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Ghaoui H, Bitam I, Zaidi S, Achour N, Zenia S, Idres T, Fournier PE. Molecular detection and MST genotyping of Coxiella burnetii in ruminants and stray dogs and cats in Northern Algeria. Comp Immunol Microbiol Infect Dis 2024; 106:102126. [PMID: 38325127 DOI: 10.1016/j.cimid.2024.102126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 01/04/2024] [Accepted: 01/07/2024] [Indexed: 02/09/2024]
Abstract
Aiming at identifying the reservoir and contamination sources of Coxiella burnetii in Northern Algeria, we investigated the molecular presence of the bacterium in 599 samples (blood, placenta, liver, spleen, and uterus) collected from cattle, sheep, dogs and cats. Our qPCR results showed that 15/344 (4.36%) blood samples and six/255 (2.35%) organ specimens were positive for C. burnetii. In cattle, three (4%) blood and liver samples were positive. In sheep, one blood (1.19%) and 3 (8.57%) placenta samples were positive. At the Algiers dog pound, 8 (10%) and 3 (5%) blood samples were qPCR positivein dogs and cats, respectively. In addition, MST genotyping showed that MST 33 was present in cattle and sheep, MST 20 in cattle,andMST 21 in dogs and cats.
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Affiliation(s)
- H Ghaoui
- IRD, MEPHI, Aix-Marseille Université, IHU Méditerranée Infection, Marseille, France; Ecole Nationale Supérieure Vétérinaire d'Alger, RABIE BOUCHAMA, Preclinical Departement Alger, Algeria; EHS des maladies infectieuses ELHADI FLICI, Laveran et Nicolle Departement Alger, Algeria; Aix-Marseille Univ, IRD, APHM, VITROME, Marseille, France; Association Scientifique Algérienne de Recherche en Infectiologie (ASARI), Algeria.
| | - I Bitam
- Ecole Supérieure en Sciences de l'Aliment et des Industries Agroalimentaire d'Alger, Algeria; Aix-Marseille Univ, IRD, APHM, VITROME, Marseille, France; Centre de Recherche en Agropastoralisme, Djelfa, Algeria.
| | - S Zaidi
- Ecole Nationale Supérieure Vétérinaire d'Alger, RABIE BOUCHAMA, Preclinical Departement Alger, Algeria
| | - N Achour
- EHS des maladies infectieuses ELHADI FLICI, Laveran et Nicolle Departement Alger, Algeria; Association Scientifique Algérienne de Recherche en Infectiologie (ASARI), Algeria; Faculté de médecine d'Alger Ziania-1, Université d'Alger 1 Benyoucef Benkhadda, Algeria
| | - S Zenia
- Ecole Nationale Supérieure Vétérinaire d'Alger, RABIE BOUCHAMA, Preclinical Departement Alger, Algeria
| | - T Idres
- Ecole Nationale Supérieure Vétérinaire d'Alger, RABIE BOUCHAMA, Preclinical Departement Alger, Algeria
| | - P E Fournier
- Aix-Marseille Univ, IRD, APHM, VITROME, Marseille, France
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Chatzovoulou K, Mayeur A, Cagnard N, Mohammed Z, Bole C, Nitschke P, Jabot-Hanin F, Rötig A, Monnot S, Bonnefont J, Munnich A, Achour N, Steffann J. P-250 A shared gene expression signature in human blastocyst embryos affected by a mitochondrial disorder. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Do human blastocyst embryos affected by mitochondrial disorders have gene expression disruption?
Summary answer
A global transcriptional repression was found in embryos carrying mutations in mitochondrial genes, primarily affecting oxidative phosphorylation and cell survival pathways.
What is known already
Mitochondria are thought to play a critical role for embryo development by supplying adequate energy levels. Whether a metabolic rescue through mitochondrial metabolism modifications is taking place during the blastocyst stage, remained to be elucidated. For instance, abnormally elevated mtDNA levels were detected in human blastocyst embryos carrying the m.3243>G pathogenic variant, suggestive of a compensatory response, while this was not the case for embryos carrying another mtDNA mutation (m.8344A>G).
Study design, size, duration
To investigate if mitochondrial mutations affect gene expression of human blastocysts, transcriptome profiling between 33 control and 9 mitochondrial embryos was performed and analyzed by RNA-Sequencing.
Participants/materials, setting, methods
In total, 42 blastocyst embryos (Day-5/6/7) from 27 unrelated couples were collected after a preimplantation genetic testing analysis, concluding in an affected status. Among them, 33 were affected by a non-metabolic, non-mitochondrial genetic disorder (control group), and 9 were affected by a mitochondrial disorder (mitochondrial group). Transcriptomic analyses were performed on whole blastocyst embryos, by RNA-Sequencing.
Main results and the role of chance
Gene expression profiling of human blastocyst embryos revealed a global transcriptional repression in mitochondrial embryos, with a total of 566 genes being down-regulated, while only 52 genes were up-regulated (p ≤ 0.05; fold-change=2). A similar pattern was observed among all mitochondrial embryos, affecting a significant proportion of differentiation factors (such as KLF4, p = 1.88x10-2; OXT2, p = 3.32x10-3 and POU5F1, p = 8.03x10-3), as well as nuclear genes encoding mitochondrial proteins (n = 59). If oxidative phosphorylation was at the top of the most significant deregulated pathways (p = 6.32x10-14), cell survival (p = 2.19x10−10) and autophagy (p = 4.56x10-9) were found to be significantly decreased in these embryos, questioning their viability.
Limitations, reasons for caution
The number of mitochondrial embryos was limited due to the rarity of the material, however similar molecular profiles were detected among them. The control group included embryos affected by genetic disorders, although the resulting potential transcriptional biases were neutralized by selecting embryos affected by various and distinct genetic disorders.
Wider implications of the findings
The differentially expressed genes identified in this study represent biomarkers predictive of mitochondrial dysfunction, which will be useful for the establishment of therapeutic or mitochondrial replacement trials. Because of the role of mitochondria, they are also interesting to test in the context of in-vitro fertilization, as biomarkers of preimplantation development.
