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1.
Infect Genet Evol ; 102: 105300, 2022 08.
Article in English | MEDLINE | ID: covidwho-1946053

ABSTRACT

Since the beginning of the Coronavirus disease-2019 pandemic, there has been a growing interest in exploring SARS-CoV-2 genetic variation to understand the origin and spread of the pandemic, improve diagnostic methods and develop the appropriate vaccines. The objective of this study was to identify the SARS-CoV-2s lineages circulating in Tunisia and to explore their amino acid signature in order to follow their genome dynamics. Whole genome sequencing and genetic analyses of fifty-eight SARS-CoV-2 samples collected during one-year between March 2020 and March 2021 from the National Influenza Center were performed using three sampling strategies.. Multiple lineage introductions were noted during the initial phase of the pandemic, including B.4, B.1.1, B.1.428.2, B.1.540 and B.1.1.189. Subsequently, lineages B1.160 (24.2%) and B1.177 (22.4%) were dominant throughout the year. The Alpha variant (B.1.1.7 lineage) was identified in February 2021 and firstly observed in the center of our country. In addition, A clear diversity of lineages was observed in the North of the country. A total of 335 mutations including 10 deletions were found. The SARS-CoV-2 proteins ORF1ab, Spike, ORF3a, and Nucleocapsid were observed as mutation hotspots with a mutation frequency exceeding 20%. The 2 most frequent mutations, D614G in S protein and P314L in Nsp12 appeared simultaneously and are often associated with increased viral infectivity. Interestingly, deletions in coding regions causing consequent deletions of amino acids and frame shifts were identified in NSP3, NSP6, S, E, ORF7a, ORF8 and N proteins. These findings contribute to define the COVID-19 outbreak in Tunisia. Despite the country's limited resources, surveillance of SARS-CoV-2 genomic variation should be continued to control the occurrence of new variants.


Subject(s)
COVID-19 , SARS-CoV-2 , Amino Acids/genetics , COVID-19/epidemiology , Genome, Viral , Humans , Mutation , Phylogeny , SARS-CoV-2/genetics , Spike Glycoprotein, Coronavirus/chemistry , Spike Glycoprotein, Coronavirus/genetics , Tunisia/epidemiology
2.
PLoS One ; 17(7): e0270814, 2022.
Article in English | MEDLINE | ID: covidwho-1919122

ABSTRACT

INTRODUCTION: Influenza A virus infection is a contagious acute respiratory infection which mostly evolves in an epidemic form, less frequently as pandemic outbreaks. It can take a severe clinical form that needs to be managed in intensive care unit (ICU). The aim of this study was to describe the epidemiological and clinical aspects of influenza A, then to determine independent predictive factors of ICU mortality in Abderrahmen Mami hospital, Ariana, Tunisia. METHODS: It was a single-center study, including all hospitalized patients in intensive care, between November 1st, 2009 and October 31st, 2019, with influenza A virus infection. We recorded demographic, clinical and biological data, evolving features; then multivariate analysis of the predictive factors of ICU mortality was realized. RESULTS: During the study period (10 consecutive seasons), 120 patients having severe Influenza A were admitted (Proportion = 2.5%) from all hospitalized patients, with a median age of 48 years and a gender-ratio of 1.14. Among women, 14 were pregnant. Only 7 patients (5.8%) have had seasonal flu vaccine during the year before ICU admission. The median values of the Simplified Acute Physiology Score II, Acute Physiologic and Chronic Health Evaluation II and Sepsis-related Organ Failure Assessment were respectively 26, 10 and 3. Virus strains identified with polymerase chain reaction were H1N1 pdm09 (84.2%) and H3N2 (15.8%). Antiviral therapy was prescribed in 88 (73.3%) patients. A co-infection was recorded in 19 cases: bacterial (n = 17) and aspergillaire (n = 2). An acute respiratory distress syndrome (ARDS) was diagnosed in 82 patients. Non-invasive ventilation (NIV) was conducted for 72 (60%) patients with success in 34 cases. Endotracheal intubation was performed in 59 patients with median duration of invasive mechanical ventilation 8 [3.25-13] days. The most frequent complications were acute kidney injury (n = 50, 41.7%), shock (n = 48, 40%), hospital-acquired infections (n = 46, 38.8%) and thromboembolic events (n = 19, 15.8%). The overall ICU mortality rate was of 31.7% (deceased n = 38). Independent predictive factors of ICU mortality identified were: age above 56 years (OR = 7.417; IC95% [1.474-37.317]; p = 0.015), PaO2/FiO2 ≤ 95 mmHg (OR = 9.078; IC95% [1.636-50.363]; p = 0.012) and lymphocytes count ≤ 1.325 109/L (OR = 10.199; IC95% [1.550-67.101]; p = 0.016). CONCLUSION: Influenza A in ICU is not uncommon, even in A(H1N1) dominant seasons; its management is highly demanding. It is responsible for considerable morbi-mortality especially in elderly patients.


