School-based intervention to promote healthy nutrition in Sousse, Tunisia

Introduction: Obesity among children is a major risk factor for chronic diseases. School interventions programs can represent a mean to implement healthy nutrition attitudes at early ages. Our objective was to evaluate the effects of a school intervention program to promote healthy nutrition among adolescents, in terms of knowledge, behaviors and intention. Methods: Quasi experimental study among urban students in Sousse, Tunisia with 2 groups, intervention and control. The intervention group had an interactive program integrated with school courses that promoted healthy nutrition habits. Both groups had a pre post evaluation. Results: 2200 students aged from 12 to 16 participated to the pre post evaluation. In the intervention group, there were significant changes form pre to post test in knowledge, intentions, and behaviors. In the control group, almost no significant changes were observed. Conclusion: School intervention programs can represent an interesting approach to promote healthy nutrition habits among adolescent

Assessment of the validity of self-reported smoking status among schoolchildren in Sousse, Tunisia

Introduction: Tobacco use, which begins in adolescence and childhood and continues in later life, is the major avoidable risk for non-communicable diseases and death in the world. Self-reports have frequently been used to estimate smoking prevalence and health consequences. This study explores the validity of self-reports of smoking behavior among schoolchildren in Tunisia. Materials and methods: This study was conducted in March 2014 among a sample of 147 schoolchildren randomly selected. Data concerning the smoking habit were collected by a questionnaire designed for the purposes of this work. Then, exhaled CO, a biochemical marker of smoke exposure, was measured using piCO+ Smokerlyzer® breath CO monitor among participants. Sensitivity and specificity of self-reports were calculated. Results: The prevalence of reported smoking was 9.5% with 16.7% and 1.7% respectively among boys and girls. Their mean age was 14.5±1.28 years old. When considering 4 ppm as the cut-off level of breath CO, sensitivity and specificity of self-reports were 100% and 93.7%, respectively. But at a breath CO cut-off of 3 ppm, self-reporting was 62.5% sensitive and 93.5% specific. Conclusion: According to our findings, we suggest that self-reports can be considered as a good tool to be used with a reasonable confidence to assess the smoking status

Clustering of chronic disease risk factors with tobacco smoking habits among adults in the work place in Sousse, Tunisia

Introduction: The aim of our study was to explore the major non-communicable risk factors (unhealthy diet, sedentarily, alcohol consumption) of smokers and nonsmokers in workplaces. Methods: A cross-sectional study was derived from an initial assessment in workplaces which was part of a community-based intervention to prevent chronic disease risk factors conducted in 2009 in the region of Sousse, Tunisia. The surveyed subjects were employees in six factories spread across three delegations in the region. Overall, 1770 of 2250 employees participated in the assessment. In this study, the clustering of non-communicable diseases risk factors with smoking habits was made only for male employees including in this study 1099 among 2250. Data were collected at worksites by a questionnaire, via interview or self-report .The main items assessed socio-demographics characteristics, smoking status, eating habits, level of physical activity and alcohol use of the participants. Results: The percentage of male smokers was 54.0%(n=594). Their average age of daily smoking initiation was 19.22 (±4.24 years). The percentage of male smokers consuming 5 fruits and vegetables per day was significantly lower than nonsmokers (57.2% vs 63.5%, p=0.04). The proportion of male smokers consuming alcohol was about three times that of nonsmokers (16.5% vs 5.8%, p=0.001). The proportion of male employees who agree with anti-smoking laws in work places was higher for nonsmokers than for smokers. Conclusion: A strong association existed between smoking and risky lifestyles factors in the work place. Such findings are potentially useful in directing intervention efforts regarding smoking cessation in occupational settings.Pan African Medical Journal 2016; 2

Understanding and acting on the developmental origins of health and disease in Africa would improve health across generations.

Data from many high- and low- or middle-income countries have linked exposures during key developmental periods (in particular pregnancy and infancy) to later health and disease. Africa faces substantial challenges with persisting infectious disease and now burgeoning non-communicable disease.This paper opens the debate to the value of strengthening the developmental origins of health and disease (DOHaD) research focus in Africa to tackle critical public health challenges across the life-course. We argue that the application of DOHaD science in Africa to advance life-course prevention programmes can aid the achievement of the Sustainable Development Goals, and assist in improving health across generations. To increase DOHaD research and its application in Africa, we need to mobilise multisectoral partners, utilise existing data and expertise on the continent, and foster a new generation of young African scientists engrossed in DOHaD

Attitudes Toward Physical Activity According to Weight Status Among Schoolchildren in Sousse, Tunisia