Trial registration number
Not applicable
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Affiliation(s)
| | - A Mayeur
- Antoine Beclere Hospital , Embryology, Clamart, France
| | - N Cagnard
- Imagine Institute , Bioinformatics, Paris, France
| | - Z Mohammed
- Imagine Institute , Genomics, Paris, France
| | - C Bole
- Imagine Institute , Genomics, Paris, France
| | - P Nitschke
- Imagine Institute , Bioinformatics, Paris, France
| | | | - A Rötig
- Imagine Institute , Genetics, Paris, France
| | - S Monnot
- Imagine Institute , Genetics, Paris, France
| | | | - A Munnich
- Imagine Institute , Genetics, Paris, France
| | - N Achour
- Antoine Beclere Hospital , Embryology, Clamart, France
| | - J Steffann
- Imagine Institute , Genetics, Paris, France
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Hsairi M, Fakhfakh R, Bellaaj R, Achour N. [Knowledge and practice of doctors and midwives working in primary health care regarding screening for cervical and breast cancers]. East Mediterr Health J 2021. [DOI: 10.26719/2003.9.3.353] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Nous avons évalué les connaissances et les pratiques de 286 médecins et 126 sages-femmes exercant dans les soins de santé primaires à Tunis en ce qui concerne les cancers du col utérin et du sein au moyen d’un auto-questionnaire anonyme. Les questions avaient trait aux connaissances de l’épidémiologie de ces deux cancers, aux chances de survie en cas de détection précoce, au suivi antérieur d’une formation dans ce domaine et au degré de participation à ce dépistage. Le niveau de connaissances épidémiologiques des deux cancers en Tunisie, aussi bien des médecins que des sages-femmes, est relativement modeste. La pratique systématique du frottis cervico-vaginal [FCV] a été significativement plus fréquente chez les sages-femmes que chez les médecins. Il en est de méme pour l’examen systématique des seins. Le manque de formation en matière de pratique du FCV et le nombre élevé de consultants par jour ont été identifies comme les principaux facteurs freinant respectivement la pratique du FCV et l’examen des seins
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Saadi A, Saadi H, Chakroun M, Karray O, Achour N, Bouzouita A, Derouiche A, Ben Slama R, Mnif N, Ayed H, Chebil M. Traumatismes scrotaux : intérêt de l’échographie préopératoire dans la prédiction de la rupture de l’albuginée. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ghaoui H, Bitam I, Ait-Oudhia K, Achour N, Saad-Djaballah A, Saadnia F, Kedjour S, Fournier PE. Corrigendum to ‘Coxiella burnetii infection with women's febrile spontaneous abortion reported in Algiers’. New Microbes New Infect 2019; 27:53. [PMID: 30622710 PMCID: PMC6305685 DOI: 10.1016/j.nmni.2018.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Ghaoui H, Bitam I, Ait-Oudhia K, Achour N, Saad-Djaballah A, Saadnia FZ, Kedjour S, Fournier PE, Raoult D. Coxiella burnetii infection with women's febrile spontaneous abortion reported in Algiers. New Microbes New Infect 2018; 26:8-14. [PMID: 30245827 PMCID: PMC6141670 DOI: 10.1016/j.nmni.2018.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 07/21/2018] [Accepted: 08/03/2018] [Indexed: 11/25/2022] Open
Abstract
We investigated Q fever infection in Febrile Spontaneous Abortions in women by using a serologic method (Immuno-Fluorescence Assay, IFA) and a molecular method (real-time quantitative PCR, qPCR) in Obstetric-Gynaecology (OB-GYN) services in two hospitals in Algiers. We included in the case group 380 women who experienced Febrile Spontaneous Abortion; the control group comprised 345 women who gave birth without any other infections or complications. Among the 725 women included, antibodies against Coxiella burnetii were detected by IFA in three (03) cases patients; all control group samples were IFA negative. In other hand, only four (04) placental samples among the case group came back with q PCR positive for IS1111 and IS30a too. A relationship between C. burnetii infection and febrile spontaneous abortion exists in OB-GYN services in Algiers.
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Affiliation(s)
- H Ghaoui
- IRD, MEPHI, Aix-Marseille Université, IHU Méditerranée Infection, Marseille, France.,École Nationale Supérieure Vétérinaire d'Alger, RABIE BOUCHAMA, Alger, Algérie
| | - I Bitam
- IRD, MEPHI, Aix-Marseille Université, IHU Méditerranée Infection, Marseille, France.,École Supérieure En sciences de l'Aliment et des industries Agroalimentaire d'Alger, Algérie
| | - K Ait-Oudhia
- École Nationale Supérieure Vétérinaire d'Alger, RABIE BOUCHAMA, Alger, Algérie
| | - N Achour
- EHS des maladies infectieuses, ELHADI FLICI, Alger, Algérie
| | | | | | - S Kedjour
- EPH HASSEN BADI Ex BELFORT, El-Harrache, Alger, Algérie
| | - P-E Fournier
- IRD, VITROME, Aix-Marseille Université, IHU Méditerranée Infection, Marseille, France
| | - D Raoult
- IRD, MEPHI, Aix-Marseille Université, IHU Méditerranée Infection, Marseille, France
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Achour N, Khiari E, Bouhamed R. IPF-10 - Difficultés de diagnostiques des leishmanioses viscérales quand les moelles osseuses font défaut. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30429-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Critchley J, Capewell S, O'Flaherty M, Abu-Rmeileh N, Rastam S, Saidi O, Sözmen K, Shoaibi A, Husseini A, Fouad F, Ben Mansour N, Aissi W, Ben Romdhane H, Unal B, Bandosz P, Bennett K, Dherani M, Al Ali R, Maziak W, Arık H, Gerçeklioğlu G, Altun DU, Şimşek H, Doganay S, Demiral Y, Aslan Ö, Unwin N, Phillimore P, Achour N, Aissi W, Allani R, Arfa C, Abu-Kteish H, Abu-Rmeileh N, Al Ali R, Altun D, Ahmad B, Arık H, Aslan Ö, Beltaifa L, Ben Mansour N, Bennett K, Ben Romdhane H, Ben Salah N, Collins M, Critchley J, Capewell S, Dherani M, Demiral Y, Doganay S, Elias M, Ergör G, Fadhil I, Fouad F, Gerçeklioğlu G, Ghandour R, Göğen S, Husseini A, Jaber S, Kalaca S, Khatib R, Khatib R, Koudsie S, Kilic B, Lassoued O, Mason H, Maziak W, Mayaleh MA, Mikki N, Moukeh G, Flaherty MO, Phillimore P, Rastam S, Roglic G, Saidi O, Saatli G, Satman I, Shoaibi A, Şimşek H, Soulaiman N, Sözmen K, Tlili F, Unal B, Unwin N, Yardim N, Zaman S. Contrasting cardiovascular mortality trends in Eastern Mediterranean populations: Contributions from risk factor changes and treatments. Int J Cardiol 2016; 208:150-61. [PMID: 26878275 DOI: 10.1016/j.ijcard.2016.01.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 11/05/2015] [Accepted: 01/01/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Middle income countries are facing an epidemic of non-communicable diseases, especially coronary heart disease (CHD). We used a validated CHD mortality model (IMPACT) to explain recent trends in Tunisia, Syria, the occupied Palestinian territory (oPt) and Turkey. METHODS Data on populations, mortality, patient numbers, treatments and risk factor trends from national and local surveys in each country were collated over two time points (1995-97; 2006-09); integrated and analysed using the IMPACT model. RESULTS Risk factor trends: Smoking prevalence was high in men, persisting in Syria but decreasing in Tunisia, oPt and Turkey. BMI rose by 1-2 kg/m(2) and diabetes prevalence increased by 40%-50%. Mean systolic blood pressure and cholesterol levels increased in Tunisia and Syria. Mortality trends: Age-standardised CHD mortality rates rose by 20% in Tunisia and 62% in Syria. Much of this increase (79% and 72% respectively) was attributed to adverse trends in major risk factors, occurring despite some improvements in treatment uptake. CHD mortality rates fell by 17% in oPt and by 25% in Turkey, with risk factor changes accounting for around 46% and 30% of this reduction respectively. Increased uptake of community treatments (drug treatments for chronic angina, heart failure, hypertension and secondary prevention after a cardiac event) accounted for most of the remainder. DISCUSSION CHD death rates are rising in Tunisia and Syria, whilst oPt and Turkey demonstrate clear falls, reflecting improvements in major risk factors with contributions from medical treatments. However, smoking prevalence remains very high in men; obesity and diabetes levels are rising dramatically.
