[Eating habits and cardiovascular risk factors. Epidemiologic study of the Tunisian Sahel]. / Habitudes alimentaires et facteurs de risque cardiovasculaire. Etude épidémiologique au Sahel Tunisien.

OBJECTIVES: We assessed carbohydrate, fat and protein calorie intake in the urban population of Sousse, Tunisia in 1996 to evaluate the relationship with cardiovascular risk factors. PATIENTS AND METHODS: A descriptive epidemiology study of a representative sample (n = 957) of the adult population living in the urban areas of Sousse was based on a standardized questionnaire and physical examination (blood pressure, weight, height). Dietitians recorded food intake (previous 24 hours) and eating habits in all participants. In this population, estimated prevalences were: hypertension 18.8%, diabetes 10.2%, obesity 27.7%, android obesity 36%, smoking 21.4%. RESULTS: Total calorie intake was 2483 kcal (67% carbohydrates, 18% protein, 15% fat). There were no significant differences by sex or by presence or absence of cardiovascular risk factors. CONCLUSION: This descriptive study confirmed the epidemiologic transition of the urban population of Sousse, Tunisia. Increased cardiovascular risk results from high, predominantly carbohydrate, calorie intake. It would be advisable to encourage nutritional education on the individual level and the Mediterranean diet on the population level.

Prevalence of cardiovascular risk factors in the urban population of Soussa in Tunisia.

BACKGROUND: With the epidemiological transition phenomenon, Tunisia is now facing the growing prevalence of chronic diseases. Environmental and behavioural changes such as the adoption of new dietary habits and a sedentary lifestyle, and the stress of urbanization and of working conditions all lead to the rise in cardiovascular disease (CVD) risk factors. METHODS: The aim of this study is to estimate the prevalence of the main CVD risk factors in an urban context. For this, we have undertaken a household epidemiological survey of a representative sample of the adult urban population of Soussa, Tunisia (n = 957). RESULTS: This study shows high prevalences of hypertension (blood pressure >160/95 mmHg) of 18.8 per cent with an adjusted rate of 15.6 per cent, history of diabetes of 10.2 per cent, and obesity (body mass index > 30) of 27.7 per cent [significantly higher in women (34.4 per cent)], android obesity 36 per cent, smoking habits 21.5 per cent [significantly higher in men (61.4 per cent)]. CONCLUSION: With this profile of CVD risk factors, Tunisia must implement a national strategy of primary prevention and heart health promotion in addition to the efforts recently made in secondary prevention of some chronic diseases such as hypertension and diabetes.

[Using prenatal care in the Tunisian context: barriers and motivation factors]. / Recours aux visites prénatales dans le contexte tunisien: barrières et facteurs de motivation.

Several barriers to and motivators of antenatal care are analysed in the context of a developing country. The authors found that socio-cultural factors are as important as organizational factors in motivating women to seek antenatal care. While social and economic development may improve the quality of life in the long term, it is important to respond now to the needs of pregnant women in order to encourage them to use such services. A comprehensive analysis of certain organizational factors would be useful in achieving this goal.

[Risk factors in cardiovascular diseases in a semi-urban community of the Tunisian Sahel]. / Facteurs de risque des maladies cardiovasculaires dans une communauté semiurbaine du Sahel Tunisien.

Cardiovascular diseases are the leading cause of mortality in the western countries at the same time they are beginning to appear with increasing frequency in developing countries. An epidemiologic study was carried out at Kalaa Kebira (Sousse-Tunisia) to determine the prevalence of the different risk factors of cardiovascular diseases. The study was performed on a representative sample of 555 adults of 20 years and more (response rate of 76%). There was a high proportion of adult males smokers (66%). The prevalence of hypertension varied from 15% to 25%, those of diabetes was 6.5%. An hypercholesterolemia greater than 6.2 mmole/l was observed for 12% of the sample and obesity for 20%.