IntroductionDespite its well-known acute and long-term harmful effects on a person’s mental health and well-being, alcohol remains the most commonly used psychoactive substance among adolescents after tobacco products in many... more
IntroductionDespite its well-known acute and long-term harmful effects on a person’s mental health and well-being, alcohol remains the most commonly used psychoactive substance among adolescents after tobacco products in many countries.ObjectivesWe aimed at studying the prevalence of alcohol use, and identify associated factors in Tunisian high school adolescents.MethodsWe used national data from the 2021-Mediterranean School Survey Project on Alcohol and Other Drugs (MedSPAD). Based on a clustered two-stage stratification sampling method, a representative sample of teenagers aged 16 to 18 years, was selected. Data collection was performed using a self-administered standardized questionnaire, assessing socio-demographic characteristics and risky behaviours, and including questions about alcoholic beverages patterns of use. Binary logistic regression model was used to assess associated factors and adjusted Odds Ratios (AORs) were presented with 95% confidence intervals (CI). Cspro so...
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IntroductionTobacco use among youth is a real public health concern in most developing countries. To provide recent epidemiological data regarding tobacco use among this specific population, a national survey was conducted in Tunisia in... more
IntroductionTobacco use among youth is a real public health concern in most developing countries. To provide recent epidemiological data regarding tobacco use among this specific population, a national survey was conducted in Tunisia in 2021. We aimed to determine cigarette smoking prevalence in Tunisian adolescents and assess associated factors.ObjectivesWe aimed to determine cigarette smoking prevalence in Tunisian adolescents and assess associated factors.MethodsData from the Mediterranean school survey on alcohol and other drugs (MedSPAD 2021) were used. Based on three-stage stratification sampling method, first and second grade high school students were enrolled. A self-administered standardized questionnaire was used and weighted prevalence estimates for cigarette smoking “at least once in a lifetime” were studied. Binary logistic regression model was used to assess associated factors and Adjusted Odds Ratios (AORs) were presented. The independent factors included were: sex, a...
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IntroductionNon-Medical Use of Anxiolytics (NMUA) and sedatives is a focus of scientific interest worldwide. In Tunisia, no national epidemiological data related to this issue, are published.ObjectivesWe aimed to determine the prevalence... more
IntroductionNon-Medical Use of Anxiolytics (NMUA) and sedatives is a focus of scientific interest worldwide. In Tunisia, no national epidemiological data related to this issue, are published.ObjectivesWe aimed to determine the prevalence of NMUA in Tunisian adolescents and assess specificities from a gender scope.MethodsData from the 2021-Mediterranean school Survey on Alcohol and other Drugs (MedSPAD) were used. Based on random sampling method (three-stage stratification), high school teenagers in first and second year of secondary education, were enrolled. Data were collected using a self-administered standardized questionnaire assessing socio-demographic characteristics, and specific questions related to NMUA (among adolescents and close environment), perceived accessibility and initiation age. We studied weighted prevalence estimates of NMUA at least once in a lifetime, presented with 95% Confidence Interval (CI). Epi data software was used for data entry and statistical analysi...
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Aims: The present survey aims to assess the overall mood disorder prevalence and identify associated socio-demographic and clinical factors in a Tunisian community sample, with special attention to the COVID-19 pandemic. Background: Mood... more
Aims: The present survey aims to assess the overall mood disorder prevalence and identify associated socio-demographic and clinical factors in a Tunisian community sample, with special attention to the COVID-19 pandemic. Background: Mood disorders are one of the leading causes of all non-fatal burdens of disease, with depression being at the top of the list. The COVID-19 pandemic may have increased the prevalence of mood disorders, especially in Low and Middle-income countries (LMICs) and in vulnerable populations. Objective: 1/ Assess point and lifetime prevalence of depressive and bipolar disorders as well as subthreshold bipolarity in a representative population sample of La Manouba governorate and assess treatment patterns for these disorders; 2/Study socio-demographic and clinical correlates of mood disorders 3/ Assess the association between mood disorders and quality of life 4/ Study the impact of the COVID-pandemic on the prevalence of mood disorders 5/ Assess coping mechani...
