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1.
BMC Public Health ; 21(1): 1625, 2021 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-34488704

RESUMO

BACKGROUND: Sexually Transmitted Infections (STIs) are a public health problem, especially for reproductive-age women. The aim of this study was to determine the incidence and trend of STIs during 11 years in Tunisia (2007-17). METHODS: We conducted a descriptive study including all women with curable STIs (chlamydia, gonorrhea, syphilis and trichomoniasis) diagnosed with the syndromic approach in all basic health care centers of the Governorate of Monastir (Tunisia) from 2007 to 2017. Syndromes included, Pelvic Pain (PP), Vaginal Discharge (VD) and Genital Ulceration (GU). RESULTS: We analyzed 40,388 episodes of curable STIs with a crude incidence rate and age standardized incidence rate of 1393 (95% Confidence Interval (CI); 1348-1438) / 100,000 Person Year (PY) and 1328 (95%CI; 1284-1372) /100,000 PY respectively. The incidence rate showed a positive trend over 11 years for all age groups and syndromes. VD was the most common syndrome with a crude incidence rate of 1170/100,000 PY. For all syndromes, women aged 20 to 39 were the most affected age group (p < 0.001). CONCLUSION: In conclusion, the incidence rate of STIs episodes among women diagnosed with the syndromic approach was high, consistent with the global evidence. Focusing on reviewing STIs surveillance system in low and middle-income countries could allow the achievement of the ending of STIs epidemics by 2030.


Assuntos
Gonorreia , Doenças Sexualmente Transmissíveis , Feminino , Gonorreia/epidemiologia , Humanos , Atenção Primária à Saúde , Vigilância de Evento Sentinela , Doenças Sexualmente Transmissíveis/epidemiologia , Tunísia/epidemiologia
2.
East Mediterr Health J ; 27(8): 764-771, 2021 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-34486712

RESUMO

Background: Healthcare-associated infections (HCAIs) occurring outside of health facilities are underestimated because there are a lack of structured preventive organization and absence of epidemiological surveillance. HCAI prevalence is likely to grow with the increase in patient care outside of health institutions. Aims: To set up a situational analysis of good hygiene practices among private general practitioners (GPs) to better organize HCAI prevention in this sector. Methods: A descriptive cross-sectional study was conducted between November 2017 and March 2018, using a self-administered questionnaire among all GPs in Sousse City, Tunisia. Results: Participation rate was 93.1%. There was a predominance of male GPs (63%), with a sex ratio of 1.7:1. Up-to-date vaccination status was reported by 82 (75.9%) of GPs. Fifty-six (51.3%) GPs used hydroalcoholic solutions, 13 (12.1%) adopted autoclaving, and 106 (98.1%) wore gloves during invasive care. Blood exposure accidents (BEAs) were reported by 38 (35.2%; declared in 26.3% of cases) and were more prevalent in the group aged > 50 years who used significantly more reusable equipment. BEAs were primarily due to needle-stick injuries (86.8%). Conclusion: We identified the priority axes to be considered in organizing HCAI prevention in the private sector, which allows guidance of GPs, avoiding their isolation and compensating for their lack of training and information. This requires willingness and a culture of improving the quality and safety of care in this sector. Committed involvement of several stakeholders at different levels of decision-making in health care is needed.


Assuntos
Clínicos Gerais , Setor Privado , Estudos Transversais , Humanos , Higiene , Masculino , Tunísia/epidemiologia
4.
Pan Afr Med J ; 39: 55, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34422178

RESUMO

Atrial fibrillation (AF), the most common sustained arrhythmia, is one of the risk factors with the largest relative increase in attributed cardiovascular mortality in Africa. There are important knowledge gaps in the epidemiology of AF in Africa, along with inadequate service provision for cardiac arrhythmias including AF. This paper comments on the available data on the prevalence and correlates of obstructive sleep apnea (OSA) in patients with AF in Africa. Two studies from Tunisia revealed a high prevalence of OSA based on polysomnography (77% and 90%) among patients with AF. Patients with OSA were more likely to report snoring, were older and had longer AF duration compared to those without OSA. The implications of these findings are discussed. Furthermore, key points on the mechanisms underlying the association between AF and OSA, the impact of OSA on AF-related outcomes and the screening and management of OSA in patients with AF are highlighted.


