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 NATO: see North Atlantic Treaty Organization. NATO in full North Atlantic Treaty Organization International military alliance created to defend western Europe against a possible Soviet invasion. 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 personal hygiene person n → Körperhygiene f , 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 infectious diseases: see communicable diseases. and disregard of basic principles of hygiene and prophylaxis prophylaxis (prō'fĭlăk`sĭs), measures designed to prevent the occurrence of disease or its dissemination. Some examples of prophylaxis are immunization against serious diseases such as smallpox or diphtheria; quarantine to confine , 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 morbidity rate n. The proportion of patients with a particular disease during a given year per given unit of population. morbidity rate Epidemiology The number of cases of a particular disease in a unit of population and prevalence of diseases in hot climate areas are high temperatures, humidity, poor sanitary and hygienic hy·gien·ic adj. 1. Of or relating to hygiene. 2. Tending to promote or preserve health. 3. Sanitary. standards of a region, especially low standards of public sanitation, lack of safe sources of drinking water drinking water supply of water available to animals for drinking supplied via nipples, in troughs, dams, ponds and larger natural water sources; an insufficient supply leads to dehydration; it can be the source of infection, e.g. leptospirosis, salmonellosis, or of poisoning, e.g. or domestic sewage treatment Sewage treatment Unit processes used to separate, modify, remove, and destroy objectionable, hazardous, and pathogenic substances carried by wastewater in solution or suspension in order to render the water fit and safe for intended uses. facilities as well as widespread use of excrement excrement /ex·cre·ment/ (eks´kri-mint) 1. feces. 2. excretion (2). ex·cre·ment n. Waste matter or any excretion cast out of the body, especially feces. as manure to irrigate ir·ri·gate v. To wash out a cavity or wound with a fluid. 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 Sexually transmitted diseases Infections that are acquired and transmitted by sexual contact. Although virtually any infection may be transmitted during intimate contact, the term sexually transmitted disease is restricted to conditions that are largely are the centre of attention of sanitary services. (6) Regions such as the Middle East and the peacekeeping mission Noun 1. peacekeeping mission - the activity of keeping the peace by military forces (especially when international military forces enforce a truce between hostile groups or nations) peacekeeping, peacekeeping operation in Lebanon, where thousands of UNIFIL UNIFIL United Nations Interim Force In Lebanon (United Nations Interim Force in Lebanon The United Nations Interim Force in Lebanon, or UNIFIL, was created by the United Nations, with the adoption of Security Council Resolution 425 and 426 on March 19, 1978, to confirm Israeli withdrawal from Lebanon, restore international peace and security, and help the ) soldiers have been deployed, require expertise in the existing risks and preventive medicine preventive medicine, branch of medicine dealing with the prevention of disease and the maintenance of good health practices. Until recently preventive medicine was largely the domain of the U.S. 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 retrospective study, a study in which a search is made for a relationship between one phenomenon or condition and another that occurred in the past (e.g. was designed to determine the rate of morbidity, the rate of transmission dynamics on constant and inconstant in·con·stant adj. 1. Changing or varying, especially often and without discernible pattern or reason. 2. Relating to a structure that normally may or may not be present. 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 chi-square test: see statistics. 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: see communicable 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 salmonellosis (săl'mənĕlō`sĭs), any of a group of infectious diseases caused by intestinal bacteria of the genus Salmonella, , staphylococcal staphylococcal pertaining to Staphylococcus spp. staphylococcal clumping test used as a means of measuring the quantity of fibrinogen-split products in a sample of blood. food poisoning food poisoning, acute illness following the eating of foods contaminated by bacteria, bacterial toxins, natural poisons, or harmful chemical substances. It was once customary to classify all such illnesses as "ptomaine poisoning," but it was later discovered that and viral hepatitis viral hepatitis n. Any of various forms of hepatitis caused by a virus. viral hepatitis, n an inflammatory condition of the liver, caused by the hepatitis viruses: A, B, C, delta, E, F, G, or H. 