The genetic diversity of blood parasites within the freshwater turtles Mauremys leprosa and Emys orbicularis in Tunisia reveals coinfection with Haemogregarina spp.

Haemogregarina species are apicomplexan blood parasites infecting vertebrates such as fish, lizards, and turtles. Due to the high morphological similarity of the erythrocytic stages infecting host species, it has always been a challenge to identify the true diversity of these parasites. Therefore, taxonomic studies are presently based on the combination of morphological and molecular data. In Tunisia, two species of Haemogregarina have been reported within the freshwater turtle Mauremys leprosa (Geoemydidae) for more than 40 years. Since M. leprosa occurs in the same aquatic environments as Emys orbicularis (Emydidae) in Tunisia, our objectives were to assess parasite diversity and specificity on the basis of both morphological and molecular approaches. The turtles were surveyed and sampled across six aquatic areas of Tunisia. Among the 39 specimens of M. leprosa and seven of E. orbicularis that were trapped and investigated, the presence of haemogregarines was detected in the blood of turtles only at sites where leeches were observed. Three 18S variants were identified, which corresponded to three distinct Haemogregarina species, among which one was identified as Haemogregarina stepanowi. The two other species that were detected are likely new to science. Because we show the occurrence of more than one blood parasite species within a single host specimen, our study provides the first report of coinfection with molecularly distinct Haemogregarina spp.

Molecular Phylogenies of Leeches and Haemoparasites Infecting Freshwater Turtles in Aquatic Ecosystems of Northern Africa Suggest Phylogenetic Congruence between Placobdella costata Sensu Lato and Haemogregarina stepanowi Sensu Lato.

Haemogregarines are blood parasites with a life-cycle involving a vertebrate as the intermediate host and an invertebrate as the definitive host and vector. Extensive phylogenetic investigations based on 18S-rRNA gene sequences have shown that Haemogregarina stepanowi (Apicomplexa: Haemogregarinidae) is able to infest a large diversity of freshwater turtle species, including the European pond turtle Emys orbicularis, the Sicilian pond turtle Emys trinacris, the Caspian turtle Mauremys caspica, the Mediterranean pond turtle Mauremys leprosa, and the Western Caspian turtle Mauremys rivulata, among others. From the same molecular markers, H. stepanowi is further considered to be a complex of cryptic species predisposed to infect the same host species. While Placobdella costata is known to be the unique vector of H. stepanowi, it is only recently that independent lineages within P. costata have been illustrated-suggesting the presence of at least five unique leech species across Western Europe. The aims of our study were therefore to investigate from mitochondrial markers (COI) the genetic diversity within haemogregarines and leeches infecting freshwater turtles of the Maghreb, in order to identify processes of parasite speciation. We showed that H. stepanowi consists of at least five cryptic species in the Maghreb, while two Placobella species were identified in the same area. Although an Eastern-Western speciation pattern was apparent for both leeches and haemogregarines, we cannot make definitive conclusions regarding co-speciation patterns between parasites and vectors. However, we cannot reject the hypothesis of a very strict host-parasite specificity within leeches.

Study of the psychological determinants of COVID-19 vaccination among health workers in a Western Algeria.

INTRODUCTION: Vaccine hesitancy is a major challenge in controlling the COVID-19 pandemic, with healthcare professionals playing a major role in its acceptance. AIM: To assess the acceptance of COVID-19 vaccines among health workers in Sidi Bel Abbès and to identify the psychological determinants of vaccination acceptance. METHODS: A descriptive cross-sectional study was conducted from December 01, 2021 to January 31, 2022 and involved health professionals in Sidi Bel Abbès, through an anonymous questionnaire. Psychological determinants were assessed using the 5C scale (15 items), whereas the Vaccine Conspiracy Beliefs Scale (VCBS) (7 items) was used to estimate the effect of vaccine conspiracy beliefs. 5C and VCBS scores were analyzed using the Receiver Operating Characteristic (ROC) curve.