Subject(s)
Influenza A Virus, H1N1 Subtype , Influenza A Virus, H3N2 Subtype , Influenza, Human , Aged , Female , Hospital Mortality , Humans , Influenza, Human/epidemiology , Influenza, Human/mortality , Influenza, Human/therapy , Influenza, Human/virology , Intensive Care Units , Male , Middle Aged , Noninvasive Ventilation , Patient Acuity , Pregnancy , Risk Factors , Tunisia/epidemiology
3.
PLoS One ; 17(6): e0269573, 2022.
Article in English | MEDLINE | ID: covidwho-1879325

ABSTRACT

The COVID-19 pandemic has caused over 500 million cases and over six million deaths globally. From these numbers, over 12 million cases and over 250 thousand deaths have occurred on the African continent as of May 2022. Prevention and surveillance remains the cornerstone of interventions to halt the further spread of COVID-19. Google Health Trends (GHT), a free Internet tool, may be valuable to help anticipate outbreaks, identify disease hotspots, or understand the patterns of disease surveillance. We collected COVID-19 case and death incidence for 54 African countries and obtained averages for four, five-month study periods in 2020-2021. Average case and death incidences were calculated during these four time periods to measure disease severity. We used GHT to characterize COVID-19 incidence across Africa, collecting numbers of searches from GHT related to COVID-19 using four terms: 'coronavirus', 'coronavirus symptoms', 'COVID19', and 'pandemic'. The terms were related to weekly COVID-19 case incidences for the entire study period via multiple linear and weighted linear regression analyses. We also assembled 72 variables assessing Internet accessibility, demographics, economics, health, and others, for each country, to summarize potential mechanisms linking GHT searches and COVID-19 incidence. COVID-19 burden in Africa increased steadily during the study period. Important increases for COVID-19 death incidence were observed for Seychelles and Tunisia. Our study demonstrated a weak correlation between GHT and COVID-19 incidence for most African countries. Several variables seemed useful in explaining the pattern of GHT statistics and their relationship to COVID-19 including: log of average weekly cases, log of cumulative total deaths, and log of fixed total number of broadband subscriptions in a country. Apparently, GHT may best be used for surveillance of diseases that are diagnosed more consistently. Overall, GHT-based surveillance showed little applicability in the studied countries. GHT for an ongoing epidemic might be useful in specific situations, such as when countries have significant levels of infection with low variability. Future studies might assess the algorithm in different epidemic contexts.


Subject(s)
COVID-19 , COVID-19/epidemiology , Humans , Incidence , Pandemics , Search Engine , Tunisia
4.
BMC Health Serv Res ; 22(1): 489, 2022 Apr 12.
Article in English | MEDLINE | ID: covidwho-1789120