Assuntos
Fibrilação Atrial/epidemiologia , Polissonografia , Apneia Obstrutiva do Sono/epidemiologia , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Ronco/epidemiologia , Fatores de Tempo , Tunísia/epidemiologia
5.
J Forensic Leg Med ; 82: 102232, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34385020

RESUMO

BACKGROUND: Considerable effort has been devoted to elucidating correlates of psychopathy in males, but only few researchers have turned their attention to this field in female counterparts, with most of the research in this field having been driven from western countries. We aimed to explore psychopathic traits, impulsiveness and psychiatric symptoms that characterize a Tunisian female prison population. METHOD: Data were collected in a cross-sectional design during September 2017. The sample was comprised of 100 adult females who were incarcerated at the "Manouba Women's Prison" at the time of the survey. The Levenson Self-Report Psychopathy Scale, the Barratt Impulsiveness Scale, and The Brief Symptom Inventory were used. RESULTS: In the univariate analysis, socioeconomic level (p = .001), tobacco use (p = .001), poly drug use (p = .014) and physically aggressive behaviors in the 6 months before incarceration (p = .043) were significantly associated with psychopathy total scores. After multivariable adjustment, motor impulsiveness (ß = 0.426, p < .01) and phobic anxiety (ß = 0.284, p < .05) contributed significantly to the variance of psychopathy total scores. CONCLUSION: The current findings not only add to the growing body of literature on female psychopathy, but also help inform decision making about mental health-related programs and policies in female prison settings in underdeveloped and underrepresented countries similar to our sociocultural context.


Assuntos
Prisioneiros/psicologia , Mulheres/psicologia , Adulto , Idoso , Agressão/psicologia , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Psicopatologia , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/psicologia , Tunísia/epidemiologia
6.
Artigo em Inglês | MEDLINE | ID: mdl-34387538

RESUMO

The present study objective was to assess polycyclic aromatic hydrocarbons in Bizerte and Ghar El Melh Lagoons Solea solea and to assess the potential risk to human health from its consumption. To reach these objectives twenty fish samples from each site were collected and 15 priority polycyclic aromatic hydrocarbons (PAHs) were analyzed in their muscles using high-performance liquid chromatography with a fluorescence detector. Total PAH sole concentrations from Bizerte and Ghar El Melh Lagoons were similar or lower to those recorded in other species from other regions across the world. In the studied fish species, the 2 and 3 ring PAHs are the dominated compounds that enter to the composition of PAHs which indicates that PAHs could be principally derived from a petrogenic origin for the both studied lagoons. The human health risk by sole consumption was evaluated and revealed to exhibit no hazard to the local population health concerning PAH intakes. The findings of this biomonitoring study will help in the implementation of sustainable environmental policies for effective water pollution control and the two investigated lagoons management.


Assuntos
Linguados , Hidrocarbonetos Policíclicos Aromáticos , Poluentes Químicos da Água , Animais , Bioacumulação , Monitoramento Ambiental , Humanos , Hidrocarbonetos Policíclicos Aromáticos/análise , Medição de Risco , Tunísia , Poluentes Químicos da Água/análise
7.
Artigo em Inglês | MEDLINE | ID: mdl-34444371

RESUMO

The multitude of national strategies used against the COVID-19 pandemic makes it necessary to review and synthesize them in order to identify potential gaps and shortcomings, and to help prioritize future control efforts. This systematic mapping review is aimed at identifying the coronavirus pandemic management strategies adopted by France, Tunisia, and Germany during the early stage of the COVID-19 outbreak. A set of government websites in addition to the PubMed and Google Scholar databases were searched to identify scientific articles and institutional documents related to the national strategies of the three countries up until July 2020. The references included were mapped and narratively synthesized based on the pillars of the Monitoring and Evaluation Framework of the Strategic Preparedness and Response Plan defined by the World Health Organization. Of the 2765 records screened, 65 documents were included in the study. The analysis of these documents showed that Germany was the first country to implement mass screening of cases and that France was the first country to implement measures to impose general containment at the national level. It also showed that Tunisia was the only country to have imposed the confinement of passengers on repatriation flights in dedicated containment centers and at the expense of the state.


