Comparison of cigarette and waterpipe smoking among pupils in the urban area of Sousse, Tunisia

Epidemiological and observational evidence suggests that waterpipe use is growing in popularity worldwide. The purpose of this study was to examine the prevalence of cigarette and water pipe tobacco use among pupils aged 13-17 years in the urban area of Sousse, Tunisia and to identify the factors which predict current cigarette and/or waterpipe smoking in this population. A cross-sectional study was carried Out on a representative sample of schoolchildren aged between 13 and 17 years in colleges and public secondary schools of the urban area of Sousse. We used a pre tested and self administered questionnaire to measure tobacco consumption. The significance level for all analyses was p<0.05. Statistical analysis was conducted with SPSS 10.0 software. Participants were 1569 youth. Fifty two percent of them were male. The mean age of the sample was 15 +/- 1.5 years. Total cigarette smoking percentage for ever and current use were 33.1%and 7.6%respectively. Total water pipe smoking percentage for ever and current use were 19.3%and 5.2%respectively. Overall, the total percentages of cigarette and water pipe smoking [ever and current] were higher for male and aged pupils. Multivariate regression analyses showed that the two types of tobacco use were related. Despite the growing adoption of water-pipe smoking, there remains limited research in this area. Increased surveillance and additional research are necessary to address this growing threat to public health

[Audit of management of arterial hypertension inprimary health care in sousse]

A medical audit has been carried out on a representative sample of 456 hypertensive patients followed in the health care facilities of Sousse during 2002, to evaluate the quality of management of hypertension in primary health care. The study yielded the following. the patients selected for a first line follow-up did not represent more than 79% of the studied population. The minimal recommended balance was achieved in 8% of cases only. Adequate drug therapy was prescribed in 64% of cases. 59% of patients were considered compliant. Controls of blood pressure was achieved in 5,5% of patients. The quality of management of hypertension in primary health care was considered satis factory in 28,7% of patents with a significant difference between urban and rural areas [24,9% versus 40,5%]. These results indicate that increased attention should be paid by the national program of Struggle against the Chronic Diseases to the quality of management of hypertension in primary health care institutions

[Behaviours and needs for health of secondary-school-adolescents in Sousse [Tunisia]]

It was a descriptive study bearing on a probabilistic sample of one-degree cluster composed of 685 adolescents studying in six secondary state schools in Sousse, during 1998 - 1999 school year. The facts had been collected through an anonymous and self administrated questionnaire. 23.3% of youngsters had a negative image of themselves. Parent-adolescent communication was inexistent in 30.6% of cases. At school. 24.3% of youngsters had a bad relationship with their teachers. One adolescent on four felt rather alone. One on three was not satisfied by leisure means put at his disposal. Alimentary behavior was disturbed for one adolescent on three. The prevalence rates of smoking and alcoholism were respectively 14.8% and 9%. At least, one suicide attempt was observed in 7.7%. Among sexually active youngsters, 23.8% did not use a contraceptive mean. This study revealed that adolescent was threatened by a hostile environment which may worsen his identity crisis and exposed him to adopt many risky behaviors

[Tracking of cardiovascular risk factors among school children: a four-year study of a population in Susa, Tunisia]

In order to confirm the phenomenon of tracking of cardiovascular risk factors among school children, we undertook in 2003, a prospective survey of a population of 789 pupils aged 13 to 15 years who had participated in a first investigation on cardiovascular risk factors in 1999. We were able to follow and study 453 pupils [57.4% of the initial population]. Prevalences of hypertension and obesity were respectively 11.3% and 6.1% without significant difference between sexes. On the other hand, hypercholesterolemia was significantly more elevated among girls than boys [16.1% versus 9.3%, p=0.039]. Children classified initially as hypertensive, obese or having a hypercholesterolemia were identified 4 years later at a subsequent exam as hypertensive, obese or having a hypercholesterolemia in respectively 25%, 48.9% and 59%. The stability of cardiovascular risk factors among children imposes an early screening for a better management and a policy of cardiovascular health promotion since childhood based essentially on prevention of risk factors in order to reduce the cardiovascular disease burden in adulthood