ABSTRACT
Chronic [noncommunicable] diseases such as cardiovascular disease, stroke, cancer and diabetes mellitus, are a global public health problem that is increasing, particularly in developing countries. According to the World Health Organization, over the period 2006-15, the largest increase in deaths from chronic diseases will occur in the regions of Africa and the Middle East. This article outlines the problems facing these regions with regard to chronic diseases, and discusses the urgent need for capacity building and community-based programmes in order to enhance regional capability for tackling chronic diseases
Subject(s)
Humans , Community Health Planning , World Health OrganizationABSTRACT
Health research systems in the Eastern Mediterranean Region are not well developed to generate and use knowledge to improve health, reduce inequity and contribute to economic development. This study aimed to provide core data on National Health Research Systems [NHRS] in 10 Eastern Mediterranean countries in order to inform actions to strengthen health research system governance and management. Whilst there were examples of good practice, few countries had a formal NHRS and many basic building blocks needed for an effective system had not been put in place. Although limited in focus, the study provides useful information for countries to initiate action to strengthen their NHRS
Subject(s)
World Health Organization , Research/statistics & numerical data , Research Design , Health Priorities , Health Promotion , Quality Assurance, Health Care , Delivery of Health CareABSTRACT
We assessed cardiovascular risk factors among 456 hypertensive patients in 7 health centers in Sousse. Cardiovascular risk was estimated according World Health Organization centres Mean age was 65.6 [SD = 9.8] years, male: female sex ratio was 0.18. Cardiovascular recommendations risk was not influenced by sex, age or residence. However, patients with longer duration of hypertension and more frequent co- morbidity had a significantly higher cardiovascular risk. In addition 45.9% of patients on monotherapy had high cardiovascular risk compared with 40.6% of those treated with 2 or more drugs [P = 0.02]. Non- compliance was not found to be associated with high risk
Subject(s)
Female , Humans , Male , Hypertension/mortality , Risk Factors , Risk Assessment , World Health Organization , Antihypertensive AgentsABSTRACT
We assessed the knowledge of 404 type 2 diabetic patients about their condition in order to evaluate the quality of diabetes education in primary health care units in Sousse in 2003. We found that knowledge was satisfactory in only 59% of the patients. Their knowledge about the definition of diabetes and its pathophysiology were the 2 main areas where knowledge was lacking: the proportion of correct answers were 62.6% and 50.3% respectively. More attention should be paid to educating diabetic patients within the chronic disease care national programme
Subject(s)
Female , Humans , Male , Diabetes Mellitus, Type 2/psychology , Patient Education as Topic , Patient Participation , Surveys and Questionnaires , Health Knowledge, Attitudes, PracticeABSTRACT
In Tunisia, because of an absence of population registry, data on acute leukaemia are scarce. We studied the epidemiological and cytological characteristic of 193 patients with acute leukaemia. Haemograms were carried out and slides for peripheral blood and bone marrow were prepared for each patient. The age range of the patients was 10 months to 83 years with a predominance of males [ratio: 1.27]. As regards type of leukaemia, 40.4% had acute lymphoblastic leukaemia, 51.8% had acute myeloblastic leukemia and 7.8% were unclassified. Diagnosis was made at less than 10 years in 31.6% of cases and 72% of these were the lymphoblastic type. Anaemia [Hb < 11 g/dL was found in 85% of cases, thrombocytopenia [platelets < 100 000/mm3] in 80.5% and hyperleukocytosis [WBC > 100 000/mm3] in 14.5% of cases with blasts in peripheral blood in 92% of cases
Subject(s)
Adolescent , Adult , Aged, 80 and over , Child , Female , Humans , Infant , Male , Middle Aged , Acute Disease , Age Distribution , Blood Cell Count , Bone Marrow Examination , Child, Preschool , Immunophenotyping , Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology , Leukemia, Myeloid, Acute/pathology , Sex DistributionABSTRACT
Against a background of increasing obesity among Tunisians, we conducted a transversal survey of 1569 children aged 13-19 years selected by multistage cluster sampling to evaluate the prevalence of obesity and clustering of cardiovascular risk factors among obese schoolchildren in the urban area of Sousse. Obese children were found to have higher blood pressure, higher triglyceride levels and lower high-density lipoprotein cholesterol levels than children of normal weight. In both genders, the mean height and weight across all age groups was significantly higher in urban than in rural children. Our study indicates that obesity and the adverse effects of being over the ideal body weight are no longer limited to industrialized countries
Subject(s)
Adolescent , Female , Humans , Male , Body Height , Body Weight , Cardiovascular Diseases/etiology , Cluster Analysis , Cross-Sectional Studies , Diabetes Mellitus/epidemiology , Hypercholesterolemia/epidemiology , Urban Health/statistics & numerical dataABSTRACT
