Epidemiologia (Basel, Switzerland) · 2026
How Is Lebanon's Progress Towards Measles Elimination? Review of Surveillance Performance Indicators, 2013-2024.
СтатьяНазвание и аннотация: Перевод в очереди
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Chaito Lina, Stefanoff Pawel, Sweidan Hawraa, Younes May, Albuaini Mona, Ghosn Nada
Аннотация
BACKGROUND: Lebanon adopted the World Health Organization (WHO)'s regional strategic plan (2012-2020) to achieve measles elimination. We aimed to analyze WHO measles surveillance performance indicators to identify areas for improvement.
METHODS: We reviewed suspected measles and rubella cases notified to the national epidemiological surveillance program between January 2013 and December 2024. A suspected case was defined as any patient with a febrile maculopapular rash or considered clinically compatible by physicians. We assessed notification rates of discarded non-measles/rubella suspected cases, timeliness of investigations within 48 h, completeness of case investigations (demographic and vaccination data), and proportion of cases tested for measles/rubella. Mean proportions and standard deviations were calculated across years and provinces.
RESULTS: A total of 6581 suspected cases were reported, predominantly from hospitals (66%). Outbreaks occurred in 2013 (n = 1760), 2018-2019 (n = 1984) and 2023-2024 (n = 346). Outside outbreak years, the notification rate ranged between 0.7 and 1.8 per 100,000 population. Timely investigation was achieved in 72% (±30%) of cases, while adequate investigation reached 52% (±19%). Laboratory testing was performed in 62% (±16%) of cases.
CONCLUSIONS: Surveillance in Lebanon showed suboptimal sensitivity, a high proportion of hospitalized cases, and variability in completeness of epidemiological and laboratory investigations. Strengthening outpatient reporting and continuous training of healthcare professionals are essential to improve surveillance performance.
METHODS: We reviewed suspected measles and rubella cases notified to the national epidemiological surveillance program between January 2013 and December 2024. A suspected case was defined as any patient with a febrile maculopapular rash or considered clinically compatible by physicians. We assessed notification rates of discarded non-measles/rubella suspected cases, timeliness of investigations within 48 h, completeness of case investigations (demographic and vaccination data), and proportion of cases tested for measles/rubella. Mean proportions and standard deviations were calculated across years and provinces.
RESULTS: A total of 6581 suspected cases were reported, predominantly from hospitals (66%). Outbreaks occurred in 2013 (n = 1760), 2018-2019 (n = 1984) and 2023-2024 (n = 346). Outside outbreak years, the notification rate ranged between 0.7 and 1.8 per 100,000 population. Timely investigation was achieved in 72% (±30%) of cases, while adequate investigation reached 52% (±19%). Laboratory testing was performed in 62% (±16%) of cases.
CONCLUSIONS: Surveillance in Lebanon showed suboptimal sensitivity, a high proportion of hospitalized cases, and variability in completeness of epidemiological and laboratory investigations. Strengthening outpatient reporting and continuous training of healthcare professionals are essential to improve surveillance performance.