Assuntos
COVID-19 , Pandemias , Surtos de Doenças , França/epidemiologia , Alemanha/epidemiologia , Humanos , SARS-CoV-2 , Tunísia/epidemiologia
8.
BMC Genomics ; 22(1): 540, 2021 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-34261445

RESUMO

BACKGROUND: In Tunisia a first SARS-CoV-2 confirmed case was reported in March 03, 2020. Since then, an increase of cases number was observed from either imported or local cases. The aim of this preliminary study was to better understand the molecular epidemiology and genetic variability of SARS-CoV-2 viruses circulating in Tunisia and worldwide. METHODS: Whole genome sequencing was performed using NGS approach on six SARS. CoV-2 highly positive samples detected during the early phase of the outbreak. RESULTS: Full genomes sequences of six Tunisian SARS-CoV-2 strains were obtained from imported and locally transmission cases during the COVID-19 outbreak. Reported sequences were non-identical with 0.1% nucleotide divergence rate and clustered into 6 different clades with worldwide sequences. SNPs results favor the distribution of the reported Tunisian sequences into 3 major genotypes. These SNP mutations are critical for diagnosis and vaccine development. CONCLUSIONS: These results indicate multiple introductions of the virus in Tunisia and add new genomic data on SARS-CoV-2 at the international level.


Assuntos
COVID-19 , SARS-CoV-2 , Genoma Viral , Humanos , Pandemias , Filogenia , Tunísia/epidemiologia , Sequenciamento Completo do Genoma
9.
Molecules ; 26(11)2021 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-34200152

RESUMO

Lupin seeds can represent a valuable source of phenolics and other antioxidant compounds. In this work, a comprehensive analysis of the phytochemical profile was performed on seeds from three Lupinus species, including one cultivar (Lupinus albus) and two wild accessions (Lupinus cossentinii and Lupinus luteus), collected from the northern region of Tunisia. Untargeted metabolomic profiling allowed to identify 249 compounds, with a great abundance of phenolics and alkaloids. In this regard, the species L. cossentinii showed the highest phenolic content, being 6.54 mg/g DW, followed by L. luteus (1.60 mg/g DW) and L. albus (1.14 mg/g DW). The in vitro antioxidant capacity measured by the ABTS assay on seed extracts ranged from 4.67 to 17.58 mg trolox equivalents (TE)/g, recording the highest values for L. albus and the lowest for L. luteus. The DPPH radical scavenging activity ranged from 0.39 to 3.50 mg TE/g. FRAP values varied between 4.11 and 5.75 mg TE/g. CUPRAC values for lupin seeds ranged from 7.20 to 8.95 mg TE/g, recording the highest for L. cossentinii. The results of phosphomolybdenum assay and metal chelation showed similarity between the three species of Lupinus. The acetylcholinesterase (AChE) inhibition activity was detected in each methanolic extract analyzed with similar results. Regarding the butyrylcholinesterase (BChE) enzyme, it was weakly inhibited by the Lupinus extracts; in particular, the highest activity values were recorded for L. albus (1.74 mg GALAE/g). Overall, our results showed that L. cossentinii was the most abundant source of polyphenols, consisting mainly in tyrosol equivalents (5.82 mg/g DW). Finally, significant correlations were outlined between the phenolic compounds and the in vitro biological activity measured, particularly when considering flavones, phenolic acids and lower-molecular-weight phenolics.


