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.

Prevalence of smoking in the Maghreb: a systematic review and meta-analysis.

INTRODUCTION: Tobacco is the leading preventable cause of death in the world and kills up to seven million people each year. Monitoring its prevalence is important for prevention programs. The aim of this work was to summarize the literature on the prevalence of smoking in the Maghreb countries during the past two decades. METHODS: The research was conducted on Medline via Pubmed based on the Mesh terms: «Tobacco Use¼, «Smoking¼ and «Africa, Northern¼. Were included articles reporting the prevalence of current smoking in the general population or a subgroup of the population in one or more Maghreb countries. The extracted data was related to current smoking, its definition, total prevalence and prevalence by sex. RESULTS: About 50 articles were included, the data was mainly from Morocco, Algeria and Tunisia. Two studies reported prevalence among college students in Libya. The highest prevalences in the general population were noted in Tunisia with an overall prevalence, during the period studied, of 25% (95% CI [21% -29%]). This prevalence was 16% (95% CI [14% -18%]) in Morocco and 14% (95% CI [8% -22%]) in Algeria. CONCLUSION: The prevalence reported was generally high, especially in Tunisia, although lower than in developed countries, hence the importance of setting up and strengthening prevention and control measures, mainly among young people.