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Affiliation(s)
- Julia Critchley
- Population Health Research Institute, St. George's, University of London, Cranmer Terrace, London SW17 0RE, UK.
| | - Simon Capewell
- Department of Public Health and Policy, University of Liverpool, UK
| | | | - Niveen Abu-Rmeileh
- Institute of Community and Public Health, Birzeit University, State of Palestine
| | - Samer Rastam
- Syrian Center For Tobacco Studies, Aleppo, Syria
| | - Olfa Saidi
- Cardiovascular Epidemiology and Prevention Research Laboratory, Tunisia
| | - Kaan Sözmen
- Dept. of Public Health, Faculty of Medicine, Dokuz Eylul University, Turkey
| | - Azza Shoaibi
- Institute of Community and Public Health, Birzeit University, State of Palestine
| | - Abdullatif Husseini
- Public Health Program, Department of Health Sciences, Qatar University, Doha, Qatar
| | - Fouad Fouad
- Syrian Center For Tobacco Studies, Aleppo, Syria; Department of Epidemiology and Public Health, American University of Beirut, Lebanon
| | - Nadia Ben Mansour
- Cardiovascular Epidemiology and Prevention Research Laboratory, Tunisia
| | - Wafa Aissi
- Cardiovascular Epidemiology and Prevention Research Laboratory, Tunisia
| | | | - Belgin Unal
- Dept. of Public Health, Faculty of Medicine, Dokuz Eylul University, Turkey
| | - Piotr Bandosz
- Department of Public Health and Policy, University of Liverpool, UK
| | - Kathleen Bennett
- Department of Pharmacology & Therapeutics, Trinity College, Dublin, Ireland
| | - Mukesh Dherani
- Department of Public Health and Policy, University of Liverpool, UK
| | | | - Wasim Maziak
- Syrian Center For Tobacco Studies, Aleppo, Syria; Robert Stempel College of Public Health And Social Work, Florida International University, Miami, FL, USA
| | - Hale Arık
- Dept. of Public Health, Faculty of Medicine, Dokuz Eylul University, Turkey
| | - Gül Gerçeklioğlu
- Dept. of Public Health, Faculty of Medicine, Dokuz Eylul University, Turkey
| | - Deniz Utku Altun
- Dept. of Public Health, Faculty of Medicine, Dokuz Eylul University, Turkey
| | - Hatice Şimşek
- Dept. of Public Health, Faculty of Medicine, Dokuz Eylul University, Turkey
| | - Sinem Doganay
- Dept. of Public Health, Faculty of Medicine, Dokuz Eylul University, Turkey
| | - Yücel Demiral
- Dept. of Public Health, Faculty of Medicine, Dokuz Eylul University, Turkey
| | - Özgür Aslan
- Dept. of Public Health, Faculty of Medicine, Dokuz Eylul University, Turkey
| | - Nigel Unwin
- The Faculty of Medical Sciences, University of the West Indies, Barbados
| | | | | | | | | | - Waffa Aissi
- Cardiovascular Epidemiology and Prevention Research Laboratory, Tunis, Tunisia
| | - Riadh Allani
- Cardiovascular Epidemiology and Prevention Research Laboratory, Tunis, Tunisia
| | - Chokra Arfa
- Cardiovascular Epidemiology and Prevention Research Laboratory, Tunis, Tunisia
| | | | - Niveen Abu-Rmeileh
- Institute of Community and Public Health, Birzeit University, Birzeit, State of Palestine
| | | | - Deniz Altun
- Dept of Public Health, Faculty of Medicine, Dokuz Eylul University, Turkey
| | - Balsam Ahmad
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Hale Arık
- Dept of Public Health, Faculty of Medicine, Dokuz Eylul University, Turkey
| | - Özgür Aslan
- Dept of Public Health, Faculty of Medicine, Dokuz Eylul University, Turkey
| | - Latifa Beltaifa
- Cardiovascular Epidemiology and Prevention Research Laboratory, Tunis, Tunisia
| | - Nadia Ben Mansour
- Cardiovascular Epidemiology and Prevention Research Laboratory, Tunis, Tunisia
| | - Kathleen Bennett
- Department of Pharmacology & Therapeutics, Trinity College, Dublin, Ireland
| | - Habiba Ben Romdhane
- Cardiovascular Epidemiology and Prevention Research Laboratory, Tunis, Tunisia
| | | | | | - Julia Critchley
- Division of Population Health Sciences and Education, St. George's, University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Simon Capewell
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Mukesh Dherani
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Yücel Demiral
- Dept of Public Health, Faculty of Medicine, Dokuz Eylul University, Turkey
| | - Sinem Doganay
- Dept of Public Health, Faculty of Medicine, Dokuz Eylul University, Turkey
| | | | - Gül Ergör
- Dept of Public Health, Faculty of Medicine, Dokuz Eylul University, Turkey
| | | | - Fouad Fouad
- Syrian Center for Tobacco Studies, Aleppo, Syria
| | - Gül Gerçeklioğlu
- Dept of Public Health, Faculty of Medicine, Dokuz Eylul University, Turkey
| | - Rula Ghandour
- Institute of Community and Public Health, Birzeit University, Birzeit, State of Palestine
| | - Sibel Göğen
- Primary Health Care General Directorate, Turkish Ministry of Health, Turkey
| | - Abdullatif Husseini
- Institute of Community and Public Health, Birzeit University, Birzeit, State of Palestine
| | - Samer Jaber
- Institute of Community and Public Health, Birzeit University, Birzeit, State of Palestine
| | | | - Rana Khatib
- Institute of Community and Public Health, Birzeit University, Birzeit, State of Palestine
| | - Rasha Khatib
- Institute of Community and Public Health, Birzeit University, Birzeit, State of Palestine
| | | | - Bülent Kilic
- Dept of Public Health, Faculty of Medicine, Dokuz Eylul University, Turkey
| | - Olfa Lassoued
- Cardiovascular Epidemiology and Prevention Research Laboratory, Tunis, Tunisia
| | | | - Wasim Maziak
- Syrian Center for Tobacco Studies, Aleppo, Syria; Robert Stempel College of Public Health and Social Work, Florida International University, Miami, USA
| | | | - Nahed Mikki
- Institute of Community and Public Health, Birzeit University, Birzeit, State of Palestine
| | | | - Martin O Flaherty
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Peter Phillimore
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Samer Rastam
- Syrian Center for Tobacco Studies, Aleppo, Syria
| | | | - Olfa Saidi
- Cardiovascular Epidemiology and Prevention Research Laboratory, Tunis, Tunisia
| | - Gül Saatli
- Dept of Public Health, Faculty of Medicine, Dokuz Eylul University, Turkey
| | | | - Azza Shoaibi
- Institute of Community and Public Health, Birzeit University, Birzeit, State of Palestine
| | - Hatice Şimşek
- Dept of Public Health, Faculty of Medicine, Dokuz Eylul University, Turkey
| | | | - Kaan Sözmen
- Dept of Public Health, Faculty of Medicine, Dokuz Eylul University, Turkey
| | - Faten Tlili
- Cardiovascular Epidemiology and Prevention Research Laboratory, Tunis, Tunisia
| | - Belgin Unal
- Dept of Public Health, Faculty of Medicine, Dokuz Eylul University, Turkey
| | - Nigel Unwin
- University of the West Indies, Georgetown, Barbados
| | - Nazan Yardim
- Primary Health Care General Directorate, Turkish Ministry of Health, Turkey
| | - Shahaduz Zaman
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