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Background Cannabis is the most widely used illicit psychoactive substance worldwide. In Tunisia, the prevalence of cannabis use and its association with other risky behaviours were reported in several publications interesting mainly... more
Background Cannabis is the most widely used illicit psychoactive substance worldwide. In Tunisia, the prevalence of cannabis use and its association with other risky behaviours were reported in several publications interesting mainly early adolescence. However, no publications exploring trends based on national epidemiological data are available yet. Our purpose was to determine cannabis prevalence in Tunisian high school adolescents and assess significant trends from 2013 to 2021. Methods Pooled data from Mediterranean school surveys on alcohol and other drugs conducted in 2013, 2017, and 2021, were used. Based on three-stage stratification sampling method, first and second grade secondary education students were enrolled. Were not included students enrolled in vocational training centers and out-of-school adolescents. Self-administered standardized questionnaire was used in data collection. We studied weighted lifetime prevalence of cannabis use and chi square test for trend was u...
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Background Nonmedical use of prescription drugs such as sedatives and anxiolytics is a fast growing public health threat in several countries. In Tunisia, although several studies have investigated the prevalence of nonmedical use of... more
Background Nonmedical use of prescription drugs such as sedatives and anxiolytics is a fast growing public health threat in several countries. In Tunisia, although several studies have investigated the prevalence of nonmedical use of anxiolytics among school-age students, there is a gap in knowledge regarding trends in anxiolytics misuse. We aimed to determine the prevalence of nonmedical use of anxiolytics and examine trends between 2013 and 2021. Methods Pooled data from three Mediterranean school surveys on alcohol and other drugs (MedSPAD I-2013, MedSPAD II-2017, MedSPAD III-2021) were used. Based on three-stage stratification sampling method, teenagers in first and second grades of secondary education, were enrolled. Were not included students enrolled in vocational training centers and out-of-school adolescents. Data collection was performed using a self-administered standardized questionnaire. We studied weighted lifetime nonmedical use of prescription anxiolytics and perform...
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Background Tobacco use is a global health concern, with smoking initiation often beginning in adolescence. In Tunisia, published data assessing trends of tobacco consumption at the national level only concerns middle school students aged... more
Background Tobacco use is a global health concern, with smoking initiation often beginning in adolescence. In Tunisia, published data assessing trends of tobacco consumption at the national level only concerns middle school students aged 13 to 15 years. No data related to high school students are however published yet. We aimed to determine tobacco smoking prevalence in Tunisian adolescents and assess trends from 2013 to 2021. Methods Pooled data from three Mediterranean school surveyson alcohol and other drugs (MedSPAD surveys: 2013, 2017, and 2021) were used. Based on three-stage stratification sampling method, teenagers aged between 15 and 17 years, were enrolled. Were not included students enrolled in vocational training centers and out-of-school adolescents. Data collection was performed using a self-administered standardized questionnaire assessing socio-demographic characteristics and risky behaviours. We studied weighted prevalence estimates of cigarettes and water pipe (WP)...
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Background Mortality data represent a primary source of information for monitoring a population health status over years. In Tunisia, the national Information System on Causes of Death (ISCD) lacks completeness (average coverage rate of... more
Background Mortality data represent a primary source of information for monitoring a population health status over years. In Tunisia, the national Information System on Causes of Death (ISCD) lacks completeness (average coverage rate of 40%); however, in order to examine covid-19’s effect on mortality data, the ISCD was reinforced. We aimed to give an overview of leading causes of death in Tunisia for 2020. Methods Data were obtained from Medical Certificates of Cause Of Death (MCCOD) sent by municipalities to the National Institute of Health in accordance with the legislative framework. Causes of Death (CoD) coding process was performed based on the International Classification of Diseases, Tenth Revision (ICD-10). The underlying cause of death was identified based on IRIS software, and mortality statistics were presented based on the world health organization cause-of-death lists for tabulating mortality statistics. Data analysis was performed using SPSS software. Results A total ...
