 and it was estimated at 36.7%. The highest rate of morbidity on 10.000 soldiers in the studied population was also noted in 1996 and it was estimated at 16.5 (Figure 3). The analysis of the rate of transmission dynamics on constant basis demonstrated that prevalence of contagious diseases decreased by 68.1% in relation to 1993. The highest growth in morbidity occurred in 1996 (rate of transmission dynamics on inconstant basis 408.0). Prevalence of contagious diseases within the analyzed period had been decreasing, on average, by 15.1% annually (Table 3).

The morbidity of contagious diseases is illustrated in Table 4. Cases of salmonellosis, staphylococcal food poisoning and viral hepatitis A and B were the most frequent causes of hospitalizations. Other contagious diseases treated within the studied period were, among other things, tuberculosis (6 cases), angina (8 cases), shigellosis (5 cases), herpes varicella (5 cases), and mononucleosis (5 cases).

[FIGURE 3 OMITTED]

[FIGURE 4 OMITTED]

The growth in incidence of contagious diseases which was observed in the population of the UNIFIL soldiers in 1996 and 1998 resulted from mass food poisoning. An outbreak of salmonellosis was reported in the Irish contingent in 1996. The etiological factor was Salmonella enteritidis. While in 1998 mass staphylococcal food poisoning was reported in the Polish contingent. The etiological factor was staphylococcal enterotoxin. As a result of an efficient and proper application of antiepidemic procedures by health services of particular contingents (level 1) and UNIFIL Hospital (level 2) individual elements of the epidemiological chain were quickly eliminated.

Parasitic diseases

Parasitic diseases accounted for 3.8% of all hospitalizations (90 people) within the therapeutic district of the United Nations Interim Force in Lebanon from 1993 to 2000. The highest rate of morbidity structure within the studied period was registered in 1993 and it was estimated at 44.4%. The highest rate of morbidity on 10.000 soldiers in the studied population was noted in 1993 and it was estimated at 76.2. The highest rate of morbidity on 100 hospitalized patients was also registered in 1993 and it was estimated at 12.0 (Figure 4). The analysis of the rate of transmission dynamics on constant basis indicated that prevalence of parasitic diseases within the analyzed period decreased by 85.65% in relation to 1993. The highest growth in morbidity occurred in 1997 (the rate of transmission dynamics on inconstant basis 260.8). The prevalence of parasitic diseases within the analyzed period had been decreasing, on average, by 24.2% annually (Table 5).

[FIGURE 5 OMITTED]

The morbidity of parasitic diseases in the studied population is illustrated in Tables 6 and 7. Both simple parasitic invasions (1 patient--1 parasite) as well as complex parasitic invasions (invasion of 2 or more parasites in 1 patient) were found in the population of the 90 patients hospitalized in the UNIFIL Hospital, in the study period. The latter were mainly diagnosed in soldiers of the Nepalese contingent (95% of all cases). The cases involved predominantly parasites of the digestive tract: Trichiuris trichiura, Ancylostoma duodenale, Ascaris lumbricoides, Necator americanus, Giardia intestinalis. In total, 123 cases of parasitic invasion were diagnosed. The groups of the most frequently hospitalized patients were those suffering from giardiasis, ancylostomiasis and trichuriasis. Additionally, it is remarkable that medical services of some countries participating in the UNIFIL mission did not undertake any prophylactic action. Soldiers of the Nepalese contingent did not undergo a parasitological examination of faeces in their home country prior to their arrival into the operational zone of the mission in Lebanon and it was precisely the military personnel from Nepal who were the main source of parasitic invasion in the UNIFIL. (3)

Sexually transmitted diseases

Sexually transmitted diseases (24 people) accounted for 1.2% of all hospitalizations from 1993 to 2000. The highest rate of morbidity structure within the analyzed period was recorded in 1993 and it was estimated at 66.6%; whereas in 1999 and 2000 not a single case of a venereal disease was treated in the UNIFIL Hospital. Thus, the rate of transmission dynamics could not have been determined (Table 8). The highest rate of morbidity on 10.000 soldiers in the studied population (30.5) and the highest rate of morbidity on 100 hospitalized patients (4.8) was recorded in 1993 (Figure 5).