ABSTRACT

BACKGROUND: People's lives were seriously affected by the emergence and the spread of the COVID-19 disease. Several vaccines were developed in record time to overcome this pandemic. However, putting an end to this public health problem requires substantial vaccination coverage rate. This latter depends on the acceptance of these vaccines especially by health professionals; the leaders of the current war against COVID-19. In fact, they have a central role in promoting vaccination against the SARS-CoV-2. In the developed countries, hesitancy rates towards these vaccines among health professionals vary from 4.3% to 72%. In the developing countries, few studies focused on this issue. OBJECTIVE: To estimate the prevalence and the predictors of SARS-CoV-2 vaccine hesitancy among the Tunisian health professionals. METHODS: A cross-sectional study was led online between the 7th and the 21th of January 2021 among Tunisian health professionals. At least 460 participants were required. Snowball sampling method served to recruit participants. Data were collected using a pre-established and pre-tested questionnaire recorded in a free Google form. The link of the questionnaire was disseminated online to be self-administered anonymously to the participants. The generated online Google Sheet was uploaded and exported to SPSS software for analysis. RESULTS: Of the 546 responses, 493 were retained. The mean age of participants was 37.4 (± 9.5) years. Females represented 70.2% of participants. Social media represented the most frequently used source of information about COVID-19. The prevalence of SARS-CoV-2 vaccine hesitancy among participants was 51.9% (95% CI: 47.5-56.3)). Female sex, working far from the capital and having concerns about the vaccines components predicted more hesitancy among participants. In contrast, the use of the national COVID-19 information website predicted less hesitancy among them. CONCLUSIONS: The current Tunisian communication plan about COVID-19 vaccines must be reinforced. Social media represent a cost effective communication channel that can serve to reassure Tunisian health professionals regarding the safety of COVID-19 vaccines. Special interest should be paid to females, paramedical professionals and those working far from the capital.


Subject(s)
COVID-19 , Vaccines , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Cross-Sectional Studies , Female , Humans , Middle Aged , Research Design , SARS-CoV-2 , Tunisia/epidemiology , Vaccination
5.
Front Public Health ; 10: 856167, 2022.
Article in English | MEDLINE | ID: covidwho-1776083

ABSTRACT

Background: The Revised Two Factor Study Process Questionnaire (R-SPQ-2F) is used to examine students' study approaches in higher education. The questionnaire is designed to measure two factors: deep and surface approaches. In order to measure these approaches for students in physical education and sport, a new measurement instrument should take into consideration the practical context of this field of education that makes it specific to other fields. Objective: The present study aims (a) to develop and empirical test of a new instrument for measuring the study process in physical education and sports students, and (b) to test psychometric properties of the tool. Methods: Two exploratory and confirmatory samples of physical education students enrolled in a bachelor's degree program in physical education at the High Institute of Physical Education and Sports of Kef-Tunisia, aged 19-26 years, were recruited online among female students (n = 414) and male students (n = 393). The participants filled in Google Form survey including Physical Education-Study Process Questionnaire (PE-SPQ) and the Arabic version of the Revised Study Process Questionnaire-2 Factors (R-SPQ-2F). Results: Exploratory factor analysis showed a suitable four factors solution, which is approved by confirmatory factor analysis indices [χ2 = 466.47, TLI = 0.94, CFI = 0.95; RMSEA = 0.56 IC 90% (0.050-0.062)]. Internal consistency of the PE-SPQ simultaneously checked by McDonald's ω, Cronbach's α and Gutmann's λ6 showed good reliability of the PE-SPQ. Convergent validity examined by Average variance extracted (AVE) was good. The comparison between the AVE root mean square and Pearson correlation coefficients of each factor with his indicators reveals the discriminant validity of the PE-SPQ. Furthermore, Pearson's correlation between the PE-SPQ factors and the R-SPQ-2F establishes the concurrent validity of the new scale. Conclusion: The PE-SPQ scale is valid and reliable and can be used to assess study process factors in physical education students.


Subject(s)
Physical Education and Training , Surveys and Questionnaires , Adult , Female , Humans , Male , Reproducibility of Results , Students , Tunisia , Universities , Young Adult
6.
Viruses ; 14(3)2022 03 17.
Article in English | MEDLINE | ID: covidwho-1753688