Cytochrome c oxydase I phylogenetic analysis of Haemogregarina parasites (Apicomplexa, Coccidia, Eucoccidiorida, Haemogregarinidae) confirms the presence of three distinct species within the freshwater turtles of Tunisia.

Species of Haemogregarina are apicomplexan blood parasites that use vertebrates as intermediate hosts. Due to limited interspecific morphological characters within the genus during the last decade, 18S rRNA gene sequences were widely used for species identification. As coinfection patterns were recently reported from nuclear molecular data for two sympatric freshwater turtles Mauremys leprosa and Emys orbicularis from Tunisia, our objectives were to design COI specific primers to confirm the presence of three distinct species in both host species. Blood samples were collected from 22 turtles, from which DNAs were extracted and used as templates for amplification. Following different rounds of PCR and nested PCR, we designed specific Haemogregarina COI primers that allowed the sequencing of nine distinct haplotypes. Phylogenetic Bayesian analysis revealed the occurrence of three well-differentiated sublineages that clustered together into a single clade. Based on pairwise genetic distances (p-distance), we confirmed the occurrence of three distinct but phylogenetically closely related species coinfecting M. leprosa and E. orbicularis in the same aquatic environments. Our results demonstrate that the use of fast evolving genes within Haemogregarina will help to investigate the parasite diversity within both intermediate vertebrate and definitive invertebrate hosts, and to assess the evolution, historical biogeography and specificity of haemogregarines.

Prevalence of poor medication adherence in type 2 diabetics in North Africa. Systematic review and meta-analysis.

INTRODUCTION: Medication adherence is the cornerstone of the successful drug management of a chronic disease. AIM: To develop a systematic review and meta-analysis of the prevalence and the factors associated with non-adherence in patients with type 2 diabetes in North African countries. METHODS: A literature search was conducted on Medline via Pubmed with a complementary search on Google Scholar. The meta-analysis was conducted using the Metaprop function of R software. The Cochrane Q test and Higgins I² statistic were used to estimate the heterogeneity. RESULTS: In total, 16 studies measuring the prevalence of medication adherence in North African countries were selected in this systematic review. The combined prevalence of non-adherence was 38% (95% CI 30%-47%) with a random-effects model. The meta-analysis revealed a significant heterogeneity between studies (I² = 96%, p <0.01). Factors associated with non-adherence in type 2 diabetics were education level, social security coverage, therapeutic education, cost of medication, socioeconomic level, the duration of diabetes, unbalanced diabetic diet, polypharmacy, female gender, family support and age. CONCLUSION: The combined prevalence of non-adherence among type 2 diabetics in North Africa was high and multifactorial, requiring global and integrated management by patients, physicians and pharmacists.

Psychosocial impact of COVID-19 among health workers in Algeria.

BACKGROUND: The current COVID-19 pandemic has put health care professionals in the face of increasing psychological distress, with a high risk of infection. PURPOSE: To estimate the prevalence of anxiety-depressive disorders among health professionals in Algeria and determine their associated risk factors. METHOD: A cross-sectional descriptive study was conducted from January 11 to March 09, 2021 and concerned healthcare professionals in Algeria, through an online self-assessment. The mental health rating scales used were GAD-7 (7 items) for Anxiety, and CES-D (20 items) for Depression. Resilience was estimated by the RISC-CD (10 items). An original questionnaire was used to assess three factors: fear of infection and death, isolation and stigmatization, as well as motivation and escape behaviour at work. RESULTS: A total of 1005 health professionals were included in the study, of which 51.5% were doctors, 75.6% were women and 41.1% were at the first front of the fight against COVID-19. The prevalence of Anxiety and Depression was 23.8% and 44.6% respectively. Health professionals with a high resilience score were those who were in direct contact with COVID-19 3.75 [1.11-12.7] and those who feared contracting the disease 1.22 [1.14-1.31]. Among the study population, 508 employees (50.5%) were free from anxiety-depressive disorder: Good mental health of health personnel, has been determined by the male sex 1,55 [1,07, 2,24], without co-morbidity 0,57 [0,39, 0,83], without direct intervention in the fight against COVID-19 0.63 [0.45, 0.89], having a low score of Depression and Anxiety with respectively 0.43 [0.36- 0.50], 0.50 [0.41- 0.58] while denouncing a high Resilience score 1.03 [1.01- 1.05]. CONCLUSION: In Algeria, the fight against the COVID-19 pandemic has had an impact on the mental health of health professionals, hence the urgent need for intervention programs, for strengthening their mental health in a more sustainable and effective struggle.