The morbidity of sexually transmitted diseases is illustrated in Table 9. Cases of STD posed a serious epidemiological problem from 1992 to 1994 (over 80% of all cases treated in the UNIFIL Hospital). In the following years venereal diseases were a side issue and within the years 1999-2000 not a single patient diagnosed with STD was hospitalized. Most cases of venereal diseases were diagnosed in patients of the Swedish nationality (Swedish contingent terminated its service in the UNIFIL in 1994). The most frequently treated disease in this group within the studied period was gonorrhea (50.0% of cases). Cases of AIDS, diagnosed and treated in the UNIFIL Hospital, had been imported from home countries of soldiers deployed in Lebanon (Ghana, Ireland).

DISCUSSION

Expertise in the epidemiological situation in Lebanon is drawn from dissertations of epidemiologists employed in medical academies, especially at the American University of Beirut as well as reports prepared by specialists commissioned by the World Health Organization and the World Bank. The epidemiological research conducted in Lebanon indicates that the prevalence of infectious diseases in this country does not deviate very much from the one registered in economically-developed countries. (8)

Table 10 illustrates cases of the most commonly occurring infectious diseases in the population of the Lebanese people from 1998 to 1999. (9) It is notable that there are no official data on the occurrence of AIDS or HIV infections in this table. This fact does not signify that no cases of the disease occur in Lebanon but rather it indicates that the disease is deliberately concealed from the family and public opinion, which in a Muslim country such as Lebanon would surely ostracize the diseased and condemn them to strict isolation. This, in turn, results in a fact that doctors willing to protect their patients against public condemnation do not report information of the disease to sanitary services. Thus, the exact number of AIDS and HIV infected is hard to be determined. (10) The number of HIV infections was estimated at 529 (including 147 people suffering from AIDS) in a report issued by the Department of Preventive Medicine at the Lebanese Ministry of Public Health in 2000. The most common cause of the disease or its carrier state was sexual intercourse (71.9% of all cases). (11)

Reports on prevalence of infectious diseases subjected to compulsory vaccination according to the WHO's schedule are also worth mentioning. From 1998 to 1999 the incidence of measles and viral hepatitis B was considerable. Prevalence of tetanus and pertussis did not pose any epidemiological hazards; no cases of diphteria or poliomyelitis have been reported within the given period. (9) Furthermore, a considerable number of food- and water-borne diseases (typhoid fever/paratyphoids, shigellosis, salmonellosis, staphylococcal food poisoning, viral hepatitis A) need to be pointed out. High incidence of the afore-said diseases was undoubtedly influenced by unsatisfactory sanitary-hygienic living standards of people, neglect of basic personal hygiene principles along with principles of water and feeding hygiene, and underdeveloped public health service.

Further causes of high incidence of infectious diseases in the Lebanese population are as follows: growth in rural-urban migration, overpopulation in poor districts and refugee camps, disregard of sanitary principles in the process of dumping human and industrial waste. (12) Until recently the Lebanese Ministry of Public Health did not possess any guidelines regarding food and feeding standards. There were no food-testing laboratories supervised by the government. Such negligence resulted in the fact that food-stuffs rejected by countries of fixed sanitary standards were sold in the uncontrolled Lebanese market. (13)

In the 1990s laboratory research into diagnostics of parasitic diseases was conducted in two Lebanese medical centers. Parasitic diseases were observed in 8.5% out of 33.253 people examined at the American University in Beirut. Complex parasitic infections were diagnosed in 8.8% of cases. The most commonly diagnosed invasive diseases were giardiasis (20.7%), amebiasis (19.4%), taeniasis (6.0%) and ascariasis (2.1%). Whereas in the Muslim Hospital in Tripoli parasitic diseases were observed in as much as 45.3% of the examined population. Complex parasitic infections were diagnosed in 3.5% of cases. The most frequently diagnosed parasitoses were ascariasis (46.0 %), giardiasis (10.5%), and taeniasis (4.1%). (14)

