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Ghali H, Bouhlel H, Bhiri S, Helal S, Zitouni C, Somaii S, Othmen TB, Belhadj N, Saad OB, Balhi S, Khefacha S, Rejeb MB, Cheikh AB, Latiri HS. Connaissances et pratiques des étapes préalables à la stérilisation des dispositifs médicaux thermorésistants : Etude au Centre Hospitalo-Universitaire Sahloul, Sousse-Tunisie - 2022. Ann Pharm Fr 2024:S0003-4509(24)00060-9. [PMID: 38649136 DOI: 10.1016/j.pharma.2024.04.003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 03/09/2024] [Accepted: 04/15/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVES The standard process of central sterilization is crucial for the optimal functioning of the operating room. The outcome of this process is closely linked to the steps preceding the steps prior to the sterilization step itself. These steps include pre-disinfection carried out in the operating rooms and other stages, namely washing, drying and packaging, which must be performed in the central sterilization unit. In this context, this study aimed to describe the knowledge of the staff in the operating rooms and the central sterilization unit at Sahloul University Hospital in Sousse (Tunisia) in 2022, regarding the steps prior to the sterilization of reusable thermoresistant medical devices and to describe their practices in terms of compliance with these steps. METHOD A descriptive study was conducted from January 2022 to June 2022 with the aforementioned staff, using a self-administered questionnaire to assess their knowledge of the pre-sterilization steps and a direct observation audit of their practices with regard to these steps. Both measurement instruments were pre-tested. RESULTS Out of 102 self-administered questionnaires (knowledge assessment) distributed to the staff concerned, only 80 were returned and correctly filled out, giving a response rate of 78.4%. Participants' responses regarding the order of steps prior to the sterilization were incorrect in 64% of cases. With regard to the evaluation of professional practices, 224 observations were made in the study area (practice audit). In 82% of these observations, the pre-disinfection step was confused with the washing step. The use of Betadine brushes and scrubbing pads for device washing was noted in 89.3%, along with the absence of swabbing of the canals and hollow parts in 9.4% of cases and the absence of drying of the canals with compressed air. CONCLUSION Mastery of the steps prior to sterilisation of reusable thermoresistant medical devices was insufficient in our institution, suggesting the importance of reinforcing the implementation of the procedure through a continuous training program followed by action plans.
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Affiliation(s)
- Hela Ghali
- Service de Prévention et Sécurité des Soins, CHU Sahloul, Sousse, Tunisie; Université de Sousse, Faculté de Médecine de Sousse, Sousse, Tunisie
| | - Hela Bouhlel
- Médecine de Famille, Faculté de Médecine de Sousse, Sousse, Tunisie
| | - Sana Bhiri
- Service de Prévention et Sécurité des Soins, CHU Sahloul, Sousse, Tunisie; Université de Sousse, Faculté de Médecine de Sousse, Sousse, Tunisie
| | - Sondes Helal
- Ecole Supérieure des Sciences et Techniques de la Santé de Sousse, Sousse, Tunisie
| | - Chaima Zitouni
- Ecole Supérieure des Sciences et Techniques de la Santé de Sousse, Sousse, Tunisie
| | - Sarra Somaii
- Ecole Supérieure des Sciences et Techniques de la Santé de Sousse, Sousse, Tunisie
| | - Takwa Ben Othmen
- Service de Prévention et Sécurité des Soins, CHU Sahloul, Sousse, Tunisie
| | - Nouha Belhadj
- Médecine de Famille, Faculté de Médecine de Sousse, Sousse, Tunisie
| | - Omar Ben Saad
- Service de Prévention et Sécurité des Soins, CHU Sahloul, Sousse, Tunisie
| | - Salma Balhi
- Service de Prévention et Sécurité des Soins, CHU Sahloul, Sousse, Tunisie; Université de Sousse, Faculté de Médecine de Sousse, Sousse, Tunisie
| | - Salwa Khefacha
- Service de Prévention et Sécurité des Soins, CHU Sahloul, Sousse, Tunisie
| | - Mohamed Ben Rejeb
- Service de Prévention et Sécurité des Soins, CHU Sahloul, Sousse, Tunisie; Université de Sousse, Faculté de Médecine de Sousse, Sousse, Tunisie
| | - Asma Ben Cheikh
- Service de Prévention et Sécurité des Soins, CHU Sahloul, Sousse, Tunisie; Université de Sousse, Faculté de Médecine de Sousse, Sousse, Tunisie
| | - Houyem Said Latiri
- Service de Prévention et Sécurité des Soins, CHU Sahloul, Sousse, Tunisie; Université de Sousse, Faculté de Médecine de Sousse, Sousse, Tunisie
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Ayadi S, Ghali H, Ben Abdelberi S, Kochbati A, Bkhairia S, Khefacha S. Prevalence and associated factors of unhealthy diet among adolescents: cross-sectional study among Tunisian high school students. Int J Adolesc Med Health 2024; 36:187-193. [PMID: 38515002 DOI: 10.1515/ijamh-2024-0006] [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: 01/10/2024] [Accepted: 03/03/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVES According to World Health Organization (WHO),Unhealthy Diet (UD)is a major risk factor for chronic diseases. That's why it is important to study the UD and its associated factors. Our study aimed to describe the dietary behavior of young high school students and determine associated factors of UD. METHODS A cross-sectional study was carried out among students of seven high schools in center-eastern Tunisia during the academic year 2021/2022. Data collection was carried out in April2022 by questionnaires. The questions concerned the socio-demographic characteristics, food habits and physical activity. WHO defined UD as the consumption of less than five fruits and vegetables per day. Data analysis was done using SPSS software. RESULTS A total of 740 adolescents were included. The mean age was17±1.16 years with extremes ranging from 14to19 years. Sex-ratio was 0.66. UD was found among 91.6 % of the study population. At multivariate analysis, eating cake (aOR=4.062; CI [1.685-9.795]; p=0.002),eating fried-food (aOR=3.239; CI [1.118-9.385]; p=0.03)and consuming sweets (aOR=3.263; CI [1.666-6.394]; p=0.001)were independent risk factors of UD. In the other hand, regular physical activity (aOR=0.524; CI [0.294-0.936]; p=0.029)and having breakfast regularly (aOR=0.523; CI [0.297-0.923]; p=0.025)were independent protective factors of UD. CONCLUSIONS The findings of this study showed an alarming prevalence of UD. Therefore, it is mandatory to establish effective strategies to support healthy diets and physical activity among adolescents in order to reduce non-communicable diseases related to UD.
