3 research outputs found
Profil épidémiologique et clinique des tentatives de suicide chez l'enfant et l'adolescent en Tunisie en post révolution
Introduction: les conduites suicidaires sont en augmentation en Tunisie et touchent une population de plus en plus jeune. Le but de notre étude était de décrire le profil sociodémographique et clinique des tentatives de suicide chez l'enfant et l'adolescent.
Méthodes: cette étude était transversale et descriptive, incluant 50 suicidants, recrutés au service de pédopsychiatrie de l'HÎpital Razi de la Manouba et dans deux services de réanimation et de pédiatrie de Tunis, entre juillet 2012 et juin 2013. Ont été relevés les facteurs sociodémographiques et cliniques, les antécédents de maltraitance, la scolarité, les caractéristiques de la TS, l'intentionnalité suicidaire évaluée par le Suicide Intent Scale, et les troubles psychopathologiques à l'aide du Mini-International Neuropsychiatric Interview.
RĂ©sultats: le sex-ratio Ă©tait de 0,56, la moyenne d'Ăąge Ă©tait de 12,4 ans avec des extrĂȘmes de 7 Ă 16 ans. Un Ă©chec ou un flĂ©chissement scolaire a concernĂ© 86% des suicidants. Dans 38% des cas il s'agissait de rĂ©cidive; des antĂ©cĂ©dents d'automutilations ont Ă©tĂ© retrouvĂ©s dans les mĂȘmes proportions. Un contexte de maltraitance a Ă©tĂ© signalĂ© dans 46% des cas. L'ingestion mĂ©dicamenteuse Ă©tait le moyen le plus frĂ©quent, les psychotropes Ă©tant les plus reprĂ©sentĂ©s. Une diffĂ©rence significative entre le genre a Ă©tĂ© retrouvĂ©e dans le recours aux moyens suicidaires, ainsi les garçons ont eu davantage recours aux moyens physiques (p=0,04) et les filles aux intoxications (p=0,001). L'intentionnalitĂ© suicidaire Ă©tait Ă©levĂ©e dans 44%. Un Ă©pisode dĂ©pressif majeur et le trouble de l'adaptation Ă©taient les troubles les plus frĂ©quemment retrouvĂ©s dans respectivement 58% et 24% des cas.
Conclusion: les troubles dĂ©pressifs et la maltraitance se dĂ©gagent comme des facteurs de risque des TS chez les enfants et les adolescents, ces facteurs doivent ĂȘtre pris en considĂ©ration dans les stratĂ©gies de prĂ©vention du suicide dans cette population
Health system challenges of NCDs in Tunisia
Objectives
The objective of this study was to present a qualitative âsituation analysisâ of the healthcare system in Tunisia, as it applies to management of cardiovascular disease (CVD) and diabetes. A primary concern was the institutional capacity to manage non-communicable diseases (NCDs).
Methods
Research took place during 2010 (analysis of official documents, semi-structured interviews with key informants, and case studies in four clinics). Walt and Gilsonâs framework (1994) for policy analysis was used: content, actors, context, and process.
Results
Problems of integration and coordination have compounded funding pressures. Despite its importance in Tunisian healthcare, primary health is ill-equipped to manage NCDs. With limited funds, and no referral or health information system, staff morale in the public sector was low. Private healthcare has been the main development filling the void.
Conclusion
This study highlights major gaps in the implementation of a comprehensive approach to NCDs, which is an urgent task across the region. In strategic planning, research on the health system is vital; but the capacity within Ministries of Health to use research has first to be built, with a commitment to grounding policy change in evidence.</p
Living with diabetes and hypertension in Tunisia: popular perspectives on biomedical treatment
Objectives
The growing prevalence of non-communicable diseases across the Middle East and North Africa poses major challenges for underfunded health services. This article presents data on the perspectives of ordinary Tunisians who are coping with two of these diseasesâdiabetes and hypertensionâand who are obtaining treatment through Tunisian public health clinics. Little has been written to date on patient experiences of biomedical treatment in Maghreb countries.<p></p>
Methods
Based on qualitative methods and semi-structured interviews with 24 patients attending two clinics, one urban and one rural.<p></p>
Results
We examine popular aetiological beliefs, ideas about biomedical treatment and its implications, and comparative views on the benefits and drawbacks of treatment in both public and private clinics.<p></p>
Conclusions
We highlight two main themes. One was nostalgia for a recent past when âpureâ and ânaturalâ food, âproperâ meals and less stressful lives meant less chronic illness, with demanding and costly treatment. The other concerned communication in the clinic, and the recurrent dismay patients felt at what they saw as the cursory attention and guidance they received from clinic staff in public facilities.<p></p