It is remarkable that only several decades ago malaria posed a considerable health hazard for the Lebanese people. At present, following liquidation of the disease's endemic focus in the 1960s, only a few imported cases of malaria have been registered. They mainly occur in people arriving into Lebanon from areas where malaria is endemic, especially from West Africa. (3) Low sanitary-hygienic and epidemiological standards in the region where the United Nations Interim Force in Lebanon have been deployed are decidedly the most important factors influencing the prevalence and morbidity of infectious diseases. Major problems relate to difficulty in maintaining high hygienic standards of food-processing sections and sanitary facilities. Technical condition of buildings intended for kitchens and canteens is poor. Rodents and insects (especially cockroaches) can be found in kitchens and warehouses. All these issues determine the occurrence of food poisoning and parasitic invasions. Faulty construction or damages in sewage and plumbing systems lead to environmental pollution. Despite strict regulations which prohibit breeding animals, UNIFIL soldiers keep cats and dogs at military posts, which due to contact with wild or domesticated animals, remain a serious source of animal-borne diseases. (13)

Admittedly, sanitary requirements are the same for contingents of all nationalities, however, some cultural and national differences can be observed. The concept of high-standard hygiene is not only interpreted differently, but also put into practice by means of different methods, especially in the population of soldiers coming from Asia and Oceania. Their daily routines, accommodation, methods of food storage and food processing or use of sanitary facilities are all culturally determined and they differ significantly from commonly accepted European standards. These are the reasons why the execution of obligatory sanitary regulations by supervising sanitary inspectors meets with obstacles. (3)

ACKNOWLEDGEMENTS

The author of the article thanks the Force Medical Officer of UNIFIL Headquarters and the Commanding Officer of UNIFIL Hospital for the providing the used data and for giving the permission to publish the results of the study.

REFERENCES

(1.) Korzeniewski K. Soldier's Handbook. Lebanon. Warszawa: PPH Zapol, 2005.

(2.) Korzeniewski K. The Middle East. UNIFIL UNDOF. UN Peacekeeper's Handbook. Bydgoszcz: STUDIO PLUS, 2006.

(3.) Korzeniewski K. Epidemiological analysis of diseases and traumas among people treated in the United Nations Interim Force in Lebanon Hospital from 1993 to 2000. Ludz, Doctoral dissertation, 2002.

(4.) Buczy_ski A, Kocur J, Kierznikowicz B. Sanitary and mental protection of soldiers in UN peace missions. In: Kierznikowicz B, Knap J (ed). Health Service of the Polish Armed Forces in Peace Missions. Warszawa: Eurostar Ltd, 2001.

(5.) Korzeniewski K, Olsza_ski R. Problems Concerning Preventive Medicine Among Representatives of Temperate Climate in the Tropics. Polish Journal of Environmental Studies 2006;15(4b):87-90.

(6.) Korzeniewski K, Olsza_ski R, Nowicki R. Environmental Health Risk Factors Occurring in the Hot Climate, in Warfare Zone. Polish Journal of Environmental Studies 2006;15(4b):81-86

(7.) Korzeniewski K. Epidemiological analysis of stationary area of Polish soldiers serving in UN peace missions in the Middle East. Military Doctor 2005;81(1):11-15.

(8.) Korzeniewski K. Lebanon. Warszawa: DIALOG, 2004.

(9.) Ministry of Health. Lebanese Epidemiological Newsletter, Lebanon 2000;7.

(10.) Zabielski S, Korzeniewski K. Morbidity on venereal diseases in the population of people from catchment area of the Hospital of the United Nations Interim Force in Lebanon from 1993 to 2000. Military Doctor 2003;79(1):39-43.

(11.) Kalaajieh WK. Epidemiology of human immunodeficiency virus and acquired immunodeficiency syndrome in Lebanon from 1984 through 1998. International Journal of Infectious Diseases 2000;4:209-213.

