Owned and free-roaming dogs in the North West of Tunisia: estimation, characteristics and application for the control of dog rabies.

Understanding the structure of dog population and the evaluation of the accessibility of dogs to vaccination is essential to succeed in the fight against dog rabies and to adapt the strategy of its control. We studied the characteristics of the unowned and owned dogs using the beck method during a rabies vaccination campaign in randomly selected sectors (urban and rural sites) in the North West of Tunisia. During a door-to-door investigation of households, data on owned dogs were collected to describe the owned population dog. A photographic-recapture method was used to characterize and estimate the size of the unowned dogs. A total of 1432 households accounting for 5403 inhabitants were interviewed during the survey (1298 (90.6%) in the urban site and 134 (9.3%) in the rural site). The dog-owning households were significantly higher in the rural site (76.1% (102/134)) compared to the urban site (17.8% (231/1298)) (P < 0.000000). Of the 17.8% dog-owning households in urban site, 58.4% owned one dog and 9% between 4 and 8 dogs. While, of the 76.1% dog-owning households in rural site, 24.5% owned one dog and 32.3% owned between 4 and 10 dogs. The dog: human ratio was 1:11 in the urban site and 1:1.6 in the rural site. The dog population density was estimated at 16 dogs/km2 and 4 dogs/km2 in the urban and rural sites, respectively. The confinement practices varied significantly among the urban and rural sites (P < 0.000000). The percentage of free-roaming owned dogs was 51.1% in the rural site and 31.4% in the urban site. More than 60.0% of the owned dogs in the urban site were confined. The majority of dogs in the rural site were born in the house, although, a high percentage (56.7%) of owned dogs in the urban site was adopted from neighbours, others sectors, or countries. The vaccination coverage findings indicated that 77.8% and 84.2% of the owned dog were vaccinated in the urban and rural sites, respectively. The estimated size of the free-roaming dogs was 72 dogs in the urban site (Kalaat Senan) and 16 dogs in the rural site (Sod el Khir).

An epidemiological study of sheep pox in Tunisia (2008-2017).

Sheep pox is a highly contagious disease causing significant economic losses on livestock farms, especially among young animals. Epidemiological analysis of retrospective data on sheep pox surveillance over ten years revealed the endemicity of the disease in Tunisia. Temporally, the prevalence of infected farms increased during the last five years analysed (2013-2017), despite control measures for the disease, which are based essentially on vaccination. Analysis of the seasonality of infection showed that most outbreaks occurred in autumn and winter. The geographical distribution and spatial analyses classified the governorate of Sidi Bouzid as the area most affected by sheep pox duringthe period of study. It was observed that vaccination coverage decreasedbelow the recommended value (80%) in the last four years (2013-2016).

La clavelée est une maladie extrêmement contagieuse qui se traduit par d'importantes pertes économiques dans les élevages, les jeunes ovins étant les plus touchés. Une analyse épidémiologique rétrospective des données recueillies sur la clavelée, au cours d'une période de dix ans, a révélé que la maladie est présente à l'état endémique en Tunisie. Les données temporelles ont fait ressortir une prévalence accrue des élevages infectés au cours des cinq dernières années de la période d'étude (2013-2017), malgré les mesures de lutte appliquées contre la maladie, essentiellement la vaccination. L'analyse de la saisonnalité de l'infection a montré que la plupart des foyers se déclaraient en automne et en hiver. Les données spatiales relatives à la distribution géographique des foyers ont révélé que le gouvernorat de Sidi Bouzid était la zone la plus affectée par la clavelée pendant la période étudiée. Il a été constaté que la couverture vaccinale est passée en dessous du seuil recommandé (80 %) au cours des quatre dernières années de l'étude (2013-2016).

La viruela ovina es una enfermedad muy contagiosa que afecta especialmente a los animales jóvenes y causa importantes pérdidas económicas en las explotaciones de producción pecuaria. El análisis epidemiológico retrospectivo de los datos de vigilancia de la viruela ovina correspondientes a diez años reveló que la enfermedad reviste carácter endémico en Túnez. Por lo que respecta a la secuencia temporal, la prevalencia de explotaciones infectadas aumentó en el curso de los cinco últimos años analizados (2013-2017) pese a las medidas instauradas para combatir la enfermedad, basadas esencialmente en la vacunación. El análisis de la estacionalidad de la infección puso de manifiesto que la mayoría de los brotes se declaraban en otoño e invierno. A tenor del análisis espacial y de la distribución geográfica, la zona más afectada por la viruela ovina durante el período de estudio fue la prefectura de Sidi Bouzid. Se observó asimismo que en los últimos cuatro años (2013-2016) la cobertura de vacunación descendió por debajo del valor recomendado (un 80%).

