Food consumption, nutritional intakes and the role of milk formulas in nutrient adequacy among young children from birth to 2 years living in urban Algeria.

OBJECTIVE: Undernutrition, stunted growth and obesity remain a concern in Algeria. Currently, limited data are available on nutrient intakes among children. Our study aimed to describe food and nutrient intakes and the role of milk formulas among Algerian children. DESIGN: Dietary intakes were collected using a 4-d interview-based survey for children aged 0-24 months, living in urban areas in Algeria in 2019. SETTING: Food consumptions were described. For children aged 6-24 months, nutrient intakes and adequacy were estimated. Modelling was used to estimate the nutritional impact of substituting cow's milk for age-appropriate infant formulas (IF). PARTICIPANTS: Totally, 446 children aged 0-24 months. RESULTS: Before 6 months, 91·6 % of infants were breastfed. Breastmilk was also the main milk consumed between 6 and 12 months, whereas cow's milk predominated after 12 months. In children aged 6-24 months, nutrient adequacy prevalence was above 75 % for the majority of nutrients. However, less than 30 % of the children had adequate intakes for total fats, Fe and vitamin D. Simulated substitution of cow's milk for IF led to improved adequacy for proteins, Fe, and vitamins D and E. CONCLUSIONS: Our study showed that breast-feeding rates were high until 6 months, then declined with age. Consumed foods allowed Algerian children aged 6-24 months to meet most of their nutritional needs, but inadequate intakes were reported for some key nutrients. Our modelling suggested that milk formulas may help to improve nutrient adequacy among non-breastfed infants. Other dietary changes could also be further investigated to enable children to meet all nutritional recommendations.

Thyroid cancer incidence and trends by demographic and tumor characteristics in Oran, Algeria: 1993-2013, a population-based analysis.

OBJECTIVES: Incidence rates of thyroid cancer have dramatically increased over recent decades in many countries, particularly the papillary histotype and microcarcinomas. We examined thyroid cancer incidence and trends by demographic and tumor characteristics based on 1443 patients with thyroid cancer diagnosed between 1993 and 2013 in Oran district, in Northwest Algeria. METHODS: All thyroid cancer cases were abstracted from medical records and pathology reports and classified according to the International Classification for Diseases in Oncology, third edition. Age-specific, age-standardized incidence rates per 100 000 person-years, and annual percent changes (APC) in the incidence were calculated. RESULTS: Age-standardized incidence was 11.7 per 100 000 for women and 2.0 per 100 000 for men. Thyroid cancer incidence increased over time significantly in women (APC: +3.72%; P < 0.05), mostly due to an increased incidence of the papillary histotype (APC: +5.48%; P < 0.05), and microcarcinomas (APC: +17.34%; P < 0.05). During the same time period, the incidence of follicular thyroid carcinomas decreased (APC: -3.74%; P < 0.05). CONCLUSIONS: The results of our study showing an upward trend of thyroid cancer incidence driven largely by increases in the papillary histotype are consistent with previous studies. The higher increase has coincided with the introduction of fine needle aspiration and thyroid ultrasound in the 1990s, and may have led to overdiagnosis. However, the increased papillary-to-follicular ratio observed over time is possibly a late effect of iodine supplementation implemented in Algeria in 1967 to combat endemic goiter. Further larger-scale population-based research is needed to gain insight into thyroid cancer etiology.

Vitamin D status in preschool children in Algeria.

