[Audit on the quality of school vaccination in the region of Monastir [Tunisia]]

We conducted a clinical audit by observing 55 vaccinators in schools in the governorate of Monastir in 2014. We used a set of criteria by referring to the national immunization programme. The cold chain was respected in most cases. Accumulators, the collector of syringes and needles, cotton balls soaked in alcohol and emergency box were available in 85.5%, 76.4%, 98.2% and 41.8% of cases respectively. Hand washing before immunization session was performed in 29.1% of cases. Waste disposal according to the hygiene rules was done by 40 agents. Health education of students regarding the interest of vaccination was done in 67.3% of cases. Therefore, improvements in hand hygiene practice and education are recommended

Psychometric examination of an Arabic version of the state-trait anger expression inventory

Objectives: this study aimed to examine the psychometric properties of an Arabic version of the trait anger and anger expression scales of the State-Trait Anger Expression Inventory [STAXI]

Methods: this study took place between April 2005 and August 2014. Adults in Yemen [n = 334] and Tunisia [n = 200] were recruited from university campuses and a smoking cessation clinic, respectively. The STAXI was translated into Arabic using backtranslation methods. An explanatory principal component analysis was conducted to explore the factor structure of the anger expression scale, utilising parallel analyses to determine the number of retained factors

Results: good internal consistency of the trait anger scale was observed among the Yemeni [Cronbach's alpha = 0.76] and Tunisian [Cronbach's alpha = 0.86] samples. The parallel analysis suggested a three-factor solution for the anger expression scale [anger in, anger out and anger control], in accordance with the original STAXI. The internal consistency of anger in, anger out and anger control factors ranged between 0.51-0.79 in the Yemeni sample and 0.66-0.81 in the Tunisian sample. Overall, items loaded on the anger control factor included all items proposed by the original authors and this factor had higher reliability than the other two factors in both samples

Conclusion: the results of the current study provide initial support for the use of the trait anger and anger expression scales of the STAXI in Arabic-speaking countries

Tracking medication pathway as per better securing drugs' use in three clinical departments at the university hospital of monastir [Tunisia]

In Tunisia, few studies have an interest to the assessment of medication errors and the implementation of preventive measures. The aim of this study was to evaluate the barriers existing in hospital pharmacies in order to prevent medication errors and to help institutions to make improvement actions. First step: a clinical audit was conducted by observation against a set of standards that are representing a guideline. Second step: interview with health professionals to identify their perceptions about medication safety. Third step: in this step we develop adverse events scenarios according to results of the clinical audit in order to be investigated by the field practice. Fourth step: organizing a multi-professional feedback meeting to raise health professional's awareness and to make them more conscientious about adverse drug events negative consequences and invite them to contribute in the establishment and implementation of corrective solutions. In the participating departments medical prescription did not include patient information's [age, weight medical background]. Nurses do not verify systematically duration of prescription and administration route. Health professionals interview revealed that physician's have lack of awareness about prescription rules. Lack of communication was the main nurse's problem that requires improvement. This project has led to a first overview of the situation of medication use in Tunisia. Results will be used to create a dynamic process to improve the medication system safety

[Implementation of the safe surgery checklist of the World Health Organization at the University hospital of Monastir [Tunisia]]

To evaluate the impact of introduction of the WHO safe surgery checklist in the university hospital of Monastir over a period of five months. We conducted a longitudinal study [before - after] with evaluation of five result indicators which were: percentage of surgical site infections, not prescribed antibioprophylaxis, unplanned return to the operating room, postoperative length of stay and postoperatively death. We identified 185 patients during the period and 323 patients after the introduction of the WHO checklist. The proportion of surgical site infection decreased significantly from 13.5% in the reference period to 1.3% after the introduction of the checklist [p < 0.001]. The proportion of unplanned return to the operative room was 10.3% before the introduction of the checklist and deceased significantly to 1.3% at the intervention period [p = 0.003]. The proportion of not prescribed antibioprophylaxis and median post-operative length of stay deceased also significantly during the study period [p < 0.001]. The surgical checklist control contributes to the development of a safety culture in the operating room. Maintaining its use should be supported by incentives such as certification and accreditation

