[Smoking prevalence in a factory in the region of Sousse, Tunisia]

Background: Smoking is a public health problem because of its high prevalence and its serious consequences at all levels

Aim: The aim of this study was to determine the prevalence of smoking among workers in a private company and describe the characteristics of smokers to guide prevention efforts

Methods: It is a cross-sectional study conducted in 2010 among all employees of a private company. Data collection was done by a questionnaire administered by interview

Results: The participation rate was 90.4%. All smokers were men, with a prevalence of active smoking among men of 57.9%. The mean age of smokers was 33.2 +/- 8 years, significantly lower than nonsmokers. The comparison between smokers and nonsmokers according to occupational category showed a statistically significant difference. Among smokers, 43.6% were in the contemplation stage and 46.3% at the stage of preparation for smoking cessation

Conclusion: An intervention for prevention and fight against smoking in the workplace should be established for the promotion of employee health

Comparison of cigarette and waterpipe smoking among pupils in the urban area of Sousse, Tunisia

Epidemiological and observational evidence suggests that waterpipe use is growing in popularity worldwide. The purpose of this study was to examine the prevalence of cigarette and water pipe tobacco use among pupils aged 13-17 years in the urban area of Sousse, Tunisia and to identify the factors which predict current cigarette and/or waterpipe smoking in this population. A cross-sectional study was carried Out on a representative sample of schoolchildren aged between 13 and 17 years in colleges and public secondary schools of the urban area of Sousse. We used a pre tested and self administered questionnaire to measure tobacco consumption. The significance level for all analyses was p<0.05. Statistical analysis was conducted with SPSS 10.0 software. Participants were 1569 youth. Fifty two percent of them were male. The mean age of the sample was 15 +/- 1.5 years. Total cigarette smoking percentage for ever and current use were 33.1%and 7.6%respectively. Total water pipe smoking percentage for ever and current use were 19.3%and 5.2%respectively. Overall, the total percentages of cigarette and water pipe smoking [ever and current] were higher for male and aged pupils. Multivariate regression analyses showed that the two types of tobacco use were related. Despite the growing adoption of water-pipe smoking, there remains limited research in this area. Increased surveillance and additional research are necessary to address this growing threat to public health

Bibliometric profile of Tunisian medical publications indexed in medline from 2000 to 2003: party 2 social relevance

This work, which is part of the medical documentary wakefulness, tries to evaluate the social relevance of the Tunisian medical publications indexed in the Medline's database. This descriptive study covered the whole of the articles indexed in [Medline] between 2000 and 2003. We retained the medical papers whose author's address was a Tunisian health structure of either medical care or education with the first and / or the last author was a Tunisian doctor. The social relevance of the publications was measured by the agreement level of their content, studied through the [Major Essential Key Words], with the death causes and the morbidity global charge components, made by the World Health Organisation in its [report about the health in the world] in 2 003. A [Major Essential Key Word] is a word chosen among the word's list [MeSH Major Topic] proposed by the bibliographic notice of Medline's database to summarize the essential topic of the article. The 1 248 articles eligible to this study, have been indexed in [Medline] by [MeSH Major Topic] words using 3 471 indexation lines. Among the [Top 20] list of the [Major Essential Key Words] only 9 themes were concordant with the community health needs, including four in relation with the epidemiologic [pre transition] epidemiology [tuberculosis, pregnancy complications, lung diseases, anemia] and five in connection with the epidemiologic [post transition] epidemiology [diabetes mellitus, breast neoplasms, leukemia, cardiovascular diseases, multiple myeloma]. What emerges from this study is that medical research in Tunisia isn't concordant enough with the country epidemiologic priorities and public health national programs. The social relevance should be the principal selection criterion in the public financing of the research projects

Predictive factors of surgery in severe attacks of ulcerative colitis

The purpose of our study was to determine clinical, biological or endoscopic factors that predict surgery after a glucocortico steroid treatment failure in severe attacks of ulcerative colitis. Sixty one patients were analyzed. A therapeutic response for glucocorticosteroid was defined as the absence of resort to surgery within the first 30 days after hospitalization. Predictive factors were assessed using univariate and multivariate analysis. Fifteen patients [24,6%] had a medical response. In univariate analysis, predictive factors of surgery were: male sex, tobacco, number of colitis attacks in case history, temperature over 38°C, ery-throcyte sedimentation rate over 30 mm, systolic blood pressure below 11, deep and wide ulcers. During the course, bowel movements/ day over 7, pulse over 90/mn, temperature over 38°C on day 3 after treatment initiation as well as passage of blood on day 5 were identified as predictors of surgery. In multivariate analysis, bowel movements over II day on day 3 of hospitalization was independently predicted a surgery. Bowel movements/ day over 7 on day 3 of hospitalization was the only independently predictive factor of surgery after glu-cortico steroid treatment failure