Description of a new Agraecina species from Tunisia (Araneae: Liocranidae), with a review of all species of the genus.

While Liocranidae is a family encompassing 283 species distributed in 32 genera (World Spider Catalog 2019), the genus Agraecina Simon, 1932 currently counts only six described species: Agraecina canariensis Wunderlich, 1992 from the Canaries, A. cristriani (Georgescu, 1989) from Romania, A. hodna Bosmans, 1999 from Algeria, A. lineata (Simon, 1878) from Europe and Kazakhstan, A. rutilia (Simon, 1897) from Sierrra Leone, and A. scupiensis Deltshev, 2016 from Macedonia. During an ecological survey in the north of Tunisia, a new Agraecina species was discovered and is described here. Spiders were collected using pitfall traps in a salt marsh.

Attitudes of health professionals towards the response to the COVID-19 pandemic in Maghreb.

OBJECTIVE: Measuring the attitudes of health professionals in two Maghreb countries (Tunisia and Algeria) with regard to the response to COVID-19 during the first quarter of 2020. METHODS: This scoping study was based on a "Google Form" covering three constituents of the response plan against COVID-19: responders, activities and crisis communication. The attitudes of health professionals who are working in Tunisia and Algeria were measured through the Likert scale with four propositions, grouped in pairs, during the analysis. RESULTS: The study population consisted of 280 health professionals, 170 of whom are Tunisians along with 110 Algerians. The medians of age and that of professional seniority are, respectively, 37 and 10 years. The role of "health workers", "Mass Media" and "civil society associations" was found to be satisfactory according, respectively, to 92%, 71%, and 55% of the respondents. As far as 72% of health professionals are concerned, the "barrier measures" were respected by the population. Approximately, seven in ten respondents were satisfied with the quality of communication occuring between the Ministries of Health and its epidemiological structures. CONCLUSION: Health professionals of the Maghreb working in Tunisia and Algeria had a generally positive perception of the role of population responders, community engagement, and the quality of official communication in regards to the response plan against COVID- 19. This perception would be a prerequisite for the success of community participation and multisectoral action as well as essential in the strategy of prevention and control of this pandemic and of possible other health emergencies.

Counter-COVID- 19 pandemic strategy in the Maghreb Central. Qualitative study of the perceptions of health professionals.

CONTEXT: The Maghreb Central, like all the countries of the world, was strongly mobilized (governments, ministries of health, population, civil society) in the response against COVID-19, immediately after the registration of the first cases on its territory (end of February, beginning of March) and according to pre-established control strategies. OBJECTIVES: Describe the perceptions of health professionals in the Central Maghreb (Tunisia, Algeria and Morocco) as to the Strengths/Opportunities and Weaknesses/Threats of the national response plans against COVID-19, during the first weeks of their execution, and report their proposals for optimizing the performance of control strategies. METHODS: This is a qualitative study of the perceptions of health professionals in the Maghreb Central regarding their experience of the first six weeks of fighting the COVID-19 pandemic. The data was collected using the "Delphi" technique in one turn, based on an electronic form such as "Google Form", developed according to SWOT analysis. The respondents' verbatim was grouped into homogeneous groups of items, the occurrence of which was subsequently measured. RESULTS: A total of 382 health professionals from the Maghreb Central participated in this study, with a median age of 37 years and a median professional tenure of 10 years. The major force of the Maghreb response strategies, the most shared by the respondents, was the performance of the human resources mobilized (doctors, biologists, nurses, etc.) who succeeded in quickly learning from the international epidemiological expertise accumulated in Asia and in Europe. The fight against COVID-19 in the Central Maghreb was confronted with the general and chronic fragility of the national health systems and the low support of the general population for the recommendations of the steering committees of response, threatening the capacity of the Maghreb to confront new epidemics. CONCLUSION: The success of the national response plans against COVID-19 and of possible epidemics or pandemics in the Central Maghreb, is strongly attributed to the commitment of health professionals and to community participation, necessitating the launch of assistant motivation programs. and development of health personnel and mobilization and loyalty of civil society.