It is well established today that an optimal vitamin D intake plays a crucial role in the constitution of optimal osseous mass during childhood, and hence in the prevention of the osteoporosis in adults. The prevalence of the vitamin D deficiency is increasing globally and Algeria is no exception in this regard. Our study is the first to be carried out with healthy children of preschool age in North Africa. AIMS: The study aimed to evaluate the vitamin D status of a pediatric population, during all four seasons of the year, living in the north of Algeria, as well as to estimate the prevalence of vitamin D deficiency, identifying the potential risk factors. MATERIAL AND METHODS: This was an analytic and cross-sectional study carried out between March 2014 and March 2016 with healthy preschool infants from an urban environment in the town of Hussein Dey. A total of 1016 infants aged 9-72 months were included during this period. The consensual threshold value was 20ng/mL. RESULTS: The sex ratio was of 1.47 (535 boys/481 girls) and the average age of the children was 36.5±1.79 months. The daily average calcium ratio was 395±23 mg/with food contributions in vitamin D at an estimated average of 164 UI/day (4.1µg/day). The average concentration of the total 25-OHD for all four seasons of the year was 18.6±10.4ng/mL with an average rate of parathyroid hormone (PTH) of 30.9±14.6pg/mL. There was a highly significant inverse correlation between the serum level of vitamin D and PTH (r=-0.57; P=0.0001), the point of inflection was situated at 34.1ng/mL. The prevalence of vitamin D deficiency follows a seasonal variation that is statistically significant (P=0.0001), and the prevalence is higher during the autumn-winter period. The risk factors identified by multiple logistic regression were autumn-winter season (OR: 7; 95% CI: 3-11; P=0.001), age less than 24 months (OR: 3.8; 95% CI: 3.4-4.4; P=0.0001), high body mass index (OR: 2; 95% CI: 1.2-3.2; P=0.3), darker skin pigmentation (OR: 2.8; 95% CI: 2.2-5.2; P=0.001), duration of sunlight exposure less than 15min (OR: 6.1; 95% CI: 3.6-10.2; P=0.0001), low socioeconomic status (OR: 3.9; 95% CI: 1.5-4.3; P=0.01), calcium intake lower than 500 mg/day (OR: 2.5; 95% CI: 1.8-6; P=0.001), and a weekly dietary intake of vitamin D lower than 200 UI (OR: 2.6; 95% CI: 1.6-4.2; P=0.02). DISCUSSION: No studies have been conducted in north Africa or Algeria concerning healthy preschool children; however, this population has a rapid growth rate and deserves special attention. The prevalence of vitamin D deficiency in the children of this study was higher than that reported in studies of children of the same age living in Europe or America, despite the fact that Algeria is closer to the equator (36° latitude north). CONCLUSION: The changes experienced by Algerian society and the shorter exposure of the population to the sun call for more efforts regarding the detection and treatment of vitamin D deficiency, as well as an update of the vitamin D supplementation schedule.

Vitamin D Deficiency and Low Serum Calcium as Predictors of Poor Prognosis in Patients with Severe COVID-19.

BACKGROUND: The severity of Coronavirus Disease 2019 (COVID-19) is a multifactorial condition. An increasing body of evidence argues for a direct implication of vitamin D deficiency, low serum calcium on poor outcomes in COVID-19 patients. This study was designed to investigate the relationship between these two factors and COVID-19 in-hospital mortality. MATERIALS: This is a prospective study, including 120 severe cases of COVID-19, admitted at the department of Reanimation-Anesthesia. Vitamin D was assessed by an immuno-fluoroassay method. Total serum calcium by a colorimetric method, then, corrected for serum albumin levels. The association with in-hospital mortality was assessed using the Kaplan-Meier survival curve, proportional Cox regression analyses and the receiver operating characteristic curve. RESULTS: Hypovitaminosis D and hypocalcemia were very common, occurring in 75% and 35.8% of patients. When analyzing survival, both were significantly associated with in-hospital mortality in a dose-effect manner (pLog-Rank = 0.009 and 0.001 respectively). A cutoff value of 39 nmol/l for vitamin D and 2.05 mmol/l for corrected calcemia could predict poor prognosis with a sensitivity of 76% and 84%, and a specificity of 69% and 60% respectively. Hazard ratios were (HR = 6.9, 95% CI [2.0-24.1], p = 0.002 and HR = 6.2, 95% CI [2.1-18.3], p = 0.001) respectively. CONCLUSION: This study demonstrates the high frequency of hypocalcemia and hypovitaminosis D in severe COVID-19 patients and provides further evidence of their potential link to poor short-term prognosis. It is, therefore, possible that the correction of hypocalcemia, as well as supplementation with vitamin D, may improve the vital prognosis.

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.

Impact of vitamin D supplementation model on the circulating levels of 25 (OH) D in Algerian children aged 1-23 months.

Vitamin D deficiency is a public health problem around the world. In Algeria, the nutritional situation is still subject to uncertainties. In order to evaluate the vitamin D status and to know the impact of the current vitamin D supplementation model on the circulating levels of 25 (OH) D, an investigation was conducted on a group of Algerian children. The study was conducted in the Blida region (Northern Algeria). Sampling focused on 150 healthy children, aged between 1 and 23 months old, recruited from Ben Boulaïd hospital pediatric ward. 83% of children (n = 125) have been supplemented with vitamin D (D3 B.O.N®) according to a scheme currently designed in Algeria (the first intake of 200 000 IU at 1 month and the second intake of 200 000 IU at 6 months). 17% of children (n = 25) have escaped from a supplementation. The average values of 25(OH) D are respectively: 51 ±â€¯20 µg/L for 103 supplement children with vitamin D (25 (OH)D ≤ 100 µg/L), 222 ±â€¯106 µg/L for 22 supplement children with vitamin D (25(OH) D > 100 µg/L) and 30 ±â€¯16 µg/L for 25 non-supplement children with vitamin D. The prevalence of vitamin D deficiency is lower (4%) among the children group with vitamin D supplement. These results show that the vitamin D supplementation model seems entirely efficient on the improvement of vitamin D status.