[Epidemiological and clinical features of patients with type2 diabetes mellitus in health primary care facility [Sousse, Tunisie]]

As a results of epidemiologic transition, diabetes mellitus became a major public health problem in Tunisia. We tried to determine the epidemiological and clinical features of patients with type 2 diabetes mellitus in primary health care units in Sousse [Tunisia]. It was a cross sectional study about a stratified sample of 404 type 2 diabetes mellitus patients followed in primary care offices in Sousse in 2003. Average age was 60+10.9 years and sex-ratio was 0.5. Hypertension and obesity were found in respectively 71.3% and 37.6% Diabetic neuropathy was the most frequent degrenerative complication [41, 1%] followed by diabetic retinopathy [18.3%] Thus, type 2 diabetes mellitus patients, followed in primary care units show a high cardiovascular risk with serious and frequent complications. That's why, the national care program of type diabetes mellitus, in primary health care should take in consideration, in its guidelines, the clinical and epidemiological characteristics of these patients

[Audit of management of arterial hypertension inprimary health care in sousse]

A medical audit has been carried out on a representative sample of 456 hypertensive patients followed in the health care facilities of Sousse during 2002, to evaluate the quality of management of hypertension in primary health care. The study yielded the following. the patients selected for a first line follow-up did not represent more than 79% of the studied population. The minimal recommended balance was achieved in 8% of cases only. Adequate drug therapy was prescribed in 64% of cases. 59% of patients were considered compliant. Controls of blood pressure was achieved in 5,5% of patients. The quality of management of hypertension in primary health care was considered satis factory in 28,7% of patents with a significant difference between urban and rural areas [24,9% versus 40,5%]. These results indicate that increased attention should be paid by the national program of Struggle against the Chronic Diseases to the quality of management of hypertension in primary health care institutions

[Behaviours and needs for health of secondary-school-adolescents in Sousse [Tunisia]]

It was a descriptive study bearing on a probabilistic sample of one-degree cluster composed of 685 adolescents studying in six secondary state schools in Sousse, during 1998 - 1999 school year. The facts had been collected through an anonymous and self administrated questionnaire. 23.3% of youngsters had a negative image of themselves. Parent-adolescent communication was inexistent in 30.6% of cases. At school. 24.3% of youngsters had a bad relationship with their teachers. One adolescent on four felt rather alone. One on three was not satisfied by leisure means put at his disposal. Alimentary behavior was disturbed for one adolescent on three. The prevalence rates of smoking and alcoholism were respectively 14.8% and 9%. At least, one suicide attempt was observed in 7.7%. Among sexually active youngsters, 23.8% did not use a contraceptive mean. This study revealed that adolescent was threatened by a hostile environment which may worsen his identity crisis and exposed him to adopt many risky behaviors

[Tracking of cardiovascular risk factors among school children: a four-year study of a population in Susa, Tunisia]

In order to confirm the phenomenon of tracking of cardiovascular risk factors among school children, we undertook in 2003, a prospective survey of a population of 789 pupils aged 13 to 15 years who had participated in a first investigation on cardiovascular risk factors in 1999. We were able to follow and study 453 pupils [57.4% of the initial population]. Prevalences of hypertension and obesity were respectively 11.3% and 6.1% without significant difference between sexes. On the other hand, hypercholesterolemia was significantly more elevated among girls than boys [16.1% versus 9.3%, p=0.039]. Children classified initially as hypertensive, obese or having a hypercholesterolemia were identified 4 years later at a subsequent exam as hypertensive, obese or having a hypercholesterolemia in respectively 25%, 48.9% and 59%. The stability of cardiovascular risk factors among children imposes an early screening for a better management and a policy of cardiovascular health promotion since childhood based essentially on prevention of risk factors in order to reduce the cardiovascular disease burden in adulthood

Hypertension arterielle du sujet de plus de 60 ans: Enquete epidemiologique dans la region de Sousse [Tunisie]

High blood pressure [HBP] is one of the most important cardiovascular risk factors all over the world. We conducted a prospective study including 600 elderly people aged more than 60 years in the district of sousse. The mean age of our patients was 69 +/- 7.1 years with a ratio of 1.3 [340 females and 260 males]. The prevalence of HBP was at 69.3%, diabetes 23% and obesity 24.2%. it is important to note that in 31% of cases HBP was newly diagnosed during our investigation. In 51.7% of patients with known hypertension there was evidence of non compliance to treatment and uncontrolled PB. It is obvious that HBP is a major health problem in our country and that inadequate control of hypertension is a potential source for cardiovascular problems. Our findings emphasize the need for implementing an educational program as well as sensitization campaigns targeting people, particularly those aged more than 60 years