ABSTRACT

Documenting the circulation dynamics of SARS-CoV-2 variants in different regions of the world is crucial for monitoring virus transmission worldwide and contributing to global efforts towards combating the pandemic. Tunisia has experienced several waves of COVID-19 with a significant number of infections and deaths. The present study provides genetic information on the different lineages of SARS-CoV-2 that circulated in Tunisia over 17 months. Lineages were assigned for 1359 samples using whole-genome sequencing, partial S gene sequencing and variant-specific real-time RT-PCR tests. Forty-eight different lineages of SARS-CoV-2 were identified, including variants of concern (VOCs), variants of interest (VOIs) and variants under monitoring (VUMs), particularly Alpha, Beta, Delta, A.27, Zeta and Eta. The first wave, limited to imported and import-related cases, was characterized by a small number of positive samples and lineages. During the second wave, a large number of lineages were detected; the third wave was marked by the predominance of the Alpha VOC, and the fourth wave was characterized by the predominance of the Delta VOC. This study adds new genomic data to the global context of COVID-19, particularly from the North African region, and highlights the importance of the timely molecular characterization of circulating strains.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/epidemiology , Genome, Viral , Humans , Molecular Epidemiology , SARS-CoV-2/genetics , Tunisia/epidemiology
7.
Int J Environ Res Public Health ; 19(4)2022 Feb 15.
Article in English | MEDLINE | ID: covidwho-1686797

ABSTRACT

The COVID-19 pandemic-related measures in the Near East and North Africa (NENA) region have resulted in many lifestyle modifications, including changes in diet and food buying patterns among adults. However, the pandemic has impacted women and men differently and exacerbated existing socio-economic and gender inequalities. Indeed, numerous studies conducted worldwide have shown that the COVID-19 pandemic had a disproportionately negative impact on women compared to males. Therefore, this paper aims to analyze the effects of COVID-19 on women's food behaviors in three countries of the North Africa sub-region, namely, Egypt, Morocco, and Tunisia. The study was based on an online poll conducted by SurveyMonkey from 15 September to 5 November 2020, with 995 participants. The outcomes of the research found that when compared to men, (1) women tend to consume more food out of fear, anxiety, or boredom; (2) women prefer to eat more unhealthy food; (3) women tend to stockpile a greater amount of food; and (4) women tend to modify their shopping habits more often. The findings should inform gender-sensitive strategies and policies to address the negative impacts of the pandemic and foster transition towards healthier diets and resilient food systems during the recovery period.


Subject(s)
COVID-19 , Adult , Africa, Northern/epidemiology , COVID-19/epidemiology , Egypt/epidemiology , Female , Humans , Male , Morocco/epidemiology , Pandemics , SARS-CoV-2 , Tunisia/epidemiology
8.
Int J Health Plann Manage ; 37(3): 1838-1846, 2022 May.
Article in English | MEDLINE | ID: covidwho-1680340

ABSTRACT

OBJECTIVES: Coronavirus disease (COVID-19) is one of the most detrimental pandemics that affected the humanity throughout the ages. The irregular historical progression of the virus over the first year of the pandemic was accompanied with far-reaching health and social damages. To prepare logistically against this worsening disaster, many public authorities around the world had set up screening and forecasting studies. This article aims to analyse the time-frequency co-evolution of the number of confirmed cases (NCC) in Tunisia and the related number of performed polymerase chain reaction (PCR) tests over the COVID-19 first year. Accurately predicting such a relationship allows Tunisian authorities to set up an effective health prevention plan. STUDY DESIGN: In order to keep pace with the speed of evolution of the virus, we used uninterrupted daily time series from the Tunisian Ministry of Public Health (TMPH) recorded over the COVID-19 first year. The objective is to: (1) analyse the time-frequency progress of the NCC in relationship with the number of PCR tests, (2) identify a multi-scale two-factor stochastic model in order to develop a robust bivariate forecasting technique. METHODS: We assume a bivariate stochastic process which is projected onto a set of wavelet sub-spaces to investigate the scale-by-scale co-evolvement the NCC/PCR over the COVID-19 first year. A wavelet-based multiresolutional causality test is then performed. RESULTS: The main results recommend the rejection of the null hypothesis of no instantaneous causality in both directions, while the statistics of the Granger test suggest failing to reject the null hypothesis of non-causality. However, by proceeding scale-by-scale, the Granger causality is proven significant in both directions over varying frequency bands. CONCLUSIONS: It is important to include the NCC and PCR variables in any time series model intended to predict one of these variables. Such a bivariate and multi-scale model is supposed to better predict the needs of the public health sector in screening tests. On this basis, testing campaigns with multiple periodicities can be planned by the Tunisian authorities.