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Affiliation(s)
- Souhir Ayadi
- Family Medicine, Faculty of Medicine of Sousse, Sousse, Tunisia
| | - Hela Ghali
- Department of Prevention and Security of Care, Sahloul University Hospital, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | | | - Amal Kochbati
- Higher School of Health Sciences and Techniques of Sousse, Sousse, Tunisia
| | - Siwar Bkhairia
- Higher School of Health Sciences and Techniques of Sousse, Sousse, Tunisia
| | - Salwa Khefacha
- Department of Prevention and Security of Care, Sahloul University Hospital, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
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Yacoub A, Ayadi A, Ayed W, Ayari S, Chebbi S, Magroun I, Ben Afia L, Mersni M, Mechergui N, Brahim D, Ben Said H, Bahri G, Youssef I, Ladhari N, Mziou N, Grassa A, M'rad M, Khessairi N, Krir A, Chihaoui M, Mahjoub S, Bahlous A, Jridi M, Cherif Y, Derbal S, Chebbi D, Hentati O, Ben Dahmen F, Abdallah M, Hamdi I, Sahli F, Ouerdani Y, Mnekbi Y, Abaza H, Ajmi M, Guedria A, Randaline A, Ben Abid H, Gaddour N, Maatouk A, Zemni I, Gara A, Kacem M, Maatouk I, Ben Fredj M, Abroug H, Ben Nasrallah C, Dhouib W, Bouanene I, Sriha A, Mahmoudi M, Gharbi G, Khsiba A, Azouz M, Ben Mohamed A, Yakoubi M, Medhioub M, Hamzaoui L, Azouz M, Ben Attig Y, Hamdi S, Essid R, Ben Jemia E, Rezgui B, Boudaya MS, Hassine H, Dabbabi H, Fradi Y, Cherif D, Lassoued I, Yacoub H, Kchir H, Maamouri N, Khairi W, Ben Ammar H, Abaza H, Chelbi E, Merhaben S, Neffati W, Ajmi M, Tarchalla S, Boughzala S, Gazzeh M, Gara S, Labidi A, Touati H, Nefzi AM, Ben Mustpha N, Fekih M, Serghini M, Boubaker J, Zouiten L, Driss A, Meddeb N, Driss I, Walha S, Ben Said H, Bel Hadj Mabrouk E, Zaimi Y, Mensi A, Trad N, Ayadi S, Said Y, Mouelhi L, Dabbèche R, Belfkih H, Bani M, Moussa A, Souissi S, Trabelsi Werchfeni B, Chelly S, Ezzi O, Ammar A, Besbes M, Njah M, Mahjoub M, Ghali H, Neffati A, Bhiri S, Bannour R, Ayadi S, Khouya FE, Kamel A, Hariz E, Aidani S, Kefacha S, Ben Cheikh A, Said H, Dogui S, Atig A, Gara A, Ezzar S, Ben Fradj M, Bouanène I, M'kadmi H, Farhati M, Dakhli N, Nalouti K, Chanoufi MB, Abouda SH, Louati C, Zaaimi Y, Dabbeche R, Hermi A, Saadi A, Mokaddem S, Boussaffa H, Bellali M, Zaghbib S, Ayed H, Bouzouita A, Derouiche A, Allouche M, Chakroun M, Ben Slama R, Gannoun N, Kacem I, Tlili G, Kahloul M, Belhadj Chabbah N, Douma F, Bouhoula M, Chouchene A, Aloui A, Maoua M, Brahem A, Kalboussi H, El Maalel O, Chatti S, Jaidane M, Naija W, Mrizek N, Sellami I, Feki A, Hrairi A, Kotti N, Baklouti S, Jmal Hammami K, Masmoudi ML, Hajjaji M, Naaroura A, Ben Amar J, Ouertani H, Ben Moussa O, Zaibi H, Aouina H, Ben Jemaa S, Gassara Z, Ezzeddine M, Kallel MH, Fourati H, Akrout R, Kallel H, Ayari M, Chehaider A, Souli F, Abdelaali I, Ziedi H, Boughzala C, Haouari W, Chelli M, Soltani M, Trabelsi H, Sahli H, Hamdaoui R, Masmoudi Y, Halouani A, Triki A, Ben Amor A, Makni C, Eloillaf M, Riahi S, Tlili R, Jmal L, Belhaj Ammar L, Nsibi S, Jmal A, Boukhzar R, Somai M, Daoud F, Rachdi I, Ben Dhaou B, Aydi Z, Boussema F, Frikha H, Hammami R, Ben Cheikh S, Chourabi S, Bokri E, Elloumi D, Hasni N, Hamza S, Berriche O, Dalhoum M, Jamoussi H, Kallel L, Mtira A, Sghaier Z, Ghezal MA, Fitouri S, Rhimi S, Omri N, Rouiss S, Soua A, Ben Slimene D, Mjendel I, Ferchichi I, Zmerli R, Belhadj Mabrouk E, Debbeche R, Makhloufi M, Chouchane A, Sridi C, Chelly F, Gaddour A, Kacem I, Chatti S, Mrizak N, Elloumi H, Debbabi H, Ben Azouz S, Marouani R, Cheikh I, Ben Said M, Kallel M, Amdouni A, Rejaibi N, Aouadi L, Zaouche K, Khouya FE, Aidani S, Khefacha S, Jelleli N, Sakly A, Zakhama W, Binous MY, Ben Said H, Bouallegue E, Jemmali S, Abcha S, Wahab H, Hmida A, Mabrouk I, Mabrouk M, Elleuch M, Mrad M, Ben Safta N, Medhioub A, Ghanem M, Boughoula K, Ben Slimane B, Ben Abdallah H, Bouali R, Bizid S, Abdelli MN, Ben Nejma Y, Bellakhal S, Antit S, Bourguiba R, Zakhama L, Douggui MH, Bahloul E, Dhouib F, Turki H, Sabbah M, Baghdadi S, Trad D, Bellil N, Bibani N, Elloumi H, Gargouri D, Ben Said M, Hamdaoui R, Chokri R, Kacem M, Ben Rejeb M, Miladi A, Kooli J, Touati S, Trabelsi S, Klila M, Rejeb H, Kammoun H, Akrout I, Greb D, Ben Abdelghaffar H, Hassene H, Fekih L, Smadhi H, Megdiche MA, Ksouri J, Kasdalli H, Hayder A, Gattoussi M, Chérif L, Ben Saida F, Gueldich M, Ben Jemaa H, Dammak A, Frikha I, Saidani A, Ben Amar J, Aissi W, Chatti AB, Naceur I, Ben Achour T, Said F, Khanfir M, Lamloum M, Ben Ghorbel I, Houman M, Cherif T, Ben Mansour A, Daghfous H, Slim A, Ben Saad S, Tritar F, Naffeti W, Abdellatif J, Ben Fredj M, Selmi M, Kbir GH, Maatouk M, Jedidi L, Taamallah F, Ben Moussa M, Halouani L, Rejeb S, Khalffalah N, Ben Ammar J, Hedhli S, Azouz MM, Chatti S, Athimni Z, Bouhoula M, Elmaalel O, Mrizak N, Maalej M, Kammoun R, Gargouri F, Sallemi S, Haddar A, Masmoudi K, Oussaifi A, Sahli A, Bhouri M, Hmaissi R, Friha M, Cherif H, Baya C, Triki M, Yangui F, Charfi MR, Ben Hamida HY, Karoui S, Aouini F, Hajlaoui A, Jlassi H, Sabbah M, Fendri MN, Kammoun N, Fehri S, Nouagui H, Harzalli A, Snène H, Belakhal S, Ben Hassine L, Labbene I, Jouini M, Kalboussi S, Ayedi Y, Harizi C, Skhiri A, Fakhfakh R, Jelleli B, Belkahla A, Fejjeri M, Zeddini M, Mahjoub S, Nouira M, Frih N, Debiche S, Blibech H, Belhaj S, Mehiri N, Ben Salah N, Louzir B, Kooli J, Bahri R, Chaka A, Abdenneji S, Majdoub Fehri S, Hammadi J, Dorgham D, Hriz N, Kwas H, Issaoui N, Jaafoura S, Bellali H, Shimi M, Belhaj Mabrouk E, Sellami R, Ketata I, Medi W, Mahjoub M, Ben Yacoub S, Ben Chaabene A, Touil E, Ben Ayed H, Ben Miled S, El Zine E, Khouni H, Ben Kadhi S, Maatoug J, Boulma R, Rezgui R, Boudokhane M, Jomni T, Chamekh S, Aissa S, Touhiri E, Jlaiel N, Oueslati B, Maaroufi N, Aouadi S, Belkhir S, Daghfous H, Merhaben S, Dhaouadi N, Ounaes Y, Chaker K, Yaich S, Marrak M, Bibi M, Mrad Dali K, Sellami A, Nouira Y, Sellami S, Anane I, Trabelsi H, Ennaifer R, Benzarti Z, Bouchabou B, Hemdani N, Nakhli A, Cherif Y, Abdelkef M, Derbel K, Barkous B, Yahiaoui A, Sayhi A, Guezguez F, Rouatbi S, Racil H, Ksouri C, Znegui T, Maazaoui S, Touil A, Habibech S, Chaouech N, Ben Hmid O, Ismail S, Chouaieb H, Chatti M, Guediri N, Belhadj Mohamed M, Bennasrallah C, Bouzid Y, Zaouali F, Toumia M, El Khemiri N, El Khemiri A, Sfar H, Farhati S, Ben Chehida F, Yamoun R, Braham N, Hamdi Y, Ben Mansour A, Mtir M, Ayari M, Toumia M, Rouis S, Sakly H, Nakhli R, Ben Garouia H, Chebil D, Hannachi H, Merzougui L, Samet S, Hrairi A, Mnif I, Hentati O, Bouzgarrou L, Souissi D, Boujdaria R, Kadoussi R, Rejeb H, Ben Limem I, Ben Salah I, Greb D, Ben Abdelghaffar H, Smadhi H, Laatiri H, Manoubi SA, Gharbaoui M, Hmandi O, Zhioua M, Taboubi