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

Epidemiological profile of health-care-associated infections in the central-east area of Tunisia

This study aimed to estimate the prevalence and risk factors for health-care-associated infection [HAI] in all 9 hospitals of the central-east area of Tunisia in 2005. Of 1373 patients admitted for more than 48 hours, 74 developed HAI, a prevalence of 5.4% [95% Cl: 4.2%-6.6%]. The prevalence was significantly higher in the intensive care units [18.4%] and neonatal departments [12.7%]. There were 79 infections and the most frequent sites of infection were respiratory tract and urinary tract. Microbiological examination was performed for 25 cases of HAI and Pseudomonas aeruginosa was identified in 8 cases. Multiple logistic regression analysis indicated that HAI was linked to diabetes [OR = 2.0], immunosuppression [OR = 3.3], length of stay [OR = 4.5], central venous catheter [OR = 2.5] and peripheral venous catheter [OR = 10.2]. We conclude that HAI sare of concern in this area of Tunisia

Prevalence and predictors of smoking among adolescent schoolchildren in Monastir, Tunisia

A study in Monastir, Tunisia estlinared the prevalence of smoking and analysed the determinants of tobacco use among adolescents aged 10-19 years. An observational cross-sectional study was performed in the 8 colleges and high schools of Monastir city in 2004. The mean age of the 900 respondents was 15.8 [SD 2.2] years and 47.7% were aged under 16 years. The overall prevalence of cigarette use during the past year was 16.0% [30.2% among males and 4.6% among females]. The first smoking experience was initiated by friends in 45.8% of cases, at a mean age of 13.8 [SD 2.3] years. One-fifth of smokers [21.5%] had used other forms of tobacco. In multivariate analysis, male sex, academic failure, poor family management, antisocial behaviour and addictive behaviour were the main predictors of adolescent smoking status. The prevalence of smoking among adolescents in Monastir is high and requires targeted action

[New criteria and quality of health care services in the governorate of Monastir, Tunisia]

In 2005 new quality criteria [7 items] were introduced for services provided to mother and child under the national perinatality programme. We evaluated this new version in a descriptive study conducted among a random sample of 400 parturient women from Monastir governorate. Mean age was 29.3 [SD 5] years and 42% were primipara. Although prenatal care was adequate in terms of number of antenatal visits for 82.5% of women, for only 21% were all 7 quality criteria fulfilled. The rates of caesarean section and premature birth were significantly higher in women who received quality care [P < 0.05]. In logistic regression analysis, age and parity were the only factors independently associated with the quality of care. Additional efforts are needed to ensure good maternal and infant quality of care

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]

consultation of anonymous and free tracking of the HIV: attitudes and perception of the risk by the consultants

The infection by human immunodeficiency virus [HIV] is a worldwide public health problem. A Voluntary Anonymous Counseling and Screening Consultation [VASC] give the opportunity to inform high-risk population about the disease transmission its severity and especially the main prevention ways. Our study aims the description of the profile, attitudes and risk perception of consultants in Monastir University Hospital. We performed a descriptive study with a total of 172 consultants who used the services of the VASC during a period of three years [2006-2008]. Information's were gathered from an auto-questionnaire assessing infection risks. Consultant's means age was 26.8 +/- 7.5 years with a female predominance [sex ratio=0.67]. Two patients out of three did not exceed the primary school level and the 3/4 were single. Unprotected sex with multiple partners was the main consultation reason for 84% of patients and 96% knew that HIV is a severe infection. Regarding the practices, 38% had never used condoms and half [562%] had presented past episodes of sexually transmitted infections. According to our study, it is clear that the knowledge of consultants were satisfactory. However efforts should be made to address risk behaviours and attitudes toward infection