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 Angina Definition Angina is pain, "discomfort," or pressure localized in the chest that is caused by an insufficient supply of blood (ischemia) to the heart muscle. (8 cases), shigellosis Shigellosis Definition Shigellosis is an infection of the intestinal tract by a group of bacteria called Shigella. The bacteria is named in honor of Shiga, a Japanese researcher, who discovered the organism in 1897. (5 cases), herpes Herpes Any virus of the herpesvirus group, which comprises a family of 70 species, 5 of which are pathogenic to humans; the term also refers to any infection caused by these viruses. varicella varicella: see chicken pox. (5 cases), and mononucleosis mononucleosis /mono·nu·cle·o·sis/ (-noo?kle-o´sis) excess of mononuclear leukocytes (monocytes) in the blood. chronic mononucleosis chronic fatigue syndrome. (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 etiological pertaining to etiology. etiological diagnosis the name of a disease which includes the identification of the causative agent, e.g. Streptococcus agalactiae mastitis. factor was Salmonella enteritidis Salmonella en·ter·it·i·dis n. Gärtner's bacillus. . While in 1998 mass staphylococcal food poisoning was reported in the Polish contingent. The etiological factor was staphylococcal enterotoxin Noun 1. staphylococcal enterotoxin - a soluble exotoxin produced by some strains of staphylococcus; a cause of food poisoning enterotoxin - a cytotoxin specific for the cells of the intestinal mucosa . As a result of an efficient and proper application of antiepidemic procedures by health services health services Managed care The benefits covered under a health contract 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 digestive tract n. See alimentary canal. Digestive tract The organs that perform digestion, or changing of food into a form that can be absorbed by the body. : Trichiuris trichiura, Ancylostoma duodenale Ancylostoma du·o·de·na·le n. A species of hookworm widespread in temperate areas that can infest the small intestine of humans, causing ancylostomiasis. , Ascaris lumbricoides Ascaris lum·bri·coi·des n. A common roundworm that is parasitic in the intestines of humans and that causes restlessness, fever, and sometimes diarrhea. , Necator americanus Necator americanus Medtalk Hookworm, see there , Giardia Giardia /Gi·ar·dia/ (je-ahr´de-ah) a genus of flagellate protozoa parasitic in the intestinal tract of humans and other animals, which may cause giardiasis; G. lam´blia (G. intestina´lis) is the species found in humans. intestinalis. In total, 123 cases of parasitic invasion were diagnosed. The groups of the most frequently hospitalized patients were those suffering from giardiasis giardiasis (jēärdī`əsĭs, järdī`əsĭs), infection of the small intestine by a protozoan, Giardia lamblia. Giardia, which was named after Alfred M. , ancylostomiasis ancylostomiasis /an·cy·los·to·mi·a·sis/ (an?si-los?to-mi´ah-sis) infection with hookworms; see hookworm disease, under disease. an·cy·lo·sto·mi·a·sis n. and trichuriasis trichuriasis /trich·u·ri·a·sis/ (trik?u-ri´ah-sis) infection with Trichuris, often asymptomatic in adults but with gastrointestinal symptoms in children. trich·u·ri·a·sis n. pl. . Additionally, it is remarkable that medical services of some countries participating in the UNIFIL mission did not undertake any prophylactic prophylactic /pro·phy·lac·tic/ (pro?-fi-lak´tik) 1. tending to ward off disease; pertaining to prophylaxis. 2. an agent that tends to ward off disease. pro·phy·lac·tic n. action. Soldiers of the Nepalese contingent did not undergo a parasitological parasitological pertaining to or emanating from parasitology. parasitological examination includes examination of feces for protozoa, worm eggs or larvae and for tapeworm segments, skin scrapings for arthropod parasites, blood 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 venereal disease (vənēr`ēəl): see sexually transmitted 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 (Subscriber Trunk Dialing) Long distance dialing outside of the U.S. that does not require operator intervention. STD prefix codes are required and billing is based on call units, which are a fixed amount of money in the currency of that country. 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 gonorrhea (gŏnərē`ə), common infectious disease caused by a bacterium (Neisseria gonorrhoeae), involving chiefly the mucous membranes of the genitourinary tract. (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 American University of Beirut, at Beirut, Lebanon; English language; chartered by New York State in 1866 as Syrian Protestant College, rechartered 1920 as the American Univ. 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 This is a list of Lebanese people. The list has been ordered by Alphabetical order of Section names. No specific order was used within the sections. Activists
tr.v. os·tra·cized, os·tra·ciz·ing, os·tra·ciz·es 1. To exclude from a group. See Synonyms at blackball. 2. To banish by ostracism, as in ancient Greece. 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 sexual intercourse or coitus or copulation Act in which the male reproductive organ enters the female reproductive tract (see reproductive system). (71.9% of all cases). (11) Reports on prevalence of infectious diseases subjected to compulsory vaccination according to according to prep. 1. As stated or indicated by; on the authority of: according to historians. 2. In keeping with: according to instructions. 3. 