Lessons learned from the fight against COVID-19 in the Great Maghreb.Five lessons for better resilience.

OBJECTIVE: To compile the lessons learned in the Greater Maghreb, during the first six months of the fight against the COVID-19 pandemic, in the field of "capacity building" of community resilience. METHODS: An expert consultation was conducted during the first week of May 2020, using the "Delphi" technique. An email was sent requesting the formulation of a lesson, in the form of a "Public Health" good practice recommendation. The final text of the lessons was finalized by the group coordinator and validated by the signatories of the manuscript. RESULTS: A list of five lessons of resilience has been deduced and approved : 1. Elaboration of "white plans" for epidemic management; 2. Training in epidemic management; 3. Uniqueness of the health system command; 4. Mobilization of retirees and volunteers; 5. Revision of the map sanitary. CONCLUSION: Based on the evaluation of the performance of the Maghreb fight against COVID-19, characterized by low resilience, this list of lessons could constitute a roadmap for the reform of Maghreb health systems, towards more performance to manage possible waves of COVID-19 or new emerging diseases with epidemic tendency.

Lessons learned from the fight against COVID-19 in the Great Maghreb. Five lessons for a better response.

OBJECTIVE: Identify the lessons learned in the Greater Maghreb, during the first semester of the fight against the COVID-19 pandemic, in the field of response. METHODS: During the first week of May 2020, a consultation of experts was conducted, using the "Delphi" technique, through an email asking each of them, the drafting of a good practice recommendation for "Public health". The Group coordinator finalized the text of the lessons, later validated by the signatories of the manuscript. RESULTS: Five lessons of good «response¼ against epidemics have been deduced and approved by Maghreb experts, linked to the following aspects: 1. Total reservation of hospital beds for patients; 2. Clinical management of the response; 3. Discreet conflict of interest; 4. Community participation in the response; 5. Contextualization of the global fight strategy. CONCLUSION: Based on the finding of low relevance of the Maghreb response against COVID-19, this list of lessons would help support the performance of Maghreb health systems in the management of epidemics.

Lessons learned from the fight against COVID-19 in the Greater Maghreb. Five lessons for better preparation.

OBJECTIVE: To compile the lessons learned in the Greater Maghreb, during the first six months of the fight against the COVID-19 pandemic, in the field of preparation of health systems. METHODS: An expert consultation was conducted during the first week of May 2020, using the "Delphi" technique. An email was sent to them requesting the formulation of a lesson, in the form of a "Public Health" good practice recommendation. The final text of the lessons was finalized by the group coordinator and validated by the signatories of the manuscript. RESULTS: A list of five lessons for the preparation of the national health systems of the Greater Maghreb for the fight against epidemics, was deduced and approved: 1. Liberal health systems are incapable of managing epidemics; 2. The specialties of "Public Health" are often marginalized; 3. Health personnel in the Maghreb are doubly devalued; 4. Flagrant regional disparities in the field of health care are still observed; 5. A general shortage of preventive equipment and medical devices has been noted. CONCLUSION: Based on the evaluation of the performance of the Maghreb fight against COVID-19, characterized by the vulnerability of the preparation of health systems, this list of lessons could constitute a roadmap for the reform of health systems. Maghrebian health, towards more performance in managing possible waves of COVID-19 or new emerging diseases with epidemic tendency.

[Neurogenic paraosteopathy of the elbow: results of surgical arthrolysis (a retrospective study of 37 cases)]. / La para-ostéopathie neurogène du coude: résultat de l'arthrolyse chirurgicale (étude rétrospective de 37 cas).