Subject(s)
COVID-19 , SARS-CoV-2 , Causality , Humans , Pandemics , Tunisia/epidemiology
9.
Int J Environ Res Public Health ; 19(3)2022 Jan 24.
Article in English | MEDLINE | ID: covidwho-1648821

ABSTRACT

This study describes for the first time in the central Mediterranean Sea the effects of bottom trawling on macrobenthic fauna in tidal channels of the Kneiss Islands in the Gulf of Gabès, Tunisia. Following a BACI protocol, two control stations (protected by artificial reefs) and two trawled stations (impacted stations) were sampled during a period with the absence of bottom trawling activity (the COVID-19 pandemic lockdown period from March to May 2020) and during a trawled period. Although bottom trawling had no impact on sediment composition, this anthropogenic activity reduced the concentration of dissolved oxygen and had a noticeable effect on water column turbidity. The absence of trawling led to a significant increase in biomass, number of species, and abundance of total macrofauna. This illustrated the negative effect of trawling activity in shallow waters and the high resilience of macrobenthic communities of the tidal ecosystem of the Kneiss Islands. In the future, it would be very important to control the use of this destructive fishing gear due to its negative impact on the marine habitat and macrofauna, which represents essential prey for fishes and birds living in this protected area.


Subject(s)
COVID-19 , Ecosystem , Animals , Communicable Disease Control , Humans , Invertebrates , Mediterranean Sea , Pandemics , SARS-CoV-2 , Tunisia
10.
Pan Afr Med J ; 40: 197, 2021.
Article in English | MEDLINE | ID: covidwho-1633989

ABSTRACT

INTRODUCTION: restrictive measures imposed during the COVID-19 pandemic, such as quarantine, may induce psychiatric outcomes among concerned individuals. The present study aimed to describe the mental health status of Tunisian adults under mandatory institutional quarantine imposed during the COVID-19 pandemic, and to determine factors influencing the occurrence of psychiatric symptoms. METHODS: a cross-sectional phone survey was conducted from April to November 2020 using convenience sampling of persons who had experienced mandatory institutional quarantine. A standardized questionnaire was administered to participants including questions about socio-demographic characteristics and quarantine related information. Generalized anxiety disorder, depression symptoms, and sleep quality during quarantine were assessed using, respectively, the generalized anxiety disorder-7 (GAD-7), the centre for epidemiological studies depression (CES-D-10) and the insomnia severity index (ISI) scales. Bivariate and multivariate analyses were performed to determine factors associated with anxiety and/or depression and with clinical insomnia. RESULTS: among 506 participants, 38.3% experienced anxiety and/or depression symptoms (anxiety: 15.4%; depression: 37.4%) and 19.2% had clinical insomnia. The prevalence of anxiety and/or depression symptoms and insomnia were higher among women those who spent three hours or above on COVID-19 news, those who had economic difficulties due to COVID-19 pandemic, those who were not satisfied by the accommodation conditions of quarantine facilities, and those who had experienced stigma. CONCLUSION: high prevalence of psychiatric symptoms among quarantined individuals was found in this study. Psychological interventions should thus be an integral part of the COVID-19 control strategy in order to provide adequate psychological support to persons quarantined due to COVID-19.


Subject(s)
COVID-19 , Quarantine , Adult , Cross-Sectional Studies , Depression/epidemiology , Female , Health Status , Humans , Pandemics , SARS-CoV-2 , Tunisia/epidemiology
11.
Microbiol Spectr ; 9(3): e0063921, 2021 12 22.
Article in English | MEDLINE | ID: covidwho-1593211