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Bensaadi N, Chalah S, Iddir S, Achour N, Cherifi N, Tariket A. P-521 – Apport du fond d'œil dans le diagnostic de la miliaire tuberculeuse. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30696-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Achour N, Khiari M, Bouhamed R, Badaoui N, Arban Y. P-065 – Observation originale: leishmaniose cutanée (LC) et leishmaniose viscérale (LV) chez une transplantée rénale. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30250-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Achour N, Khiari M, Bouhamed R, Saidi F, Kitous N. P-532 – Une association non fortuite syndrome d'activation macrophagique et leishmaniose viscérale. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30707-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Arhab D, Ahmane H, Hamzaoui A, Achour N, Cherifi N, Chikhi S. P-182 – Papillomavirus Humain et vaccination: que savent les adolescents? Pleuropneumopathie révélatrice d'un pleuropneumoblastome. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30364-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bennani A, Chikhi S, Ahmane H, Arhab D, Achour N, Hamzaoui A. CO-49 – Ingestion medicamenteuse accidentelle de l'enfant. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30150-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bennani A, Chikhi S, Arhab D, Achour N, Hamzaoui A. P-289 – L'erythro-enzymopathie héréditaire liée à l'X chez la fille. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30469-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bennani A, Chikhi S, Arhab D, Achour N, Hamzaoui A. P-117 – Boiterie révélant un abcès sous périosté de la symphyse pubienne. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30301-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Berton-Rigaud D, Selle F, Ray-Coquard I, Floquet A, Largillier R, Hardy-Bessard A, Jaubert D, Roemer-Becuwe C, Venat-Bouvet L, Lesoin A, Guardiola E, Alexandre J, Provansal M, Blot E, Achour N, Pujade-Lauraine E. Encourage: the Use in Routine Practice of Bevacizumab in First-Line Therapy for Patients with Ovarian Cancer– a Gineco Prospective Cohort Study. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu338.66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Karaoud M, Bouafif N, Malouche D, Kouni C, Achour N. La mortalité parmi les enfants âgés de moins de 15ans en Tunisie peut être liée à la température. Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2014.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Ben Alaya N, Sadok R, Bellali H, Mrabet A, Achour N, Chahed M. Surmortalité associée au froid en Tunisie : analyse d’une série chronologique de 1991 à 2007. Rev Epidemiol Sante Publique 2012. [DOI: 10.1016/j.respe.2012.06.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Ben Alay N, Bellali H, El Bez H, Achour N, Chahed M. Paludisme d’importation en Tunisie : analyse des données clinico-épidémiologiques 2002–2007. Rev Epidemiol Sante Publique 2012. [DOI: 10.1016/j.respe.2012.06.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Ben Ali S, Belfki H, Skhiri H, Traissac P, Maire B, Delpeuch F, Achour N, Ben Romdhane H. Prevalence and determinants of the metabolic syndrome among Tunisian adults. Rev Epidemiol Sante Publique 2012. [DOI: 10.1016/j.respe.2012.06.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Ben Ali S, Belfki H, Skhiri H, Traissac P, Maire B, Delpeuch F, Achour N, Ben Romdhane H. Prevalence, awareness, treatment and control of hypertension among Tunisian adults. Rev Epidemiol Sante Publique 2012. [DOI: 10.1016/j.respe.2012.06.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Ben Gobrane, H, Aounallah-Skhiri H, Ben Hamida A, Somrani N, Ayachi M, Achour N, Hsairi M. Motifs du recours aux services d’urgence des principaux hôpitaux du Grand Tunis. East Mediterr Health J 2012. [DOI: 10.26719/2012.18.1.56] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Ben Gobrane HL, Aounallah-Skhiri H, Ben Hamida A, Somrani N, Ayachi M, Achour N, Hsairi M. [Reasons for using emergency departments of major hospitals in Greater Tunis]. East Mediterr Health J 2012; 18:56-65. [PMID: 22360012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Tunisia, similar to many countries, has a problem of overcrowding of the emergency departments (ED). This study aimed to analyse the reasons for using EDs, and to describe the seriousness of the attendees' condition and their itinerary before their arrival at ED. This cross-sectional study in 2009 was conducted in ED of 4 hospitals in GreaterTunis and targeted 1058 patients of both sexes, aged 18 years, with stratification according to time of day of presentation to ED (morning, afternoon and evening). Information was recorded on the sociodemographic characteristics of the study participants, reasons for choosing ED, time of and reason for consultation, diagnosis and severity of illness. Over half the patients (52.5%) were male and the mean age was 46.0 (SD 18.1) years. The main reasons for choosing the ED were: speed (54.0%) and ease of access (47.7%) of ER and occurrence of an acute episode (26.4%). Patients with serious illness accounted for only 6.3% of those interviewed. Implementation of good practices and better coordination between public and private services and the ED are needed to reduce unnecessary visits to ED.
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Aounallah-Skhiri H, Traissac P, El Ati J, Eymard-Duvernay S, Landais E, Achour N, Delpeuch F, Ben Romdhane H, Maire B. P001 Association d’un score de modernisation de l’alimentation avec les facteurs socio-économiques, la corpulence et la pression artérielle chez les adolescents tunisiens. NUTR CLIN METAB 2011. [DOI: 10.1016/s0985-0562(11)70069-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Ben Alaya-Bouafif N, Chahed MK, El Bez H, Bellali H, Ayari L, Achour N. Completeness of malaria notification in Tunisia assessed by capture recapture method. Asian Pacific Journal of Tropical Disease 2011. [DOI: 10.1016/s2222-1808(11)60025-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Ayoub WHB, Rais H, Zehani S, Hsairi H, Achour N, Abdallah MB. P1-172 Cancer epidemiology in the North of Tunisia 1999-2003. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976d.65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abdallah MB, Ayoub WHB, Rais H, Zehani S, Hsairi H, Achour N. SP3-5 Incidence of breast cancer in northern Tunisia: trend and projection into 2024. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976o.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Metges J, Ramée J, Raoul J, Gourlaouen A, Porneuf M, Capitain O, Achour N, Egreteau J, Douillard J, Grude F. What is the benefit for patients suffering from metastatic colorectal cancer (mCRC) after bevacizumab-based regimen (BBR), cetuximab-based regimen (CBR), and panitumumab (P)? J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
595 Background: Metastatic colorectal cancer (mCRC) management has been clearly improved by targeted therapies such as anti VEGF and /or anti-HER1 drugs. The evaluation of the use of targeted therapies in the real world is strategic to assess health politics. OMIT Bretagne-Pays de la Loire is a network of private and public cancer centers that has been leading cohort studies evaluating Folfiri-bevacizumab treatment, the cost of targeted therapies and the succession of targeted therapies. Methods: The purpose of this study is to evaluate the benefit and safety of three consecutive targeted therapies in patients with KRAS wild-type unresectable mCRC. Sex, age, localization of the primary tumor site, successive chemotherapeutic regimens, toxicities, response rates, progression free survival and overall survival have been studied. Results: 34 patients (22 men, 12 women, median age 63 years [43-82]) have been prospectively recruited between 2003 and 2010. All of them received bevacizumab specially in association with FOLFIRI, cetuximab in association with irinotecan, panitumumab as monotherapy and others chemotherapies than FOLFOX, FOLFIRI, XELOX. The primary tumor site was colon (71%), junction (5%), and rectum (24%). 22 patients had metastatic colorectal tumor, 28 were operated on their primary tumor and 12 underwent resection after one line of treatment. Patients received successively 3 to 8 different lines of treatment for progressive mCRC. Toxicities of targeted therapies were manageable. Objective responses were observed in 38% (13) of the patients treated with BBR, 37% (11) treated with CBR and 25% (6) treated with P. Disease stabilization was achieved in 32% (11) of the patients treated with BBR, in 10% (3) with CBR and in 8% (2) with P. PFS at 80 months is 15%. Median OS from first metastatic line at death was 47.43 months (24.23-70.84). PFS and OS curves will be shown during the meeting. Conclusions: Our study clearly shows that patients receiving successively the three schedules (BBR, CBR, P) have a high overall survival with manageable side effects. No significant financial relationships to disclose.
