[Sentinel surveillance of diarrhea in Ksar-Hellal (Tunisia)]. / Surveillance sentinelle de la diarrhée à Ksar-Hellal (Tunisie).

BACKGROUND: In order to simplify the national data collection related to diarrhea, a sentinel surveillance system was implemented in the Ksar-Hellal district (Tunisia). POPULATION AND METHODS: This system was based on 461 cases of diarrhea collected from health centers and hospitals between June 1994 and December 1995. RESULTS: The collected information confirmed the previous data provided by the national system: frequency of diarrhea in health centers (4.14%), occurrence of the disease especially in the summer period, rate of hospitalization (10%) and low proportion of severe dehydration. The system also gave some new information related to the proportion of persistent diarrhea (7.1%), the low frequency of malnutrition (11%) and the etiology. CONCLUSION: The sentinel surveillance system validates information previously provided by the National Surveillance System. It also gave new information not obtained by the classical surveillance system.

A five-year study of the incidence of insulin-dependent diabetes mellitus in young Tunisians (preliminary results).

Three Tunisian districts were selected to estimate the incidence of insulin-dependent diabetes mellitus (IDDM): Beja, Monastir and Gafsa. A population-based registry for new cases of IDDM was established in 1990 in these three areas according to WHO DIAMOND project methodology. A local extension of the protocol consisted in the inclusion of children up to 19 years of age. Children with a diagnosis of IDDM discharged from general hospitals and private clinics in these areas were recorded in the corresponding registry. A secondary source of case ascertainment was provided by regional school health centers. The findings of the five-year study showed that 156 cases of IDDM were recorded among children aged 0 to 19 years in the three regions. The degree of ascertainment was estimated at 96%. The global age-adjusted incidence rates were 6.76.100,000(-1) year-1 and 6.95.100,000(-1).year-1 in the 0 to 14- and 0 to 19-year age-groups respectively. Age-adjusted incidence rates were lower in Monastir than in Beja and Gafsa, respectively 4.69, 8.13 and 8.33.100,000(-1).year-1 for subjects aged 0 to 19 years. Incidence rates showed no significant difference by gender but were lower in the 0 to 4- and higher in the 10 to 14-year age groups. No time trend was detected. Sixty-two percent of all cases were diagnosed in the cold season. The incidence rate of IDDM in Tunisia is thus close to that observed in most Mediterranean countries.