Prevalence of and factors associated with smoking among students in Sousse, Tunisia.

Within the framework of the fight against tobacco among young people, we conducted a descriptive cross-sectional study in 2013 to estimate the prevalence of smoking and to identify associated factors among students in Sousse. A questionnaire was administered to a representative sample of 556 students in 5 academic institutions in Sousse randomly drawn. The age of the participants was between 17 and 35 years. The prevalence of tobacco consumption in the past 12 months was 22.1% and consumption during the past 3 months was 65.3%. The average age of starting smoking was 17 years. Smoking prevalence was significantly higher for males (P < 0.001) and those aged over 25 years (P = 0.002). Students from 2 of the institutions were using more tobacco than their colleagues in the other institutions (P = 0.027). The high prevalence of smoking found among the students means that prevention measures are essential; this requires increasing self-esteem and evaluating intervention programmes implemented before smoking the first cigarette.

[Respiratory morbidity in family practice in the region of Sousse, Tunisia]. / La morbidité respiratoire en médecine générale dans la région de Sousse (Tunisie).

We determined the profile of respiratory morbidity in family practice in the region a cross-sectional study in 86 primary health care centres in Souse over 1 year (2002-03). Medical records for 3 weeks per season were randomly selected. The International Classification of Primary Care (ICPC) was used to code recorded data. Respiratory diseases ranked first both for reason for consultation (8397/24 882, 33.7%) and for diagnosis made (7788/18 097, 43.0%). Of the 7715 respiratory complaints, cough was the most common complaint (54.8%). Of respiratory diagnoses, 37.1% were acute tonsillitis, 26.5% acute bronchitis and 21.6% were acute respiratory tract infection. Children under 5 years were most affected by acute upper respiratory tract infections (44.5%). Acute bronchitis was the primary diagnosis for patients aged over 45 years.

[Diagnosed morbidity in primary health care in the sanitary region of Sousse (Tunisia)]. / La morbidité diagnostiquée en première ligne dans la région sanitaire de Sousse (Tunisie).

Primary health care is one of the pillars of the Tunisian health care system. However, we have very little information about the specificities of general practice and the patterns of the morbidity encountered in this field. This study was interested on the diagnosed morbidity in primary health care settings. We aimed to illustrate the patterns of morbidity in general practice and identify the main diagnoses which are established by the general practitioners (GPs). The study design was descriptive and cross-sectional. 85 (out of 92) primary health centres of the province of Souse (Tunisia) have been included during one year, from June 2002 to May 2003. We have targeted a representative sample of 16.271 encounters in these primary care settings. On the methodological plan, we proceeded by a poll to two degrees; the first concerned the weeks within every season: 3 weeks were drawn out by lot; the second interested the encounters, proceeding by a systematic pull and the step of poll was fixed to 5. The International Classification of Primary Care (ICPC) was used to code recorded data. The main results of this study showed that among the 16.271 patient-doctor encounters we registered 24.882 reasons for encounter (RFE) (1.9 +/- 0.8 per encounter), 18.097 diagnoses (1.3 +/- 0.5 per encounter), and 40.190 procedures (3.2 +/- 1.9 per encounter). In this paper we have only explored the results of encounters related to the decision of general practitioners, i.e. the diagnosed morbidity. With regard to sex distribution there was a predominance of females (62%). The study population was relatively young as 50% were aged less than 25 years. According to ICPC chapters, we found that respiratory diseases were the main established diagnoses (43%) followed by digestive (10.1%), locomotive (8.9%) cardiovascular affections (8.7%) and skin diseases (8.4%). These five affections constituted alone about 80% of the total.

[Humane professional attitudes of doctors in the health region of Sousse (Tunisia)]. / Les attitudes professionnelles humaines des médecins de la région sanitaire de Sousse (Tunisie).

The new chronic and multi-factorial morbidity, the limited efficiency of classical medicine, as well as the preponderant position currently occupied by an individual in social life have imposed a patient-oriented approach as an ideal model of medical practice. The objective of this work is to evaluate physicians' listening skills, their empathy and their participation with patients in the health region of Sousse. It is a descriptive and transversal study on a collective of 133 practitioners working in the Sousse region in both the liberal and public sectors of care. Data were collected during the year 1999 through an auto-managed questionnaire. Among the main results: 28% of doctors declared having had difficulties while communicating with their patients and 31% of those asked do not give a great deal of importance to the psycho-social aspects of their patients. Only 31% of practitioners were in favour of patients participating in the decision-making process. This survey demonstrates that the domination of the bio-medical model of care, as much in teaching field as in medical practice, has weakened the basic competencies necessary for humanitarian medical practice based on the respect and the implication of the patient. Reforming the medical teaching curriculum with a focus on the person suffering and orientating the professional environment towards the community are both indispensable in order to reach a reconciliation between the patient's needs and the care available.