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Affiliation(s)
- J. Metges
- CHU Brest, Brest, France; Centre Catherine de Sienne, Nantes, France; Centre Eugène Marquis and European University in Brittany, Rennes, France; CH Morlaix, Morlaix, France; CH St Brieuc, Saint Brieuc, Georgia; CRLCC Paul Papin, Angers, France; Clinique Pasteur, Brest, France; CHBS Lorient, Lorient, France; Centre René Gauducheau, Nantes, France; OMIT Bretagne Pays de Loire, Angers, France
| | - J. Ramée
- CHU Brest, Brest, France; Centre Catherine de Sienne, Nantes, France; Centre Eugène Marquis and European University in Brittany, Rennes, France; CH Morlaix, Morlaix, France; CH St Brieuc, Saint Brieuc, Georgia; CRLCC Paul Papin, Angers, France; Clinique Pasteur, Brest, France; CHBS Lorient, Lorient, France; Centre René Gauducheau, Nantes, France; OMIT Bretagne Pays de Loire, Angers, France
| | - J. Raoul
- CHU Brest, Brest, France; Centre Catherine de Sienne, Nantes, France; Centre Eugène Marquis and European University in Brittany, Rennes, France; CH Morlaix, Morlaix, France; CH St Brieuc, Saint Brieuc, Georgia; CRLCC Paul Papin, Angers, France; Clinique Pasteur, Brest, France; CHBS Lorient, Lorient, France; Centre René Gauducheau, Nantes, France; OMIT Bretagne Pays de Loire, Angers, France
| | - A. Gourlaouen
- CHU Brest, Brest, France; Centre Catherine de Sienne, Nantes, France; Centre Eugène Marquis and European University in Brittany, Rennes, France; CH Morlaix, Morlaix, France; CH St Brieuc, Saint Brieuc, Georgia; CRLCC Paul Papin, Angers, France; Clinique Pasteur, Brest, France; CHBS Lorient, Lorient, France; Centre René Gauducheau, Nantes, France; OMIT Bretagne Pays de Loire, Angers, France
| | - M. Porneuf
- CHU Brest, Brest, France; Centre Catherine de Sienne, Nantes, France; Centre Eugène Marquis and European University in Brittany, Rennes, France; CH Morlaix, Morlaix, France; CH St Brieuc, Saint Brieuc, Georgia; CRLCC Paul Papin, Angers, France; Clinique Pasteur, Brest, France; CHBS Lorient, Lorient, France; Centre René Gauducheau, Nantes, France; OMIT Bretagne Pays de Loire, Angers, France
| | - O. Capitain
- CHU Brest, Brest, France; Centre Catherine de Sienne, Nantes, France; Centre Eugène Marquis and European University in Brittany, Rennes, France; CH Morlaix, Morlaix, France; CH St Brieuc, Saint Brieuc, Georgia; CRLCC Paul Papin, Angers, France; Clinique Pasteur, Brest, France; CHBS Lorient, Lorient, France; Centre René Gauducheau, Nantes, France; OMIT Bretagne Pays de Loire, Angers, France
| | - N. Achour
- CHU Brest, Brest, France; Centre Catherine de Sienne, Nantes, France; Centre Eugène Marquis and European University in Brittany, Rennes, France; CH Morlaix, Morlaix, France; CH St Brieuc, Saint Brieuc, Georgia; CRLCC Paul Papin, Angers, France; Clinique Pasteur, Brest, France; CHBS Lorient, Lorient, France; Centre René Gauducheau, Nantes, France; OMIT Bretagne Pays de Loire, Angers, France
| | - J. Egreteau
- CHU Brest, Brest, France; Centre Catherine de Sienne, Nantes, France; Centre Eugène Marquis and European University in Brittany, Rennes, France; CH Morlaix, Morlaix, France; CH St Brieuc, Saint Brieuc, Georgia; CRLCC Paul Papin, Angers, France; Clinique Pasteur, Brest, France; CHBS Lorient, Lorient, France; Centre René Gauducheau, Nantes, France; OMIT Bretagne Pays de Loire, Angers, France
| | - J. Douillard
- CHU Brest, Brest, France; Centre Catherine de Sienne, Nantes, France; Centre Eugène Marquis and European University in Brittany, Rennes, France; CH Morlaix, Morlaix, France; CH St Brieuc, Saint Brieuc, Georgia; CRLCC Paul Papin, Angers, France; Clinique Pasteur, Brest, France; CHBS Lorient, Lorient, France; Centre René Gauducheau, Nantes, France; OMIT Bretagne Pays de Loire, Angers, France
| | - F. Grude
- CHU Brest, Brest, France; Centre Catherine de Sienne, Nantes, France; Centre Eugène Marquis and European University in Brittany, Rennes, France; CH Morlaix, Morlaix, France; CH St Brieuc, Saint Brieuc, Georgia; CRLCC Paul Papin, Angers, France; Clinique Pasteur, Brest, France; CHBS Lorient, Lorient, France; Centre René Gauducheau, Nantes, France; OMIT Bretagne Pays de Loire, Angers, France
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Ben Slama F, Ayari I, Ouzini F, Belhadj O, Achour N. [Exclusive breastfeeding and mixed feeding: knowledge, attitudes and practices of primiparous mothers]. East Mediterr Health J 2010; 16:630-635. [PMID: 20799590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
We assessed the knowledge attitudes and practices of primiparous women with regard to exclusive breastfeeding and the use of formula milk. A total of 260 women were interviewed and the results showed that 41.5% of the women breastfed exclusively while 58.5% bottle-fed only or did so together with breastfeeding. Of those who breastfed, 43.0% did not do so soon after giving birth and did not know about colostrum. Overall, the knowledge, attitudes and practices of the mothers were unsatisfactory concerning the golden rules for successful breastfeeding, the ideal duration of exclusive breastfeeding and the food to include when introducing complementary feeding. This might be due to a low level of schooling and information, hence the need for improving strategies for maternal care during the antenatal and postnatal periods.
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Affiliation(s)
- F Ben Slama
- lnstitut National de Santé Publique, Tunis, Tunisie.