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 tetanus (tĕt`nəs, –ənəs) or lockjaw, acute infectious disease of the central nervous system caused by the toxins of Clostridium tetani. and pertussis pertussis: see whooping cough. did not pose any epidemiological hazards; no cases of diphteria or poliomyelitis poliomyelitis (pō'lēōmī'əlī`tĭs), polio, or infantile paralysis, acute viral infection, mainly of children but also affecting older persons. have been reported within the given period. (9) Furthermore, a considerable number of food- and water-borne diseases (typhoid typhoid or typhoid fever Acute infectious disease resembling typhus (and distinguished from it only in the 19th century). Salmonella typhi, usually ingested in food or water, multiplies in the intestinal wall and then enters the bloodstream, causing 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 living standards npl → nivel msg de vida living standards living npl → niveau m de vie living standards living npl of people, neglect of basic personal hygiene principles along with principles of water and feeding hygiene, and underdeveloped un·der·de·vel·oped adj. Not adequately or normally developed; immature. public health service. Further causes of high incidence of infectious diseases in the Lebanese population are as follows: growth in rural-urban migration Rural-urban migration is the moving of people from rural areas into cities. When cities grow rapidly, as in Chicago in the late 19th century or Shanghai a century later, the movement of people from rural communities into cities is considered to be the main cause. , overpopulation overpopulation Situation in which the number of individuals of a given species exceeds the number that its environment can sustain. Possible consequences are environmental deterioration, impaired quality of life, and a population crash (sudden reduction in numbers caused by 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 American University, at Washington, D.C.; United Methodist; founded by Bishop J. F. Hurst, chartered 1893, opened in 1914. It was at first a graduate school; an undergraduate college was opened in 1925. Programs provide for student research at many government institutions. in Beirut. Complex parasitic infections were diagnosed in 8.8% of cases. The most commonly diagnosed invasive diseases were giardiasis (20.7%), amebiasis amebiasis: see dysentery. (19.4%), taeniasis taeniasis /tae·ni·a·sis/ (te-ni´ah-sis) infection with tapeworms of the genus Taenia. tae·ni·a·sis or te·ni·a·sis n. Infestation with tapeworms. (6.0%) and ascariasis ascariasis /as·ca·ri·a·sis/ (as?kah-ri´ah-sis) infection with the roundworm Ascaris lumbricoides. After ingestion, the larvae migrate first to the lungs then to the intestine. as·ca·ri·a·sis n. (2.1%). Whereas in the Muslim Hospital in Tripoli Tripoli, city, Lebanon Tripoli (trĭp`əlē) or Tarabulus (täräb`  l 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 health hazard Occupational safety Any agent or activity posing a potential hazard to health. Cf Physical hazard. for the Lebanese people. At present, following liquidation The collection of assets belonging to a debtor to be applied to the discharge of his or her outstanding debts. A type of proceeding pursuant to federal Bankruptcy 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 West Africa A region of western Africa between the Sahara Desert and the Gulf of Guinea. It was largely controlled by colonial powers until the 20th century. West African adj. & n. . (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 cockroaches insects which may carry Salmonella spp. in their gut and play a part in the spread of the disease. ) 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 Cats and Dogs A slang term referring to speculative stocks that have short or suspicious histories for sales, earnings, dividends, etc. Notes: In a bull market analysts will often mention that everything is going up, even the cats and dogs. at military posts, which due to contact with wild or domesticated animals This article or section may contain original research or unverified claims. Please help Wikipedia by adding references. See the for details. This article has been tagged since September 2007. This is a list of animals which have been domesticated by humans. , 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 Food processing is the set of methods and techniques used to transform raw ingredients into food for consumption by humans or animals. The food processing industry utilises these processes. 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 UNDOF United Nations Disengagement Observer Force . 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 catchment area or drainage basin, area drained by a stream or other body of water. The limits of a given catchment area are the heights of land—often called drainage divides, or watersheds—separating it from neighboring drainage 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 human immunodeficiency virus n. HIV. Human immunodeficiency virus (HIV) A transmissible retrovirus that causes AIDS in humans. and acquired immunodeficiency syndrome acquired immunodeficiency syndrome, see AIDS. 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 tropical medicine, study, diagnosis, treatment, and prevention of certain diseases prevalent in the tropics. The warmth and humidity of the tropics and the often unsanitary conditions under which so many people in those areas live contribute to the development and , 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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