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Belmabrouk S, Abdelhedi R, Bougacha F, Bouzid F, Gargouri H, Ayadi I, Abdelmoula NB, Abdelmoula B, Abdellaoui N, BenMarzoug R, Triki N, Torjmen M, Kharrat M, Jmaiel M, Kharrat N, Rebai A. Prevalence of self-reported food allergy in Tunisia: General trends and probabilistic modeling. World Allergy Organ J 2023; 16:100813. [PMID: 37811397 PMCID: PMC10558849 DOI: 10.1016/j.waojou.2023.100813] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 08/20/2023] [Accepted: 08/22/2023] [Indexed: 10/10/2023] Open
Abstract
Background Food allergy (FA) has become a major public health concern affecting millions of children and adults worldwide. In Tunisia, published data on FA are scarce. Methods This study, was intended to fill the gap and estimate the frequency of allergy to different foods in the Sfax region, Tunisia, within self-reported FA. One hundred twenty-five (125) children (56% males, 1-17 years old), and 306 adults (17% males, 18-70 years old) were interviewed using a bilingual questionnaire. Results The number of self-reported food allergens in this sample was 105; allergens were clustered in 8 foods: fruits, seafood, eggs, milk and dairy, cereals, nuts, vegetables, and peanuts. Cutaneous reactions were the most frequent symptoms, in both children and adults. About 40% of children and 30% of adults had a family history of FA. About 81% of adults and 38% of children are allergic to at least 1 non-food allergen. The most prevalent food allergen was the fruit group in both adults and children, followed by seafood. Most food allergies were mutually exclusive and 90% of individuals have a single FA. The relationship between self-declared FA was modeled using a Bayesian network graphical model in order to estimate conditional probabilities of each FA when other FA is present. Conclusions Our findings suggest that the prevalence of self-reported FA in Tunisia depends on dietary habits and food availability since the most frequent allergens are from foods that are highly consumed by the Tunisian population.
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Affiliation(s)
- Sabrine Belmabrouk
- Laboratory of Screening Cellular and Molecular Process, Center of Biotechnology of Sfax, Sidi Mansour Road km 7, P.O Box 1177, 3018, Sfax, Tunisia
| | - Rania Abdelhedi
- Laboratory of Screening Cellular and Molecular Process, Center of Biotechnology of Sfax, Sidi Mansour Road km 7, P.O Box 1177, 3018, Sfax, Tunisia
| | - Fadia Bougacha
- National Institute of Statistics, 70, Ech-cham Road, P.O Box 265 CEDEX. Tunis, Tunisia
| | - Fériel Bouzid
- Laboratory of Screening Cellular and Molecular Process, Center of Biotechnology of Sfax, Sidi Mansour Road km 7, P.O Box 1177, 3018, Sfax, Tunisia
| | - Héla Gargouri
- Laboratory of Screening Cellular and Molecular Process, Center of Biotechnology of Sfax, Sidi Mansour Road km 7, P.O Box 1177, 3018, Sfax, Tunisia
| | - Imen Ayadi
- Laboratory of Screening Cellular and Molecular Process, Center of Biotechnology of Sfax, Sidi Mansour Road km 7, P.O Box 1177, 3018, Sfax, Tunisia
- Faculty of Sciences of Sfax, La Soukra Road km 4 - BP 1171-3000, Sfax, Tunisia
| | - Nouha Bouayed Abdelmoula
- Genomics of Signalopathies at The Service of Medicine, Medical University of Sfax, Majida Boulila Road, Tunisia
| | - Balkiss Abdelmoula
- Genomics of Signalopathies at The Service of Medicine, Medical University of Sfax, Majida Boulila Road, Tunisia
| | - Nawel Abdellaoui
- Genomics of Signalopathies at The Service of Medicine, Medical University of Sfax, Majida Boulila Road, Tunisia
| | - Riadh BenMarzoug
- Laboratory of Screening Cellular and Molecular Process, Center of Biotechnology of Sfax, Sidi Mansour Road km 7, P.O Box 1177, 3018, Sfax, Tunisia
| | - Nersrine Triki
- Laboratory of Screening Cellular and Molecular Process, Center of Biotechnology of Sfax, Sidi Mansour Road km 7, P.O Box 1177, 3018, Sfax, Tunisia