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Ben Slama F, Ayari I, Ouzini F, Belhadj O, Achour N. Exclusive breastfeeding and mixed feeding: knowledge, attitudes and practices of primiparous mothers. East Mediterr Health J 2010. [DOI: 10.26719/2010.16.6.630] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Lazaar HBG, Aounallah Skhiri H, Oueslati F, Frikha H, Achour N, Hsairi M. Cost-effectiveness analysis of screening strategies for cervical cancer in Tunisia. East Mediterr Health J 2010. [DOI: 10.26719/2010.16.6.602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Lazaar HBG, Aounallah-Skhiri H, Oueslati F, Frikha H, Achour N, Hsairi M. [Cost effectiveness analysis of screening strategies for cervical cancer in Tunisia]. East Mediterr Health J 2010; 16:602-608. [PMID: 20799586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
We aimed to identify the most appropriate screening strategy for cervical cancer (periodicity of 3, 5 or 10 years) for Tunisia, taking into consideration the incidence of the disease, costs of screening and economic implications. We simulated follow-up of a fictitious cohort of 1 million women 35-39 years over 30 years. Computation of yearly medical care costs was based on data from medical files of patients diagnosed with cervical cancer in 2004 at the National Institute of Cancer, Tunis. For a 60% coverage level of screening, cervical cancer reduction would be 49.2% for a 3-year periodicity. The reduction would be 40.3% and 33.1% for 5 and 10 years periodicity respectively. Considering cost-effectiveness, 10-year screening gave the lowest annual cost to avoid 1 cervical cancer case.
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Metges J, Raoul J, Achour N, Capitain O, Gourlaouen A, Ramée J, Egreteau J, Douillard J, Traoré S, Grudé F. PANERB study: Panitumumab after cetuximab-based regimen failure. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e14000] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Aounallah-Skhiri H, Ben Romdhane H, Maire B, Elkhdim H, Eymard-Duvernay S, Delpeuch F, Achour N. Health and behaviours of Tunisian school youth in an era of rapid epidemiological transition. East Mediterr Health J 2009; 15:1201-1214. [PMID: 20214134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
To assess youth health behaviours and related quality of life in urban Tunisia, we conducted a cross-sectional survey of a representative sample of 699 secondary-school students. The overweight rate was 20.7%. Most of the sample had an insufficient level of physical activity and were unfamiliar with the recommended frequency of moderate physical activity. Norm-based scores of psychological state were about average, slightly better for boys than girls. Girls perceived themselves to be more stressed than boys. Of all students, 35% declared having smoked a cigarette and 14% having drunk alcohol at least once in their lives. The main sources of health education were mass media (59%) and medical staff (36%).
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Ben Abdallah M, Zehani S, Maalej M, Hsairi M, Hechiche M, Ben Romdhane K, Boussen H, Saadi A, Achour N, Ben Ayed F. [Breast cancer in Tunisia: epidemiologic characteristics and trends in incidence]. Tunis Med 2009; 87:417-425. [PMID: 20063673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The goal of this study is to analyze certain epidemiologic characteristics of breast cancer in Tunisia and to foresee the consequences that will arise from the trends in incidence of this cancer. Data obtained from the North-Tunisia Cancer Registry (NTCR) and from the Salah AZAIZ Institute (SAI) Registry is used to estimate the different incidence rates and to compare these rates with those of other countries. In 15 years the crude incidence rate for breast cancer in the North Tunisia almost doubled to reach 21.5 cases/100,000 women per year during 1994-1998. The high rate of this cancer among women younger than 35 years (11%) could be related to a relatively low incidence among post-menopausal women. The clinical profile of breast cancer remains quite alarming: 40.2% of cases have a tumor with a clinical diameter equal or greater than 5 cm. Birth cohort effect, also know as the generation effect, is expected to lead to an increase of cancer incidence in the future. The rather high number of young cases is a source of additional cost on social and financial level. The priority is now to solve the problem of late diagnosis it has aggravated the prognosis of this cancer in Tunisia.
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Ben Gobrane H, Fakhfakh R, Rahal K, Ben Ayed F, Mâalej M, Ben Abdallah M, Achour N, Hsairi M. [Breast cancer prognosis in Salah Azaiez Institute of Cancer, Tunis]. East Mediterr Health J 2007; 13:309-18. [PMID: 17684853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
We estimated survival rate at 9 years of all (470) women with breast cancer diagnosed at Salah Azaïez Institute of Cancer in Tunis to identify the main prognosis factors. Data were collected on residence, socioeconomic level, circumstances of discovery of the tumour, histological type, tumour size, presence of metastases, extension of the tumour, treatment and survival. Comparison of survival curves was done with Log Rank test. Cox model was used for multivariate adjustments and calculation of the hazard ratio (HR) (relative risk of death). There was a survival rate of 61% at 5 years and of 51% at 9 years. Tumour size >5 cm was significantly associated with lower survival as was capsular rupture. After stratification for tumour size and age, only surgery and radiotherapy were significantly associated with improved survival.
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Affiliation(s)
- H Ben Gobrane
- Institut national de la Santé publique, Tunis, Tunisie
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Ben Romdhane H, Haouala H, Belhani A, Drissa H, Kafsi N, Boujnah R, Mechmèche R, Slimane ML, Achour N, Nacef T, Gueddiche M. [Epidemiological transition and health impact of cardiovascular disease in Tunisia]. Tunis Med 2005; 83 Suppl 5:1-7. [PMID: 16094843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
OBJECTIVE We aim at analysing the increase of CVDs in the Tunisian hospitals in order to assess the burden of NCDs in the transitional context. METHODS Data are recorded through the Tunisian National Morbidity and Mortality Survey (TNMMS). In order to assess the CVDs (CHDs vs RHDs) trend, two representative samples of Cardiology Departements patients were compared one is selected from the TNMMS and the second from the hospitalisations recorded in 1992. Causes, stay duration, status at the end of the hospitalisation, transfer to another hospital and patients socio-demographic characteristics are recorded and compared for the two periods. All the diagnosis are coded referring to the DMC 10. To analyze the determinant of the epidemiological transition, we have elaborated the CVD causal pattern and we have documented all their determinants. RESULTS CHD rate has dramatically increased, while RHD has decreased especially on men. In 1992, 39.2% of men and 11.8% of women were admitted for CHD. In 2002, these rate are respectivly 58.8% and 38.2% while RHD rates were, in 1992, 11.8% on men and 25.3% on women vs 4.4% and 11.7% respectively. CONCLUSION This study has confirmed that so far controlling transmitted diseases seems to be successful, Tunisian people are about to face a new problems as hypertension, obesity, diabetes and tobacco smoking. The new challenge with the burden of diseases requires the implementation of a national strategy relevant to the epidemiological, social and economical transition. Population needs and cost effectiveness of interventions assessment is crucial to set the national priorities.
