Seasonality of Pulmonary Tuberculosis in Sousse (Tunisia).

INTRODUCTION: Seasonal variation of Pulmonary tuberculosis (TB) has attracted the attention in several regions of the world. AIM: To explore the relationship between variations of mean meteorological parameters (temperature, atmospheric pressure, relative humidity and duration of sunshine) and the occurrence of cases of pulmonary TB. METHODS: This is a retrospective descriptive study of two-time series (meteorological data, case of pulmonary TB) from 1th January 2010 to 31th December 2014.Meteorological data were collected throughout the 5-year period. RESULTS: We collected 180 cases confirmed by direct examination. The relationship between seasonality and the occurrence of TB cases was addressed in two ways considering either the date of the bacteriological diagnosis or the date date of onset of symptoms of TB as the date of the census of cases. Taking into account the date of bacteriological diagnosis, it appeared that spring (33.7%) and summer (25.9%) had the most days with positive diagnosis (p = 0.012). However, considering the date of onset of symptoms of TB , it appeared that winter (34.2%) and spring (28%) had the most days with positive diagnosis with a significant difference. The comparison of the mean of meteorological parameters between days with and without bacteriological diagnosis showed that only the mean duration of sunshine was significatively associated with more cases(p=0.002). This same comparison between the days with and without TB according to the date of onset of symptoms of TB showed significant difference only for mean temperatures which were lower  during the days when patients présented symptoms of TB (p=0.013). CONCLUSION: Our results have highlighted the possible implication of meteorological parameters in the occurrence of pulmonary TB cases.

"Spirometric" lung age reference equations: A narrative review.

The aim of the present paper was to conduct a narrative review of the published norms of the "spirometric" lung-age (SLA). A literature search which covered the period 1970 to June 2017, was conducted using the Pubmed. The search strategy had used the following MeSH words: "Spirometry"[Majr]) AND "Aging"[Majr]. Six original studies have reported equations predicting SLA for adults aged 18-90 years [USA (n=2), Japan (n=2); Australia (n=1) and Tunisia (n=1)]. Their sample sizes varied from 125 to 15238, with a total of 32334 volunteers (11788 men). Several models of norms were developed. They included one (often, FEV1) or more spirometric data in addition to one (often, height) or more anthropometric data. All studies have validated their norms in additional one or more groups, with satisfactory results. Only three authors have proposed algorithms to interpret SLA. All studies presented several limitations concerning the sample size and/or representation, the age distribution, the use of old spirometric data and/or equipment, the application of old spirometric methods, and especially mathematical and statistical flaws.

6-min walk-distance norms in adults Arab populations: a literature review.

INTRODUCTION: The primary outcome of the 6-min walk-test is the 6-min walk-distance (6MWD). Its interpretation relies upon the comparison of the measured 6MWD with the predicted one from published norms. OBJECTIVE: The aim of the present review is to report the 6MWD norms published for healthy adults Arab populations. METHODS: The review includes a literature search, from 1970 to January 5th 2017 using the PubMed search engine. Reference equations lists of retrieved English/French articles were searched for any supplementary references. The research includes the combination of the following (or their synonyms) "Medical Subject Headings" or "Title/Abstract" terms: «walking¼ AND «reference values¼ AND «Arabs¼. RESULTS: Five studies, conducted in Saudi-Arabia (n=2), Tunisia (n=2) and Algeria (n=1) were included. Norms comprised the following factors: age (Yrs), height (cm), weight (kg), body mass index (BMI, kg/m2), sex (0:women; 1:men) and physical activity level. Five norms were proposed for Tunisian aged 40-79 years [6MWD (m) = 299.8 - 4.34xAge + 3.43xHeight - 1.46xWeight + 62.5xSex] or aged 40-85 years [6MWD (m) = 720.50 + 160.27xSex - 5.14xAge - 2.23xWeight + 2.72xHeight], for Saudi-Arabian aged 16-50 years [6MWD (m) = - 28.5 + 2.81xHeight + 0.79xAge] or aged 18-71 years [6MWD (m) = 342.650 + 74.31xPhysical activity level + 33.88xSex - 4.25xAge] and for Algerian aged 16-40 years [6MWD (m) = 800.05 + 64.71xSex - 10.23xBMI - 1.63xAge + 2.05xWeight]. These norms explained 25% to 77% of the 6MWD variability. CONCLUSION: Fewer 6MWD norms exist for adults' Arab population. Other norms are welcome.

Influencing factors of the 6-min walk distance in adult Arab populations: a literature review.

Background Walk tests, especially the 6-min walk-test (6MWT), are commonly used in order to evaluate submaximal exercise capacity. The primary outcome of the 6MWT is the 6-min walk-distance (6MWD). Numerous demographic, physiological and anthropometric factors can influence the 6MWD in healthy adults. Objective The purpose of the present review is to highlight and discuss the 6MWD influencing factors in healthy of the healthy adult Arab populations. Methods It is a review including a literature search, from 1970 to September 31th 2015 using the PubMed, the Science Direct databases and the World Wide Web on Google search engine. Reference lists of retrieved English/French articles were searched for any additional references. Results Six studies, conducted in Tunisia (n=2), Saudi Arabia (n=3) and Algeria (n=1) were included. All studies were conducted according to the 2002-American-thoracic-society guidelines for the 6MWT. In addition to anthropometric data (sex, age, height, weight, body mass index, lean mass), the following data were recognized as 6MWD influencing factors: schooling and socioeconomic levels, urban origin, parity, physical activity score or status, metabolic equivalent task for moderate activity, spirometric data, end-walk heart-rate, resting diastolic blood pressure, dyspnoea Borg value and niqab-wearing. Conclusion The 6MWD influencing factors in adult Arab populations are numerous and include some specific predictors such as parity, physical activity level and niqab-wearing.