A minireview of cholera outbreak in Lebanon – a rising public health concern

Berjaoui, Christin; Akoum, Nourhane Al; Nouiri, Ahmad El; khayat, Saadeddine; Abbass, Mortada; Mousawi, AlHareth Al; Wellington, Jack; Uwishema, Olivier

doi:10.1097/ms9.0000000000000293

Cited by 4 publications

(3 citation statements)

References 14 publications

(20 reference statements)

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“…Third, the limited access to healthcare and resources in such conditions further hinders effective cholera response measures [41]. Fourth, the economic instability compromises healthcare systems and public health interventions, hindering disease surveillance and control efforts including those aimed at cholera prevention [42]. Consequently, these factors pose serious threats for cholera transmission, especially among vulnerable populations in con ict-a icted and economically unstable regions.…”

Section: Introductionmentioning

confidence: 99%

“…In early September 2022, an outbreak of cholera was declared in Syria, a Middle Eastern country that suffered from the consequences of civil war for more than a decade [43]. The outbreak also affected Lebanon, the neighboring country for Syria, which was suffering from economic instability with a large population of refugees [42]. The cholera outbreaks in Syria and Lebanon led to several measures in Jordan, another neighboring country.…”

Section: Introductionmentioning

confidence: 99%

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Attitude towards Cholera Vaccination and its Related Factors in Jordan amid the 2022 Middle East Outbreak

Sallam,

Athamneh,

Alkhazaleh

et al. 2024

Preprint

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Background: An outbreak of cholera was reported in the Middle East by the second half of 2022. Raising public awareness and vaccination against cholera represent critical factors in the preventive efforts. The current study aimed to assess the knowledge of cholera and attitude towards its vaccination among a sample of the general public residing in Jordan. Methods: An online self-administered questionnaire was distributed to the residents in Jordan using a snowball convenience-based sampling approach. The questionnaire based on previously published studies included items to evaluate sociodemographic variables, knowledge about cholera symptoms, transmission, and prevention and the willingness to accept cholera vaccination. Additionally, four items based on the validated 5C scale in Arabic were included to assess the psychological factors influencing attitude to cholera vaccination. Results: The final study sample comprised 1339 respondents, of whom 1216 (90.8%) heard of cholera before the study. Among those who heard of cholera, and on a scale from 0 to 20, the overall mean cholera Knowledge score (K-score) was 12.9±3.8. In multivariate analysis, being over 30 years old and occupation as healthcare workers or students in healthcare-related colleges were significantly associated with a higher K-score compared to younger individuals and students in non-healthcare-related colleges. Overall, the acceptance of cholera vaccination if cases are recorded in Jordan, and if the vaccine is safe, effective, and provided freely was reported among 842 participants (69.2%), while 253 participants were hesitant (20.8%) and 121 participants were resistant (10.0%). In linear regression, the significant predictors of cholera vaccine acceptance were solely the three psychological factors namely high confidence, low constraints, and high collective responsibility. Conclusions: In this study, the identified gaps in cholera knowledge emphasize the need to enhance educational initiatives. Although cholera vaccine acceptance was relatively high, a significant minority of the respondents exhibited vaccination hesitancy or resistance. The evident correlation between the psychological determinants and attitudes toward cholera vaccination emphasizes the need to consider these factors upon designing public health campaigns aimed at cholera prevention. The insights of the current study highlight the importance of addressing both knowledge gaps and psychological barriers to optimize cholera control strategies.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Attitude towards Cholera Vaccination and its Related Factors in Jordan amid the 2022 Middle East Outbreak

Sallam,

Athamneh,

Alkhazaleh

et al. 2024

Preprint

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“…This was further exacerbated by a failure to pay healthcare workers causing many staff, including doctors and nurses, to emigrate [ 37 ]. Furthermore, in October 2022, the country declared the first cholera outbreak since 1993 [ 38 ]. Rent costs have increased, leading to increased eviction threats and evictions that have particularly affected refugees and women-led households in urban areas [ 17 , 20 , 34 ].…”

Section: Introductionmentioning

confidence: 99%

Gender based violence (GBV) coordination in a complex, multi-crisis context: a qualitative case study of Lebanon’s compounded crises (2019–2023)

Raftery,

Usta,

Kiss

et al. 2023

Confl Health

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Background Since 2019 Lebanon has faced multiple compounded crises. Political and social instability, the COVID-19 pandemic, and the Beirut Port explosion, alongside the influx of refugees related to the ongoing Syrian conflict, have resulted in a nationwide economic emergency. In the context of the humanitarian response to the Syrian conflict, the UN and government-led gender-based violence (GBV) task force has coordinated the sub-sector since 2012. The compounded crisis, however, created new challenges for GBV coordination and service delivery, which we explore in this paper. We highlight lessons for strengthening GBV coordination in Lebanon and other complex emergencies. Methods We conducted 29 remote in-depth interviews, reviewed key policy documents and observed seven GBV task force meetings. We analysed and presented our findings across three key themes: context-relevant and adaptable coordination mechanisms; coordination to support GBV service delivery; and stakeholders’ roles, legitimacy and power. Results Parallel response frameworks developed to address the multiple crises, created a complex humanitarian architecture within an increasingly challenging operating context, with some perceived inefficiencies. Positively, coordination was integrated under the established government-UN interagency system and the GBV task force maintained GBV sub-sector coordination. The task force was commended for effectively adapting to the evolving context, including working remotely, maintaining essential GBV services, assessing the compounded crises’ impact on programming and adjusting accordingly, and harmonising guidance, tools and approaches. The importance of ensuring a government co-led response was highlighted by both UN and government informants, who pointed to examples where marginalising government leadership compromised coordination effectiveness and sustainability. The participation of local actors had become increasingly important but more difficult, with the impact of the various crises, and remote modalities, challenging service delivery and staff wellbeing. Conclusion Experiences from Lebanon highlight the essential role of government leadership in coordination; the value of investing in local GBV capacity; the significance of effective national, subnational and intersectoral coordination to support service delivery and address cross-cutting GBV issues; the importance of targeted interventions to support marginalised populations; and the need to prioritize the well-being of front-line staff during crisis response. In Lebanon, and other complex crises, donors are encouraged to increase flexible, multiyear funding for GBV coordination and services, while women-led organizations should be at the forefront of recovery efforts, contributing to a more equitable society.

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Attitude towards cholera vaccination and its related factors in Jordan amid the 2022 Middle East outbreak

Sallam,

Athamneh,

Alkhazaleh

et al. 2024

BMC Public Health

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A minireview of cholera outbreak in Lebanon – a rising public health concern

Cited by 4 publications

References 14 publications

Attitude towards Cholera Vaccination and its Related Factors in Jordan amid the 2022 Middle East Outbreak

Attitude towards Cholera Vaccination and its Related Factors in Jordan amid the 2022 Middle East Outbreak

Gender based violence (GBV) coordination in a complex, multi-crisis context: a qualitative case study of Lebanon’s compounded crises (2019–2023)

Attitude towards cholera vaccination and its related factors in Jordan amid the 2022 Middle East outbreak

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