ABSTRACT

Recent efforts have reported numerous variants that influence severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral characteristics, including pathogenicity, transmission rate, and detectability by molecular tests. Whole-genome sequencing based on next-generation sequencing technologies is the method of choice to identify all viral variants; however, the resources needed to use these techniques for a representative number of specimens remain limited in many low- and middle-income countries. To decrease sequencing costs, we developed a primer set allowing partial sequences to be generated in the viral S gene, enabling rapid detection of numerous variants of concern (VOCs) and variants of interest (VOIs); whole-genome sequencing is then performed on a selection of viruses based on partial sequencing results. Two hundred one nasopharyngeal specimens collected during the decreasing phase of a high-transmission COVID-19 wave in Tunisia were analyzed. The results reveal high genetic variability within the sequenced fragment and allow the detection of first introductions in the country of already-known VOCs and VOIs, as well as other variants that have interesting genomic mutations and need to be kept under surveillance. IMPORTANCE The method of choice for SARS-CoV-2 variant detection is whole-genome sequencing using next-generation sequencing (NGS) technologies. Resources for this technology remain limited in many low- and middle-income countries, where it is not possible to perform whole-genome sequencing for representative numbers of SARS-CoV-2-positive cases. In the present work, we developed a novel strategy based on a first partial Sanger screening in the S gene, which includes key mutations of the already known VOCs and VOIs, for rapid identification of these VOCs and VOIs and to help better select specimens that need to be sequenced by NGS technologies. The second step consists of whole-genome sequencing to allow a holistic view of all variants within the selected viral strains and confirm the initial classification of the strains based on partial S gene sequencing.


Subject(s)
COVID-19/virology , SARS-CoV-2/classification , SARS-CoV-2/genetics , Spike Glycoprotein, Coronavirus/genetics , Adolescent , Adult , Aged , Aged, 80 and over , Base Sequence , COVID-19/transmission , COVID-19 Testing/methods , Child , Child, Preschool , Female , Genome, Viral , High-Throughput Nucleotide Sequencing , Humans , Male , Middle Aged , Mutation , Phylogeny , Serogroup , Tunisia , Whole Genome Sequencing , Young Adult
12.
Pan Afr Med J ; 40: 126, 2021.
Article in English | MEDLINE | ID: covidwho-1591427

ABSTRACT

The SARS CoV-2 pandemic is a global health threat with high morbidity and mortality (1 to 4%) rates. COVID-19 is correlated with important immune disorders, including a "cytokine storm". A new therapeutic approach using the immunomodulatory drug, Anti-IL6 (tocilizimub), has been proposed to regulate it. We report here the first Tunisian experience using tocilizimub in two severe cases of COVID-19 pneumonia. The diagnosis was confirmed by chest scan tomography. Biological parameters showed a high level of Interleukin-6 (IL-6) that increased significantly during hospitalization. The patients developed hypoxia, so they received intravenously 8 mg/kg body weight tocilizumab. There was a resultant decrease in the level of IL6, with clinically good evolution. Blocking the cytokine IL-6 axis is a promising therapy for patients developing COVID-19 pathology.


Subject(s)
COVID-19 , Antibodies, Monoclonal, Humanized , COVID-19/drug therapy , Humans , SARS-CoV-2 , Treatment Outcome , Tunisia
13.
Asian Pac J Cancer Prev ; 22(11): 3499-3506, 2021 Nov 01.
Article in English | MEDLINE | ID: covidwho-1539062

ABSTRACT

BACKGROUND: Vaccination is the most effective way to fight the COVID-19 pandemic and to protect people who have a higher risk of developing severe illness and death from COVID-19 such as cancer patients. We aimed in this study to determine the acceptance rate of COVID-19 vaccination of the Salah Azaiez Institute (SAI) of cancer of Tunisia patients and to identify its associated factors. METHODS: It was a cross sectional study about patients admitted to the SAI for treatment during the month of February 2021. Univariate and multivariate analyses were performed to identify factors associated with the COVID-19 vaccine acceptance among Tunisian cancer patients. RESULTS: A total of 200 patients were included in this study with a mean age of 54.4±12.7 years and a gender ratio of 0.5. Only 35.0% of surveyed patients reported their acceptance to receive the COVID-19 vaccine. Multivariate analysis showed that believing in COVID-19 vaccine safety and efficacy (OR=3.1 [1.3-7.4]), enrollment in the COVID-19 vaccine platform (OR=8.3 [1.8-38.1]) and the willingness to receive influenza vaccine (OR=3.9 [1.6-9.3]) were independently associated with the COVID-19 vaccine acceptance among SAI cancer patients. CONCLUSIONS: The COVID-19 vaccine acceptance rate found in this study was low. Communication strategies of the vaccination campaigns should provide clear, simple and detailed messages about the efficacy and the benefits of the COVID-19 vaccines. More engagement of health authorities to promote COVID-19 vaccination is necessary.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Health Knowledge, Attitudes, Practice , Neoplasms/prevention & control , Patient Acceptance of Health Care , SARS-CoV-2/isolation & purification , Vaccination/psychology , Adult , COVID-19/epidemiology , COVID-19/virology , Cross-Sectional Studies , Female , Health Belief Model , Humans , Male , Middle Aged , Neoplasms/epidemiology , Neoplasms/virology , Surveys and Questionnaires , Tunisia/epidemiology , Young Adult
14.
Pan Afr Med J ; 39: 245, 2021.
Article in English | MEDLINE | ID: covidwho-1449272