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Management, Demography, Global Health, Environmental Health, General Internal Medicine, and 15 moreMedicine, Prevention, Population, Hypertension, Blood Pressure, Diagnosis, Guidelines, Science Technology, Adults, Adherence, Elsevier, Middle Income, Systematic Analysis, Chronic NCDs research, and Medical and Health Sciences
From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in... more
From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory ...
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Background Diabetes management requires access to health care, patient awareness about hygiene and diet measures, and patient adherence to prescribed treatment. Health care renunciation (HCR) can make diabetes management really... more
Background Diabetes management requires access to health care, patient awareness about hygiene and diet measures, and patient adherence to prescribed treatment. Health care renunciation (HCR) can make diabetes management really challenging. We aimed to determine the prevalence of HCR in diabetic Tunisian patients and assess associated factors. Methods Data were obtained from the 2016 Tunisian Health Examination Survey, a household survey stratified at three degrees. For each household, two people aged 18 and over were randomly selected. Data were collected using: a household questionnaire and an individual questionnaire (risk behaviours and medical history). Diabetic patients were asked whether, they had renounced any health care service, the last time they needed to seek healthcare. Data analysis was performed with R software. Results A total of 880 diabetic patients were included in this survey, with a mean age of 61±12 years and a sex ratio M/F equal to 0.9. The prevalence of HCR...
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The identification of elevated blood pressure (BP) in children and adolescents relies on complex percentile tables. The present study compares the performance of 11 simplified methods for assessing elevated or high BP in children and... more
The identification of elevated blood pressure (BP) in children and adolescents relies on complex percentile tables. The present study compares the performance of 11 simplified methods for assessing elevated or high BP in children and adolescents using individual-level data from 7 countries. Data on BP were available for a total of 58 899 children and adolescents aged 6 to 17 years from 7 national surveys in China, India, Iran, Korea, Poland, Tunisia, and the United States. Performance of the simplified methods for screening elevated or high BP was assessed with receiver operating characteristic curve (area under the curve), sensitivity, specificity, positive predictive value, and negative predictive value. When pooling individual data from the 7 countries, all 11 simplified methods performed well in screening high BP, with high area under the curve values (0.84–0.98), high sensitivity (0.69–1.00), high specificity (0.87–1.00), and high negative predictive values (≥0.98). However, po...
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Demography, Adolescent, Medicine, Humans, Child, and 13 moreBlood Pressure, Female, Male, Clinical Sciences, Public health systems and services research, Internationality, Circulation, Body Weight, Body Height, Reference Values, Cross Sectional Studies, Cardiovascular medicine and haematology, and Percentile
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Demography, Epidemiology, Biostatistics, Environmental Health, Developing Countries, and 15 moreMedicine, Family history, Population, Humans, Diabetes mellitus, Female, Male, Cluster Analysis, Data Collection, Aged, Middle Aged, Adult, Cross Sectional Studies, Interviews as topic, and Impaired fasting glucose
To assess youth health behaviours and related quality of life in urban Tunisia, we conducted a cross-sectional survey of a representative sample of 699 secondary-school students. The overweight rate was 20.7%. Most of the sample had an... more
To assess youth health behaviours and related quality of life in urban Tunisia, we conducted a cross-sectional survey of a representative sample of 699 secondary-school students. The overweight rate was 20.7%. Most of the sample had an insufficient level of physical activity and were unfamiliar with the recommended frequency of moderate physical activity. Norm-based scores of psychological state were about average, slightly better for boys than girls. Girls perceived themselves to be more stressed than boys. Of all students, 35% declared having smoked a cigarette and 14% having drunk alcohol at least once in their lives. The main sources of health education were mass media (59%) and medical staff (36%).
