Epidemiology and medical cost of hospitalization due to rotavirus gastroenteritis among children under 5 years of age in the central-east of Tunisia

Data on the economic burden of rotavirus infection in Tunisia are needed to inform the decision to include rotavirus in routine childhood immunizations. This study aimed to describe the epidemiological profile of rotavirus disease in central-east Tunisia and to estimate its hospital cost. In the first stage - the prospective collection of epidemiological data - we enrolled all patients < 5 years old who were hospitalized for acute diarrhoea at 5 university paediatric departments in central-east Tunisia during the period 2009-2011. Rotavirus was responsible for 65 [23.3%] of the 279 cases enrolled. In the second stage, cost data were collected retrospectively using an activity-based costing method from the medical records of the children who were positively diagnosed with rotavirus. The average cost of care per child was TD 433 [SD 134]. This is a significant economic burden in Tunisia, where a safe and effective vaccine is available but not yet introduced to the immunization schedule

Epidemiological and chronological profile of preterm birth in the region of Monastir [Tunisia] between 1994 and 2012

Data about the profile and risk factors of premature births in Tunisia are scarce. The objective of this study was to describe the epidemiological profile of preterm births in Monastir, Tunisia, and to study the chronological trends of associated factors over the years 1994-2012. A population-based study was conducted using data from the regional births database on all deliveries in public maternity units. The overall prevalence of preterm births among the 161 116 deliveries in the 19-year period was 5.60% [95% CI: 5.13%-6.07%]. The rate of preterm births and of adequate prenatal care increased significantly over the study period. Extremes of maternal age [/= 35 years], having a twin pregnancy and the occurrence of complications during pregnancy were significant predictors of prematurity in the final regression model. Efforts should be made to improve the quality of health care in the region, especially for high-risk pregnancies

[Integrated management of mother and child health in the region of Monastir [Tunisia]]

The programme of integrated management of child health [IMCI] was established in Tunisia in 2002 in some health districts. This study evaluated the management of children under 5 years of age and their mothers using the IMCI programme in Zeramdine, a town 20 km south-west of Monastir. A cross-sectional study was conducted on a convenience sample of 526 medical records of children under 5 years attending the Zeramdine maternal and child health centre. The study evaluated preventive and curative aspects of child health. The mean age was 21.9 [SD 16.7] months. On the curative side, respiratory diseases were the leading reason for consultation [71.2%] followed by diarrhoea [15.4%]. For preventive services, physicians systematically checked the child's immunization status and height and weight on the growth charts, and screened for strabismus and anaemia. The contribution to child health of IMCI is undeniable; it allows comprehensive care of the child, develops staff skills, upgrades the health system and improves family and community practices

Trends in hospital morbidity among adults in the region of Monastir [Tunisia] between 1996 and 2007

To study trends of hospital morbidity among adults in the region of Monastir during a period of 12 years [1996 - 2007]. We analyzed data from the morbidity database of the university hospital of Monastir [Tunisia] between 01/01/1996 and 31/12/2007. Data were drawn from the register of hospital morbidity implemented in the Department of Preventive Medicine and Epidemiology since 1995. The International Classification of Diseases [tenth revision] was used to identify and classify morbid conditions. During the study period, we collected 150749 admissions with male tendency [sex-ratio = 1.27]. Among these admissions 24.4% were over than 64 years. Morbid conditions were dominated by Ischemic Heart diseases [4.24%] followed by cancers and diabetes mellitus [3.3% and 2.52% respectively]. Chronological trends, using Spearman correlation rank test, showed that overall rate of chronic conditions increased significantly from 4.4% in 1996 to 9.1% in 2007 [r'= |0.88|, p-value < 0.001]. In contrast, the rate of infectious and parasitic diseases decreased from 4.3% to 2.9% [r'= |0.98|, p-value < 0.001]. Morbidity trends reflect the epidemiological transition of our country and call to a backing of the ambulatory system and the development of specific services able to decrease the needs of hospitalizations

Knowledge and practices of women in Monastir, Tunisia regarding breastfeeding

We assessed the prevalence of breastfeeding and its determinants and mothers' knowledge and practices towards this issue among 354 women attending primary health centres for their child's 6- month vaccination in the region of Monastir in 2008. The mean age of the women was 30 [SD 5.5] years. Most [90.8%] knew that breastfeeding helped prevent infections in babies but only 38.5% knew that breast milk supplies all infant feeding needs until 6 months of age. While was 94.4% breastfed their babies to start, only 1.9% continued exclusive breastfeeding until 6 months. Main reasons for stopping breastfeeding were perceived breast milk insufficiency followed by return to work. Exclusive breastfeeding over 3 months was associated with skin-to-skin contact [OR = 1.93; 95% CI: 1.016-3.69] and mothers' knowledge about breast milk benefits [OR = 2.8; 95% CI: 1.2-6.6] Early weaning was related to using pacifiers and breast-milk substitutes [OR = 0.17; 95% CI: 0.08-0.36 and OR = 0.14; 95% CI: 0.05-0.38 respectively]