(12.) Buczy_ski A, Korzeniewski K, Dziedziczak-Buczy_ska M. Infectious diseases among persons from catchment area of the Hospital of the United Nations Interim Force in Lebanon from 1993 to 2000. Epidemiological Review 2004;58:313-323.

(13.) Buczy_ski A, Korzeniewski K, Bzdega I, Jerominko A. Epidemiological analysis of parasitic diseases in persons treated in the Hospital of the United Nations Interim Force in Lebanon from 1993 to 2000. Epidemiological Review 2004;58:303-312.

(14.) Araj GF, Abdul-Baki NY, Hamze MM, Alami SY, Nassif RE, Naboulsi MS. Prevalence and etiology of intestinal parasites in Lebanon. Le Journal Medical Libanais 1996; 44(3):129-33.

Krzysztof Korzeniewski

Military Institute of Health Service

Department of Epidemiology and Tropical Medicine, Gdynia, Poland

Corresponding author: Lt. Col. Krzysztof Korzeniewski MD, PhD Military Institute of Health Service Department of Epidemiology and Tropical Medicine Grudzi_skiego St. 4 81-103 Gdynia 3, Poland

E-mail: kktropmed@wp.pl
TABLE 1--Prevalence of contagious and parasitic diseases in the
population of soldiers treated in UNIFIL Hospital from 1993 to 2000
(N = 253)

 Year of Number Contagious & parasitic diseases
examination of all Number Structure rate [%]
 admissions of cases
 1993 333 74 29.2
 1994 359 37 14.6
 1995 248 13 5.2
 1996 310 56 22.1
 1997 208 15 5.9
 1998 220 36 14.3
 1999 202 16 6.3
 2000 174 6 2.4
 Total 2054 253 100

Source: UNIFIL. Own studies.

TABLE 2--Prevalence of contagious and parasitic diseases
in the population of soldiers treated in UNIFIL Hospital
from 1993 to 2000 according to nationality (N = 253).

 Number Contagious & parasitic diseases
Nationality of all Number Structure rate [%]
 admissions of cases

 Irish 406 63 24.9
 Nepalese 293 52 20.6
 Polish 379 44 17.4
 Fijian 363 44 17.4
 Norwegian 156 13 5.1
 Ghanaian 155 13 5.1
 Others 232 9 3.9
 Indian 47 7 2.8
 Swedish 23 7 2.8
 Total 2054 253 100

Source: UNIFIL. Own studies.

TABLE 3--Morbidity of contagious diseases in the population of soldiers
treated in UNIFIL Hospital from 1993 to 2000 (N = 139)

 Year of Number Number Structure Rate on
examination of all of contagious rate [%] 10.000
 admissions cases soldiers

 1993 333 18 12.9 34.3
 1994 359 21 15.1 41.1
 1995 248 10 7.2 20.4
 1996 310 51 36.7 109.6
 1997 208 7 5.0 15.6
 1998 220 24 17.3 53.6
 1999 202 5 3.6 11.1
 2000 174 3 2.2 5.6
 Total 2054 139 100.0 35.9

 Year of Rate on Rate of dynamics on the basics
examination 100 constant inconstant
 admissions [%] [%]

 1993 5.4 100.0 --
 1994 5.8 108.2 108.2
 1995 4.0 74.6 68.9
 1996 16.5 304.6 408.0
 1997 3.4 62.6 20.6
 1998 10.9 201.8 324.2
 1999 2.5 45.8 22.7
 2000 1.7 31.9 69.7
 Total 6.8 Geometrical mean g=84.9%

Source: UNIFIL. Own studies.

TABLE 4--Structure of contagious diseases in the population of soldiers
treated in UNIFIL Hospital from 1993 to 2000 (N = 139)

 Year of Contagious Salmonellosis Staphylococcal
examination diseases food poisoning

 1993 18 4 4
 1994 21 3 8
 1995 10 2 1
 1996 51 45 0
 1997 7 1 0
 1998 24 0 17
 1999 5 0 1
 2000 3 0 0
 Total 139 55 31

 Year of Viral Others
examination hepatitis

 1993 0 10
 1994 4 (type A, B) 6
 1995 3 (type A, B) 4
 1996 4 (type A) 2
 1997 1 (type A) 5
 1998 2 (type A) 5
 1999 1 (type A) 3
 2000 2 (type B) 1
 Total 17 36

Source: UNIFIL. Own studies.

