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Trabelsi J.D.,Service De Medecine Communautaire Et Depidemiologie | Trabelsi J.D.,University of Sfax | Kammoun S.Y.,Service De Medecine Communautaire Et Depidemiologie | Kammoun S.Y.,University of Sfax | And 8 more authors.
Tunisie Medicale | Year: 2011

Aim: To study the principal causes of death of the women dead at an âge ranging between 15 and 49 years old and having been hospitalized in a public medical structures of the gouvernorat of Sfax. Methods: Retrospective study concerning all the included deaths between 1999 and 2007. Results: The study was related to 728 deaths, which correspond to an average of 80.88 deaths FAR per year. Public highway accidents were the major cause of death (83 cases, 11.4% of the causes of death) followed by the burns (37 cases, 5%) and the cerebral vascular accidents (31 cases, 4.25%). The classification of the causes of death according to groups of pathologies showed the prevalence of thecardio- vascular diseases (18.7%), the external causes of death (18.2%), cancers (11.6%) and the causes related to the pregnancy and the childbirth (8.5%). The maternal death rate was of 56.91 per 100000. The cause of maternal death was directly related to the pregnancy in 67.74% of the cases. The immediate causes were prevailed by the hemorrhagic causes (27.5%). The death was avoidable in 48.83% of the cases and the failures were related to the woman in 60% of the cases. Conclusion: The prevention of new practices of life (female nicotinism, obesity, bad food habits, lack of vigilance in traffic) and a better practice of the primary and secondary prevention in medicine could decrease the premature death rates in Tunisia.

Frikha M.,Service dOncologie Medicale | Yaiche O.,Center Dar Attabib | Elloumi F.,Service de Radiotherapie carcinologie | Mnejja W.,Service de Radiotherapie carcinologie | And 3 more authors.
Journal de Gynecologie Obstetrique et Biologie de la Reproduction | Year: 2013

Objectives: Evaluation of three rounds of mammography screening pilot programme operated between 2004 and 2010 in Sfax by the founders of Dar El Amal association. Patients and methods: A biennial screening was offered to women aged over 45 years and residing in five delegations of Sfax. Two radiologists independently interpret the mammograms. Results: Twelve thousand six hundred and fifty-seven mammographies were performed. The rate of participation was 17.35%. Women under 50 years had the higher rate of participation (34.7%). Some 17.2%/8% (prevalent/incident round) of participants were recalled for further assessment. The chirurgical biopsy rate was 2.1% in prevalence and 1.34% in incidence. The predictive positive value (PPV) of biopsy was 26.5% and 47.14% in the prevalent and incident rounds, respectively. The cancer detection rate amounted to 5.6‰ in prevalent round and to 6.3‰ in incident round. Twenty-five percent of invasive detected cancers were less or equal to 10 mm in size and 65.5% were node-negative. The rate of interval cancer was 0.78‰. The performance of screening in this study was undermined by the relative importance of women younger than 50 years. The cost of one test was 26,200 TD and the cost of one cancer case screening was 6142 TD. Conclusion: This study identified the benefits and limitations of this pilot programme to inform policy makers on the importance and feasibility of an organized mammography screening of breast cancer in Tunisia in a context of a generalization. © 2013 Elsevier Masson SAS. Tous droits réservés.

Mezghani Maalej S.,Laboratoire Of Microbiologie | Rekik M.,Laboratoire Of Microbiologie | Boudaouara M.,Policlinique CNSS | Jardak N.,Policlinique CNSS | And 6 more authors.
Medecine et Maladies Infectieuses | Year: 2010

Objective: The authors studied the epidemiology of pharyngitis in children and evaluated the contribution of a rapid streptococcal test. Patients and methods: This prospective study was conducted from June 2007 to May 2008 in a primary health care institution (Policlinique de la Caisse Nationale de Sécurité Sociale) in Tunisia. Clinical findings were recorded; throat swabs were performed, and a rapid streptococcal test was made. Results: Five hundred and four children were included in this study. The mean age was 5 years and 8 months. Culture was positive for group A streptococcus in 166 cases (32.9 %). Group A streptococcus was more frequently isolated in children aged 5 to 8 years. There was no difference in clinical features between groups of streptococcal and non-streptococcal pharyngitis. The sensitivity and specificity of the rapid test were respectively 93.2 and 95.3 %. Conclusion: Pharyngitis was of bacterial origin in one third of cases; among these, group A streptococcus was the most frequent bacterium. The rapid test is a quick and reliable tool for the diagnosis of pharyngitis and hence an appropriate treatment. © 2009 Elsevier Masson SAS.

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