Aim: To investigate differences in attitude toward physical activity in normal-weight, overweight, and obese adolescents. Materials and Methods: We conducted a cross-sectional survey carried out in 2009/2010. It concerned randomly selected schoolchildren of colleges of Sousse in seventh and ninth grade. The sample was composed of 4003 schoolchildren. A questionnaire was used to evaluate habits and perception of physical activity, and we took anthropometric measurements of height and weight. Results: Among schoolchildren who performed a recommended level of physical activity, there was no significant difference in perceptions according to weight status. However, among those who did not practice physical activity, obese participants had significantly less positive perception. Overweight and obesity significantly increase the risk of negative perception of physical activity practice among participants who do not do the recommended level of physical activity. However, this association becomes non significant among those who practice recommended level of physical activity. The same findings were observed after adjustment by age and sex. Conclusion: Negative attitudes among inactive children may favor the development of a vicious circle perpetuating physical inactivity among normal-weight and overweight children

Tobacco use: the most influential risk factor on cannabis use among middle schoolchildren in Sousse, Tunisia

Background Early adolescence is a critical period usually associated with substances experimentation. In Tunisia, some studies were carried out recently to evaluate tobacco and cannabis use in the colleges and high schools. However, few studies were led in the middle schools. While onset of substances use usually occur during early adolescence. Aims: To evaluate the prevalence of tobacco and cannabis use and to determine if there is an association between their use among the young adolescents of Sousse. Methods A cross-sectional study was conducted in the region of Sousse, Tunisia during the 2013/2014 school year among a proportional and stratified sample of 4272 schoolchildren randomly selected in 16 public middle schools from the region of Sousse. Data about sociodemographic characteristics, tobacco products and cannabis use among the schoolchildren, their parents, their siblings and their friends were collected using a self administrated questionnaire. Results Females represented 50.5% (2157) of participants. The mean age of schoolchildren was 13.3 ±1.2 years. Among participants, 12.9% (CI 95% : 11.9%-13.9%) reported lifetime tobacco use, 4.5% (CI 95% : 3.9%-5.1%) were current cigarette smokers, 3.2% (CI 95% : 2.7%-3.7%) were current water pipe users and 1.9% (CI 95% : 1.5%-2.3%) reported lifetime cannabis use. The age of tobacco use onset (11.2 ±2.7 years) was significantly inferior to the age of cannabis use onset (13.1±2 years) (p< 0.001). The most influential risk factor on cannabis use was current cigarette smoking with an adjusted odds ratio of 7.3 (CI 95% : 4.2-12.5). Conclusions National school-based substances use prevention program is required in Tunisia. Tobacco use prevention deserves more efforts as it is a gateway to other substances use such cannabis

© 2009 Academic Journals Full Length Research Paper Tracking of overweight among urban school children: A

Our objective was to examine tracking patterns of body mass index (BMI) as well as their predictors between childhood and adolescence. A cohort of 452 Tunisian children aged 13- 15 years was followed for 4 years (1999- 2003). Tracking of BMI was defined as in individual maintaining a certain status or relative position (relative BMI quartile) overtime. After 4 years, almost 50 % of the subjects had maintained their relative positions, but 25 % had moved into a lower or higher quartile. The BMIs of thin and fat were more likely to track: 61.9 and 66.7 % remained in the bottom and upper quartiles, respectively. Overweight children were 2.6 times as likely as all other children to become overweight adolescents. Individual’s initial BMIs, sex and socioeconomic status helped to predict tracking and change in BMI. Predictors of overweight tracking found in this study would be useful to select children at risk for preventive intervention. Key words: Obesity, adolescents, cardiovascular risk factor

Clinical and Epidemiological Profile of Reversible Acute Kidney Injury with Full Recovery: Experience of a Nephrology Department

Purpose: Acute kidney injury (AKI) is a real public health problem due to its severity and gravity. In a 2013 meta-analysis, Susantitaphong, et al. estimated the incidence of AKI worldwide at between 10% and 20%. In the latter study, no African studies were included, given the lack of data in the literature. Our objective was to identify the clinical and paraclinical epidemiological characteristics of patients with AKI.Patients and methods: We conducted a retrospective study including patients who had AKI with recovery of normal renal function hospitalized in a nephrology service between 2002 and 2015.Results: Our population consisted of 107 men and 107 women with a median age of 61 years (IQR 43-73.25) of which 42.1% were multitargeted. Functional AKI represented the predominant mechanism of AKI retained in our study with a rate of 53.2% with dehydration as the main etiology for 108 patients (50.46%). Organic cause was retained in 38.8% of patients, with acute tubular necrosis (ATN) as the most frequent etiology (37.35%). Kidney disease improving global outcomes (KDIGO) stage 3 was the stage retained for 115 patients included in our series, 31 of whom required extra renal purification. During their hospitalization, 78.5% of the patients presented a persistent AKI (duration of the episode &gt; 7 days). A glomerular filtration rate (GFR) lower than 60 ml/min/1.73 m&sup2; at discharge was found in 119 patients and 10 patients had a GFR higher than 90 ml/min/1.73 m&sup2;. After 3 months from discharge, 77.5% of patients had a GFR between 60 and 90 ml/min/1.73 m&sup2;.Conclusion: Our results give us an idea of the epidemiological and clinical characteristics of patients who have had acute renal failure with recovery of normal renal function and enable us to better recognize patients at risk in order to avoid such complications. AKI remains a major issue and knowing its epidemiological and clinical characteristics will allow its prevention