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.

High Prevalence of Multidrug-Resistant Escherichia coli in Urine Samples from Inpatients and Outpatients at a Tertiary Care Hospital in Sétif, Algeria.

The worldwide dissemination of multidrug-resistant (MDR) Enterobacteriaceae is a major public health issue. The aim of this study was to investigate the prevalence of MDR Escherichia coli (MDR-EC) isolates, in inpatients/outpatients with urinary tract infections at Sétif University Hospital (Algeria). Bacterial cultures were obtained from 426 of the 3,944 urine samples collected from January 2015 to February 2017. Among these cultures, 215 E. coli isolates were identified by mass spectrometry, and 38 (17.7%) were MDR-EC (disk diffusion method): 36 produced only extended-spectrum ß-lactamases (ESBL), one ESBL and a carbapenemase, and one only a cephalosporinase (double-disk synergy test). Multiplex PCR and sequencing analyses showed that 37 ESBL-producing isolates harbored genes encoding CTX-M enzymes (CTX-M-15 in 33 isolates, 89.19%; and CTX-M-14 group in four isolates, 10.81%). One CTX-M-15-producing isolate co-expressed also an OXA-48-like carbapenemase. Phylogenetic group analysis of the 37 ESBL-producing and 178 non-ESBL-producing isolates indicated that the most common phylogenetic group was B2 (54.05% of ESBL-producing and 48.31% of non-ESBL-producing isolates), followed by A and D for ESBL-, and by B1, A, and F for non-ESBL-producing isolates. This is the first report highlighting the presence of MDR-EC isolates that produce both CTX-M and OXA-48-like enzymes in Sétif, Algeria.

Sleep disturbances and neurotoxicity in workers exposed to hydrocarbons. An observational study from Algeria.

BACKGROUND: Occupational exposure to solvents may lead to neurotoxicity and sleep disturbances. We aimed to investigate the association of occupational exposure to petroleum-derived hydrocarbons with neurotoxicity and sleep disturbance symptoms. METHODS: We included male workers handling/distributing petroleum products (exposed, n = 250) and electricians (non-exposed, n = 250) from two companies in Tlemcen (Algeria). Neurotoxicity was evaluated with the Q-16 questionnaire, and sleep disturbances with the Epworth and the Berlin questionnaires. Multivariable Poisson regression models with robust error variances were applied obtaining risk ratios (RR) and their 95% confidence interval (CI). RESULTS: Overall, the prevalence of reported neurotoxicity and sleep disturbance symptoms was higher in exposed than in non-exposed workers. Significant adjusted associations were observed for neurotoxicity, snoring, and excessive sleepiness (RR = 2.2, CI: 1.7-2.8; RR = 1.4; CI: 1.1-1.7; RR = 1.3, CI: 1.2-1.5, respectively). No significant associations were observed with the Epworth score. CONCLUSIONS: Our questionnaire-based cross-sectional study suggests that exposure to petroleum-derived hydrocarbons is associated with self-reported sleep disturbances and neurotoxicity symptoms.

[Catheterization and fungal infection risk in the University Hospital of Tlemcen: epidemiology and susceptibility to antifungals]. / Cathétérisme et risque infectieux fongique au centre hospitalo-universitaire de Tlemcen: épidémiologie et sensibilité aux antifongiques.

Fungal infections are a major cause of morbidity and mortality, and are frequently associated with the implantation of vascular catheters, especially in immune-compromised patients. Unfortunately, the therapeutic arsenal available for the treatment of these infections, caused generally by the yeasts of the genus Candida is still limited because of the toxicity and/or of the emergence of resistance against some antifungal agents. That is why we have undertaken this study, which is to determine the incidence and the degree of sensitivity of Candida spp., isolated from peripheral venous catheters at the University Hospital of Tlemcen (Algeria) to caspofungin and amphotericin B. The results show that the rate of colonization of vascular catheters was 19 % by yeasts of Candida spp., of which 60 % are Candida parapsilosis, 20 % Candida albicans, 14.3 % Candida glabrata and 5.7 % Candida famata. The minimum inhibitory concentrations (MIC) for amphotericin B are between 0.5 and 2 µg/mL and for caspofungin, they are between 0.125 and 2 µg/mL.

