Epidemiology and medical cost of hospitalization due to rotavirus gastroenteritis among children under 5 years of age in the central-east of Tunisia

Data on the economic burden of rotavirus infection in Tunisia are needed to inform the decision to include rotavirus in routine childhood immunizations. This study aimed to describe the epidemiological profile of rotavirus disease in central-east Tunisia and to estimate its hospital cost. In the first stage - the prospective collection of epidemiological data - we enrolled all patients < 5 years old who were hospitalized for acute diarrhoea at 5 university paediatric departments in central-east Tunisia during the period 2009-2011. Rotavirus was responsible for 65 [23.3%] of the 279 cases enrolled. In the second stage, cost data were collected retrospectively using an activity-based costing method from the medical records of the children who were positively diagnosed with rotavirus. The average cost of care per child was TD 433 [SD 134]. This is a significant economic burden in Tunisia, where a safe and effective vaccine is available but not yet introduced to the immunization schedule

[Clinical features of rotavirus infections: influence of child age on clinical manifestations]

The aim of the present study was to describe clinical features of rotavirus infections in children and to compare the observed symptoms according to the age of the patients. Clinical files of 278 rotavirus-positive children under 5 years of age were retrospectively examined. The presence of group A rotavirus antigens in stool samples collected from children was detected by direct sandwich enzyme-linked immuno-sorbent assay. Pearson's correlation tests were used to determine the relationship between each clinical sign noticed and patients' age. Among the 278 rotavirus-positive children, 93.9% presented with diarrhea, 79.1% vomiting, 71.6% fever, 37.4% respiratory troubles, and 33.1% neurological signs. Intravenous rehydration was needed for 59.7% of the children. The comparison of clinical signs according to the age showed that diarrhea [p = 0.001], vomiting [p = 0.007], fever [p = 0.045], respiratory troubles [p = 0.01] and dehydration [p<0.001] were significantly more frequent in infants of 1 to 24 months old. The severity of rotavirus illness seems to be directly influenced by child's age. Interestingly, infants of 1 to 5 years old often presented with disease as severe as babies of 6 to 24 months old

Actinomycotic mycetoma: a report of a new Tunisian case

Mycetomas are inflammatory pseudotumors containing fungal or actinomycosis-type grains. They are frequent in tropical and subtropical countries but rare in Tunisia. We report a new case in a 32-year-old man who presented with a tumefaction of the foot with multiple skin fistulae. The diagnosis of mycetoma was suspected on physical examination and confirmed after histopathological examination

[Prevalence of celiac disease in patients with type 1 diabetes mellitus]

The aim of our study was to determine the prevalence of celiac disease in patients with type 1 diabetes mellitus. Between january 2004 and december 2005, 72 patients with type I diabetes mellitus and having pseudo ulcerous dyspepsia were included in this prospective study. Upper gastrointestinal endoscopy with proximal intestinal biopsies was performed in all patients. Patients with villous atrophy were tested for anti-gliadine antibodies, anti-endomysium antibodies and for anti-human tissue transglutaminase antibodies. Villous atrophy was observed in three patients [4, 1%]. It was subtotal in two cases and total in one case. Anti-gliadine antibodies, anti-endomysium antibodies and anti-human tissue transglutaminase antibodies were positive to three patients. The prevalence of celiac disease in patients with type 1 diabetes mellitus is high [4, 1%]. Early screening of celiac disease must be recommended to this diabetic population