F, Hamza Y, Hannach W, Jaziri H, Gharbi R, Hammami A, Dahmani W, Ben Ameur W, Ksiaa M, Ben Slama A, Brahem A, Elleuch N, Jmaa A, Kort I, Jlass S, Benabderrahim S, Turki E, Belhaj A, Kebsi D, Ben Khelil M, Rmadi N, Gamaoun H, Alaya Youzbechi F, Brahim T, Boujnah S, Abid N, Gader N, Kalboussi S, Ben Sassi S, Loukil M, Ghrairi H, Ben Said N, Mrad O, Ferjaoui M, Hedhli L, Ben Kaab B, Berriche A, Charfi R, Mourali O, Smichi I, Bel Haj Kacem L, Ksentini M, Aloui R, Ferchichi L, Nasraoui H, Maoua M, Chérif F, Belil Y, Ayed MA, Alloulou Y, Belhadj S, Daghfous J, Mehiri N, Louzir B, Abbes A, Ghrab A, Chermiti A, Akacha A, Mejri O, Debbiche A, Yahiaoui C, Binous M, Tissaoui A, Mekni K, El Fekih C, Said MA, Chtioui S, Mestiri S, Smaoui H, Ben Hamida S, Haddar A, Mrizek N, Gares N, Zaibi A, Bouazizi N, Gallas S, Lachhab A, Belhadj M, Hadj Salem N, Garrouch A, Mezgar Z, Khrouf M, Abbassi H, Souissi D, Hamra I, Ben Mustapha N, Abessi I, Boubaker F, Bouchareb S, ElOmma Mrabet H, Touil I, Boussoffara L, Knani J, Boudawara N, Alaya W, Sfar MH, Fekih S, Snène H, Boudawara N, Gargouri I, Benzarti W, Knaz A, Abdelghani A, Aissa S, Hayouni A, Mejri I, Kacem M, Mhamdi S, Daboussi S, Aichaouia C, Moatemri Z, Chaachou A, Fsili R, Ben Ghezala H, Ben Jazia A, Brahmi N. 2022 TUNISIAN NATIONAL CONGRESS OF MEDICINE ABSTRACTS. Tunis Med 2023; 101:62-64. [PMID: 37682263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Indexed: 09/09/2023]
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Mziou E, Ghali H, Bhiri S, Ben Cheikh A, Bannour R, Ghribi M, Trabelsi S, Khefacha S, Ben Rejeb M, Said Latiri H. Control of Acinetobacter baumannii outbreak in intensive care units in Tunisia, 2022. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.390] [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: 11/13/2022] Open
Abstract
Abstract
Introduction
Acinetobacter baumannii is an emerging pathogen that is increasingly resistant to antibiotics and is mainly responsible for pneumopathy in fragile patients. This germ is frequently responsible for epidemics in hospitals. We aimed to describe the steps of the investigation of an outbreak of Acinetobacter baumannii affected our hospital, the measures implemented and the follow-up of the actions.
Methods
Following alerts issued by the microbiology department concerning 5 swabs detecting Acinetobacter of the same strain and the same antibiotic resistance profile in 3 different departments of intensive-care units (ICU), a team of the prevention and healthcare security department went onsite for an investigation in the hospital.
Results
We identified five cases with identical strains of multi-resistant Acinétobacter. The field visit allowed to identify some deficiencies in professional practices. All the patients were hospitalized in ICU (medical and surgical). The synoptic table showed that there was an overlap of hospitalization periods.A crisis cell was set up to validate, coordinate and implement control measures in accordance with CTINILS recommendations. Indeed, we proceeded to a technical isolation of the cases in their hospitalization sector, reinforced the basic hygiene and bio-cleaning measures and sensitized the medical and paramedical. Given that the three ICU departments shared the same medical staff during night shifts, the assumption that the germ was carried by the caregivers was the most likely hypothesis. We proceeded with a swab of the elements of the environment in the services concerned. Results showed that Acinetobacter was found on the nursing cart (visibly clean). A training about bio-cleaning and hygiene standard precautions is programmed.
Conclusions
Continuous surveillance, continuous hygiene trainings, combined with a rapid reaction capacity in case of identification of a new case, is essential to control the spread of nosocomial germs.
Key messages
• Multidrug-resistant Acinetobacter baumannii (MRAB) is an emerging cause of intensive care unit (ICU) outbreaks.
• Enhanced infection control measures limited the outbreak.
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Affiliation(s)
- E Mziou
- Department of Prevention and Security of Care, Sahloul University Hospital , Sousse, Tunisia
| | - H Ghali
- Department of Prevention and Security of Care, Sahloul University Hospital , Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse , Sousse, Tunisia
- Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care LR20SP06, , Tunisia
| | - S Bhiri
- Department of Prevention and Security of Care, Sahloul University Hospital , Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse , Sousse, Tunisia
- Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care LR20SP06, , Tunisia
| | - A Ben Cheikh
- Department of Prevention and Security of Care, Sahloul University Hospital , Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse , Sousse, Tunisia
- Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care LR20SP06, , Tunisia
| | - R Bannour
- Department of Prevention and Security of Care, Sahloul University Hospital , Sousse, Tunisia
- Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care LR20SP06, , Tunisia
| | - M Ghribi
- Family Medicine, Faculty of Medicine of Sousse , Sousse, Tunisia
| | - S Trabelsi
- Family Medicine, Faculty of Medicine of Sousse , Sousse, Tunisia
| | - S Khefacha
- Department of Prevention and Security of Care, Sahloul University Hospital , Sousse, Tunisia
| | - M Ben Rejeb
- Department of Prevention and Security of Care, Sahloul University Hospital , Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse , Sousse, Tunisia
- Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care LR20SP06, , Tunisia
| | - H Said Latiri
- Department of Prevention and Security of Care, Sahloul University Hospital , Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse , Sousse, Tunisia
- Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care LR20SP06, , Tunisia
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Ghali H, Bhiri S, Ben Cheikh A, Bannour R, Khefacha S, Ben Rejeb M, Said Latiri H. Time trends in Surgical Site Infection rates in a Tunisian university hospital. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.386] [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: 11/13/2022] Open
Abstract
Abstract
Background
Surgical site infections (SSIs) are the most common hospital-acquired infections (HAIs) in low- and middle-income countries. Many reports have shown that surveillance and management of factors associated with SSI decreased rates and improved overall outcomes.This study aimed to appraise the prevalence trend and risk factirs of SSIs during 10-year period (2012 - 2021) in a Tunisian university hospital.
