12 research outputs found
Challenges and lessons learnt from a workplace based program to control tobacco use in Tunisia 2009-2014
Background
Tobacco use has become the leading preventable cause of death worldwide.
Therefore, Tunisia has ratified the WHO Framework Convention on Tobacco Control in
2010. Objectve: We aimed to outline
an experience of implementing a workplace based program of tobacco control in
Sousse, Tunisia (2009-2014) in order to identify barriers and recommendations
for future interventions in low and middle income countries.
Methods
We conducted a
quasi-experimental study among a representative sample of employees in Sousse,
Tunisia with two groups, intervention and control. Our three years workplace program
consisted of a collective intervention (Smoking free workplace, open
sensitization day : films and workshops on tobacco harmful effects) and an
individual one (Free clinics for tobacco cessation offering free nicotine
replacement therapy products). Participants enrolled at the pre intervention
and post intervention assessments belonged to two independant samples in each group.
Results
Overall, the intervention showed positive effets in
improving the knowledge of the participants on the harmful effects of active and
passive smoking and on light cigarettes. The intervention was associated to a
significant increase of the employers involvment in tobacco control efforts. Regarding
the smoking behaviors, in the intervention group, the prevalence of tobacco use
decreased from 39.2% at the pre-assessment to 37.5% at the post assessment (p=0.43)
with no substantial
difference in the number of cigarettes consumed.
Conclusions
Despite the absence of
positive effect of this project on smoking behavior, severall lessons may be
deducted and it would be therefore considered as a corner stone. The fight
against tobacco use is dependent on deep environmental changes. The role the
employer is crucial but not sufficient. A multisectoral approach garanteeing an
actual involvement of all the stakeholders and topped by a political will is strongly
needed
Second hand smoking among schoolchildren in the region of Sousse
Background
Secondhand smoke
(SHS) contains an estimated 4000 toxic chemicals and is a serious health hazard
to non-smokers. Exposure to tobacco smoke causes extremely serious damages, placing
exposed persons at increased risk of a number of adverse health outcomes, such
as asthma, lung cancer and
cardiovascular diseases.
In this context, this work was carried out
in order to evaluate exposure to smoking among schoolchildren in the region of Sousse.
Methods
We conducted a cross sectional design
study among a representative sample of students from all colleges in the
delegation of Sousse Jawhra and Sousse Erriadh.
We used an Arabic, pre tested
and self administered questionnaire to collect data about Socio -demographic
characteristics and student's smoking behavior.
Results
Our population was composed of 2170 students. Girls accounted for 1100
(51.3%) and 1070 (48.7%) boys. The mean age of our population was 13.23±(1,19).
The prevalence of smoking in our population was 4.8%.
In the month preceding our study 75% of our population was exposed to a
second-hand smoking. 36.7 % was exposed at home and almost one third (27.3%) at
school. But second hand smoking was affecting smoking and non smoking students.
We noticed that 74.5% of non smoker were exposed to secondhand smoking despite
the that the majority (92.0 %) knew that
second hand smoking is dangerous . We highlighted also that non-smokers were
significantly more in favor of implementing tobacco control laws (94.6% vs 94%
of smokers ; p=0.02).
Conclusions
Exposure to an involuntary smoke is an urgent issue, because
there is no safe level of SHS exposure, even minimal exposure is harmful. And
as we noticed the Second hand smoking is very high among students in the Sousse region. Therefore
there is an urgent need for a program to prevent and control this scourge of
active and passive smoking among schoolchildren
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
Three year school based intervention for Tobacco prevention in the region of Sousse: quasi experimental design 2009-2014
Background
Tobacco use is one of the biggest public health
threats the world has ever faced. Tunisia is one of the countries suffering
from the heavy burden of tobacco use. It
is in this context that the Chronic Disease Prevention Research Center in Sousse
established a school based intervention for tobacco control and prevention. Our objective was to evaluate the
feasibility and effectiveness of our intervention in tobacco control and
prevention by the evaluation of smoking behavior among schoolchildren at pre
and post assessment in both intervention and control groups.
Methods
We conducted a three years school based quasi-experimental
study with an intervention and a control groups. We enrolled a representative
sample of schoolchildren from all colleges of intervention and control areas. We
have carried out a pre-assessment before the intervention in 2009-2010 and a
post assessment of the same parameters at the end of the intervention in both
groups in 2013-2014. We used a pre tested self
administered questionnaire to assess tobacco use.
Results
Overall, 4003
schoolchildren were included: 1929 in the intervention group and 2074 in the
control group. After the intervention, 4275 schoolchildren participated in the
evaluation with respectively 2170 and 2105 in each group. The age of the
schoolchildren varied between 11 and 16 years. There was a
decrease in tobacco use in the intervention group from 5.7% to 4.8% contrary to
an increase in the control group from 7.5% to 9.2%. Among boys, the prevalence
of tobacco use decreased in both groups. However, among girls, in the
intervention group a decrease was noticed in the contrary to the control group
where a significant increase was observed from 1.1% to 5.2%.