Many professors of medicine oppose the Arabization of the teaching of medical science in the Maghreb countries, under pretext of the inability of Arabic to convey scientific concepts objectively compared with French. We made a qualitative survey of surgical and radiological semiology used in the Faculty of Medecine, Ibn El Jazzar. Terms, expressions and synonyms were identified and classified according to their cultural load into two categories: "culturally adapted terms" and "culturally strange terms" in relation to the national culture. It was evident that the majority of the recorded expression were based on Western culture. Thus the hypothesis of the neutrality of the French language in the medical teaching is invalid. Furthermore the use of French poses difficulties for students in underst and ing the scientific matter taught, and indirectly promotes Western culture within the medical academic establishments of the Arabic world. The use of the mother tongue in teaching medicine is today an educational necessity
Subject(s)
Humans , Cultural Diversity , Curriculum/standards , Education, Medical, Graduate/standards , Education, Medical, Undergraduate , Qualitative Research , Surveys and Questionnaires , Radiology/education , Semantics , General Surgery/educationABSTRACT
The therapeutic knowledge of physicians is the corner stone to the rational use of medicines; however information about medicines is generally obtained from the pharmaceutical industry via their sales representatives [reps]. We aimed to identify general practitioners' [GPs] attitudes to pharmaceutical reps and the information they provide. We surveyed 140 GPs using a self-administered questionnaire. The response rate was 78% [72 GPs from the public sector and 68 from the private sector]. About 10% of the GPs said they received daily visits from pharmaceutical reps; 84% of GPs considered them an efficient source of information and 31% said they might change their therapeutic prescribing following visits from these reps. Because of their positive perception of pharmaceutical reps, GPs are susceptible to the information they provide. Controlling the validity of the therapeutic information imparted by the pharmaceutical industry is thus a fundamental component of the programme for the rational use of medicines
Subject(s)
Humans , Commerce , Drug Industry , Health Knowledge, Attitudes, Practice , Organizational Innovation , Pharmacology/education , Practice Patterns, Physicians'/organization & administration , Drug Prescriptions , Surveys and QuestionnairesABSTRACT
We undertook an epidemiological survey based on a representative sample of 793 rural schoolchildren in Sousse, Tunisia to assess the prevalence of certain cardiovascular disease risk factors. The prevalence of hypertension [11.2%], hypercholesterolaemia [2.9%], hypertriglyceridaemia [1.0%], high levels of low-density lipoprotein cholesterol [0.6%] and obesity [4.0%] showed no statistically significant difference based on sex. However, smoking [4%] showed a significant gender difference [boys: 7.3%; girls 1.2%]. The relatively low cardiovascular disease risk factor profile of Tunisian children needs to be encouraged through to adulthood. Thus a school programme of heart health promotion should be established
Subject(s)
Adolescent , Child , Female , Humans , Male , Analysis of Variance , Cross-Sectional Studies , Epidemiologic Studies , Hyperlipidemias/epidemiology , Hypertension/epidemiology , Obesity/epidemiology , Risk Factors , Rural Health/statistics & numerical data , Smoking/epidemiologyABSTRACT
To assess the risk to Tunisian children of cardiovascular diseases [CVD], we undertook an epidemiological survey of 1569 urban schoolchildren from Sousse. Prevalence rates for the following CVD risk factors were determined: hypertension, hypercholesterolaemia and other lipid disorders, obesity and tobacco consumption. Hypertension and hypertriglyceridaemia showed no statistically significant difference by sex. Hypercholesterolaemia, high levels of low-density lipoprotein cholesterol and obesity were all significantly higher for girls than boys. Smoking was significantly higher among boys. The relatively low CVD risk factor profile of Tunisian schoolchildren should be encouraged in adulthood and a school heart health programme should be established
Subject(s)
Humans , Male , Female , Risk Factors , Schools , Child , Urban Population , Hypertension , Hypercholesterolemia , Obesity , Smoking , Lipoproteins, LDLABSTRACT
To illustrate the distribution of hypertension in the community, an epidemiological survey was conducted based on a representative sample of 957 adults aged >/= 20 years resident in Soussa, Tunisia in 1995. The prevalence of hypertension according to the new World Health Organization criteria [systolic blood pressure >140 mmHg and/or diastolic blood pressure >90 mmHg] was 28.9%. Hypertension was significantly higher in cases with obesity, android obesity and for persons aged >40 years. History of diabetes was found in 10.2% of cases, obesity in 27.7%, overweight in 56.7%, android obesity in 36.0% and smoking in 61.4% of men and 4.2% of women