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Health Behavior, Health Education, Life Style, Adolescent, Health behaviour, and 15 moreHumans, Female, Alcohol Drinking, Exercise, Health Status, Cross Section, Analysis of Variance, Alcool, Eastern Mediterranean, Health surveys, Chi Square Distribution, Cross Sectional Studies, Adolescent Behavior, attitude to health, and conditions de vie
BACKGROUND Health system reforms in many countries have shown that the delivery of integrated primary health care services according to family medicine is the most efficient approach to achieve universal health coverage. In Tunisia, the... more
BACKGROUND Health system reforms in many countries have shown that the delivery of integrated primary health care services according to family medicine is the most efficient approach to achieve universal health coverage. In Tunisia, the issue is therefore the capacity of our health system to integrate a care approach based on family practice. AIM To assess the preparedness to implement family medicine in our country Methodology: this is a qualitative study carried out over a period of 9 months during the year 2017.Based on a WHO protocol addressing the 13 pillars of family practice, our study explores health policy context, actors (using interviews with key informants at national, regional and local level) and health content. RESULTS Family practice model is a strategic priority in Tunisia. However, this political recognition suffers from a lack of operationalization, in relation with continuing medical training, registration of patients and families by doctors, referral system, min...
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La mesure des indicateurs de sante a l'echelle regionale est plus interessante que leur mesure a l'echelle nationale, elle permet d'etudier les disparites interregionales et leur tendance evolutive. Dans le but de savoir... more
La mesure des indicateurs de sante a l'echelle regionale est plus interessante que leur mesure a l'echelle nationale, elle permet d'etudier les disparites interregionales et leur tendance evolutive. Dans le but de savoir comment les disparites ont evolue dans le temps, nous avons etudie sept indicateurs, appartenant aux differentes categories de la classification de l'Organisation Mondiale de Sante, a partir des donnees des statistiques annuelles et des resultats des recensements decennaux. Les disparites inter-regionales ont ete evaluees par le rapport entre les valeurs regionales extremes. Ce travail a revele une tendance globale a la baisse des disparites inter-regionales pour les indicateurs que nous avons etudies. L'amelioration des indicateurs de ressources et de niveau socio-economique au cours du temps est associee a une amelioration des indicateurs d'etat de sante. L'etude des disparites inter-regionales permet de cibler les actions de sante dans...
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1. Insert 'was' between 'dietary intake' and 'assessed'(Methods section) Authors’ response: this has been added in the revised version. 2. Decreasing relationship OF WHAT with total fat ? (line 19) Authors’... more
1. Insert 'was' between 'dietary intake' and 'assessed'(Methods section) Authors’ response: this has been added in the revised version. 2. Decreasing relationship OF WHAT with total fat ? (line 19) Authors’ response: the decreasing relationship pertained also to the modern dietary pattern (traditional to modern gradient). The first part of the sentence (which is indeed quite long) assessed relationships with food groups, while the second part described the pattern from a nutrient perspective. This has been rewritten so as to make it clearer (cf line 19 & 20 in the revised version). 3. Last line: nutrients ASSOCIATED WITH LOWER RISK... Authors’ response: the purpose of the second sentence of the conclusion in the abstract was to underline one of the main points of the study i.e. that the traditional to modern diet pattern has contrasted characteristics from a nutritional and health outcomes point of view (that we tried to emphasized by the “but” in the middle ...
High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering... more
High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, an...
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Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with,... more
Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher. For this analysis, we pooled national, subnational, or community population-based studies that had measured blood pressure in adults aged 18 years and older. We used a Bayesian hierarchical model to estimate trends from 1975 to 2015 in mean systolic and mean diastolic blood pressure, and the prevalence of raised blood pressure for 200 countries. We calculated the contributions of changes in prevalence versus population growth and ageing to the increase in the number of adults with raised blood pressure. We pooled 1479 studies that had measured the blood pressures of 19·1 million adults. Global age-standardised mean syst...
