Psychological and Psychosocial Consequences of Zoonotic Cutaneous Leishmaniasis among Women in Tunisia: Preliminary Findings from an Exploratory Study

Background The incidence of zoonotic cutaneous leishmaniasis (ZCL) makes it the most widespread parasitic disease in Tunisia and the Arab world. Yet, few studies have addressed its psychological and psychosocial effects. The purpose of this study was to examine the psychosocial impact of ZCL scars among Tunisian women. Methods We conducted an exploratory study, we administered Revised Illness Perception Questionnaire (IPQ-R), World Health Organization Quality Of Life-26 (WHOQOL-26) and Psoriasis Life Stress Inventory (PLSI) to a group of girls and women with ZCL scar in the region of Sidi Bouzid. This group was randomly selected from volunteers who came to primary health care facilities to seek for treatment for any pathology. Results Descriptive statistics showed that the collected scores from the three scales exhibit heterogeneous distributions: IPQ-R (M = 63.6, SD = 15.6), PSLI (M = 9.5, SD = 6.7), WHOQOL-Physical (M = 63, SD = 12.9), WHOQOL-Psychological (M = 52.6, SD = 11.1), WHOQOL-Social (M = 61.8, SD = 17.5), and WHOQOL-Environmental (M = 47.8, SD = 13.3). The correlation analyses performed on Inter and intra-subscales showed that the emotional representations associated with ZCL were correlated with the loss of self-esteem and feelings of inferiority (r = 0.77, p<0.05). In addition, high education level and the knowledge about ZCL are positively correlated with cognitive and emotional representation in the IPQ-R (r = 0.33, p<0.05). "Rejection experiences" and the "anticipation and avoidance of stress" were respectively negatively correlated with age (r = -0.33, p<0.05 and r = -0.31, p<0.05). Correlations between the scores on IPQ-R domains and PLSI factors were significant. The results showed that anticipation of rejection and avoidance of stress are strongly correlated with a negative perception of ZCL. Quality of life scores were not correlated with either age, education level, time of illness, or the number of facial or body scars. However, the correlations between quality of life scores and the multiple IPQ-R domains were all insignificant. Finally, there was a negative correlation between the scores on the perceived quality of social life and the knowledge about ZCL (r = -0.34, p<0.05). Conclusions This makes it vital to strengthen preventive health education. Conducting studies on ways to establish a holistic support system for managing ZCL, a system that covers the psychological challenges and the barriers it causes to women’s social and professional integration, is a vital first step

Su(3) Symmetry in a Bootstrap Model

Transmission of zoonotic cutaneous leishmaniasis (ZCL) depends on the presence, density and distribution of Leishmania major rodent reservoir and the development of these rodents is known to have a significant dependence on environmental and climate factors. ZCL in Tunisia is one of the most common forms of leishmaniasis. The aim of this paper was to build a regression model of ZCL cases to identify the relationship between ZCL occurrence and possible risk factors, and to develop a predicting model for ZCL's control and prevention purposes. Monthly reported ZCL cases, environmental and bioclimatic data were collected over 6 years (2009-2015). Three rural areas in the governorate of Sidi Bouzid were selected as the study area. Cross-correlation analysis was used to identify the relevant lagged effects of possible risk factors, associated with ZCL cases. Non-parametric modeling techniques known as generalized additive model (GAM) and generalized additive mixed models (GAMM) were applied in this work. These techniques have the ability to approximate the relationship between the predictors (inputs) and the response variable (output), and express the relationship mathematically. The goodness-of-fit of the constructed model was determined by Generalized cross-validation (GCV) score and residual test. There were a total of 1019 notified ZCL cases from July 2009 to June 2015. The results showed seasonal distribution of reported ZCL cases from August to January. The model highlighted that rodent density, average temperature, cumulative rainfall and average relative humidity, with different time lags, all play role in sustaining and increasing the ZCL incidence. The GAMM model could be applied to predict the occurrence of ZCL in central Tunisia and could help for the establishment of an early warning system to control and prevent ZCL in central Tunisia

Allergic respiratory illness and environment of schoolchildren in Tunisia

info:eu-repo/semantics/publishe

[Evaluation of the surveillance of invasive meningococcal disease in Tunisia: capture-recapture method].

