ABSTRACT
Background: Asthma and Chronic Obstructive pulmonary Disease [COPD] are considered as a major public health problem worldwide. They are characterized by a progressive evolution with episodes of exacerbations
Objective: The aim of this work was to describe the emergency department visits for asthma and COPD according to sociodemographic characteristics of patients and to assess trends over time
Methods:We conducted a cross sectional study including all emergency department visits of the Abderrahmane Mami hospital during the period between January, 1st 2007 and the 31th of December 2010. We used a standardized questionnaire to collect age; sex and date of emergency department visits with a primary diagnosis of asthma and COPD exacerbation from the emergency register. Data analyses were performed with SPSS 17.0
Results: A total of 9814 emergency department visits were reported over the period of four years, 6499 [66,2%] for asthma and 3315 [33,8%] for COPD exacerbation. The mean age was 52 +/- 21 years; it was for asthma and COPD respectively 48 +/- 21 and 60 +/- 18 years. Aging was associated with a marked decrease in the prevalence of asthma [from 51.0% to 25.6%] and with a marked increase in the prevalence of COPD [from 6.8% to 47.5%]. Men visit most frequently the emergency department for both diseases than women and particularly for COPD where the proportion of men was 75%. The number of visits increased steadily between 2007 and 2010, it peaked in January for asthma and in February for COPD and it was most important on the period from December to May
Conclusion: Asthma was most common among emergency department visits than COPD exacerbation, it affects men and women in a nearly same proportions and it is most frequent in young adults aged between 30 and 65 years. COPD exacerbation is most frequent in men aged over 65 years. Our study suggests that there is significant seasonal variation in the emergency department visits for respiratory illness. These findings suggest that greater attention and most adapted studies should be necessary to explain and to identify factors implied in these variations
ABSTRACT
During the last two decades, importance of general practice of medicine was more recognised. The kind of interest was different between Health decision makers and population. For Health decision makers, revalorisation of general medicine is the better solution we could develop in order to improve efficiency of the health care financing systems. However, From the side of population social image of the general physician is going down. In order to investigate the population view point about general practitioner, we conduct a trial next to 289 persons living Tunis area. Peoples recognized to the general practionner some qualities Useful for first aid he integrates all aspects of the morbidity, initiates best relations with his patients and appropriately manages medical files. In the other side. He's less qualified than the specialist to take appropriate decision for monitoring and for the quality of communication with patients. He' also lack of technicity and investigation procedures. Ours results indicate how it is urgent to lead a reform of teatching of general medicine in the country