[Determinants of risky sex practices among consultants of a Voluntary Counseling and Testing Centre]

Thirty years after the discovery of human immunodeficiency virus [HIV], knowledge and practices must be improved. Contribute to reducing the risk of virus transmission. A study about the determinants of risky practices was conducted among the consultants of the Voluntary HIV Counseling and Testing Centre [VCTC] in Monastir University Hospital. We performed a cross sectional descriptive study with a total of 241 consultants who used the services of the VCTC during the period from January 1, 2008 to December 31, 2011. Data gathering was based on a self-administered questionnaire. Consultant's mean age was 27.4 +/- 8 years with a male predominance. Three patients out of four were single and 65% have at least secondary-level education. Knowledge about the risk of HIV infection after an unprotected sex and drug use by injection were reported by 94.3% and 76.7% of the participants respectively. Risky sex practices were adopted by 89.3% of the subjects. At least secondary school level, knowledge of risk factors of contamination and fear of the virus transmission were identified as determinants of safe sexual practices [0,004 < p < 0,032]. Improving knowledge of populations at risk for HIV is a privileged axis to lead to a reduction of infectious risk in our country

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

[Epidemiological and chronological profile of the parturientes in the extreme ages in the Monastir region between 1994 and 2003]

Pregnancy outside 19-34 years interval is risk factors of the maternal and fetal morbidity and mortality. Tunisia, witch known an epidemiological transition, implanted the national program of perinatality since 1990 and one of its objectives is the surveillance of the high risk pregnancies. The aim of this study is to draw up the epidemiological profile of the parturient in extreme ages in the region of Monastir and to study the chronological tendencies of the associated factors during a decade [1994 -2003]. In all, the study interest 13225 extreme ages parturient, representing 22.5% of all women admitted for delivery in the public maternities of the district. The mean age was 18.6% +/- 0.6 years for the parturient less than 20 years and 37 +/- 2 years for the older than 35 years and more, among them 40% were older primipara. The prenatal care was inadequate for 35.4% of younger women and 47.6% of aged women. During the decade, we notice a significant decrease of the frequency of pregnancy for teenager parturient [from 3 in 1994 to 1.99% to 17.7% in 2003] [p<0.001]. Adequate prenatal care increased and the frequency of parturient without any follow-up decreased [from 17.2 to 2%] [p<0.001]. Given to this demographic and social transition, our healthcare system is called for greater vigilance and a more rigorous application of the recommendations of the national program of perinatality

[Epidemiological profile and chronological tendencies of the multiparity in the sanitary district of Monastir [Tunisia] between 1994 and 2003]

Multiparity, risk factor of maternal and foetal morbidity and mortality, is a worldwide public health problem. In Tunisia, in spite of the activities of the national program of maternal and infantile health implanted since 1966, the multiparity is yet observed in some regions of our country. Is to draw up the epidemiological profile of the multipara woman [parity<6] and the grand multipara [parity >/= 6] in the sanitary district of Monastir and to study the chronological tendencies of the factors associated during a decade [from 1994 to 2003]. In all, 16649 multipara were studied, representing 24% of the total women admitted for childbirth in the public motherhoods of the district. The global means age was 33.3 +/- 4.5 years with a statistical significance between multipara and grand multipara [32.7 and 35.6 respectively]. The prenatal follow up was absent or inadequate for 50.2% of multipara and 62.8% of the grand multipara [p <0.001]. In the decade, the main chronological tendencies are similar in the two multipara groups. Their frequency decreased from 28, 5 to 19% [p<0.001], yet the age and the adequate follow up increased from 32, 6 to 34 years and from 37, 4 to 57, 9% respectively [p<0.001]. Although the multiparity is decreasing and its associated factors seem to improve, the vigilance is asked again in order to avoid the inherent risks