Methods
The SSI surveillance module is based on the National Healthcare Safety Network (NHSN), Centers for Disease Control and Prevention (CDC). For the current study, data collected over ten years through point prevalence surveys were analyzed. Univariate and multivariate logistic analysis were used to identify SSI risk factors.
Results
Overall, 2957 patients were observed; the mean age was 48.4 ± 23.5 years and 57.2% were male. We identified 289 infected patients (9.8%) and 319 HAIs (10.8%). SSIs were found in 21.6% of cases.The prevalence of SSI decreased from 27.9% in 2012 to 21.6% in 2021. However, this decrease was not statistically significant. The majority of the positive cultures were Staphylococcus aureus (14.3%) followed by Escherichia Coli (11.1%) and Klebsiella pneumoniae (9.5%). Antimicrobial resistance was found in 17.5% of cases. Univariable analysis found that lenght of stay (p < 10-3), obesity (p = 0.047), the use of antibiotic treatment in 6 months (p = 0.002), and the use of central line (p < 10-3) were associated with SSI. Independent risk factors significantly associated with SSIs were length of stay (aOR=8.6), the use of central line (aOR=3), and the use of antibiotic treatment in 6 months (aOR=2.2).
Conclusions
With continuous surveillance, the prevalence of SSIs decreased. In Sahloul university hospital, there has been a strengthening of the application of hygiene standard precautions during the two last years, and more particularly the respect of hand hygiene, combined with continued inpatient antimicrobial stewardship programs.
Key messages
• Active surveillance and management of factors associated with surgical site infection (SSI) decreased the incidence and improved overall outcomes.
• With continuous surveillance, the prevalence of SSIs decreased over the 10-year study period.
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Affiliation(s)
- H Ghali
- Department of Prevention and Security of Care, Sahloul University Hospital , Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse , Sousse, Tunisia
- LR20SP06, Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care , Tunisia
| | - S Bhiri
- Department of Prevention and Security of Care, Sahloul University Hospital , Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse , Sousse, Tunisia
- LR20SP06, Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care , Tunisia
| | - A Ben Cheikh
- Department of Prevention and Security of Care, Sahloul University Hospital , Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse , Sousse, Tunisia
- LR20SP06, Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care , Tunisia
| | - R Bannour
- Department of Prevention and Security of Care, Sahloul University Hospital , Sousse, Tunisia
- LR20SP06, Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care , Tunisia
| | - S Khefacha
- Department of Prevention and Security of Care, Sahloul University Hospital , Sousse, Tunisia
- LR20SP06, Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care , Tunisia
| | - M Ben Rejeb
- Department of Prevention and Security of Care, Sahloul University Hospital , Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse , Sousse, Tunisia
- LR20SP06, Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care , Tunisia
| | - H Said Latiri
- Department of Prevention and Security of Care, Sahloul University Hospital , Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse , Sousse, Tunisia
- LR20SP06, Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care , Tunisia
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Ghali H, Ben Cheikh A, Bhiri S, Khefacha S, Ben Rejeb M, Said Latiri H. [Therapeutic education in patients with coronary artery disease: impact on smoking cessation]. Ann Cardiol Angeiol (Paris) 2022; 71:187-193. [PMID: 35718551 DOI: 10.1016/j.ancard.2022.05.003] [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: 03/26/2022] [Revised: 04/29/2022] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
AIM OF THE STUDY To describe the results of a therapeutic education program (cessation rate and success factors) among smoking coronary patients followed in the smoking cessation clinic at Sahloul University Hospital in Sousse during the period from 2015 to 2020. PATIENTS AND METHODS A descriptive cross-sectional study was conducted among smokers with coronary artery disease who presented to the smoking cessation clinic at Sahloul University Hospital during the period from 2015 to 2020. The data collection was done by reviewing the records of smokers. We defined cessation as complete and continuous abstinence at 1 week, at 3 months, at 6 months and at 12 months and more. The study of cessation success factors involved subjects whose cessation was maintained for 1 year or more. RESULTS Among 93 patients with coronary artery disease, the prevalences of smoking cessation rates were 54.8% (n = 51), 44.1% (n = 41), 35.5% (n = 33), 31.2% (n = 29), and 24.7% (n = 23) at 1 week, 1 month, 3 months, 6 months, and 12 months respectively. In univariate analysis, the number of visits greater than or equal to three (p = 0.000) and nicotine treatment (p = 0.018) were significantly associated with successful smoking cessation at 12 months. In multivariate analysis, being non-active (p = 0.028) with a Fagerstrom score <7 (p = 0.040) and three or more visits (p = 0.005) were the independent factors associated with successful smoking cessation at 12 months. CONCLUSION The evaluation of the smoking cessation axis of therapeutic education of the coronary patient with tobacco addiction at the Sahloul University Hospital, allowed us to note that the cessation rate is comparable or even higher than that of other studies. However, the rate of maintenance of this cessation at 1 year and more proved to be low despite the strong motivation of the consultants. This observation allows us to better orientate the areas of improvement in the management of our consultants.
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Affiliation(s)
- Hela Ghali
- Service de Prévention et de Sécurité des Soins, CHU Sahloul, Sousse, Tunisie; Faculté de Médecine de Sousse, Université de Sousse, Sousse, Tunisie.
| | - Asma Ben Cheikh
- Service de Prévention et de Sécurité des Soins, CHU Sahloul, Sousse, Tunisie; Faculté de Médecine de Sousse, Université de Sousse, Sousse, Tunisie.
| | - Sana Bhiri
- Service de Prévention et de Sécurité des Soins, CHU Sahloul, Sousse, Tunisie; Faculté de Médecine de Sousse, Université de Sousse, Sousse, Tunisie.
| | - Salwa Khefacha
- Service de Prévention et de Sécurité des Soins, CHU Sahloul, Sousse, Tunisie.
| | - Mohamed Ben Rejeb
- Service de Prévention et de Sécurité des Soins, CHU Sahloul, Sousse, Tunisie; Faculté de Médecine de Sousse, Université de Sousse, Sousse, Tunisie.
| | - Houyem Said Latiri
- Service de Prévention et de Sécurité des Soins, CHU Sahloul, Sousse, Tunisie; Faculté de Médecine de Sousse, Université de Sousse, Sousse, Tunisie.
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Ghali H, Ben Sik Ali H, Ben Cheikh A, Bhiri S, Khefacha S, Ben Rejeb M, Said Latiri H. Educational effectiveness of simulation in teaching health science students Smoking cessation: A Systematic Review. Tunis Med 2022; 100:102-113. [PMID: 35852243 PMCID: PMC9275420] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Simulation is one of the educational tools that can be used in the learning process to help with smoking cessation. AIM To synthesize all the publications studying the contribution of simulation as an educational tool in the acquisition of skills to help with smoking cessation. METHODS We performed a systematic review of the Francophone and Anglophone literature over the past 24 years (1997 to 2020) using the PubMed, Science Direct and Cochrane Library databases. RESULTS A total of 14 articles were included. The most used methods were thestandardized patient, role play and video projection with discussion. The simulation hasnot only proved its effectiveness in terms of acquiring knowledge and self-confidencein the management of the smoking patient in the short term, but also in the acquisition of verbal and non-verbal skills in the long term. CONCLUSION This review highlighted the interest of simulation as an educational tool to acquire skills to help with smoking cessation regardless of the method used.