| | - Mouna Torjmen
- ReDCAD, National Engineering School of Sfax, La Soukra Road km4, 3038, Sfax, Tunisia
| | - Mohamed Kharrat
- Faculty of Sciences of Sfax, La Soukra Road km 4 - BP 1171-3000, Sfax, Tunisia
| | - Mohamed Jmaiel
- ReDCAD, National Engineering School of Sfax, La Soukra Road km4, 3038, Sfax, Tunisia
| | - Najla Kharrat
- Laboratory of Screening Cellular and Molecular Process, Center of Biotechnology of Sfax, Sidi Mansour Road km 7, P.O Box 1177, 3018, Sfax, Tunisia
| | - Ahmed Rebai
- Laboratory of Screening Cellular and Molecular Process, Center of Biotechnology of Sfax, Sidi Mansour Road km 7, P.O Box 1177, 3018, Sfax, Tunisia
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Morieri ML, Lamacchia O, Manzato E, Giaccari A, Avogardo A. Physicians' misperceived cardiovascular risk and therapeutic inertia as determinants of low LDL-cholesterol targets achievement in diabetes. Cardiovasc Diabetol 2022; 21:57. [PMID: 35473579 PMCID: PMC9044595 DOI: 10.1186/s12933-022-01495-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 04/05/2022] [Indexed: 12/15/2022] Open
Abstract
Background Greater efforts are needed to overcome the worldwide reported low achievement of LDL-c targets. This survey aimed to dissect whether and how the physician-based evaluation of patients with diabetes is associated with the achievement of LDL-c targets. Methods This cross-sectional self-reported survey interviewed physicians working in 67 outpatient services in Italy, collecting records on 2844 patients with diabetes. Each physician reported a median of 47 records (IQR 42–49) and, for each of them, the physician specified its perceived cardiovascular risk, LDL-c targets, and the suggested refinement in lipid-lowering-treatment (LLT). These physician-based evaluations were then compared to recommendations from EAS/EASD guidelines. Results Collected records were mostly from patients with type 2 diabetes (94%), at very-high (72%) or high-cardiovascular risk (27%). Physician-based assessments of cardiovascular risk and of LDL-c targets, as compared to guidelines recommendation, were misclassified in 34.7% of the records. The misperceived assessment was significantly higher among females and those on primary prevention and was associated with 67% lower odds of achieving guidelines-recommended LDL-c targets (OR 0.33, p < 0.0001). Peripheral artery disease, target organ damage and LLT-initiated by primary-care-physicians were all factors associated with therapeutic-inertia (i.e., lower than expected probability of receiving high-intensity LLT). Physician-suggested LLT refinement was inadequate in 24% of overall records and increased to 38% among subjects on primary prevention and with misclassified cardiovascular risk. Conclusions This survey highlights the need to improve the physicians’ misperceived cardiovascular risk and therapeutic inertia in patients with diabetes to successfully implement guidelines recommendations into everyday clinical practice. Supplementary Information The online version contains supplementary material available at 10.1186/s12933-022-01495-8.
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Affiliation(s)
- Mario Luca Morieri
- Diabetes Unit, Department of Medicine, University of Padova, via Giustiniani 2 IT, 35128, Padova, Padua, Italy.
| | - Olga Lamacchia
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Enzo Manzato
- Diabetes Unit, Department of Medicine, University of Padova, via Giustiniani 2 IT, 35128, Padova, Padua, Italy
| | - Andrea Giaccari
- Center for Endocrine and Metabolic Diseases, Department of Surgical and Medical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS-and Università Cattolica del Sacro Cuore, Rome , Italy
| | - Angelo Avogardo
- Diabetes Unit, Department of Medicine, University of Padova, via Giustiniani 2 IT, 35128, Padova, Padua, Italy
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