Assuntos
Antioxidantes/química , Lupinus/química , Compostos Fitoquímicos/química , Sementes/química , Alcaloides/química , Alcaloides/metabolismo , Antioxidantes/metabolismo , Lupinus/metabolismo , Metabolômica/métodos , Fenóis/química , Fenóis/metabolismo , Compostos Fitoquímicos/metabolismo , Extratos Vegetais/química , Extratos Vegetais/metabolismo , Sementes/metabolismo , Tunísia
10.
Epilepsy Behav ; 122: 108151, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34217034

RESUMO

INTRODUCTION: Epilepsy is one of the most stigmatizing disorders. Stigma and negative attitudes associated with epilepsy are due to poor public awareness and knowledge. This study evaluated knowledge, awareness, and attitude toward epilepsy among Tunisian general population. METHODS: This was a cross-sectional study conducted between 2017 and 2019. On national epilepsy day on February and during awareness campaigns at Sfax Tunisia, we asked people who visited the epilepsy stand to anonymously answer a 31-item questionnaire on epilepsy. RESULTS: Five hundred and four participants have been included. About 43.6% of participants had personal or familial history of epilepsy. More than seventy percent of subjects thought that epilepsy is a neurological disease and 34.1% believed it is psychiatric. Majority (92.1%) of our population believed that epilepsy is non-contagious but 37.7% thought it is hereditary and 55.8% thought it causes intellectual deficiency. EEG was the most reported diagnostic method (61.7%). The two most popular therapeutic modalities reported in our population were drug treatment alone (85.3%) and associated with Quran (35.3%). Most (91.1%) of people thought that a person with epilepsy can get married. A person with epilepsy is able to study according to 92.7% of respondents, but 66.3% assumed that he/she suffers from difficulty concentrating. Subjects younger than 45 years were more aware of the ability of people with epilepsy to study and get married. We did not find any significant differences in knowledge and attitudes between subjects familiar with epilepsy and the rest of the population. CONCLUSION: The public knowledge and attitudes toward epilepsy were acceptable with regard to this study. However, negative attitudes and misunderstanding still exist.


Assuntos
Epilepsia , Conhecimentos, Atitudes e Prática em Saúde , Estudos Transversais , Epilepsia/epidemiologia , Feminino , Humanos , Masculino , Estigma Social , Inquéritos e Questionários , Tunísia/epidemiologia
11.
JCO Glob Oncol ; 7: 802-810, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34077269

RESUMO

PURPOSE: Cancer occurrence is increasing in Africa, although research has lagged. The objective of this review was to analyze cancer research outputs from Africa, with a particular focus on Zambia. METHODS: We searched PubMed for published cancer-related articles from African countries. All articles reporting on cancer in Africa were considered. We conducted analyses to explore correlations between cancer research output and total population, gross domestic product, and new cancer cases recorded in 2020. For Zambia articles, we also analyzed cancer types and time trends. RESULTS: A total of 48,487 cancer-related publications from Africa were identified, with nearly half coming from Egypt (13,372; 28%) and South Africa (9,393; 19%). Cancer research output correlated significantly with country population (Spearman's correlation coefficient 0.74; P < .001) and the number of new cancer cases recorded in 2020 (Spearman's correlation coefficient 0.77; P < .001). Standardized by population size, Western Sahara (0.576), Seychelles (0.244), Tunisia (0.239), South Africa (0.158), and Egypt (0.131) had the highest overall output per 1,000 population. A total of 244 publications were from Zambia; the most studied cancers were cervical (25%), Kaposi sarcoma (24%), and breast (10%). Although an increase in cancer research output from Zambia was noted, only 33% of publications were first or last authored by Zambians. The major limitation of this review is that the evaluation was based on a single electronic database, PubMed. CONCLUSION: Cancer research output from Africa is very low, with many of the publications concentrated in a few countries. There is an urgent need to invest in both human resources and infrastructure to increase cancer research output from African countries, particularly in less populous countries.


Assuntos
Neoplasias , Egito , Humanos , Neoplasias/epidemiologia , Seicheles , África do Sul , Tunísia , Zâmbia/epidemiologia
12.
Emerg Infect Dis ; 27(7): 1964-1968, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34152977

RESUMO

Free-roaming camels, especially those crossing national borders, pose a high risk for spreading Middle East respiratory syndrome coronavirus (MERS-CoV). To prevent outbreaks, active surveillance is necessary. We found that a high percentage of dromedaries in Tunisia are MERS-CoV seropositive (80.4%) or actively infected (19.8%), indicating extensive MERS-CoV circulation in Northern Africa.