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Affiliation(s)
- Hela Ghali
- 1- Service de Prévention et Sécurité de Soins/Hôpital universitaire Sahloul / Université de Sousse/Faculté de Médecine de Sousse
| | - Habiba Ben Sik Ali
- 2- Service de Réanimation médicale/ Hôpital universitaire Tahar Sfar, Mahdia / Université de Monastir/Faculté de Médecine de Monastir
| | - Asma Ben Cheikh
- 1- Service de Prévention et Sécurité de Soins/Hôpital universitaire Sahloul / Université de Sousse/Faculté de Médecine de Sousse
| | - Sana Bhiri
- 1- Service de Prévention et Sécurité de Soins/Hôpital universitaire Sahloul / Université de Sousse/Faculté de Médecine de Sousse
| | - Salwa Khefacha
- 1- Service de Prévention et Sécurité de Soins/Hôpital universitaire Sahloul / Université de Sousse/Faculté de Médecine de Sousse
| | - Mohamed Ben Rejeb
- 1- Service de Prévention et Sécurité de Soins/Hôpital universitaire Sahloul / Université de Sousse/Faculté de Médecine de Sousse
| | - Houyem Said Latiri
- 1- Service de Prévention et Sécurité de Soins/Hôpital universitaire Sahloul / Université de Sousse/Faculté de Médecine de Sousse
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Dhouib W, Ibrahim B, Bannour R, ben Cheikh A, Bhiri S, Ghali H, Khefacha S, Said Latiri H, Ben Rejeb M. The burden of Alzheimer’s caregivers and social support in the Tunisian family. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.577] [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: 11/12/2022] Open
Abstract
Abstract
Background
Alzheimer is a pathology that concers the patient and his family having a physical, social, economic and psychological impact. Research on family caregivers is still lacking and little is known about caregivers burden and ist associated factors in Tunisia. The aim of this study were to describe caregiver burden among Tunisian family caregivers of patients with alzheimeŕs disease, its associated factors and ist relationship to social support.
Methods
We conducted a cross-sectional study among 118 family caregivers during three months at the neurology outpatient departments of two university hospitals. Sahloul, Sousse and Taher Sfar, Mahdia. Using the Zarit Burden Interview-22 (ZBI)items and the Medical Outcome Study-Social Support Survey to assess burden and social support among the caregivers.
Results
We included 118 caregivers of patients with Alzheimeŕs disease,with an average age of 45±15 years. Women were more predominant with a sex ratio of 0.57.Half of caregivers were the descent of patients. The Mean years of caregiving was 5±3 years with an average of 13 hours ±3 of care assistance per day. The mean ZBI Score was 38.4±18.5 and 16.1% of caregivers percived a severe burden. The mean ZBI Score was higher in female, retired, lowmsocio economic status and in rural area with a statistically significance difference. We found that caregiver burden and social support were highly correlated (p < 0.001,r=-0.41)indicating that a high level of caregiver burden was asoociated with a less level of social support.
Conclusions
The level of burden in family caregivers who are caring for a patient with alzheimeŕs disease is high. A considerate help and support from helth care and social institutions is required by taking into account the factors that contribute to caregivers burden and considering the importance of social support in alleviating caregiver burden.
Key messages
The level of burden in family caregivers who are caring for a patient with alzheimeŕs disease is high. High level of caregiver burden was asoociated with a less level of social support.
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Affiliation(s)
- W Dhouib
- University, Medecine, Sousse, Tunisia
| | - B Ibrahim
- University, Health Technology, Sousse, Tunisia
| | - R Bannour
- University, Medecine, Sousse, Tunisia
| | | | - S Bhiri
- University, Medecine, Sousse, Tunisia
| | - H Ghali
- University, Medecine, Sousse, Tunisia
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Bannour R, Harzali Z, Dhouib W, Ben Cheikh A, Bhiri S, Ghali H, Khefacha S, Said Latiri H, Ben Rejeb M. Social support and health-related quality of life among patients with chronic heart failure. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.603] [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: 11/13/2022] Open
Abstract
Abstract
Introduction
Heart failure (HF) represents a major public health issue in Tunisia due to its frequency and its consequences in terms of morbidity and mortality. Despite improved treatment, HF is still associated with high mortality and impaired quality of life. Therefore, improvement or maintenance of health-related quality of life (HRQoL) is important when caring for these patients. The aim of this study was to evaluate the health-related quality of life (HRQoL) and explore its associated factors and its relationship with social support.
Material and methods
A cross sectional study was conducted over a period of two months in the cardiology departments in the following university hospitals: Sahloul and Farhat Hached in Sousse, Fattouma Bourguiba in Monastir and Taher Sfar in Mandia. Overall, 92 participants were included. Data was collected using an interview administrated questionnaire in the Tunisian dialect. This questionnaire used the Tunisian version of the SF-36 and MSPSS.
Results
The mean age of the participants was 63.1 ± 10.4 with female predominance (53.3%). The overall score of the SF-36 was 45.1 ± 26.5. The physical component was more impaired than the mental component ((41.2 ± 29.1 VS51.3 ± 27). The two dimensions mental health and social functioning had obtained the highest averages (63.6 ± 22.4 and 51.4 ± 33.1; respectively). The MSPSS score was 52.5 ± 21. The ‘family' subscale had the highest mean (21 ± 8). HRQoL was positively associated with social support (p = 0.013; r = 0.257). The predictors of good HRQoL were: young age, university level of education, cohabitation with family, high socioeconomic level and one-sided HF.
Conclusions
Therapeutic education sessions should be implemented in order to improve the functional symptoms of HF, reduce the rate of readmissions and subsequently improve HRQOL. We also stress the importance of giving priority to strengthening social ties between the patient and their social circles.
Key messages
Heart failure is still associated with high mortality and impaired quality of life. Therapeutic education sessions should be implemented in order to improve the Quality of life of HF patients.
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Affiliation(s)
- R Bannour
- Department of Prevention and Security of Care, Sahloul University of Sousse, Sousse, Tunisia
| | - Z Harzali
- Higher School of Health Sciences and Techniques, University of Sousse, Sousse, Tunisia
| | - W Dhouib
- Department of Prevention and Security of Care, Sahloul University of Sousse, Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - A Ben Cheikh
- Department of Prevention and Security of Care, Sahloul University of Sousse, Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - S Bhiri
- Department of Prevention and Security of Care, Sahloul University of Sousse, Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - H Ghali
- Department of Prevention and Security of Care, Sahloul University of Sousse, Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - S Khefacha
- Department of Prevention and Security of Care, Sahloul University of Sousse, Sousse, Tunisia
| | - H Said Latiri
- Department of Prevention and Security of Care, Sahloul University of Sousse, Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - M Ben Rejeb
- Department of Prevention and Security of Care, Sahloul University of Sousse, Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
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10
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Dhouib W, Abdallah S, Bannour R, Ben Cheikh A, Bhiri S, Ghali H, Khefacha S, SAID Latiri H, Ben Rejeb M. Quality of life in adult patients with open-angle glaucoma:a systematic review. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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
Background
Assessment of the quality of life of glaucoma is an essential basis for their management in order to prevent deterioration of the disease. The aim of the study was to describe through a systematic review the quality of life of patients with open angle glaucoma and identify its associated factors.
