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

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

Mother's knowledge and practices in the region of Monastir [Tunisia] in front of childhood fever

Fever is a frequent infant symptom it is among the primary causes of infants morbidity in developing countries. ln Tunisia, fever constitutes a frequent motive for ambulatory consultation and hospitalization Knowledge and practices of mother to face fever conditioning party its issue. In this regard this survey aims at studying knowledge; attitudes and practices of mother facing fever in order to set up educational strategy adapted to the concerned population it is a descriptive cross study of 491 mothers who have consulted the centres of primary healthcare and centres of maternal and infantile protection of 9 delegations in the district of Monastir from 1[st] July up to 15 September 2006. Results have demonstrated that the average age of mothers was 28,5 +/- 5 years with a medium level c instruction and socio-professional. Among the questioned mothers, 80% define fever at a temperature of 38°C and 97.35% know at list one sign of gravity [convulsion is recognized by 56.2% of mothers]. 82.7% know how to measure the rectal temperature, 91.6% use physical means and 88.2% resort substances available at home to reduce temperature 34.3% of mothers have recourse to doctor temperature is diminished Principals determining knowledge and practices of mothers are the instruction and profession of the parents [p<0.01], the number of lived infants and health care education [p<0.05], We can deduce from the study that the knowledge of mothers is quite good. However many efforts are still required to promote the saint practices of mothers

[Anthropometrical parameters in infants in Monastir region, Tunisia]

We evaluated the distribution of anthropometrical parameters in infants in Monastir and compared them with the National Center of Health Statistics reference. Our prospective study included 3033 infants attending primary health care centres for vaccinations who were followed for 18 months. In each visit, we measured weight-for-age, height-for-age and weight-for-height. We found a difference between our distribution curve and the NCHS reference. The prevalence of growth retardation increased with age. The prevalence of under-weight and of wasting were less than 10%. Obesity was seen 6.2% of infants aged 3 months and 11.6% aged 9 months

[Analysis of the appropriateness of hospitalizations in Monastir, Tunisia]

We aimed to measure the extent of inappropriate hospital admissions and to identify factors associated with inappropriate hospital use. A descriptive study was carried out on a r and omized sample of 411 hospitalizations in 3 regional hospitals. The appropriateness of admissions was assessed using the Appropriateness Evaluation Protocol [AEP]. We found 21% [95% CI: 17%-25%] of the admissions were avoidable according to the AEP. Inappropriate admissions were associated with the hospital [P = 0.005], patient age [P = 0.003], length of stay and diagnosis [P < 0.001]. The most frequent reasons for appropriate admissions were parenteral therapy, an acute or progressive sensory motor circulatory or respiratory condition sufficient to incapacitate the patient and severe electrolyte or blood gas abnormality. Our study highlights the need to improve hospital management and to develop alternatives to hospitalization

Atraumatic restorative treatment and glass ionomer sealants in Tunisian children: survival after 3 years

We evaluated the survival rates of atraumatic restorative treatment restorations and of glass ionomer sealants after 3 years of usage in primary and permanent teeth in Tunisian children aged 3-15 years attending rural schools, and assessed the presence or absence of dental caries in the restored teeth. After an initial survey of 1949 children, 242 were selected and agreed to undergo treatment. The loss to follow-up after 3 years was about 40%. Of those evaluated, 45.73% of one-surface ART restorations in permanent teeth had survived, 54.96% of one-surface sealants in permanent teeth had survived and 27.85% of one-surface ART restorations in primary teeth had survived. Caries was found in only 19 teeth after 3 years

[Drugs in primary health care centres: availability and prescription in health district, Monastir, Tunisia]

Shortages in the availability of some drugs are sometimes noted in primary health care [PHC] centres in spite of the steady increase in the drug budgets in Tunisia. We conducted a survey therefore in 1998 in the health district of Monastir to study the availability of certain essential drugs [n = 15] in PHC centres and the main features of the drug prescription. We found that the drugs lacking were generally those prescribed for chronic diseases and as well as oral antibiotics. Antibiotic treatment constituted 71.8% of public prescriptions and 32.3% of these prescriptions were for an injectable treatment

[ antibiotherapy in general medicine in Monastir, Tunisia]

In order to determine the cost and frequency of antibiotic prescription by general practitioners, we studied 563 outpatients from health centres in Monastir [Tunisia]. All patients had acute diseases. Antibiotics were prescribed to 50.4%. Single antibiotics were generally prescribed, but 52.8% of these patients did not have any laboratory tests. The more frequently used antibiotics were penicillin G and A. Antibiotics cost represented 34.7% of medicinal cost borne by patients and 49.7% of the cost borne by the public sector. Rationalization of medicinal prescription would have a positive impact on household and state budgets