Neurogenic paraosteoarthropathies are ectopic ossifications which develop near the joints. They are a process of neo-ectopic osteogenesis occurring after central or peripheral neurological lesions, in some types of comas (oxygen carbon intoxication, prolonged sedation) and following peripheral traumas including burns. They inolve almost exclusively the large proximal joints of the limbs. Elbow is the second area of involvment. The purpose of our study was to analyze the results of surgical arthrolysis in 37 patients with elbow stiffness due to neurogenic osteoarthropathy of the elbow. We conducted a retrospective study of 35 patients and 37 elbows over a 25-year period. Preoperative assessment included clinical and radiological examination. Since 2003 the patients had undergone systematic elbow arthroscopy. The gold standard surgical treatment was arthrolysis. All patients underwent functional rehabilitation protocol. Outcomes were analyzed after a mean 5-year follow-up period (6 months - 10 years). Neurogenic paraosteoarthropathy was caused by head injury with coma in 58.8% of cases. Preoperative assessment showed bending stiffness in the majority of cases (88%), severe or very severe in 64.7% of cases. Intraoperatively functional elbow range of motion from -30° to 130° was obtained in 61.7% of cases and in 41% of cases in the long term. Ulnar nerve liberation was satisfactory in 92% of cases. No postoperative instability of the elbow was reported. Two patients with definitive neurological lesions had osteoma recurrence. The results were equivalent regardless surgical delay. Surgical arthrolysis is an effective treatment for neurogenic osteomas of the elbow.

[Phenetic analysis of populations of Porcellionides pruinosus (Brandt, 1833) (Crustacea, Isopoda, Oniscidea)]. / Analyse phénétique des populations de Porcellionides pruinosus (Brandt, 1833) (Crustacea, Isopoda, Oniscidea).

The cosmopolitan species, Porcellionides pruinosus (Brandt, 1833), exhibited a geographical variation of its morphological features and its reproduction pattern. In fact, some Tunisian populations had a seasonal reproductive period and other ones showed a reproductive activity. A phenetic analysis has been performed to compare populations belonging to P. pruinosus from different geographical localities. For this, nineteen quantitative characters in 800 specimens of P. pruinosus issued from nine populations located in the North, the Centre, and the South of Tunisia, and one population from Athens (Greece) were studied. These populations were characterized by different reproductive behaviours. The populations of Tabarka, Korba, and Tamerza showed reproductive activity, whereas those of Garat Nâam, Raccada, Sahline, Gafsa, Rdayef, Gabès, and Athens exhibited a seasonal reproductive period. The variability of the first three axes of the principal components analysis (PCA) and their significance showed an intraspecific variability structure. The graphical representation of the population's dispersion generated by the two first axes (63.55% of the total variability) revealed a great heterogeneity among females of the different populations of P. pruinosus. The Garat Nâam population was set apart from the other ones by its cephalic width and length and also by its apophysis length. Furthermore, cephalic and uropod length separated the Garat Nâam and Tabarka populations. The dendrogram, based on Euclidean coordinates, confirms an isolation of the populations of Tabarka and Garat Nâam, exhibiting respectively reproductive activity and seasonal reproduction. However, the other populations do not show any relationship with the reproduction behaviour. They were clustered in two groups. The first one is represented by the populations of the Southeast and the West of Tunisia. The second pooled the populations of the Northeast and the Centre of Tunisia with the population of Athens (Greece). Phenetic analysis of Tunisian populations exhibits an important heterogeneity, which is worth noting. Thus, we need to complete and deepen this study by genetic analysis and crossbreeding tests in order to define the taxonomic status of these populations.

Antibacterial activity, structure and CMC relationships of alkanediyl alpha,omega-bis(dimethylammonium bromide) surfactants.