Methods
It was a systematic review conducted based on the preferred reporting items for Systematic Reviews and Meta-analyses (PRISMA).Criteria for eligibility were all published population-based primary literature in Pubmed and Embase interface, written in English, since January 2014 to 31 December 2019. Electronic research was done through the following documentary query ((((‘glaucoma'[MeSH Terms]) AND (‘quality of life'[MeSH Terms])) AND (‘open angle glaucoma'[Title/Abstract])) AND (‘adult'[MeSH Terms])) AND (‘risk factors'[MeSH Terms]).Level of evidence and grades of recommendation was assessed according to the Scottish Intercollegiate Guidelines Network (SIGN).
Results
Among 139 articles, 15 were selected. Most of them were descriptive cross-sectional studies using different measuring instruments. We found that the quality of life of glaucoma patients varies according to the regions in Asia, Europe, America and Africa. The highest scores were recorded in Asia, followed by North America and Europe, which have very close scores. The risk factors associated with the quality of life of glaucoma patients were: Age, sex, level of education, professional status, marital status, visual acuity and disability, anxiety and depression.
Conclusions
The level of quality of life in this type of patient varies considerably between regions and countries and even in the same country. Associated factors are predominantly socio-demographic.
Key messages
The level of quality of life in patients with glaucoma varies considerably between regions and countries. Associated factors are predominantly socio-demographic.
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Affiliation(s)
- W Dhouib
- University, Medecine, Sousse, Tunisia
| | - S Abdallah
- University, Higher School of Health Sciences and Techniques, Sousse, Tunisia
| | - R Bannour
- University, Medecine, Sousse, Tunisia
| | | | - S Bhiri
- University, Medecine, Sousse, Tunisia
| | - H Ghali
- University, Medecine, Sousse, Tunisia
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11
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Ghali H, Cheikh AB, Bhiri S, Fredj SB, Layouni S, Khefacha S, Dhidah L, Rejeb MB, Latiri HS. [Adverse events in a Tunisian university hospital: incidence and risk factors]. Sante Publique 2020; 32:189-198. [PMID: 32989948 DOI: 10.3917/spub.202.0189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To determine the incidence and risk factors of adverse events (AE) in a Tunisian university hospital. METHOD We carried out a longitudinal observational study in 2016 over a period of 3 months in the Sahloul university hospital of Sousse, Tunisia. Data were collected using a pretested form filled by doctors previously trained in the collection methodology, upon each visit to all hospitalized patients. RESULTS Overall, 1,357 patients were eligible. We identified 168 AEs in 131 patients with AEs incidence of 12.4% (95% CI: [7.41 – 17.38]), and patient incidence of 9.7% (95% CI: [4.63 – 14.76]). The incidence density of AEs was 1.8 events per 100 days of hospitalization. Hospital acquired infection and unplanned readmission related to previous healthcare management were the most common AEs (43.4 and 12.5% respectively). Multivariate analysis revealed as independent factors of AEs: surgery (P = 0.013; RR = 1.68; CI: [1.11-2.54]), the use of central-venous-catheter (P < 10–3; RR = 4.1 ; CI: [2.1-8]), tracheotomy (P = 0.001; RR = 21.8; CI: [3.7-127.8]), transfusion (P = 0.014; RR = 2.1; CI: [1.16-3.87]) and drug intake (P = 0.04; RR = 2.2; CI: [1.04-4.7]). CONCLUSION The present study showed a high incidence of AEs and the involvement of invasive devices in their occurrence. Thus, targeted interventions are needed.
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Ghali H, Khefacha S, Ben Cheikh A, Bhiri S, Tourki Dhidah M, Dhidah L, Ben Rejeb M, Said Latiri H. Characteristics of smoking behavior in adolescents, Sousse, Tunisia. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.866] [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: 11/12/2022] Open
Abstract
Abstract
Background and aims
Adolescence is a period of physical, psychological and socio-cultural transformation, but also of curiosity, experimentation and acquisition. It is mainly during adolescence that people are introduced to the use of legitimate psychoactive substances, such as alcohol and tobacco, as well as illicit substances such as cannabis. We aimed to determine the prevalence of smoking among high school students in the region of Sousse and to specify its characteristics.
Methods
We conducted a cross-sectional study in two public schools in the governorate of Sousse during the 2017/2018 school year. The data were collected by anonymous self-administered questionnaire, then processed and analyzed using the SPSS software version 20.
Results
A total of 294 students were included. The sex ratio was 0.78 with mean age of 17.03 years (standard deviation = 1.51). Results showed that 27.6% of students reported having already tasted tobacco. Among them, 61.8% of their parents did not know they were smoking. 17.28% started before the age of 14. Only 26% of them tried to stop but failed. Boys smoked twice as much as girls (p = 0.001). In addition, 63% of young smokers used chicha, 48.1% drank alcohol, and 35.8% used cannabis at least once.
Conclusions
The prevalence of smoking among these adolescents is worrying. Knowledge of related factors is important for program planning to prevent the tobacco epidemic in schools.
Key messages
Adolescence is the age of initiation for addictive substance use specially, Tobacco use. Knowledge of related factors is important for prevention program planning.
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Affiliation(s)
- H Ghali
- Department of Prevention and Security of Care, Sahloul hospital, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - S Khefacha
- Department of Prevention and Security of Care, Sahloul hospital, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - A Ben Cheikh
- Department of Prevention and Security of Care, Sahloul hospital, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - S Bhiri
- Department of Prevention and Security of Care, Sahloul hospital, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - M Tourki Dhidah
- Department of Prevention and Security of Care, Sahloul hospital, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - L Dhidah
- Department of Prevention and Security of Care, Sahloul hospital, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - M Ben Rejeb
- Department of Prevention and Security of Care, Sahloul hospital, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - H Said Latiri
- Department of Prevention and Security of Care, Sahloul hospital, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
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13
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Ghali H, Bhiri S, Ben Cheikh A, Khefacha S, Tourki Dhidah M, Dhidah L, Ben Rejeb M, Said Latiri H. Risk factors of illicit substance use among Tunisian adolescents of Sousse. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.867] [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
Background and aims
Adolescence is a period of physical, psychological and socio-cultural transformation, but also of curiosity, experimentation and acquisition. It is mainly during adolescence that people are introduced to the use of legitimate psychoactive substances, such as alcohol and tobacco, as well as illicit substances such as cannabis. Studying its predictors could help deal with this problem more efficiently. We aimed to determine the prevalence of life time illicit substance use and its predictors among Tunisian adolescents.
Methods
We conducted a cross-sectional study in two public schools in the governorate of Sousse during the 2017/2018 school year. The data were collected by anonymous self-administered questionnaire, then processed and analyzed using the SPSS software version 20.
Results
A total of 294 students were included. The mean age was of 17.03 years (standard deviation = 1.51). Females represented 56.1% of participants (sex ratio was 0.78). Among respondents: 60 (20.4%) had used illicit substance at least once. Cannabis was the main substance used by 35 (58.3%) students. The average age of the illicit substance use initiation was 16.3 (±1.1) years while it was 15.7 (±1.5) and 14.7 (±1.8) years for alcohol and tobacco use initiation respectively. Proportions of male students and academic failure were significantly more important among illicit substance users than among non users. While the most influential factors on illicit substance use were: alcohol use, and tobacco use (p < 10-3). However, no significant association was found between illicit substance use and video games and internet use.