Assuntos
Infecções por Coronavirus , Coronavírus da Síndrome Respiratória do Oriente Médio , Animais , Camelus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/veterinária , Prevalência , Tunísia/epidemiologia , Zoonoses
13.
Pan Afr Med J ; 38: 300, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34178219

RESUMO

Introduction: interventional cardiology procedures have become complex and expensive in time with a higher risk of exposure to ionizing radiations. The purpose of our study was to assess radiation protection knowledge and practices among Tunisian cardiologists exposed to X-rays. Methods: we conducted a descriptive, analytical study in October 2019. An anonymous survey on the knowledge and practices regarding radiation protection was sent to all Tunisian cardiologists exposed to X-rays. Results: among 126 cardiologists exposed to X-rays and having received the survey, 58 physicians responded to the survey (48%), with a male predominance (72%, n=42). Thirty-eight physicians (65%) were public sector workers. Average years of working experience were 12.02 years (SD 6.88 years). Half of doctors had a knowledge score of less than 50%. The average practice score was 43.83 (SD 13.95%). Wearing a lead apron, thyroid shield, dosimeter, lead glasses, lead cap accounted for 100% (n=58), 86.2% (n=50), 30.7% (n=18), 12.1% (n=7) and 1.7% (n=1) respectively. There was no correlation between scores and doctor's age as well as the length of working experience. There was no statistical differences between knowledge scores of males and females (p=0.06) or between public sector and private sector (p=0.9). Practice score was significantly higher among men (0.007) and interventional cardiologists compared to rhythmologists and pediatric cardiologists (p<0.001). Conclusion: the level of knowledge and practices among Tunisian cardiologists regarding radiation protection is generally insufficient. Then, health authorities should implement regular training programs.


Assuntos
Cardiologistas/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Exposição Ocupacional/prevenção & controle , Proteção Radiológica/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Equipamento de Proteção Individual/estatística & dados numéricos , Fatores Sexuais , Inquéritos e Questionários , Tunísia
14.
Parasitol Res ; 120(7): 2479-2491, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34125301

RESUMO

Chloromyxum squali Gleeson and Adlard, 2012 originally described from Squalus acanthias Linnaeus, 1758 is reported for the first time from the gallbladder of Squalus blainville (Risso, 1827) caught from the eastern coast of Tunisia. In the present study, this chloromyxid was described based on morphological and ultrastructural features combined with molecular analysis of 18S rDNA. Young plasmodia were found attached to the gallbladder, while mature plasmodia and myxospores were observed floating free in the bile. Mature plasmodia were polysporic, subspherical in shape, measured 97.8 ± 0.5 µm long and 63.4 ± 0.4 µm wide. Mature myxospores were ovoid with a pointed anterior end, measuring 10.2 ± 0.5 µm long and 8.3 ± 0.5 µm wide. Two asymmetrical shell valves adhered together along an S-shaped suture line. Each valve has 5-7 elevated surface ridges parallel to suture line. A bundle of long caudal filaments extended from the basal end of shell valves. Four pyriform polar capsules equal in size, measuring 3.1 ± 0.4 µm long and 2.5 ± 0.3 µm wide, were situated at the same level in the anterior pole of the myxospore, each with a polar filament coiled in 7-8 turns. Pairwise comparisons among the SSU rDNA sequences revealed significant similarity between Chloromyxum squali infecting S. acanthias with the sequence obtained in this study. Phylogenetic analysis revealed that C. squali clustered in the clade of Chloromyxum species infecting the gallbladder of marine Chondrichthyes. Chloromyxum squali showed a seasonal variation of prevalence with significantly higher prevalence noted in summer and in autumn and absence of infection in winter.


Assuntos
Myxozoa/classificação , Filogenia , Squalus/parasitologia , Animais , Bile/parasitologia , Doenças dos Peixes/parasitologia , Vesícula Biliar/parasitologia , Mar Mediterrâneo , Myxozoa/ultraestrutura , Doenças Parasitárias em Animais , RNA Ribossômico 18S/genética , Especificidade da Espécie , Tunísia
15.
Sci Total Environ ; 791: 148268, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34139493

