[Epidemiological data on scorpion envenomation in Algeria]. / Données épidémiologiques sur l'envenimation scorpionique en Algérie.

The scorpion envenomation is a major public health problem in Algeria. Given this fact, the Ministry of Health has developed a national strategy for prevention and control based on the training of health personnel, information, education and communication, and standardization of care on the basis of a therapeutic consensus. The monitoring and evaluation activities are carried out by epidemiological indicators through the implementation of an information system based in the services of Epidemiology, INSP (National Institute of Public Health) and Prevention Department of the Health Ministry. The information carriers are report cards implemented in different health facilities that collect data on bites and deaths from scorpion envenomation. Summaries of notifications from the wilayas are collected monthly, and processed by the Epi info software using monitoring indicators. From 1991 to 2010, there has been a stagnation in the number of stings with an average of 50,000 cases per year, but mortality decreased from more than 100 deaths in the last fifty years to 50 nowadays. The higher proportion of stings was recorded during the summer period. The most affected group is from 15 to 49 years which constitute the workforce, but children from 5 to 14 years rank first in terms of mortality. But these rates vary across years and regions. Despite all these efforts, the scorpion envenomation in Algeria remains of concern and our main challenges are to strengthen cross-sectional actions at the local level and improving the quality of care.

Incidence and severity of scorpion stings in Algeria

Scorpion stings are a public health problem in the Maghreb region. In Algeria, epidemiological data were collected over the past twenty years by the Algerian health authorities. This study is an analysis of morbidity and mortality data collected from 2001 to 2010. Annual incidence and mortality due to scorpion envenoming were 152 ± 3.6 stings and 0.236 ± 0.041 deaths per 100,000 people (95% CI), respectively. The risk of being stung by a scorpion was dramatically higher in southern areas and central highlands due to environmental conditions. Incidence of envenoming was especially higher in the adult population, and among young males. In contrast, mortality was significantly higher among children under 15 years, particularly ages 1-4. Upper limbs were more often affected than lower limbs. Most stings occurred at night, indoors and during the summer. Data collected since 2001 showed a reduction of mortality by nearly 50%, suggesting that the medical care defined by the national anti-scorpion project is bearing fruit.(AU)

[Practical approach to lung health strategy in Algeria]. / L'approche pratique de la santé respiratoire en algérie.

SETTING: A total of 77 health care facilities in 10 provinces. OBJECTIVE: To perform a feasibility study before the extension of the Practical Approach to Lung (PAL) health strategy. METHOD: A cross-sectional study comparing before and after findings of a training course for general practitioners. RESULTS: Respiratory symptoms were the main reason for attending the primary health care services, accounting for 31.6% and 31.1% in the two periods studied. Acute respiratory infections constituted 70% of all respiratory disorders identified during the two periods. Chronic respiratory disorders, particularly asthma, were diagnosed more frequently after the training course (15.9% vs. 10.9%). Tuberculosis (TB) suspects accounted for only a minority of patients seeking health care and were more easily identified post-training. Treatment recommendations were more rational after training, which led to a reduction in prescription costs. CONCLUSIONS: The adoption of the PAL strategy by general practitioners led to an improvement in the quality of diagnosis of respiratory disorders and TB, fewer secondary investigations, less patient travel and an increase in the efficiency of medical practice by lowering prescription costs.

Health effects of PM10 air pollution in a low-income country: the case of Algiers.

SETTING: Although there are proven risk factors related to air pollution, the prevalent situation in low-income countries is not well known. OBJECTIVE: To quantify the health impacts associated with particulate air pollution in the city of Algiers. DESIGN: Descriptive study to evaluate a health impact assessment (HIA) approach based on a dose-response curve from the literature. A study area was defined around an air quality monitoring site in Algiers. Daily health data were obtained from a network of physicians practising in out-patient health centres. RESULTS: Over the period studied, the number of consultations for respiratory reasons attributable to PM10 exposure was 439, representing 4.5% of all health events observed. Different scenarios were examined, showing that a reduction in ambient levels of PM10 would be accompanied by important public health gains. CONCLUSION: The study allowed us to test the applicability of the HIA approach in a low-income country and to confirm the interest of the approach. Although the estimation of dose-response functions obeys a complex methodology, the HIA is an alternative that constitutes an important decision-making tool.

Air pollution: a new respiratory risk for cities in low-income countries.

Since the major accidents that occurred in the 1960s, air pollution has commonly been considered as a respiratory risk factor whose effects are most often studied in industrialised countries. Our aim is to show that it is now the turn of low- and middle-income countries to take this risk factor into account. After a discussion of the characteristics of air pollution, how it is diffused and the main known health effects (short- and long-term effects), we describe the specific differences between the cities in the North and the South. As a result of late industrialisation, cities in the South are now faced with pollution from industrial sources and urban traffic with polluting vehicles. The case of Algeria and Morocco illustrates this situation and its potential health risks. In order to prevent the health risks of air pollution in the cities of the South, systems for measuring pollution levels and epidemiological surveillance need to be put in place rapidly. This strategy can only work if it is supported by a strong partnership from industrialised countries.

[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.