Conclusions
This study highlights the strong association between the other risk behaviors and illicit drug use. Future interventions should focus on the whole risk behaviors simultaneously at late adolescence with regard to the environmental context.
Key messages
Our results highlight the need to better understand behaviors at risk in Tunisia and the perceptions of prevention policies among students. Mainly during adolescence that people are introduced to the use of illicit substances.
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Affiliation(s)
- H Ghali
- Department of Prevention and Security of Care, Sahloul hospital, Faculty of Medicine of Sousse, Sousse, Tunisia
| | - S Bhiri
- Department of Prevention and Security of Care, Sahloul hospital, Faculty of Medicine of Sousse, Sousse, Tunisia
| | - A Ben Cheikh
- Department of Prevention and Security of Care, Sahloul hospital, Faculty of Medicine of Sousse, Sousse, Tunisia
| | - S Khefacha
- Department of Prevention and Security of Care, Sahloul hospital, Faculty of Medicine of Sousse, Sousse, Tunisia
| | - M Tourki Dhidah
- Department of Prevention and Security of Care, Sahloul hospital, Faculty of Medicine of Sousse, Sousse, Tunisia
| | - L Dhidah
- Department of Prevention and Security of Care, Sahloul hospital, Faculty of Medicine of Sousse, Sousse, Tunisia
| | - M Ben Rejeb
- Department of Prevention and Security of Care, Sahloul hospital, Faculty of Medicine of Sousse, Sousse, Tunisia
| | - H Said Latiri
- Department of Prevention and Security of Care, Sahloul hospital, Faculty of Medicine of Sousse, Sousse, Tunisia
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Cheikh AB, Bhiri S, ketaka N, Gara A, Khefacha S, Rejeb MB, Latiri HS. Ventilator-Associated Pneumonia: Incidence and risk factors six intensive care units in Tunisia. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.712] [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: 11/12/2022] Open
Abstract
Abstract
Background
Ventilator-Associated Pneumonia (VAP) continues to cause significant morbidity, mortality, and hospital costs, especially in the intensive care unit (ICU). This study aimed to determine incidence and factors associated with VAP in six ICUs of the University Hospital-Sahloul (Sousse, Tunisia) in 2018.
Methods
We conducted a prospective observational cohort study over a three months period in six ICUs of the University Hospital-Sahloul (Sousse, Tunisia) in 2018. All patients hospitalized with mechanical ventilation (MV) for more than 48 hours in the ICUs were included. Logistic regression with the stepwise method of Hosmer and Lemeshow was used to identify factors associated with VAP.
Results
Overall, 110 patients were enrolled. The mean age of patients was 44 ± 25 years. Of them, 66.4% were male. The median duration of MV was 5 days [2-16]. The incidence of VAP was 32% and the density incidence was 33/1000 ventilator days. The most common organism were Pseudomonas aeruginosa (n = 14). Of them, 12 were ceftazidime-resistant and thee were resistant to imipenem. Independent risk factors associated with VAP in ICU were history of antibiotic therapy during last 6 months (p = 0.007), tracheotomy (p < 0.001) and reintubation (p < 0.001).
Conclusions
VAP rates in our ICUs were very high. Antimicrobial stewardship programs involving pharmacists and physicians must be elaborated to optimize the antibiotic prescribing. Mechanical ventilation require more-effective interventions control in our hospital.
Key messages
Ventilator-Associated Pneumonia rates were very high. Independent risk factors associated with Ventilator-Associated Pneumonia were history of antibiotic therapy during last 6 months, tracheotomy and reintubation.
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Affiliation(s)
- A Ben Cheikh
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Department of Prevention and Security of Care, Hospital of Sahloul, Sousse, Tunisia
| | - S Bhiri
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Department of Prevention and Security of Care, Hospital of Sahloul, Sousse, Tunisia
| | - N ketaka
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Department of Prevention and Security of Care, Hospital of Sahloul, Sousse, Tunisia
| | - A Gara
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Department of Prevention and Security of Care, Hospital of Sahloul, Sousse, Tunisia
| | - S Khefacha
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Department of Prevention and Security of Care, Hospital of Sahloul, Sousse, Tunisia
| | - M Ben Rejeb
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Department of Prevention and Security of Care, Hospital of Sahloul, Sousse, Tunisia
| | - H Said Latiri
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Department of Prevention and Security of Care, Hospital of Sahloul, Sousse, Tunisia
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Ben Fredj S, Ben Cheikh A, Bhiri S, Ghali H, Khefacha S, Dhidah L, Merzougui L, Ben Rejeb M, Said Latiri H. Multimodal intervention program to improve hand hygiene compliance: effectiveness and challenges. J Egypt Public Health Assoc 2020; 95:11. [PMID: 32813132 PMCID: PMC7364722 DOI: 10.1186/s42506-020-00039-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 02/25/2019] [Accepted: 02/25/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Hand hygiene (HH) is considered the most important measure to tackle the transmission of healthcare-associated pathogens. However, compliance with recommendations is usually low and effective improvement strategies are needed. We aimed to assess the effectiveness of an intervention targeting hand hygiene promotion among healthcare workers (HCWs). METHODS We conducted a pre-post interventional study design in the university hospital Sahloul, Sousse, Tunisia, from January 2015 to December 2016. The intervention program consisted of training sessions and distribution of posters of hand hygiene guidelines. To assess the evolution of HH observance at pre- and post-intervention, the same observation form was distributed and collected at healthcare workers' workplace. RESULTS Of the 1201 and 1057 opportunities for hand hygiene observed among all categories of HCWs, overall compliance enhanced significantly from 32.1 to 39.4% (p < 0.001) respectively at pre- and post-intervention. Nurses were the most compliant with a significant improvement from 34.1 to 45.7% (p < 0.001) respectively at pre- and post-intervention. Furthermore, analysis by department showed significant improvement of compliance in orthopedic department (p < 0.001), maxillofacial-surgery department (p < 0.001), pediatrics department (p = 0.013), and emergencies (p = 0.038). CONCLUSION This study showed the feasibility and effectiveness of a health-setting-based intervention to enhance hand hygiene observance in the context of a developing country.
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Affiliation(s)
- Sihem Ben Fredj
- Department of Prevention and Care Safety, University Hospital Sahloul, 4011 Sousse, Tunisia
| | - Asma Ben Cheikh
- Department of Prevention and Care Safety, University Hospital Sahloul, 4011 Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, 4000 Sousse, Tunisia
| | - Sana Bhiri
- Department of Prevention and Care Safety, University Hospital Sahloul, 4011 Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, 4000 Sousse, Tunisia
| | - Hela Ghali
- Department of Prevention and Care Safety, University Hospital Sahloul, 4011 Sousse, Tunisia
| | - Salwa Khefacha
- Department of Prevention and Care Safety, University Hospital Sahloul, 4011 Sousse, Tunisia
| | - Lamine Dhidah
- Department of Prevention and Care Safety, University Hospital Sahloul, 4011 Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, 4000 Sousse, Tunisia
| | - Latifa Merzougui
- Department of Epidemiology, University Hospital Ibn El Jazzar, 3100 Kairouan, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, 4000 Sousse, Tunisia
| | - Mohamed Ben Rejeb
- Department of Prevention and Care Safety, University Hospital Sahloul, 4011 Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, 4000 Sousse, Tunisia
| | - Houyem Said Latiri
- Department of Prevention and Care Safety, University Hospital Sahloul, 4011 Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, 4000 Sousse, Tunisia
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Ben Cheikh A, Ben Fredj S, Bhiri S, Ghali H, Khefacha S, Dhidah L, Ben Rejeb M, Said Latiri H. Intervention on knowledge and perception of hand hygiene among healthcare workers. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.364] [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
Background
Many studies conducted in healthcare settings with limited resources reported healthcare associated infections (HAIs) rates higher than in developed countries. Hand hygiene is considered as the most effective procedure for reducing infection in a wide variety of settings. The aim of this study was to assess the effectiveness of an intervention program to improve knowledge and perception of hand hygiene among healthcare workers (HCWs).
