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Influenza Surveillance

Severe Acute Respiratory Infection Surveillance (SARI)
Rationale Severe acute respiratory infections (SARI) can be the result of several agents: viral, bacterial, and parasites, even though bacterial and parasitic agents can be less common. Among the viruses, influenza viruses are among the major causes of SARI.
Any preventive or control measure related to Influenza requires the availability of surveillance, including the seasonality pattern and the causative agents.
SARI surveillance in Lebanon was established in collaboration of the World Health Organization.
Objectives The objectives of Severe Acute Respiratory Infection (SARI) in Lebanon are:
- To estimate morbidity (incidence) of SARI in Lebanon
- To identify baseline figures and alert/outbreak thresholds
- To describe SARI cases by time, place, person, susceptibility, severity
- To identify circulating influenza strains and detect novel viruses
- To contribute to the global influenza surveillance
Sources of data Data sources are hospital sentinel sites. Sentinel surveillance focuses on collection of data from specific pre-selected health sites to carefully monitor a specific disease. The collection of the data is systemic. The sites are selected based on key criteria: willingness, activity and representativeness of the population.
The current sentinel sites are:
- In the mohafazas of Beirut and Mount Lebanon: Rafik Hariri University Governmental Hospital (RHUH), American University of Beirut Medical Center, Quarantina Governmental Hospital
- In the mohafazas of Bekaa and Baalbeck/Hermel: Baalbeck Governmental Hospital
- In the mohafazas of North and Akkar: Kheir Hospital
Case Definition An acute respiratory infection with:
- History of fever or measured fever of >=38°C and cough
- Onset within the last 10 days
- Requiring hospitalization
Case Investigation For each SARI case, data is collected including demographical and clinical data. Also, clinical specimens are collected for laboratory testing. The needed specimens are: nasopharyngeal swab (preferable one), oropharyngeal swab, bronchoalveolar lavage (if done), or tracheal aspirate (if patient intubated).
Laboratory Testing Laboratory testing for SARI patients are performed at the National Influenza Center at RHUH. The laboratory testing includes RT-PCR for Influenza viruses A and B.
SARI forms - Laboratory request form
Results - Latest weekly bulletin
- Latest weekly severity indicators
- Link to WHO database
 
Intensive Care Unit Based Surveillance (ICU)
Objectives The main objectives of ICU-based surveillance are to:
 - Measure and monitor on weekly basis morbidity indicators related to severe acute respiratory infections in Lebanon
 - Detect abnormal pattern and novel agents at an early stage, and investigate them
 - Assist decision makers on proper control measures
Data sources Data sources are both ICUs in public and private hospitals across Lebanon. The MOPH decision requested each hospital to designate a focal person from the ICU medical staff in charge of reporting to the MOPH.
Case definition - Severe Acute Respiratory Infection with fever and dyspnea
- Whatever was the etiological agent
- Admitted to ICU
Data collection Data is collected using a specific form. The form is sent every week by the hospital event if no cases were reported. The reporting form is a nominative line-listing.
Guidelines ICU-based surveillance for acute respiratory infection: Ar, En, Fr
Weekly form - ICU weekly reporting form
Results - Latest weekly summary
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ATC Name B/G Ingredients Dosage Form Price
L01FD03 KADCYLA BioTech Trastuzumab emtansine - 100mg 100mg Injectable powder for concentrate for solution 135,545,977 L.L
L01FD03 KADCYLA BioTech Trastuzumab emtansine - 160mg 160mg Injectable powder for concentrate for solution 216,872,714 L.L
L01FD03 KADCYLA BioTech Trastuzumab emtansine - 100mg 100mg Injectable powder for concentrate for solution L.L
L01FD03 KADCYLA BioTech Trastuzumab emtansine - 160mg 160mg Injectable powder for concentrate for solution L.L
J05AR10 KALUVIA G Lopinavir - 200mg, Ritonavir - 50mg Tablet, film coated 7,632,790 L.L
L01FD01 KANJINTI BioTech Trastuzumab - 420mg 420mg Injectable powder for concentrate for solution 79,305,881 L.L
L01XA02 KARBOTEEN G Carboplatin - 150mg/15ml 150mg/15ml Injectable solution 2,080,268 L.L
L01XA02 KARBOTEEN G Carboplatin - 150mg/15ml 150mg/15ml Injectable solution L.L
J01DB01 KEFLEX B Cefalexin (monohydrate) - 250mg/5ml 250mg/5ml Granules for suspension 477,384 L.L
J01DB01 KEFLEX B Cefalexin (monohydrate) - 500mg 500mg Capsule 659,123 L.L
N03AX14 KEPAM MS G Levetiracetam - 500mg/5ml 500mg/5ml Injectable solution 9,170,015 L.L
N03AX14 KEPCITAM G Levetiracetam - 500mg 500mg Tablet, film coated 2,933,608 L.L
N03AX14 KEPCITAM G Levetiracetam - 1000mg 1000mg Tablet, film coated 3,119,058 L.L
N03AX14 KEPPRA B Levetiracetam - 250mg 250mg Tablet, film coated 3,240,855 L.L
N03AX14 KEPPRA B Levetiracetam - 500mg 500mg Tablet, film coated 6,245,576 L.L
N03AX14 KEPPRA B Levetiracetam - 1000mg 1,000mg Tablet, film coated 11,749,079 L.L
C03DA05 KERENDIA G Finerenone - 10mg 10mg Tablet, film coated 6,353,687 L.L
C03DA05 KERENDIA G Finerenone - 20mg 20mg Tablet, film coated 6,353,687 L.L
C07AB05 KERLONE B Betaxolol HCl - 20mg 20mg Tablet, film coated, scored 575,165 L.L
L04AA52 KESIMPTA BioTech Ofatumumab - 20mg/0.4ml 20mg/0.4ml Injectable solution L.L
L04AA52 KESIMPTA BioTech Ofatumumab - 20mg/0.4ml 20mg/0.4ml Injectable solution 94,290,414 L.L
N01AX03 KETAMINE PANPHARMA G Ketamine HCl - 250mg/5ml 250mg/5ml Injectable solution 1,534,668 L.L
M01AE17 KETESSE B Dexketoprofen (trometamol) - 25mg 25mg Tablet, film coated 399,121 L.L
M01AE17 KETESSE B Dexketoprofen (trometamol) - 50mg/2ml 50mg/2ml Injectable concentrated solution 435,405 L.L
M01AE17 KETESSE B Dexketoprofen (trometamol) - 50mg/2ml 50mg/2ml Injectable solution 435,405 L.L
M01AB15 KETO-AVI G Ketorolac tromethamine - 30mg/ml 30mg/ml Injectable solution 106,164 L.L
D01AC08 KETOCONAZOLE KORHISPANA G Ketoconazole - 2% 2% Gel 599,354 L.L
M01AB15 KETOLAC G Ketorolac trometamine - 10mg 10mg Tablet 268,769 L.L
M01AB15 KETOLAC G Ketorolac trometamine - 30mg/2ml 30mg/2ml Injectable solution 268,769 L.L
M01AE03 KETOPROFENE MACOPHARMA G Ketoprofen - 100mg/100ml 100mg/100ml Injectable solution 329,241 L.L
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