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Global Health, Population Health, Public Health, Cardiovascular disease, Medicine, and 15 morePopulation, Humans, Internal Medicine, Hypertension, Environmental public health, Blood Pressure, Prevalence, Cardiovascular Diseases, Non Communicable Disease, Chronic kidney diseases, Bayes Theorem, Elsevier, Medicine and Health, Diastole, and Medical and Health Sciences
The control of arterial hypertension (HT) is an endlessly hoped objective but usually not reached. Several factors are determinants. The physician role is crucial in the HT prevention. In order to evaluate knowledge, attitudes and... more
The control of arterial hypertension (HT) is an endlessly hoped objective but usually not reached. Several factors are determinants. The physician role is crucial in the HT prevention. In order to evaluate knowledge, attitudes and behaviours of Tunisian physicians in HT management, we conducted a cross sectional study in 2002 using a self administered questionnaire addressed to physicians working in private and public sectors. 380 generalists participated to this study. 95.5% of them confirmed that HT constitutes a public health problem. 81.1% saw at least 4 patients with HT a week. 95% insisted on the importance of the primary prevention. 90% took care themselves patients. 71.5% confirmed the importance of a training and an entrainement for the measure of the blood pressure (BP). 3.7% made diagnosis after a single visit and 10.9% confirmed it only from described symptoms. 20.4% of the generalists chose the old classification as objective level of BP. Thiazidic Diuretics and beta bl...
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The aim of this work was to study the family, social and occupational repercussions of acute myocardial infarction. Our study concerns 70 patients less than 66 years old, working before their hospitalization and having been admitted for... more
The aim of this work was to study the family, social and occupational repercussions of acute myocardial infarction. Our study concerns 70 patients less than 66 years old, working before their hospitalization and having been admitted for acute myocardial infarction between January 1st, 1999 and December 31, 2000 in the Department of Cardiac Resuscitation of hospital La Rabta of Tunis. Data were collected from retrospective review of folders and answers to a questionnaire. There were 70 patients almost exclusively men (n=69). The mean age was 49.0 +/- 6.8 years. The mean follow-up was 27.2 +/- 7.7 months. After the infarction, the majority of patients modified their activities (75.7%) notably their leisure activities (37.1%) and their travels (25.7%). Myocardial infarction had a bring about a bother in current life to 50.0% of the patients, had an influence on emotional life of 41.4% and on sexual activities of 50.0% of the population. The direct repercussions of myocardial infarction...
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To assess the medical direct cost of acute myocardial infarction. Data are recorded through a prospective study in 7 wards of cardiology of the District of Tunis during one year: from November 2001 to October 2002. Cost of hospital stay,... more
To assess the medical direct cost of acute myocardial infarction. Data are recorded through a prospective study in 7 wards of cardiology of the District of Tunis during one year: from November 2001 to October 2002. Cost of hospital stay, biologic analyses, drugs, functional investigations and possible non surgical cardiologic intervention (IC) was calculated. 632 AMI cases are recorded, the death rate is 7.8%. The average of hospital stay was 13.3 days. 49.1% of patients benefited from thrombolytic therapy, 55.5% benefited from a coronary angiography and 16.1% of an act of IC. The mean of direct cost (CGM) was 2171 Tunisian Dinars and the median was 1731 DT, of whom room costs 31.7%, 22.5% acts of IC, 7.2% drugs, 26.2% functional investigations and 12.4% biological analyses. The mean cost of IC was 3030 +/- 401 DT. The methodology of our study remains original in our country and can be used to assess the other aspects of AMI as other diseases cost management.