Ergonomic evaluation of a situation of coexposure to solvents and noise in a printing of flexible packaging.

The purpose of this paper is to present an ergonomic evaluation of a situation of co-exposure to solvents and noise in a flexible packaging printer. We discuss how such an approach carried out in the field of printing industry work has made it possible to highlight serious shortcomings in the effectiveness of the prevention actions that are supposed to protect workers from chemicals risks and noise. The ergonomic analysis identified a strain working conditions. Indeed, some jobs expose to noise and toxic risk. Lamination operations, winding and cutting are purveyors of noise. Some physical and spatial factors contribute to amplify the toxic risk. The not wearing of personal protective equipment (PPE) by the operators maybe explained by the fact that it doesn't any possibility to do "otherwise". Indeed, operators adopt a compromise to achieve the objectives of production to the detriment of their health and safety. These constraints are causing gene and psychosocial factors. The interviews revealed a state of psychosis in the workshop, which was accentuated by the reclassification of an operator which has created a climate of panic and anxiety especially for older operators who have more than 20 years exposed to handling of toxic and more exposure to high noise level.

Bedside capillary blood glucose measurements in critically ill patients: influence of catecholamine therapy.

OBJECTIVE: To evaluate the effects of catecholamine therapy on the accuracy of capillary glucose measurements in hyperglycemic patients. PARTICIPANTS: 43 hyperglycemic patients older than 18 years admitted to the intensive care unit of a tertiary medical center were included from December 2005 to March 2006. MEASUREMENTS: This prospective study compares fingerstick and earlobe measurements simultaneously to sampled laboratory venous glucose in patients treated without (group 1) or with (group 2) catecholamine. Three venous samples for serum glucose analysis at three fixed hours and simultaneously two capillary glucose determinations were performed during the two first successive days after inclusion. A difference between the methods of glucose measurements greater than 2.3 mmol/l was considered significant. RESULTS: The mean difference between the two methods was -0.05 mmol/l in group 1 and +0.29 mmol/l in group 2, while the limits of agreement were +4.03 and -4.13 mmol/l and +5.63 and -5.05 mmol/l in groups 1 and 2, respectively. A difference between paired measurements greater than 2.3 mmol/l was observed in 29% in group 1 and in 40% in group 2 (p=0.038). The alternative site did not improve the accuracy. CONCLUSIONS: In critically ill patients treated with catecholamine capillary fingerstick blood glucose measurement seems inaccurate. Earlobe sampling does not improve accuracy.

[Duration of antibiotic therapy for ventilator-associated pneumonia: comparison of 7 and 10 days. A pilot study]. / Durée de l'antibiothérapie lors du traitement des pneumopathies acquises sous ventilation mécanique : comparaison entre sept jours et dix jours. Etude pilote.

OBJECTIVE: To compare the efficiency of a 7-day antibiotics regimen with a 10-day regimen for ventilator-associated pneumonia (VAP). STUDY DESIGN: Prospective randomized study. PATIENTS AND METHODS: Adults patients ventilated for more than 48 hours in the intensive care unit (ICU) with a clinical diagnosis of VAP documented by positive quantitative cultures of tracheal aspiration were included in this study. All included patients were randomized in two groups. Ten-day group: 10 days antibiotic therapy, and 7-day group: 7 days antibiotic therapy. Primary judgment criteria were 14- and 28-day mortality, the number of days without antibiotics. Secondary judgments criteria were rate of recurrent pulmonary infection, the evolution of the clinical pulmonary infection scores (CPIS), the length of ICU stay and the length of mechanical ventilation. RESULTS: Thirty patients were included in this study (16 in the 10-day group and 14 in the 7-day group). The demographic and clinical characteristics of the groups assigned to receive antibiotic therapy for 7 or 10 days were generally similar. The 14-day and 28-day mortality rate following VAP onset were 31.2 and 37.5% in the 10-day group and 7.1 and 35.7% in the 7-day group. The difference was not significant. The number of day without antibiotics and without mechanical ventilation turned out: 1.75 and 2.06 days versus 4.14 and 3.43 days in the 10-day group and 7-day group respectively, the recurrent rate of pulmonary infection (12.5% versus 14.3%, p=0.6), the length of stay in the ICU (27.7 days versus 26.0 days, p=0.8) and the evolution of the CPIS were no different in the two groups. CONCLUSION: In patients with microbiologically confirmed VAP who received appropriate empirical antibiotic therapy, a 7-day antibiotic regimen was as efficient clinically and microbiologically as a 10-day antibiotic regimen with a reduction of antibiotic use.

Organization and education in occupational safety and health in Maghreb countries.