ABSTRACT

INTRODUCTION: the year 2020 was marked by the COVID-19 pandemic that killed more than one million people. Several vaccines have been developed and vaccination campaigns started in December 2020. The objective of our study was to assess the acceptability of the COVID-19 vaccine by hospital staff. METHODS: cross-sectional study conducted on a representative sample drawn at random from the staff of the Military General Hospital of Tunis. Data was collected between August and September 2020 by a clinical psychologist. We studied the associations between the different characteristics of our population and the decision to accept or refuse vaccination against COVID-19. RESULTS: a total of 398 hospital staff agreed to answer our questionnaire. Our sample was composed of 9% (n=36) physicians, 0.9% (n=3) pharmacists, 41.3% (n=164) paramedics, 16.1% (n=64) cleaning staff and 32.7% (n=131) administrative staff. The rapid discovery of the vaccine was hoped by 97% (n=386). Vaccination was considered a means of collective protection by 84.7% (n=337). However, only 58% (n=231) agreed to be vaccinated by the COVID-19 vaccine. The main factors significantly associated with acceptance of the COVID-19 vaccine was previous influenza vaccination (aOR: 2.58, 95% CI 1.69-3.94; p=0.000). CONCLUSION: apprehension about vaccination does not appear to be sparing the future COVID-19 vaccine. Fear of vaccine side effects outweighs fear of the disease, even among hospital staff. To achieve vaccination coverage, several awareness and communication activities must be carried out.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Vaccination Coverage/statistics & numerical data , Vaccination/statistics & numerical data , Adult , Attitude of Health Personnel , Cross-Sectional Studies , Fear/psychology , Female , Health Knowledge, Attitudes, Practice , Hospitals, General , Humans , Immunization Programs , Male , Middle Aged , Personnel, Hospital , Surveys and Questionnaires , Tunisia , Vaccination/psychology , Young Adult
15.
Virus Genes ; 56(6): 767-771, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1384547

ABSTRACT

In the present work, two complete genome sequences of SARS-CoV-2 were obtained from nasal swab samples of Tunisian SARS-CoV-2 PCR-positive patients using nanopore sequencing. The virus genomes of two of the patients examined, a Tunisian soldier returning from a mission in Morocco and a member of another Tunisian family, showed significant differences in analyses of the total genome and single nucleotide polymorphisms (SNPs). Phylogenetic relationships with known SARS-CoV-2 genomes in the African region, some European and Middle Eastern countries and initial epidemiological conclusions indicate that the introduction of SARS-CoV-2 into Tunisia from two independent sources was travel-related.


Subject(s)
COVID-19/epidemiology , Genome, Viral , Pandemics , Phylogeny , SARS-CoV-2/genetics , Adult , Asymptomatic Diseases , COVID-19/diagnosis , COVID-19/transmission , COVID-19/virology , Europe/epidemiology , Female , Hospitals, Military , Humans , Male , Middle Aged , Military Personnel , Morocco/epidemiology , Pedigree , RNA, Viral/genetics , SARS-CoV-2/classification , SARS-CoV-2/isolation & purification , Travel-Related Illness , Tunisia/epidemiology , Viral Load , Whole Genome Sequencing
16.
Int J Environ Res Public Health ; 18(16)2021 08 15.
Article in English | MEDLINE | ID: covidwho-1354979