Methods
We conducted a prospective before-and-after study design in university hospital Sahloul, Sousse, Tunisia, from January 2015 to December 2016. The same questionnaire, constructed by the WHO was distributed and collected at HCWs’ workplace.
Results
A total of 149 and 146 HCWs were enrolled, respectively at pre and post intervention. The majority was nursed women aged between 20 and 35 in pre intervention, whereas in post intervention the majority where physicians. Globally, our results showed tendencies toward improvement, but only two items were significant: the HW is the appropriate technique after injury (73.5% vs 86.8%; p = 0.006) and the hands of HCWs are the lead vehicle of HAIs (65.1% vs 83.6%; p = 0.01). On the other hand, judging by the HCWs’ responses, the probably most effective intervention to enhance hand hygiene compliance was that an alcohol-based hand-rub is available at each point of patient care. In contrast, empowering patients to remind HCWs to perform hand hygiene was mostly rated to be the least effective intervention both in pre and post intervention.
Conclusions
Our intervention to positively influence hand hygiene knowledge was unfortunately less effective than we had hoped it would be, which suggests a HCWs’ reluctance to attend the training program.
Key messages
Hand hygiene is considered as the most effective procedure for reducing nosocomial infection. the intervention to positively influence hand hygiene knowledge was effective.
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Affiliation(s)
- A Ben Cheikh
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, Tunisia
- Department of Prevention and Security of Care, University Hospital Center of Sahloul, Sousse, Tunisia
| | - S Ben Fredj
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, Tunisia
- Department of Prevention and Security of Care, University Hospital Center of Sahloul, Sousse, Tunisia
| | - S Bhiri
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, Tunisia
- Department of Prevention and Security of Care, University Hospital Center of Sahloul, Sousse, Tunisia
| | - H Ghali
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, Tunisia
- Department of Prevention and Security of Care, University Hospital Center of Sahloul, Sousse, Tunisia
| | - S Khefacha
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, Tunisia
- Department of Prevention and Security of Care, University Hospital Center of Sahloul, Sousse, Tunisia
| | - L Dhidah
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, Tunisia
- Department of Prevention and Security of Care, University Hospital Center of Sahloul, Sousse, Tunisia
| | - M Ben Rejeb
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, Tunisia
- Department of Prevention and Security of Care, University Hospital Center of Sahloul, Sousse, Tunisia
| | - H Said Latiri
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, Tunisia
- Department of Prevention and Security of Care, University Hospital Center of Sahloul, Sousse, Tunisia
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Hannachi H, Ben Cheikh A, Bhiri S, Ghali H, Khefacha S, Dhidah L, Ben Rejeb M, Said Latiri H. Surveillance of healthcare-associated infections in a Tunisian university hospital. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.513] [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
Introduction
Healthcare -associated infections has become a worldwide public health problem. The aim of this study was to estimate the incidence of healthcare- associated infections in a university hospital of Tunisia.
Methods
This was a cohort study conducted in six intensive care units in a university hospital of Tunisia during three months (from august to October 2018). Data was provided from patients’ files. Data entry and analysis was done using SPSS version 22. Multivariate analysis was used in order to identify independent risk factors for healthcare associated infection.
Results
A total of 202 patients were enrolled in this study. The incidence rate of healthcare-associated infections was 53,96%(109/202). The ratio infection/infected was estimated to 1.65(109/66).
The incidence of multi-drug resistant pathogens was 21,28% (43/202). The most common resistant pathogens included pseudomonas aeruginosa resistant to cefdazidime in 13,76%(15/109) followed by those resistant to extended spectrum cephalosporin 11.92% (13/109), followed by carbapenem-resistant acinetobcater baumanii 6,42%(7/109) then by carbapenem resistant pathogens and enterococcus resistant to vancomycin 2.75%(3/109) and finally staphylococcus aureus resistant to methicillin 2.1%(2/1.83). The multivariate analysis showed that long duration of central line catheterisation (RR = 7.44; 95%CI[2.79-19.82]), tracheotomy(RR = 8.61;95%CI[2.09-35,39]) and length of stay (RR = 1.08; 95%CI[1.04-1.13]) were found as independent risk factors for healthcare -associated infection.
Conclusions
The emergence of mutli-drug resistant pathogens needs to be deeply studied and effective measures have to be taken in order to detect and prevent transmission of resistant strains and/or their resistance determinants, especially those with phenotypes having the fewest viable treatment options.
Key messages
The incidence of healthcare associated infection in the intensive care unit was high. Effective measures have to be taken in the intensive care unit to detect and prevent transmission of resistant pathogens.
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Affiliation(s)
- H Hannachi
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, Tunisia
- Department of Prevention and Security of Care, Hospital of Sahloul, Sousse, Tunisia
| | - A Ben Cheikh
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, Tunisia
- Department of Prevention and Security of Care, Hospital of Sahloul, Sousse, Tunisia
| | - S Bhiri
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, Tunisia
- Department of Prevention and Security of Care, Hospital of Sahloul, Sousse, Tunisia
| | - H Ghali
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, Tunisia
- Department of Prevention and Security of Care, Hospital of Sahloul, Sousse, Tunisia
| | - S Khefacha
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, Tunisia
- Department of Prevention and Security of Care, Hospital of Sahloul, Sousse, Tunisia
| | - L Dhidah
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, Tunisia
- Department of Prevention and Security of Care, Hospital of Sahloul, Sousse, Tunisia
| | - M Ben Rejeb
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, Tunisia
- Department of Prevention and Security of Care, Hospital of Sahloul, Sousse, Tunisia
| | - H Said Latiri
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, Tunisia
- Department of Prevention and Security of Care, Hospital of Sahloul, Sousse, Tunisia
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Ben Cheikh A, Ben Rejeb M, Ghali H, Chelly S, Khefacha S, Said Latiri H. Healthcare-associated infections in a Tunisian University Hospital in 2017: Prevalence and risk factors. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Ghali H, Ben Rejeb M, Chelly S, Ben Cheikh A, Khefacha S, Latiri H. Incidence and risk factors of pressure ulcers in a Tunisian University Hospital. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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Said H, Ben Rejeb M, Khefacha S, Chebil D, Dhidah L, Naija W. Les bactériémies associées aux soins en milieu de réanimation – étude d’incidence au CHU Sahloul, Sousse, Tunisie (2010–2011). Rev Epidemiol Sante Publique 2013. [DOI: 10.1016/j.respe.2013.07.467] [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: 11/24/2022] Open
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Chebil D, Rejeb MB, Latiri H, Jaidane N, Khefacha S, Miladi M, Alaya KB, Dhidah L. P258: Incidence and risk factors of bacteremia associated with care intensive care environment: study in Chu Sahloul (Sousse Tunisia). Antimicrob Resist Infect Control 2013. [PMCID: PMC3687738 DOI: 10.1186/2047-2994-2-s1-p258] [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: 12/03/2022] Open
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