Characteristics of rheumatoid arthritis in Algeria: a multicenter study.

The aim of this study was to compare the epidemiology of rheumatoid arthritis (RA) in North Africa to that of Western countries. We have enrolled in a cross-sectional study all consecutive patients presenting with the diagnosis of RA according to the 1987 ACR criteria, and during a 5-month period, patients were included in 11 centers across northern Algeria. Demographics, clinical data, and health assessment questionnaires (HAQ) were collected for each patient. We have estimated means, standard deviations, and 95 % confidence intervals for all parameters. Of the 249 patients (213 females and 36 males) enrolled in the study, 10 (4 %) had juvenile onset of the disease. The mean age was 50.1 ± 14.5 years, and the mean duration of RA was 8.4 ± 7.8 years. In terms of comorbidities, 18.9 % of patients reported hypertension and 5.2 % had diabetes. The mean DAS28 at inclusion was 4.3 (95 % CI 4.1-4.5); 14.0 % were in remission (DAS28 ≤ 2.6). The mean HAQ score was 0.81 ± 0.82. Rheumatoid factor was positive in 78.5 % of cases, and anti-citrullinated protein/peptide antibodies, when measured, was positive in 69.0 % of cases. Seronegative patients were older and had a relatively less severe disease. For treatment, 89.7 % of patients were taking disease-modifying anti-rheumatic drugs and only 4 % were taking biologics (rituximab); 90.8 % of patients were taking glucocorticoids, and none of the patients satisfied the recommended calcium intake guidelines. RA in Algeria is more common in women. Compared to reports from Western countries, RA in Algeria appears to be less aggressive, with more dominant seronegative oligoarthritis forms. The remission rate is comparable to that of Western populations.

Occupational exposure to petroleum products and respiratory health: a cross-sectional study from Algeria.

OBJECTIVE: To investigate the possible impact of long-term occupational exposure to hydrocarbons on respiratory health. METHODS: Respiratory health was assessed by questionnaires, spirometry, and exhaled nitric oxide in 250 male workers from a company handling and distributing refined petroleum products (exposed) and 250 electricians (controls). Exposure to hydrocarbons was assessed by personal air monitoring. RESULTS: Aerial exposure to hydrocarbons was low. Respiratory and nasal symptoms were significantly more frequent among exposed subjects than among controls. Although forced vital capacity and forced expiratory volume in 1 second did not differ, ratio of forced expiratory volume in 1 second to forced vital capacity and maximal expiratory flows were significantly lower in exposed than in control subjects, adjusting for smoking. Exhaled nitric oxide was significantly higher among exposed subjects (30.1 ppb) than among controls (21.6 ppb), adjusting for age and smoking. CONCLUSIONS: Even low exposure to petroleum-derived hydrocarbons is associated with more respiratory and nasal symptoms, lower pulmonary function, and airway inflammation.

Polymorphisms of 5,10-methylenetetrahydrofolate reductase and cystathionine beta-synthase genes as a risk factor for neural tube defects in Sétif, Algeria.

BACKGROUND: Neural tube defects (NTD) are severe congenital malformations due to a failure in neural tube formation at the beginning of pregnancy. The etiology of NTD is multifactorial, with environmental and genetic determinants. We suggest a study of gene-gene interactions regarding the possible association of NTD with specific mutations of 5,10-methylenetetrahydrofolate reductase (MTHFR) and cystathionine beta-synthase (CBS) genes. PATIENTS AND METHODS: The genetic analysis of the MTHFR C677T polymorphism was performed by real-time polymerase chain reaction (PCR) on a Light Cycler, the CBS genotype was analyzed by PCR in a thermal cycler. Ninety-two mothers who had conceived NTD children and 48 fathers were investigated. A group of 147 adults, including 82 apparently healthy women, was used as control. RESULTS: Among control mothers, 35 (43%) were heterozygous for the C677T variant and 14 (17%) were TT homozygous. Among the cases, 25 (52%) out of 48 mothers and 22 (46%) out of 48 fathers carried the T allele; 9 mothers (19%) and 5 fathers (10%) had the TT genotype. A homozygous C677T mutation was not an NTD risk factor in this preliminary study in an Algerian population; a possible gene-gene interaction between the MTHFR C677T polymorphism and the CBS 844ins68 has also been examined in relation to NTD, but no such association has been shown. There was a statistically significant difference between the heterozygosity genotype frequency of CBS polymorphisms in mothers with a previous child with NTD compared with the mother controls (odds ratio: 3.72; 95% CI: 1.59-8.73). CONCLUSION: Our results with Algerian NTD mothers did not show a significant association for any group, suggesting that the thermolabile variant C677T in the MTHFR gene is not a risk factor for a mother to have NTD offspring; rather, folic acid supplementation or fortification should become mandatory for all women of reproductive age in Algeria.