TABLE 5--Morbidity of parasitic diseases in the population of
soldiers treated in UNIFIL Hospital from 1993 to 2000 (N = 90)

 Year of Number Number Structure Rate on
examination of all of parasitic rate [%] 10.000
 admissions cases soldiers

 1993 333 40 44.5 76.2
 1994 359 12 13.3 23.5
 1995 248 2 2.2 4.1
 1996 310 4 4.5 8.6
 1997 208 7 7.8 15.6
 1998 220 11 12.2 24.6
 1999 202 11 12.2 24.4
 2000 174 3 3.3 5.6
 Total 2054 90 100.0 23.2

 Year of Rate on Rate of dynamics on the basics
examination 100 constant inconstant
 admissions [%] [%]

 1993 12.0 100.0 --
 1994 3.3 27.8 27.8
 1995 0.8 6.7 24.1
 1996 1.3 10.7 160.0
 1997 3.4 28.0 260.8
 1998 5.0 41.6 148.9
 1999 5.4 45.3 108.9
 2000 1.7 14.4 31.7
 Total 4.4 Geometrical mean g=75.8%

Source: UNIFIL. Own studies.

TABLE 6--Structure of contagious diseases in the population of
soldiers treated in UNIFIL Hospital from 1993 to 2000 (N = 139)

 Year of Parasitic Trichuriasis Ancylostomiasis
 examination diseases

 1993 40 7 10
 1994 12 2 4
 1995 2 0 0
 1996 4 0 0
 1997 7 0 0
 1998 11 0 0
 1999 11 2 0
 2000 3 0 0
Number of patients 90 11 14

 Number of
 infestations 123 21 20
(partly multiple)

 Year of Giardiasis Ascariasis Strongyloidosis
 examination

 1993 8 1 0
 1994 2 0 1
 1995 0 0 0
 1996 1 0 0
 1997 4 0 0
 1998 0 1 7
 1999 0 1 2
 2000 0 1 0
Number of patients 15 4 10

 Number of
 infestations 18 11 10
(partly multiple)

Source: UNIFIL. Own studies.

TABLE 7--Structure of parasitic diseases in the population of
soldiers treated in UNIFIL Hospital from 1993 to 2000 (N = 90)

 Year of Parasitic Trichostrongylosis Necatorosis
 examination diseases

 1993 40 2 5
 1994 12 0 0
 1995 2 0 1
 1996 4 0 0
 1997 7 0 0
 1998 11 1 0
 1999 11 3 0
 2000 3 0 0
Number of patients 90 6 6

 Number of
 infestations 123 10 8
(partly multiple)

 Year of Amebiasis Malaria Others
 examination

 1993 3 2 2
 1994 1 0 2
 1995 0 0 1
 1996 1 1 1
 1997 0 1 2
 1998 2 0 0
 1999 0 0 3
 2000 0 0 2
Number of patients 7 4 13

 Number of
 infestations 7 4 14
(partly multiple)

Source: UNIFIL. Own studies.

TABLE 8--Morbidity of venereal diseases in the population of
soldiers treated in UNIFIL Hospital from 1993 to 2000 (N = 24).

 Venereal diseases

Year of Number Number Structure Rate on
examination of all of venereal rate [%] 10
 admissions cases soldiers

1993 333 16 66.6 30.5
1994 359 4 16.6 7.8
1995 248 1 4.2 2.0
1996 310 1 4.2 2.1
1997 208 1 4.2 2.2
1998 220 1 4.2 2.3
1999 202 0 0.0 0.0
2000 174 0 0.0 0.0
Total 2054 24 100.0 6.2

 Venereal diseases

Year of Rate on Rate of dynamics on the basics
examination 100 constant inconstant
 admissions [%] [%]

1993 4.8 100.0 --
1994 1.1 23.2 23.2
1995 0.4 8.4 36.2
1996 0.3 6.7 80.0
1997 0.5 10.0 149.0
1998 0.5 9.5 94.5
1999 0.0 0.0 0.0
2000 0.0 0.0 --
Total 1.2

Source: UNIFIL. Own studies.

