COVID-19-Related Fear and Mental Distress Among Tunisian Primary, Middle and High School Teachers: Prevalence and Predictive Factors.

This study aimed to determine the prevalence and predictive factors of fear of COVID-19 and serious mental distress among teachers in public schools of Southern Tunisia. This was a cross sectional study among a representative sample of 525 teachers. The level of Fear was assessed using the Fear of COVID-19 Scale (FCV-19S). A high level was defined as an FCV-19S ≥ 22. Kessler 6 (K6) was performed to predict serious mental distress. Serious mental distress was defined as a K6 score ≥ 13. The prevalence rates of high level of fear of COVID-19 and serious mental distress were 32.8% and 63.8%, respectively. Independent factors associated with a high level of fear of COVID-19 were female gender (Adjusted odds ratio (AOR)=1.6 [1.1-2.5]), chronic disease (AOR=1.6 [1.1-2.4]), home-living children (AOR=3.3 [1.4-7.8]), and poor material working conditions (AOR=1.5 [1.2-2.1]). The high level of fear of COVID-19 (AOR=3.1 [1.8-5.1]) was independently associated with serious mental distress. Living in a rural area (AOR=0.4 [0.3-0.8]), previous COVID-19 infection (AOR=0.5 [0.4-0.8]) and going to school on foot (AOR=0.3 [0.2-0.51]) were independently associated with a lower prevalence of serious mental distress.

Epidemiological profile and performance of triage decision-making process of COVID-19 suspected cases in southern Tunisia.

INTRODUCTION: During an epidemic, screening processes can play a crucial role in limiting the spread of the infection. The aim of this study was to describe the epidemiological profile of COVID-19 suspected cases and to evaluate the performance of the triage process in predicting COVID-19 in Southern Tunisia. METHODS: It was a prospective study including all patients consulting to the Hedi Chaker University Hospital departments from March to June 2020. A clinical triage score (CTS) was used to assess the risk of the infection and to refer patients to the appropriate part of the facility accordingly. RESULTS: Overall, 862 patients were enrolled, among whom 505 patients (58.6%) were classified as suspected cases (CTS ≥4). Of these, 46.9% (n = 237) were of mild form. Samples were collected from 215 patients (24.9%), among whom five were COVID-19 positive, representing a positive rate of 2.3%. The in-hospital cumulative incidence rate of COVID-19 was 580/100000 patients. The total daily incidence decreased significantly during the study period (p < 0.001, chi-square for linear trend = 25.6). At a cut-off of four, the CTS had a sensitivity of 40%, a specificity of 32.4%, and negative and positive predictive values of 95.8% and 1.4%, respectively. DISCUSSION: Although the triage process based on the CTS was not as performant as the RT-PCR, it was crucial to interrupt virus spread among hospitalized patients in "COVID-19-free departments".