Conclusions
Tobacco prevention needs multi-sectored approach and an extended intervention to be
effective. That's why a political will is important for such interventions
Health and Environmental Impact of Hospital Wastes: Systematic Review
Introduction: Healthcare activities are generally associated with the production of healthcare waste, a large part of which is assimilated to household waste (packaging, kitchen waste, green waste, etc.) and another category of waste which may have a risk to health and the environment given its nature and typology. This category of waste at risk includes waste at risk of infection such as stinging, sharp waste (needles, blade, scalpel, etc.), and waste at chemical risk. Poor management of hospital waste is a problem in most countries and especially in developing countries. We aimed to determine the health and environmental impacts of the poor management of healthcare waste. Methods: We carried out a systematic review of the French and English literature on the scientific research sites Medline/PubMed and Embase. This research was carried out over 3 months (April–June 2020). The search strategy was used by combining keywords and Boolean operators: Health, Health impact assessment, Hospitals, Medical waste, Waste disposal facilities, Environment, Environment/Epidemiology, Hospital waste, impact, workplace, Environment hazards, Healthcare works, Waste management. Results: It has been clear that the current management of healthcare waste is not capable of adequately preserving human health and environmental contamination from infection. The surveys analyzed showed that if incineration is properly treated, it would be an appropriate treatment method to deal with healthcare waste. However, exposure to pollutants produced by the incineration is still a public health problem. If incineration is seen as a practical solution for dealing with healthcare waste, low-temperature incinerators should be banned and replaced by modern incinerators equipped with air pollution control units. These problems are typical for any developing country which does not have the means to purchase incinerators which are more protective for the environment and equipped with the latest technologies. Conclusions: Thus, autoclaving and microwaves are considered better alternatives for treating healthcare waste. However, these methods are generally not adequate for the disposal of pathological, radioactive, laboratory, and chemotherapy wastes. Therefore, the specific management of healthcare waste is a major concern due to the potentially high risks for human health and the environment
Hospitalizations for communicable diseases in a developing country: prevalence and trends—Monastir, Tunisia, 2002–2013
Background: In spite of the epidemiological transition, communicable diseases remain a public health problem and represent a significant cause of morbidity and mortality worldwide, especially in developing countries. This study aimed to determine the crude and standardized prevalence rates of hospitalizations for communicable disease (HCD) and to assess trends in HCD by age and sex at a university hospital in Tunisia over a period of 12 years (2002–2013).
Methods: All cases of HCD from 2002 to 2013 in the university hospital departments were included. Data collected from the regional register of hospital morbidity were used. The discharge diagnoses were coded according to the International Classification of Diseases, 10th revision (ICD-10).
Results: HCD represented 17.45% of all hospitalizations during the study period (34 289/196 488; 95% confidence interval 17.28–17.62%). The median age at the time of admission was 31 years (interquartile range (IQR) 15–52 years). The median hospital length of stay (LOS) was 5 days (IQR 3–9 days). The crude prevalence rate (CPR) was 5.41 per 1000 inhabitants. The CPR was highest among patients aged ≥65 years. The four communicable disease categories that represented 70% of all HCD were abdominal infection, skin infection, genitourinary infection, and lower respiratory tract infection. The majority of HCD decreased over time; however, there was a significant increase in HIV diseases, tuberculosis, and viral hepatitis.
Conclusion: This study provides evidence of the epidemiological transition, showing a decline in communicable diseases, which needs to be sustained and improved
Healing efficiency of oligosaccharides generated from almond gum (Prunus amygdalus) on dermal wounds of adult rats
International audienceAlmond gum is a naturally occurring polymer produced by almond trees and shrubs. Its abundance, as well as its low cost production makes it a potential feedstock for use in food and pharmaceuticals. In this regard, almond gum oligosaccharides were enzymatically generated, purified and their monosaccharide composition assessed using gas chromatography-flame ionization detector. Oligosaccharide analyses show that the most prominent residues were galactose and arabinose with traces of xylose, rhamnose, glucose and mannose. The glycosyl linkage positions were analyzed using gas chromatography - mass spectrometry showing a main chain composed of galactose units [→3)-Gal-(1→] branched mainly with arabinose residues [Ara-(1→]. The potent role of the generated oligosaccharides on rats wound healing was investigated. They have been applied either alone or supplemented, as active substance, with cream formulation, on full-thickness wound created on the dorsum of the rats. The effect of oligosaccharides was assessed by measuring the wound closure percentage, reaching an average of around 100% when applied alone or supplemented to cream formulation. The healing percentage for the control group was only 74.3% at the same day. The histological evaluation of skin sections visualized by light microscopy revealed an improved collagen deposition and an increased fibroblast and vascular densities