TABLE 9--Structure of contagious diseases in the population of soldiers
treated in UNIFIL Hospital from 1993 to 2000 (N = 139)

 Year of Venereal Gonorrhea Lues Genital warts AIDS
examination diseases

 1993 16 12 2 1 0
 1994 4 0 2 1 0
 1995 1 0 0 0 1
 1996 1 0 0 0 1
 1997 1 0 1 1 0
 1998 1 0 1 1 0
 1999 0 0 0 0 0
 2000 0 0 0 0 0
 Total 24 12 6 4 2

Source: UNIFIL. Own studies.

TABLE 10--Occurrence of infectious diseases in Lebanon in 1998-1999.

 Country region
Diseases Beirut Mount North South
 Lebanon Lebanon Lebanon

Shigellosis 12 74 43 283

Salmonellosis/staphylococcal
food poisoning 20 95 215 26

Viral hepatitis A 51 84 197 93

Viral hepatitis B 126 97 24 253

Viral hepatitis C 11 22 8 43

Typhoid fever/paratyphoids 61 120 899 231

Tuberculosis 44 57 29 122

Measles 27 35 771 145

Pertussis 5 5 7 4

Tetanus 2 3 2 0

Rubeola 0 0 8 7

Mumps 27 37 24 22

Meningitis 10 26 25 25

Brucellosis 20 51 74 51

Rabies 0 0 0 0

Epidemic typhus 5 8 9 1

Malaria 18 25 6 23

Leishmaniasis 0 0 1 0

Bilharziasis 0 0 0 0

HIV/AIDS 0 0 0 0

Syphilis 24 7 1 10

Gonorrhea 0 1 1 1

Diseases Bekaa Nonspecific Total
 Valley cases

Shigellosis 97 33 544

Salmonellosis/staphylococcal
food poisoning 59 12 421

Viral hepatitis A 46 25 519

Viral hepatitis B 83 296 879

Viral hepatitis C 6 48 138

Typhoid fever/paratyphoids 254 106 1671

Tuberculosis 13 44 309

Measles 5 23 1006

Pertussis 10 0 31

Tetanus 0 1 8

Rubeola 3 0 18

Mumps 3 8 115

Meningitis 30 13 129

Brucellosis 252 29 477

Rabies 1 0 1

Epidemic typhus 4 4 31

Malaria 7 9 88

Leishmaniasis 0 0 1

Bilharziasis 0 3 3

HIV/AIDS 0 0 No data

Syphilis 0 34 76

Gonorrhea 0 1 4

Source: Ministry of Health. Lebanese Epidemiological Newsletter,
Lebanon 2000;7

Figure 1. Prevalence of diseases and injuries in the population of
soldiers treated in UNIFIL Hospital from 1993 to 2000 (N = 2054).

 Structure rate (%)
Injuries
Gastrointestinal Tract
Contagious & Parasitic 10.6
Respiratory System
Cardiovascular System
Neurological System
Urogenital System
Skin
Masculosceletal System
Others
Psychiatric Diseases & Disorders
Eye
Ear

Source: UNIFIL. Own studies.

Note: Table made from bar graph.

Figure 2. Prevalence of contagious and parasitic diseases in the
population of soldiers treated in UNIFIL Hospital from 1993 to 2000
according to nationality (N = 253).

 Structure rate (%)

Irish 24.9
Nepalese 20.6
Fijian 17.4
Polish 17.4
Norwegian 5.1
Ghanaian 5.1
Others 3.9
Swedish 2.8
Indian 2.8

Source: UNIFIL. Own studies.

Note: Table made from bar graph.
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Title Annotation:original article
Author:Korzeniewski, Krzysztof
Publication:International Journal of Health Science
Article Type:Report
Geographic Code:7LEBA
Date:Jan 1, 2009
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