RESUMO

This is the first study on the behavior and industrial fluxes of rare earth elements (REE) in the coastal fertilizer plants of Gabes (south-eastern Tunisia), the economic losses related to their wastes, and their environmental and human health hazards. The concentrations of 16 REE were assessed in phosphate rock (PR), phosphogypsum (PG) and phosphogypsum foam (PGF) samples, collected from Gabes plants. REE concentrations ranged from 0.23 (for Sc in PG) to 309.33 mg kg-1 (for Ce in PGF). Ce was the most abundant in the three matrices, with concentrations ranging between 80.40 (in PG) and 309.33 mg kg-1 (in PGF). PGF was the most enriched with REE (1075.32 mg kg-1). The annual flow of REE from the fertilizer factories to the marine environment may reach 1523.67 t. The economic losses related to the discharge of phosphogypsum REE in the Gulf of Gabes (GG) was estimated at ~58 million US$ y-1. The potential hazards of discharged REE on the local environment and human health were also evaluated and discussed. These findings show the need for the development of a new industry exploiting REE from phosphogypsum wastes (short term) and phosphate ores (long term) which should lead to reduce its high environmental and human health footprint and to potential economic gains.


Assuntos
Fertilizantes , Metais Terras Raras , Monitoramento Ambiental , Fertilizantes/análise , Humanos , Mar Mediterrâneo , Metais Terras Raras/análise , Fosfatos/análise , Tunísia
16.
Mar Pollut Bull ; 170: 112608, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34153854

RESUMO

To evaluate the trace metals contamination status in the Gulf of Tunis, forty one sediment samples were analyzed using different approaches. According to certain contamination and ecological risk indices (Contamination Factor, Geoaccumulation index and Ecological risk index), Hg has the highest contamination level while pollution by Ni, Pb, Cd and Cr was absent. The highest concentrations of trace metals were found in sediments collected from the offshore and coastal areas located opposite the main exchange points with the gulf particularly, the Mejerda and Meliane Rivers, the Khalij Channel, Ghar El Melh and El Malah lagoons, Tunis Lake and Sebkhat Ariana. However, further ecological indices (Potential ecological risk index, Toxic unit and Mean effect-range median quotient) and comparison with sediment quality guidelines suggest that in addition to Mercury, Cr, Pb and Ni concentrations are detrimental to biota in both the offshore and areas near to the exchange points with the gulf. Moreover, in these areas the results from sequential extraction and individual contamination factor calculation pointed to the mobility and bioavailability of Cr, Pb and Ni.


Assuntos
Metais Pesados , Poluentes Químicos da Água , China , Monitoramento Ambiental , Sedimentos Geológicos , Metais Pesados/análise , Medição de Risco , Tunísia , Poluentes Químicos da Água/análise
17.
Artigo em Inglês | MEDLINE | ID: mdl-34065252

RESUMO

The protective role of high high-density lipoprotein cholesterol (HDL-C) against cardiovascular risk has been questioned recently. Due to the increasing trend of cardiovascular diseases (CVD) in Tunisia, this study aimed to determine the prevalence of high HDL-C and its associated factors in Tunisian women of childbearing age. A cross-sectional survey was conducted among a subsample of 1689 women, aged 20 to 49 years, in the Great Tunis region. Data on socio-demographic and lifestyle factors were collected by a questionnaire. Overall adiposity was assessed by body mass index (BMI). All biological variables were assayed in blood samples coated with anticoagulant ethylene diamine tetra acetic acid (EDTA) by enzymatic methods. Stata software (2015) was used for data management and statistical analysis. High HDL-C values were recorded in 26.6% of selected women. After adjustment for all socio-demographic and lifestyle factors, age, hypertension, and smoking were negatively associated with high HDL-C levels, while family history of cancer was positively associated with high HDL-C in women. An additional investigation on the relationship between high HDL-C and cancer risk should be performed due to controversial results.


