[Predictors of increased cardiovascular risk in hypertensive patients in frontline facilities in Sousse, Tunisia]

We assessed cardiovascular risk factors among 456 hypertensive patients in 7 health centers in Sousse. Cardiovascular risk was estimated according World Health Organization centres Mean age was 65.6 [SD = 9.8] years, male: female sex ratio was 0.18. Cardiovascular recommendations risk was not influenced by sex, age or residence. However, patients with longer duration of hypertension and more frequent co- morbidity had a significantly higher cardiovascular risk. In addition 45.9% of patients on monotherapy had high cardiovascular risk compared with 40.6% of those treated with 2 or more drugs [P = 0.02]. Non- compliance was not found to be associated with high risk

[Knowledge of patients with type 2 diabetes about their condition in Sousse, Tunisia]

We assessed the knowledge of 404 type 2 diabetic patients about their condition in order to evaluate the quality of diabetes education in primary health care units in Sousse in 2003. We found that knowledge was satisfactory in only 59% of the patients. Their knowledge about the definition of diabetes and its pathophysiology were the 2 main areas where knowledge was lacking: the proportion of correct answers were 62.6% and 50.3% respectively. More attention should be paid to educating diabetic patients within the chronic disease care national programme

[Attitudes of teachers to tobacco smoking]

We aimed to evaluate the attitudes of teachers to tobacco smoking in Kalaa Kebira [a semi-urban region in the Tunisian Sahel]. Data from 358 of 402 teachers surveyed were obtained using a self-completed questionnaire. The mean age of the teachers was 35.7 [SD 7.9] years. The prevalence of smoking was 29.3% [51.6% of men and 3.6% of women], and 79% of smokers were addicted to nicotine according to the Fagerstrom test. About 50% of the teachers were badly-informed about the dangers of smoking and 75.2% of smoking teachers did not refrain from smoking in front of their pupils. The lack of knowledge of teachers limits their role as a model and information source in the anti-tobacco struggle. It is essential to draw up an education programme for the teaching staff

[Attitudes of general practitioners to pharmaceutical sales representatives in Sousse]

The therapeutic knowledge of physicians is the corner stone to the rational use of medicines; however information about medicines is generally obtained from the pharmaceutical industry via their sales representatives [reps]. We aimed to identify general practitioners' [GPs] attitudes to pharmaceutical reps and the information they provide. We surveyed 140 GPs using a self-administered questionnaire. The response rate was 78% [72 GPs from the public sector and 68 from the private sector]. About 10% of the GPs said they received daily visits from pharmaceutical reps; 84% of GPs considered them an efficient source of information and 31% said they might change their therapeutic prescribing following visits from these reps. Because of their positive perception of pharmaceutical reps, GPs are susceptible to the information they provide. Controlling the validity of the therapeutic information imparted by the pharmaceutical industry is thus a fundamental component of the programme for the rational use of medicines