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Hepatitis C virus (HCV) infection is thought to be chronic and the factors leading to viral clearance or persistence are poorly understood. This study was undertaken to investigate the possibility of a significant relationship between the... more
Hepatitis C virus (HCV) infection is thought to be chronic and the factors leading to viral clearance or persistence are poorly understood. This study was undertaken to investigate the possibility of a significant relationship between the spontaneous clearance or the persistence of hepatitis C virus (HCV) infection and cytokine and apoptosis gene polymorphisms in Tunisian patients on hemodialysis. Polymorphisms of the genes IL-1 (-889 IL-1alpha, -511 and +3954 IL-1beta, IL-1Ra), IL-18 (-137 and -607), IL-12 (-1188) and Apo1/Fas (-670) were determined by PCR-RFLP, PCR-SSP and PCR-VNTR in 100 healthy blood donors and 100 patients infected with HCV and undergoing hemodialysis. The patients were classified into two groups: G1 consisted of 76 active chronic hepatitis patients (positive for HCV RNA) and G2 consisted of 24 hemodialysed patients who spontaneously eliminated the virus (negative for HCV RNA). The frequency of genotype association [-137GC/-607CA] IL-18 was higher in G2 (41.7%) than in G1 (15.8%) (P=0.008; OR=0.26; 95% CI, 0.10-0.73). We also found a higher frequency of the AA genotype of the Apo1/Fas gene in G2 (41.6%) than in G1 (17.5%) (P=0.026; OR=3.49; 95% CI, 1.13-10.69). Adjustment for known covariate factors (age, gender and genotype) confirmed these univariate findings and revealed that the genotype association GC-CA of the (-137 and -607) IL-18 gene and the AA genotype of the Apo1/Fas gene were associated with the clearance of HCV (P=0.041 and 0.017, respectively). The two genotypes GC-CA of the (-137 and -607) IL-18 polymorphism and the AA genotype of the Apo1/Fas gene influence the outcome of HCV infection in Tunisian patients on hemodialysis.
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Acrodermatitis enteropathica is a rare autosomal recessive disease due to an abnormality in a zinc transporting molecule. We conducted a retrospective monocentric study on 29 Tunisian cases of Acrodermatitis enteropathica (AE) treated in... more
Acrodermatitis enteropathica is a rare autosomal recessive disease due to an abnormality in a zinc transporting molecule. We conducted a retrospective monocentric study on 29 Tunisian cases of Acrodermatitis enteropathica (AE) treated in our Department of Dermatology in Tunisia, between January 1981 and June 2008. The age of onset of disorders was between 15 d and 12 months (mean 6.86 ± 3.25 months). The delay of consultation ranged between 15 d and 8 months (mean of 2.8 ± 2.17 months) after onset. Onset of gastrointestinal and psychiatric signs depended significantly on consulting times. Plasma zinc levels ranged between 14 and 88 lg/100 ml (mean 44.86 ± 18.4 lg/100 ml). There was not a significant relation between zincemia and clinical features. Genetic analyses in 13 of our patients showed three different mutations in the SLC39A4 gene: c.1223_1227del (p.Trp411ArgfsX7) in exon 7,c.143T>G (p.Leu48X) in exon 1 and c.1784T>C (p.Gly595Val) in exon 11. No significant genotype-phenotype correlations could be established. Acrodermatitis enteropathica is a rare disease which diagnosis is easy. Its biological confirmation is made on a simple dosage of zincemia. However, the diagnosis is not always suggested, and is unfortunately made late. At present, there is a molecular test to detect SLC39A4 mutations.
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Objectives. This study aimed to evaluate the effect of menopausal status on the risk of metabolic syndrome (MetS) in Tunisian women.Methods. We analyzed a total of 2680 women aged between 35 and 70 years. Blood pressure, anthropometric... more
Objectives. This study aimed to evaluate the effect of menopausal status on the risk of metabolic syndrome (MetS) in Tunisian women.Methods. We analyzed a total of 2680 women aged between 35 and 70 years. Blood pressure, anthropometric indices, fasting glucose, and lipid profile were measured. The MetS was assessed by the modified NCEP-ATPIII definition.Results. The mean values of waist circumference, blood pressure, plasma lipids, and fasting glucose were significantly higher in postmenopausal than in premenopausal women, a difference that was no longer present when adjusting for age. Except for hypertriglyceridaemia, the frequency of central obesity, hyperglycemia, high blood pressure, and high total cholesterol was significantly higher in postmenopausal than in premenopausal women. After adjusting for age, the significance persisted only for hyperglycemia. The overall prevalence of MetS was 35.9%, higher in postmenopausal (45.7% versus 25.6%) than in premenopausal women. A binary...