Spread fortified with vitamins and minerals induces catch-up growth and eradicates severe anemia in stunted refugee children aged 3-6 y.

BACKGROUND: Multiple micronutrient deficiencies are often the basic causative factor in stunting and anemia, 2 conditions that affect entire generations of children in deprived populations. No generally accepted recommendations for micronutrient intakes for recovery from stunting are available. OBJECTIVE: The objective was to assess the effect of a highly nutrient-dense spread fortified with vitamins and minerals, with or without antiparasitic metronidazole treatment, in correcting retarded linear growth and reducing anemia in stunted children. DESIGN: Saharawi refugee children (n = 374) aged 3-6 y with initial height-for-age z scores <-2 were assigned to 1 of 5 groups: fortified spread (FS), fortified spread plus metronidazole (FS+M), unfortified spread (US), unfortified spread plus metronidazole (US+M), or control. Supervised supplementation was given daily for 6 mo. Weight, height, knee-heel length, hematologic indexes, parasitic infections, and morbidity were assessed at 0, 3, and 6 mo. RESULTS: Linear growth of children fed FS was 30% faster at 3 mo than in US and control groups, after which height-for-age z scores increased only slightly in the FS group and remained unchanged in the other groups. No additional benefits from metronidazole were observed. Increase in hemoglobin concentrations in the FS group at 6 mo was twofold that in the US and control groups (37 +/- 40, 19 +/- 15, and 16 +/- 17 g/L, respectively; P < 0.0001), and anemia was reduced by nearly 90%. CONCLUSIONS: FS, and not US, induces catch-up growth in stunted children whose diets are poor in micronutrients. Our trial provides support for delivering multiple micronutrients to reverse stunting and reduce anemia in children up to age 6 y.

[The history of the flea in art and literature]. / La storia della pulce nell'arte e nella letteratura.

The flea has been, indirectly, one of the protagonists in the history of man. As one of the two vectors of Yersinia pestis, the etiological agents of the Black Death, the flea (Xenopsylla cheopis) has contributed, over the centuries, to the death of millions of people in many countries. Galileo Galilei was the first to observe the flea with a microscope (1624), but the credit of depicting it with a stunning drawing goes to the Britisher Robert Hooke in 1665. A number of zoologists, including Antonie Van Leeuwenhoek and Diacinto Cestoni, well described and illustrated the life cycle of the flea in the XVII century. Some of these reports inspired scholars such as J. Swift and J. Donne for the composition of classic poems. Also, the flea, alone and with its hosts, has inspired a number of artists to create fine paintings; among them: G. M. Crespi, G. B. Piazzetta, G. de la Tour and others. Colorful sonnets on the flea in the Roman dialect were written by G. Belli and Trilussa. The flea also, as a theme, inspired musicians such as G. F. Ghedini and M. Mussorgsky, play writers such as Feydeau and moviemakers such as Charlie Chaplin. The flea is, indissolubly, connected with the history of Black Death. This disease in man is, in fact, caused--as demonstrated by Yersin and Simond--by the triad: bacterium (Yersinia pestis)/rat/flea (Xenopsylla cheopis). Over the centuries, Black Death has had a deep impact on both the visual arts and literature and, as a result, a very large number of paintings and other works of art have been produced to remember these tragic episodes. In the field of literature, Black Death has been skillfully described by writers such as Boccaccio, Manzoni and Camus. Finally, in recent years, following the discovery of the existence of a large market for the control of fleas in small animals, the interest in this minute insect has been resurrected and, parallel to that, the rebirth of the flea iconography, through electromicroscopy, has also taken place.