ABSTRACT

The multitude of national strategies used against the COVID-19 pandemic makes it necessary to review and synthesize them in order to identify potential gaps and shortcomings, and to help prioritize future control efforts. This systematic mapping review is aimed at identifying the coronavirus pandemic management strategies adopted by France, Tunisia, and Germany during the early stage of the COVID-19 outbreak. A set of government websites in addition to the PubMed and Google Scholar databases were searched to identify scientific articles and institutional documents related to the national strategies of the three countries up until July 2020. The references included were mapped and narratively synthesized based on the pillars of the Monitoring and Evaluation Framework of the Strategic Preparedness and Response Plan defined by the World Health Organization. Of the 2765 records screened, 65 documents were included in the study. The analysis of these documents showed that Germany was the first country to implement mass screening of cases and that France was the first country to implement measures to impose general containment at the national level. It also showed that Tunisia was the only country to have imposed the confinement of passengers on repatriation flights in dedicated containment centers and at the expense of the state.


Subject(s)
COVID-19 , Pandemics , Disease Outbreaks , France/epidemiology , Germany/epidemiology , Humans , SARS-CoV-2 , Tunisia/epidemiology
18.
Transbound Emerg Dis ; 68(4): 1966-1978, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1331778

ABSTRACT

This article presents a participative and iterative qualitative risk assessment framework that can be used to evaluate the spatial variation of the risk of infectious animal disease introduction and spread on a national scale. The framework was developed through regional training action workshops and field activities. The active involvement of national animal health services enabled the identification, collection and hierarchization of risk factors. Quantitative data were collected in the field, and expert knowledge was integrated to adjust the available data at regional level. Experts categorized and combined the risk factors into ordinal levels of risk per epidemiological unit to ease implementation of risk-based surveillance in the field. The framework was used to perform a qualitative assessment of the risk of introduction and spread of foot-and-mouth disease (FMD) in Tunisia as part of a series of workshops held between 2015 and 2018. The experts in attendance combined risk factors such as epidemiological status, transboundary movements, proximity to the borders and accessibility to assess the risk of FMD outbreaks in Tunisia. Out of the 2,075 Tunisian imadas, 23 were at a very high risk of FMD introduction, mainly at the borders; and 59 were at a very high risk of FMD spread. To validate the model, the results were compared to the FMD outbreaks notified by Tunisia during the 2014 FMD epizootic. Using a spatial Poisson model, a significant alignment between the very high and high-risk categories of spread and the occurrence of FMD outbreaks was shown. The relative risk of FMD occurrence was thus 3.2 higher for imadas in the very high and high spread risk categories than for imadas in the low and negligible spread risk categories. Our results show that the qualitative risk assessment framework can be a useful decision support tool for risk-based disease surveillance and control, in particular in scarce-data environments.


Subject(s)
Foot-and-Mouth Disease Virus , Foot-and-Mouth Disease , Animals , Disease Outbreaks/veterinary , Foot-and-Mouth Disease/epidemiology , Risk Assessment , Tunisia/epidemiology
19.
BMC Genomics ; 22(1): 540, 2021 Jul 14.
Article in English | MEDLINE | ID: covidwho-1311248

ABSTRACT

BACKGROUND: In Tunisia a first SARS-CoV-2 confirmed case was reported in March 03, 2020. Since then, an increase of cases number was observed from either imported or local cases. The aim of this preliminary study was to better understand the molecular epidemiology and genetic variability of SARS-CoV-2 viruses circulating in Tunisia and worldwide. METHODS: Whole genome sequencing was performed using NGS approach on six SARS. CoV-2 highly positive samples detected during the early phase of the outbreak. RESULTS: Full genomes sequences of six Tunisian SARS-CoV-2 strains were obtained from imported and locally transmission cases during the COVID-19 outbreak. Reported sequences were non-identical with 0.1% nucleotide divergence rate and clustered into 6 different clades with worldwide sequences. SNPs results favor the distribution of the reported Tunisian sequences into 3 major genotypes. These SNP mutations are critical for diagnosis and vaccine development. CONCLUSIONS: These results indicate multiple introductions of the virus in Tunisia and add new genomic data on SARS-CoV-2 at the international level.


Subject(s)
COVID-19 , SARS-CoV-2 , Genome, Viral , Humans , Pandemics , Phylogeny , Tunisia/epidemiology , Whole Genome Sequencing
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