Some alpha,omega-alkanediyl bis-dimethylammonium bromide compounds (gemini surfactants) referred as "m-s-m" have been synthesized, purified and characterized by usual spectroscopic methods. These compounds have been screened for antibacterial activity against Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus. Their activity was compared. The compounds tested showed excellent in vitro antibacterial activity against Staphylococcus aureus ranging from 1.5 to 20 microg/ml and had variable activity against E. coli with minimum minimum inhibitory concentration (MIC) of 50 microg/ml. These compounds are less active against P. aeruginosa. On the other hand, contrary to the antibacterial activity of these products against S. aureus, a relation between the MIC and the critical micellar concentration (CMC) was found and relationship between chain's Length and antibacterial activity was found.

Abundance and diversity of amphipods (Crustacea: Peracarida) on shallow algae and seagrass in lagoonal ecosystem of the Mediterranean Tunisian coast.

BACKGROUND: Bizerte lagoon is a semi-enclosed marine ecosystem, where various types of human activities have been developed. To investigate the distribution and temporal variation of amphipod assemblage, monthly sampling was conducted at the Menzel Jemil site from October 2009 to September 2010. RESULTS: Atotal number of 3,620 specimens were collected from floating algae and seagrass allowing the identification of 10 amphipod species. Moreover, several indices, species richness, dominance, mean density, and diversity index were estimated to characterize the amphipode assemblage. Gammarusaequicauda wasthe most dominant species in all seasons. In addition, the minimum and maximum values of species richness of amphipod were observed in January (3 species) and April (8 species), respectively. The mean density and species richness were negatively correlated with plant biomass. Mean Shannon index (H')and evenness (J')were 1.62 ± 0.34 and 0.67 ± 0.16, respectively. Non-metric multidimensional scaling (MDS) analysis based on the mean species density showed three seasonal groups of samples. Therefore, canonical correspondence analysis (CCA) made it possible to summarize the overall situation for the species, monthly sampling, and environmental parameters on a single graph. CONCLUSIONS: Thus, the temperature, turbidity, and chlorophyll a content are the most often reported factors for the distribution and structure of amphipods in the Bizerte lagoon.

[Biology and population dynamics of Porcellionides sexfasciatus (Crustacea, Isopoda, Oniscidea)]. / Biologie et dynamique de population de Porcellionides sexfasciatus (Crustacea, Isopoda, Oniscidea).

The biology and the population dynamics of Porcellionides sexfasciatus Budde-Lund (1879) were studied on a field and carried out at Garat Nâam (Kasserine, Tunisia) from July 1996 to June 1998. The reproduction exhibited a seasonal pattern extending from February/March to October/November. The juveniles appeared in the population from April to November. Size frequency distributions were analysed and 14 cohorts were recognised during the sampling period. Six cohorts were identified at the first sampling and eight new ones on the other samplings. Among these latter cohorts, three were tracked till they disappeared. Minimum average length of new cohorts ranged from 3.07 +/- 0.35 mm to 3.47 +/- 0.2 mm. Maximum average length of cohorts was 10.42 mm. P. sexfasciatus is a semi-annual species (females producing two or three broods per year), with iteroparous and amphogenes females (females reproducing twice or more in their life and producing both males and females), and bivoltine life cycle (two generations per year). The females are able to produce two broods, in the laboratory, without new mating. Fecundity and fertility, corresponding to the number of eggs or embryos per brood, appeared positively correlated with females' size. Although oscillating throughout the year, the sex ratio was often in equilibrium.

Chemical composition and antifungal activity of essential oils of seven Moroccan Labiatae against Botrytis cinerea Pers: Fr.

Essential oils of seven Moroccan Labiatae were chemically analysed by GC-MS and evaluated for their in vitro antifungal activity against Botrytis cinerea. Among them, Origanum compactum and Thymus glandulosus greatly inhibited the growth of the mycelium. The inhibition of Botrytis cinerea was 100% for both oils at 100 ppm, while the IC(50)s were 35.1 and 79.2 ppm, respectively. Mentha pulegium exhibited moderate activity at 250 ppm since the inhibition of the mycelial growth was 58.5% and the IC(50) was 233.5 ppm. The main constituents of the studied oils were also examined. Thymol and carvacrol that are the two main constituents of Thymus glandulosus and Origanum compactum exhibited the strongest antifungal activity with 100% of inhibition at 100 ppm, respectively.