[Fifteen years' experience in scorpion envenomation control in Algeria]. / Expérience de quinze années de lutte contre l'envenimation scorpionique en Algérie.

In Algeria, scorpion envenomation is real public health problem. Since the creation of the National Committee of Control of Scorpion envenomations (CNLES), several steps have been taken to deal with this problem. After a brief historical introduction, we present the main elements of the action carried out both in terms of treatment and of prevention of scorpion proliferation. The epidemiological situation is presented by stressing the difficulties involved in collecting reliable data. We also address the question of citizen and stakeholder awareness since public participation is crucial in all prevention programmes. Training for healthcare providers is also one of the principal axes of the Committee's programme which includes national, regional, and even local seminars. We describe the improvement of production and research on venoms carried out by the Institute Pasteur of Algeria. We conclude by discussing the action plan for 2001 and prospects for an enhanced strategy in the fight against the scorpion envenomation.

Blood micronutrients in Algeria, relationships with sex and age.

Despite trace elements and vitamins are major public health problems in some African countries, there are few studies reporting micronutrient status in North Africa. Therefore, it could be interesting to evaluate plasma concentrations of vitamin A, E and beta-cartene, along with zinc, copper, selenium erythrocyte glutathione peroxidase and superoxide dismutase in Algeria. Volunteers were randomly recruited in Constantine, Batna and Mila. Vitamins, trace elements and enzymes were measured in the University Hospital of Grenoble. 455 persons were included in the study. Subjects were divided in 3 groups: group I: 15 girls and 12 boys who were 6 to 12.9 years old, group II: 190 women and 192 men 13 to 49.9 years old, group III: 24 women and 24 men 50 to 65 years old. Plasma concentrations of micronutrients and enzymes are close to those commonly observed in Europe, except for vitamin A concentrations. Indeed, retinol levels are 30-35% lower than those reported in European countries, moreover almost 8% of the population showed retinol concentrations less than 1.05 mumol/l. beta-Carotene levels were also lower than in the French average population. Ten per cent of the population had plasma zinc levels lower than 10.6 mumol/l. Vitamin E, copper and selenium status seems satisfactory in Algeria. Vitamin A is not a public health problem, however a significant percentage of residents exhibits impaired vitamin A levels and may benefit from retinol supplementation. Larger studies are needed, and particularly in children, to detect possible higher prevalence of vitamin A deficiency in poor socio-economical classes and in inner geographic areas.

Multiplicity of the genes and plasmids conferring resistance to pristinamycin in staphylococci selected in an Algerian hospital.

In an Algerian hospital where pristinamycin (Pt) was extensively used for the treatment of chronic osteomyelitis and for prophylaxis in bone surgery, the prevalence of pristinamycin-resistant (PtR) staphylococci during a five-month period (20%) was higher than that among staphylococci isolated elsewhere in Algeria (4.5%). Analysis of 13 PtR staphylococci isolated in this hospital revealed a diversity of plasmids and genes conferring resistance to Pt and to related antibiotics. Most of the PtR staphylococci were unrelated: they belonged to either different taxa or types. Nevertheless, some of the unrelated staphylococci harboured structurally related plasmids carrying streptogramin resistance genes. Thus, these plasmids may have contributed to the dispersion of these genes.

[Results of a national tuberculosis survey carried out from 1980 to 1989 in Algeria]. / Résultats de l'enquête tuberculinique nationale realisée de 1980 à 1989 en Algérie.

SETTING: Algeria, where mass BCG vaccination is performed at birth, has a high prevalence of tuberculosis. OBJECTIVE: To measure the scale of the tuberculosis problem and the impact of the National Tuberculosis Control Programme set up in 1972, a tuberculin survey was performed at regular intervals from 1980-1989 in Algeria. DESIGN: The survey took place in the schools of five communities of differing socio-economic levels. During two visits five years apart, respectively 18,960 and 30,738 children aged 8.5 years were tested. During the second visit, 10,301 children aged 12.5 were included in the survey. RESULTS: The prevalence of infection in children with no scar, non-vaccinated or whose vaccination status was unknown, was 4.05% in 1980-1984 and 2.71% in 1985-1989. With an annual decrease of 7.8%, the annual risk of tuberculosis infection was 0.34% in 1980-1984 and 0.22% in 1985-1989. CONCLUSION: The results of the survey seem to indicate the continued abatement of the tuberculosis problem in the years to come. They also show that tuberculin surveys at regular intervals can be performed in high-prevalence countries where there is mass BCG vaccination at birth.