The Maghreb consists of five countries of North Africa (Mauritania, Morocco, Algeria, Tunisia and Libya) which are members of a socio-economical community called the Union of Arab Maghreb. This paper discusses the organisation of occupational health, medical protection of workers and training in occupational safety and health in these countries. After a review of socio-economic and demographic data and legislative aspects, we report epidemiological and analytic data specific to each country concerning organisation and training in occupational health. Occupational medicine in Algeria, Morocco and Tunisia has progressed but some deficiencies are still observed at several levels. Like countries of the European Union, cooperation between the Maghreb countries in occupational health and safety seems indispensable.

Septic jugular thrombophlebitis and pulmonary embolism: a case report.

Bacterial oropharyngeal infections in healthy young people rarely give rise to life threatening complications. Lemierre's disease, caused by Fusobacetrium necrophorum, manifests as pharyngitis, jugular venous thrombosis and septic pulmonary embolism. A previously fit young male presenting with prolonged pharyngitis, complicated by severe pneumonia and septicaemia is presented. Recognition of this syndrome and early antibiotic therapy can prevent significant morbidity in otherwise healthy people.

Determination of iodide in serum and urine by ion-pair reversed-phase high-performance liquid chromatography with coulometric detection.

An HPLC method is described for the determination of iodide in serum and urine using ion-pair chromatography with coulometric detection. After adding hexadecyltrimethylammonium chloride, the ions pairs formed with the iodide in the sample are extracted using an organic solvent. The solvent is then evaporated and the dry residue obtained is mixed with an appropriate volume of mobile phase so as to concentrate the sample prior to injection into the chromatograph. For a sample of 0.5 ml of serum, the method features a limit of detection (signal-to-noise ratio of 3) of 0.2 microgram l-1, sufficient to be applied in paediatric assays for the diagnosis of both iodide deficiency and excess.

Measurement of bronchial responsiveness by forced oscillation technique in occupational epidemiology.

The performance of the forced oscillation technique (FOT) in the assessment of bronchial responsiveness on the methacholine challenge test was compared with that of forced expiratory volume in one second (FEV1) in 119 active workers with normal baseline pulmonary function. Changes in resistance (delta R0%), frequency dependence of resistance (delta P) and resonant frequency (delta F%) determined by the FOT were compared to the delta FEV1%. Receiver operating characteristic (ROC) curves were established to determine values of the changes in FOT parameters which corresponded to the best sensitivity and specificity for classifying the subjects as hyperresponsive or nonresponsive on the methacholine challenge test. Significant correlations were observed between delta FEV1% and delta R0%, delta P and delta F% respectively. The ROC curves showed the following cut-off values of FOT parameters to be the best values for classifying the subjects according to the presence or absence of 20% fall in FEV1: a 65% increase in R0 (sensitivity 75%; specificity: 76%); a decrease of 65 x 10(-3) hPa.l-1.s2 in P (sensitivity 58%; specificity 83%); a 50% increase in F (sensitivity 75%; specificity 62%). Our results suggest that the FOT is a useful test for assessment of bronchial hyperresponsiveness when compared to spirometry, and can be applied to epidemiological studies of a bronchial challenge test in normal active working populations.

[Generalized ichthyosis associated with a spastic syndrome of the lower limbs, a variant of Sjögren-Larsson syndrome? Light and electron microscopy study of ichthyosis and its evolution with oral etretinate treatment]. / Ichtyose généralisée associée à un syndrome spastique des membresinférieurs, une variante de syndrome de Sjögren-Larsson? Etude en microscopie optique et électronique de l'ichtyose et de son évolution sous traitement oral à l'étrétinate.

A generalized ichthyosis with an associated spastic syndrome of the lower extremities, clinically suggestive of Sjögren-Larsson syndrome, was observed in a Tunisian boy. The fatty acid analysis of the serum phospholipids revealed significant abnormalities in the fatty acid pattern of phospholipids. However, the alterations observed were different from those reported in Sjögren-Larsson syndrome. We report light and electron microscopic changes in the ichthyotic skin of this patient, which have not been previously reported in lamellar ichthyosis and in Sjögren-Larsson syndrome. The epidermis was moderately hyperplastic and covered with a thick, compact, orthokeratotic stratum corneum. The stratum spinosum was strikingly altered in some areas. Varying numbers of keratinocytes contained big vacuoles, measuring often up to the size of the nuclei; the vacuoles, were well limited but only partially lined by a membrane, they were empty or contained small amounts of a flaky material. Attempts to stain the vacuoles with PAS, Alcian blue and Fettrot were negative. Etretinate treatment produced a marked shedding of the horny layer without significant improvement of the clinical appearance. The described microscopical alterations of the epidermis remained mostly unchanged during treatment, but, in addition, a marked oedema and vacuolisation of the upper stratum granulosum was observed.