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Ben Romdhane H, Bougatef S, Skhiri H, Gharbi D, Kafsi MN, Belhani A, Mechmèche R, Haoula H, Boujnah R, Kachboura S, Hamdoun M, Achour N. [The first Tunisian cardiovascular diseases register: processes and results]. Rev Epidemiol Sante Publique 2005; 52:558-64. [PMID: 15741917 DOI: 10.1016/s0398-7620(04)99094-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND In Tunisia, cardiovascular diseases are the leading causes of death (30%) and a few studies conducted in the population have demonstrated that the level of their risk factors is increasing. For policy makers, the health system impact of these diseases is currently a crucial issue. The National Public Health Institute has identified the implementation of a morbidity register as a priority. METHODS A CVD morbidity register is implemented since 2001, in 3 different geographical populations having contrasted levels of health status (Tunis, Ariana and Ben Arous). The 3 regions are covering about 2 millions inhabitants which is the fifth of the overall Tunisian population. All coronary heart events occurring among adults 25 years old and above in the 3 populations are recorded. The diagnosis of events, case fatality and classification are defined according to MONICA criteria. The data are recorded from public and private hospitals, death certificates and autopsies. RESULTS During the year 2001, the total number of myocardial infarction events was estimated at 942: in men, the age-standardized rates were 163.8/100000 in Tunis population vs. 161.9 in Ariana and 170.5 in Ben Arous. In women, the rates were respectively 43.4, 61.1 and 44.6. Medical causes of death registration was the most crucial problem in spite of the implementation of the death certificate designed according to WHO model. Specific surveys for clinical assessment and surveillance of risk factors were conducted in the register populations. CONCLUSION It is the first time that data on coronary heart disease incidence and fatality are available in Tunisia through this experience which highlights the practical difficulties experienced in registering and coding coronary events in a developing country. The data source quality should be improved and the register should be integrated in the local health system.
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Affiliation(s)
- H Ben Romdhane
- Laboratoire de Recherche en Epidémiologie et Prévention des Maladies Cardiovasculaires en Tunisie, Institut National de Santé Publique, Le Diplomate (10e étage), 5-7, rue Khartoum, Belvédère, 1002 Tunis, Tunisie.
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Fakhfakh R, Boujemaa O, Ben Salah F, Gharbi R, Klouze A, Lakhal M, Belkahia C, Achour N. Smoking Habits, Knowledge and Attitudes among Hospital Staff in Tunisia. Tob Induc Dis 2005. [DOI: 10.1186/1617-9625-3-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Fakhfakh R, Aouina H, Gharbi L, Hsairi H, Achour N, Lagrue G, Bouacha H. [Smoking dependence and symptoms of anxiety and depression among Tunisian smokers]. Rev Mal Respir 2003; 20:850-7. [PMID: 14743086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
INTRODUCTION The aim of this study was to describe the incidence of depression and anxiety, and their relationship with smoking dependence, in patients attending a Tunisian smoking cessation clinic. METHODS We studied 72 Tunisian smokers attending the smoking-cessation clinic at the Charle Nicolle Hospital in Tunis. Nicotine dependence was assessed by the Fageström Test for Nicotine Dependence. Anxiety and depression symptoms were measured using the HAD (Hospital Anxiety Depression) Scale. RESULTS The prevalence of anxiety and depression was 22.9% (16 patients) and 20% (14 patients) respectively with four patients (7.1%) exhibiting symptoms of both. Overall, 50% of the group had emotional morbidity with high HAD scores for depression or anxiety, or both. Smokers with symptoms of anxiety and/or depression had higher physical and psychological dependence, smoked more at times of stress, had a reduced quitting rate and endured more withdrawal symptoms than those smokers without anxiety or depression. CONCLUSIONS The data of this survey from Tunisia, a country that has just put in place a tobacco control strategy, underline the high rates of anxiety and depression that exist in patients attending a smoking cessation clinic. It confirms the association between anxio-depressive disorders and a high level of smoking dependence.
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Affiliation(s)
- R Fakhfakh
- Institut National de Santé Publique, Le Belvédère, Tunis, Tunisie.
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Hsairi M, Fakhfakh R, Bellaaj R, Achour N. [Knowledge and practice of doctors and midwives working in primary health care regarding screening for cervical and breast cancers]. East Mediterr Health J 2003; 9:353-63. [PMID: 15751928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
We assessed the knowledge and practices of breast and cervical cancer of 286 physicians and 126 midwives working in primary health care in Tunis who responded to an anonymous questionnaire. Questions were related to knowledge of the epidemiology and survival rates in the early stages of breast and cervical cancers, to training in this domain and to the degree of involvement in this screening. The knowledge of the two cancers was relatively modest among both physicians and midwives. The systematic practice of Pap smear was significantly more frequent among midwives than physicians. The same result was observed for systematic clinical breast examination. Lack of training about carrying out Pap smears and the large number of consultations were the main factors negatively associated with systematic Pap smear and clinical breast examination practice.
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Affiliation(s)
- M Hsairi
- Institut National de la Santé publique, Tunis, Tunisie
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Hsairi M, Fakhfakh R, Achour N. [Knowledge,attitudes and behaviours of women towards breast cancer screening]. East Mediterr Health J 2003. [DOI: 10.26719/2003.9.1-2.87] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
L’objectif de ce travail était de décrire les connaissances, attitudes et comportements des femmes vis-à-vis des méthodes de dépistage du cancer du sein dons deux régions du nord de la Tunisie. Ainsi 936 femmes résidant à l’Ariana [région urbanisée] et 993 femmes résidant à Zaghouan [région rurale] ont été choisies et ont répondu à un questionnaire sur leur perception de la gravité du cancer du sein, la vulnérabilité des femmes, l’efficacité du dépistage et le recours au dépistage. Le recours au dépistage était significativement plus fréquenta l’Ariana pour l’examen physique des seins et la mammographie mais demeure assez modeste. Ce faible recours au dépistage du cancer du seln contraste avec une attitude positive vis-à-vis des méthodes de dépistage de ce cancer. Les facteurs associés positivement au recours au dépistage sont la résidence en milieu urbain, l’âge compris entre 35 et 49 ans, le niveau d’instruction et la perception des progrès accomplis dans le domaine du traitement des cancers en Tunisie
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Hsairi M, Fekih H, Fakhfakh R, Kassis M, Achour N, Dammak J. [Life years lost and epidemiological transition in the Sfax region (Tunisia)]. Sante Publique 2003; 15:25-37. [PMID: 12806806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
OBJECTIVE To assess the burden of disease in the Sfax region and identify the main diseases that are the cause of lost life years due to premature death. METHODOLOGY The calculation of lost life years due to premature death was conducted using the demographic mortality data for the region obtained from the National Institute of Statistics combined with data on the classification of the causes of death collected through a survey on these causes conducted through a random sample taken from half of the deaths in the region. As described by Murray and Lopez, years of life lost as a result of premature death represent the difference between the age of death and an age corresponding to life expectancy falling between 65 and 85 years. RESULTS Out of a total of 52,316 life years lost that were recorded 27,902 were in the male population and 24,414 in the female. The main diseases found in males which cause lost life years are accidents (24.9%), cardiovascular diseases (17.3%), communicable diseases (17%), respiratory diseases (10.8%), prenatal problems (59.5%), and cancer (7.5%). For women the main causes were cardiovascular diseases (26.5%), respiratory illness (15.5%), accidents (11.5%), communicable diseases (10.3%) and cancer (9.5%). RECOMMENDATIONS These results marking the epidemiological transition in the region should serve to steer decision-makers to better rationalize and plan for health care costs and expenditure.