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Nutrition and Dietetics, Food Science, Africa, Biotechnology, Environmental Health, and 15 moreDiet, Developing Countries, Food and Nutrition, Cardiovascular disease, Medicine, Animal Production, Inventory, Humans, Exercise, Food Frequency Questionnaire, Nutritional Status, Dietary Assessment, Food Sciences, Biochemistry and molecular biology, and Nutrition assessment
ObjectiveTo assess the nutritional status of Tunisian adolescents and associated factors.DesignA cross-sectional study based on a national stratified random cluster sample.Subjects and methodsIn all, 1295 boys and 1577 girls aged 15–19... more
ObjectiveTo assess the nutritional status of Tunisian adolescents and associated factors.DesignA cross-sectional study based on a national stratified random cluster sample.Subjects and methodsIn all, 1295 boys and 1577 girls aged 15–19 years, of whom 28·4 % had already left school. Socio-economic characteristics of the parents, anthropometric measurements, food behaviours and physical activity of the adolescents were recorded during home visits.ResultsPrevalence of underweight, overweight and obesity (WHO/National Center for Health Statistics reference) were, respectively, 8·1 %, 17·4 % and 4·1 % among boys and 1·3 %, 20·7 % and 4·4 % among girls; abdominal obesity was highly prevalent among both sexes. Prevalence of overweight differed by region (from 11·5 % to 22·2 %) and was higher in urbanv. rural areas for males (21·7 %v. 10·4 %) but not for females (21·7 %v. 19·2 %). These differences were partially mediated by socio-economic and lifestyle factors for males. For females, influ...
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Demography, Obesity, Anthropometry, Environmental Health, Life Style, and 15 moreAdolescent, Medicine, Health behaviour, Overweight, Humans, North Africa, Female, Male, Cluster Analysis, Nutritional Status, Food habits, Educational Status, Cross Sectional Studies, Environment, and Medical and Health Sciences
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Background The increase in the burden of chronic diseases linked to the nutrition transition and associated dietary and lifestyle changes is of growing concern in south and east Mediterranean countries and adolescents are at the forefront... more
Background The increase in the burden of chronic diseases linked to the nutrition transition and associated dietary and lifestyle changes is of growing concern in south and east Mediterranean countries and adolescents are at the forefront of these changes. This study assessed dietary intake and association with socio-economic factors and health outcomes among adolescents in Tunisia. Methods Cross-sectional survey (year 2005); 1019 subjects 15-19 y. from a clustered random sample. Dietary intake was assessed by a validated semi-quantitative frequency questionnaire (134 items) as was physical activity; the Diet Quality Index International measured diet quality; dietary patterns were derived by multiple correspondence analysis from intakes of 43 food groups. Body Mass Index (BMI) ≥85th and 95th percentile defined overweight and obesity. Waist Circumference (WC) assessed abdominal fat. High blood pressure was systolic (SBP) or diastolic blood pressure (DBP) ≥90th of the international re...
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Environmental Health, Adolescent, Clinical Nutrition, Blood Pressure, Chronic Disease, and 15 moreFemale, Cluster Analysis, Body Mass Index, Food habits, Cross Section, Dietary pattern, Dairy Products, Abdominal Fat, Cross sectional Study, Cross Sectional Studies, Diet Quality, Energy Intake, Health Outcome, Diastolic Blood Pressure, and Dietary intake
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This work, conducted in Tunisia, aimed to calculate the number of years of life lost due to premature death caused by cancer. The data were based on mortality statistics (2006) provided by the national surveillance system of causes of... more
This work, conducted in Tunisia, aimed to calculate the number of years of life lost due to premature death caused by cancer. The data were based on mortality statistics (2006) provided by the national surveillance system of causes of death and involved calculations proposed by the World Health Organization. A total of 105,205 deaths due to cancer were recorded, 61,550 for males and 43,655 for females. The cancers were mostly of the lung and upper respiratory-digestive tract for men and breast and cervix for women. These results should prompt the health care system to emphasize tobacco control, the promotion of healthy eating and physical activity, as well as screening for breast and cervical cancer.