Assuntos
Doenças Cardiovasculares , HDL-Colesterol/sangue , Hiperlipidemias/epidemiologia , Adulto , Índice de Massa Corporal , Doenças Cardiovasculares/epidemiologia , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Tunísia/epidemiologia , Adulto Jovem
18.
J Water Health ; 19(3): 499-511, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34152302

RESUMO

Hospital effluent (HE) is one of the most important sources of pharmaceuticals released into the environment. This kind of pollution is a recognized problem for both human health and aquatic life. Consequently, in the present study, we assessed the effects of untreated hospital effluent on mice via biochemical and histopathological determinations. Female mice were given free access to water bottles containing untreated HE at different dilutions for 21 days. Then clinical biochemistry and histopathology evaluation were conducted. Serum biochemistry analysis showed the presence of significant increase in cholesterol, triglycerides, glycaemia and total bilirubin. However, phosphatase alkaline and urea activities have been significantly decreased compared to the control group. No significant variation was observed for the rest of the studied parameters (high-density lipoproteins; low-density lipoproteins and uric acid). Additionally, multiple alterations, including cellular necrosis, leucocyte infiltration and congestion, were observed in different tissues of mice exposed to the tested HE.


Assuntos
Hospitais , Animais , Feminino , Camundongos , Tunísia
19.
Artigo em Inglês | MEDLINE | ID: mdl-34068387

RESUMO

Total mercury (Hg) was determined in 450 environmental samples (seawater, sediment plant and fish) from five Mahdia coastal areas (Tunisia). Tolerable Weekly Intake% (TWI) values, according to the European Food Safety Authority (EFSA), were calculated based on the average metal concentration in fish and the average weekly fish consumption rate. Hg was accumulated mainly in fish and in Posidonia oceanica leaves. Hg in sediment ranged from 1.88 µg/kg dry weight (d.w.) to 7.48 µg/kg d.w., while it was between 0.32 µg/kg and 0.19 µg/kg in seawaters. Our study showed high concentration in Posidonia oceanica in S3 (plant = 16.76 ± 4.48 µg/kg d.w.) as compared to those in S4 sites (plant = 5.33 ± 0.05 µg/kg d.w.). Concentrations for S. aurata and S. salpa in the Rejiche area exceeded the EC 1881/2006 legislation with values of 1.9 mg/kg and 2.5 mg/kg, respectively, and consumers may be exposed to high concentrations of Hg that exceeds the EFSA. The results showed that the fish species should be constantly monitored due to their TWI% of 154.5% for S. aurata and 209.8% S. salpa respectively.


Assuntos
Mercúrio , Poluentes Químicos da Água , Animais , Monitoramento Ambiental , Peixes , Mercúrio/análise , Tunísia , Poluentes Químicos da Água/análise
20.
Pan Afr Med J ; 38: 272, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34122699

RESUMO

Introduction: emergency obstetric care (EmOC) is a high-impact priority intervention strongly recommended for improving maternal health outcomes. The objectives of this study were to assess the availability, utilization, and quality of emergency obstetric care services in the Governorate of Sousse (Tunisia). Methods: a cross-sectional study was conducted among public health facilities which performed deliveries in Sousse in 2017. Data were collected by consulting clinical records and registers and interviewing staff using WHO EmOC tools. Emergency obstetric care (EmOC) indicators were calculated. Results: only the University maternity Unit functioned as full comprehensive EmOC facility. No other public facility provided all the 7 Basic EmOC signal functions 3 months prior to the survey. The unperformed signal functions were: administration of parenteral antibiotics, manual removal of placenta and assisted vaginal delivery. The number of EmOC facilities was 0.72 per 500,000 inhabitants. The met need for EmOC was 89.5%. The proportion of caesarean section was 24.2%. The direct obstetric case fatality rate was 0.159% and intrapartum and very early neonatal death rate was 0.65%. Conclusion: raising maternity facilities to a minimum level of basic EmOC status would be a major contributing step towards maternal mortality reduction.


Assuntos
Serviços Médicos de Emergência/organização & administração , Serviços de Saúde Materna/organização & administração , Obstetrícia/organização & administração , Qualidade da Assistência à Saúde , Cesárea/estatística & dados numéricos , Estudos Transversais , Parto Obstétrico/estatística & dados numéricos , Serviços Médicos de Emergência/normas , Feminino , Instalações de Saúde/normas , Instalações de Saúde/estatística & dados numéricos , Humanos , Recém-Nascido , Serviços de Saúde Materna/normas , Mortalidade Materna , Obstetrícia/normas , Morte Perinatal , Gravidez , Tunísia
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