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Affiliation(s)
- M Hsairi
- Institut National de la Santé Publique 5-7, rue Khartoum, Bloc IV, Diplomat 10e étage, 1002, Le Belvédere, Tunis, Tunisie
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Hsairi M, Fakhfakh R, Bellaaj R, Achour N. [Knowledge, attitudes and behaviours of women towards breast cancer screening]. East Mediterr Health J 2003; 9:87-98. [PMID: 15562737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
The objective of this study was to describe knowledge, attitudes and behaviour of women towards breast cancer screening methods in two regions of north Tunisia. Thus 936 women from Ariana (urban region) and 993 women from Zaghouan (rural region) were selected and answered a questionnaire on their perception of the gravity of breast cancer, the vulnerability of women, the efficacy of screening and their use of screening. The use of screening was significantly more frequent in Ariana for both clinical breast examination and mammography, but screening use was modest. This low use of breast cancer screening contrasts with a positive attitude to breast cancer screening methods. The factors positively associated with use of screening were urban residence, age between 35 and 49 years, educational level and the perception that cancer treatment had advanced in Tunisia.
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Affiliation(s)
- M Hsairi
- Institut national de la Santé publique, Tunis, Tunisie
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Fakhfakh R, Hsairi M, Ben Romdhane H, Achour N. [Tunisian health profile: present state and trends]. Tunis Med 2002; 80:12-7. [PMID: 12071037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
We will try to value the Tunisian Health Profile, its present state and its tendencies. Data have been collected by various sources, in particular international and national organism. The total fertility rate passed from 8 in 1966 to 2.01 in 1999. Besides a light ageing of the population is started (9% of the population are aged of more than 60 years in 1999). Death rates recorded a decrease, mainly of the infantile mortality (140%@1000 in 1966 against 24.7%@1000 in 1999) and the maternal mortality (68.9 per 100,000 living births in 1994 against 220 in 1980-1984). The life expectancy at birth passed from 51 years in 1966 to 72.4 years in 1999. According the morbidity we attend the receding of the majority of transmitted diseases. Resources injected in the system of cares also evolved: The medical density passed from 1 per 6700 inhabitants in 1966 to 1 per 1300 in 1999. Tunisia recorded the most elevated scores for the preventive activities in particular at the vaccinal coverage. The global evolution of the Tunisian health profile is marked by the epidemiological transition buy which pass the country currently. This phase is delicate because it's generating of a growth of care expenses. Decision-makers must be careful to consider advantage priorities and the profitability of the investments.
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Fakhfakh R, Hsairi M, Ben Romdhane H, Achour N. [Mortality due to smoking in Tunisia in 1997]. Tunis Med 2001; 79:408-12. [PMID: 11774780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
In Tunisia, in spite of the high prevalence of the cigarette smoking among males, there consequences in term of mortality were not until evaluated. These last can be estimated from tobacco consumption data, mortality statistics and estimates of risks observed among populations of smokers in cohort studies. Numbers of deaths by causes have been estimated from WHO for 1998 year. Smoking prevalence have been estimated from a national survey conducted in 1996 by l'Institut National de Santé Publique and the National League against the Tuberculosis and the Respiratory Illness. Mortality attributable to tobacco in Tunisia has been estimated 6430 deaths. The effect of smoking are a lot more important at the man (5580 deaths), contributing to 22% of male deaths, that at the woman (850 deaths) contributing at 4% of the female deaths. The present mortality to tobacco is similar to certain developed countries as France or Canada. The consumption of cigarettes even though it recorded a light decrease during these last years, remain even elevated notably at the young. Then it is waited to see an increase of tobacco related deaths during the future decades. It is urgent to conduct an efficient politics against this tobacco epidemic by helping the smoker to stop smoking and preventing teenagers to begin to smoke.
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Affiliation(s)
- R Fakhfakh
- Institut National de Santé Publique, 5-7 rue Khartoum IMM Diplomat, Le belvédère, Tunis
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Achour N. [Medical studies in Tunisia]. Tunis Med 2001; 79:304-9. [PMID: 11515473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
In this report, the author analyses the Tunisian medical studies following their main stages of evolution, since the creation of the first medical university (1963), and focus on the major reforms. A great interest was designed to evaluate the comity findings reforms, held during the 1990, which has lead to undertake many measures for the medical studies. The author expose the measures applied, since 1990 in his report.
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Fakhfakh R, Hsairi M, Belaaj R, Ben Romdhane H, Achour N. [Epidemiology and prevention of smoking in Tunisia: current situation and perspectives]. Arch Inst Pasteur Tunis 2001; 78:59-67. [PMID: 14658240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
This paper describes the trends in tobacco sales and smoking prevalence in the Tunisian population, estimates the consequences of smoking on mortality of this population, and discusses anti-tobacco actions: educational actions, legislative measures and price increases. Sales Data were collected from the Tunisia tobacco company. Smoking prevalence data from surveys, conducted by several institutes, and numbers of deaths by causes have been estimated from WHO for the year 1998. Tobacco sales increased from 4.96 g per adult per day in 1981, to 6.3 g, in 1993, then decreased widely. The proportion of smokers was 30% in 1996. 55% among men versus 5.6% among women. Among 17 to 24 years old young adults, the proportion of smokers was 29.2% in 1994 (50% among men versus 3.9%, among women). Mortality attributable to tobacco in Tunisia has been estimated to 6430 deaths in 1997 (5580 among men versus 850 among women). These deaths represent 22% of the total male deaths and 4% of the female ones. Anti-tobacco measures have been reinforced by the enactment of anti-tobacco law. Proportion of young smokers remaining elevated, it is expected that consequences of the tobacco addiction in Tunisia, in term of mortality, will be even heavier in the next two decades, if efficient anti-tobacco actions are not implemented.
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Affiliation(s)
- R Fakhfakh
- Institut National de Santé Publique, 5-7, rue Khartoum Imm. Diplomate 1002-Le Belvédère, Tunis
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Hsaïri M, Fakhfakh R, Ghyoula M, Ben Abdallah M, Achour N. [Cost effectiveness of cervical cancer screening strategies in Tunisia]. Tunis Med 2000; 78:557-61. [PMID: 11190738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Cervical cancer is a public health problem in developing countries and is the first cancer among women in several of these countries. Screening using the Pap test is the principle control strategy for this cancer. The aim of this study is to identify the highest cost-effectiveness strategy of Pap test screening, according to age group (20-64 years, 35-64 years and 40-64 years) and the frequency of this test (every 3 years or every 5 years). Number of cases avoid by screening and mean cost to prevent one case were used to compare these screening strategies. The principles results showed that the number of cervical cancer cases avoid increase with the coverage level of the screening and age group size, and decrease with the frequency of the Pap tests. The screening strategy interesting age group "40-64 years" every 5 years observed the highest cost-effectiveness ratio (19 MD); however cost is 23 MD for age grovy 35-64 years. These results lead to choice a frequency of Pap tests every 5 years. However, for determination of age group, other factors, as psycho-social ones, should be taken into account besides economic criterias.
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Abstract
Because tobacco-related diseases are a growing health problem, we assessed tobacco smoking in Tunisia since 1970 using different sources. The average consumption of tobacco calculated over the period of 10 years [1981-90] was 1493 g per person and per year; equivalent of 75 packets of cigarettes. Cigarettes are the most popular form of tobacco smoking. Cigarette smoking increased from 1981 to 1993 but since has decreased slightly. According to a national study of respiratory diseases conducted in 1996, the current prevalence of tobacco smoking is 30.4% for both sexes: around 52% for males and 6% for females. Average consumption is 17.7 cigarettes/day, irrespective of sex. For young people, the prevalence is 29.21%: 50% for males and 3.9% for females. Young people who attend school smoke less than those who do not [18.1% versus 38.4%]. Most started smoking between 14 years and 18 year
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