International audienceThe objective of this study was to assess the completeness of the epidemiological surveillance system for invasive meningococcal diseases in greater Tunis.A six-year retrospective study (2003-2008) identified all cases of invasive meningococcal disease reported on Mandatory Notification records of the Tunis Regional Department of Health and those reported by the Tunis Children's hospital microbiology laboratory, considered to be the main source of diagnoses of invasive meningococcal disease in Greater Tunis. The "capture-recapture" method was applied. Thirty-eight cases of invasive meningococcal disease reported to the Regional Department of Health and 47 cases provided by the children's hospital were analysed during the study period and 25 cases common to both sources were identified. The total number of cases of invasive meningococcal disease was estimated to be 71 (95% CI = [60-82]), using the capture-recapture method. Completeness rates were 53.5% (95% CI = [46.6 to 62.9]) for Mandatory Notification to the Regional Department of Health and 66.2% (95% CI = [57.6 to 77.8]) for children's hospital. Stratified analyses suggest that the two data sources were probably independent. The capture-recapture method applied to the invasive meningococcal disease surveillance system in Greater Tunis showed a poor sensitivity of the Mandatory Notification. Factors influencing under-reporting of cases should be identified to improve this surveillance

Impact of Music Therapy on Quality of Life in Children with Cancer

Background: Music therapy (MT) is a non-pharmacological treatment increasingly used to reduce stress and anxiety in hospitalized children affected by cancers. The aim of this study was to evaluate the impact of MT on quality of life in children with cancer and determine its effect on cardiorespiratory rates. Methods: We conducted a quasi-experimental study between 1 April and 31 August 2021 at Bechir Hamza children’s Hospital in Tunis, including children treated for cancer. The child or parent completed the PedsQL Module Cancer French version 3.0 questionnaires before and after four weekly music therapy sessions. The child’s respiratory and heart rates were measured before and after each session. Results: We included 20 children whose mean age was 7 ± 4.5 years. The median value of the total questionnaire score increased from 57 [46; 70] to 72 [67; 85] (p −3) noting a significant reduction in pain (p = 0.02), nausea (p = 0.009), and anxiety related to medical procedures (p = 0.009) and worry about the future (p = 0.005). We highlighted a significant decrease in respiratory and heart rate after MT (p < 0.05). Conclusions: MT has positive impact on quality of life in children with cancer and reduces stress by lowering their cardiorespiratory rates

EMERGENCY SURGERY FOR OBSTRUCTING COLON CANCER: MORBIDITY AND RISK FACTORS OF EARLY POSTOPERATIVE MORTALITY – A COHORT STUDY OF 118 CASES

ABSTRACT BACKGROUND: Occlusion is the most common complication of colon cancer. Surgical treatment is associated with the highest morbidity and mortality rate (10–27%) and has the worst prognosis. It is necessary for immediate management, avoiding colic perforation and peritonitis. The increase in mortality in emergency colon cancer surgery is multifactorial. AIMS: The aim of this study was to identify the risk factors for early postoperative mortality that highlights the therapeutic strategy in the management of obstructive colon cancer. METHODS: A retrospective study was performed on patients admitted from 2008 to 2020 at the Department of General Surgery due to obstructive colon cancer and operated on as an emergency (within 24 h of admission). RESULTS: In all, 118 patients with colon cancer were operated, and the early postoperative mortality was 10.2%. The univariate analysis highlighted that the American Society of Anesthesiology score III or IV, perforation tumor, one postoperative complication, and two simultaneous postoperative complications were considered significant risk factors for early postoperative mortality after emergent surgery. Multivariate analysis showed that only tumor perforation and the occurrence of two postoperative complications were significant risk factors. CONCLUSION: This study showed that postoperative complication is the leading cause of early postoperative mortality after emergency surgery for obstructive colon cancer. Optimizing the postoperative management of these higher risk patients is still necessary and may reduce the mortality rate

Comparison of residuals vs. fitted values from different GAM(M) models.

<p>Comparison of residuals vs. fitted values from different GAM(M) models.</p

Predictive trend line from the final GAM with 95% predictive interval using data from July 2014 to June 2015.

<p>Predictive trend line from the final GAM with 95% predictive interval using data from July 2014 to June 2015.</p

Spatial distribution of dwellings included in the study.

<p>(A) Location of Tunisia within the Mediterranean basin. (B) Location of Sidi Bouzid governorate within Tunisia. (C) Location of the study areas.</p