May Measurement Month 2019: an analysis of blood pressure screening results from Tunisia.

We performed a May Measurement Month (MMM) screening campaign among adult volunteers aged 18 years old and over in Tunisia. The objective was to raise awareness, and to estimate the prevalence, awareness, treatment, and control of hypertension, one of the main cardiovascular risk factors. Following the MMM protocol, three blood pressure (BP) measurements were taken by physicians and standard interviewing procedures were used to record medical history, socio-demographic, and cardiovascular disease risk factors.

Highlighting successes and challenges of the mental health system in Tunisia: an overview of services, facilities, and human resources.

Background: Tunisia is a lower-middle-income country located in North Africa with strengths and challenges to its mental health system.

Aims: We present an overview of available services, facilities, and human resources to offer mental health care in Tunisia.

Methods: We conducted a cross-sectional study, where data for the year 2017 was collected between May 2018 and May 2019 by consulting stakeholders involved in the health field in Tunisia.

Impact of contact tracing, respect of isolation, and lockdown in reducing the number of cases infected with COVID-19. Case study: Tunisia's response from March 22 to May 4, 2020.

Background: Coronavirus disease 2019 (COVID-19) has spread rapidly across the world. Tunisia reacted early to COVID-19, resulting in a low number of infections during the first wave of the pandemic. This study was performed to model the effects of different interventions on the evolution of cases and to compare these with the Tunisian experience.

Premature mortality attributable to smoking among Tunisian men in 2009.

Introduction: Tobacco smoking is a significant public health threat in the world, a risk factor for many diseases, and has been increasing in prevalence in many developing countries. In this study, we aimed to estimate the burden of premature deaths attributable to smoking among Tunisian men aged 35-69 years in 2009.

Methods: The number of deaths attributable to smoking was estimated using the population attributable risk fraction method.

Explaining income-related inequalities in cardiovascular risk factors in Tunisian adults during the last decade: comparison of sensitivity analysis of logistic regression and Wagstaff decomposition analysis.

Background: It is important to quantify inequality, explain the contribution of underlying social determinants and to provide evidence to guide health policy. The aim of the study is to explain the income-related inequalities in cardiovascular risk factors in the last decade among Tunisian adults aged between 35 and 70 years old.

Methods: We performed the analysis by applying two approaches and compared the results provided by the two methods.

KRAS and NRAS pyrosequencing screening in Tunisian colorectal cancer patients in 2015.

Background: Mutations in KRAS and NRAS often result in constitutive activation of RAS in the epidermal growth factor receptor (EGFR) signaling pathway. Mutations in KRAS exon 2 (codon 12-13) predict resistance to anti-EGFR targeted therapy in patients with metastatic colorectal carcinoma (mCRC). However, it's currently known that a significant proportion of mCRC have RAS mutations outside KRAS exon 2, particularly in exons 3 and 4 of KRAS and exons 2, 3 and 4 of NRAS.

Comparing Strategies to Prevent Stroke and Ischemic Heart Disease in the Tunisian Population: Markov Modeling Approach Using a Comprehensive Sensitivity Analysis Algorithm.

Background: Mathematical models offer the potential to analyze and compare the effectiveness of very different interventions to prevent future cardiovascular disease. We developed a comprehensive Markov model to assess the impact of three interventions to reduce ischemic heart diseases (IHD) and stroke deaths: (i) improved medical treatments in acute phase, (ii) secondary prevention by increasing the uptake of statins, (iii) primary prevention using health promotion to reduce dietary salt consumption.

Methods: We developed and validated a Markov model for the Tunisian population aged 35-94 years old over a 20-year time horizon.

[Investigating into whether systematic fetal weight estimation by ultrasound in the delivery room increases the risk of cesarean delivery].

Ultrasound is a valuable tool commonly used in the delivery room. It has multiple applications. The objective of this study was to investigate whether systematic fetal weight estimation by ultrasound in the delivery room increases the risk of cesarean delivery.

Contribution of verbal autopsy in the study of cancer mortality among reproductive-age women in Tunisia.

Background In Tunisia, the information system on medical causes of death  is based on the use of standard death certificate model based on international model recommended by the World Organization started in January 2001. However, this system is still burdened with a major death causes of under-registration. Only specific surveys on mortality have FAR generate reliable mortality indicators.

Cancer mortality among reproductive age women in Tunisia.

Background: Cause-of-death data are critical to formulating good public health programs. In Tunisia, the mortality surveys of reproductive age women are specifically interested in maternal mortality and we do not have data on deaths from noncommunicable diseases including cancer.

Aim: To identify the main cancers causing death among Tunisian women in reproductive age.

Contrasting cardiovascular mortality trends in Eastern Mediterranean populations: Contributions from risk factor changes and treatments.

Background: Middle income countries are facing an epidemic of non-communicable diseases, especially coronary heart disease (CHD). We used a validated CHD mortality model (IMPACT) to explain recent trends in Tunisia, Syria, the occupied Palestinian territory (oPt) and Turkey.

Methods: Data on populations, mortality, patient numbers, treatments and risk factor trends from national and local surveys in each country were collated over two time points (1995-97; 2006-09); integrated and analysed using the IMPACT model.

Forecasting Tunisian type 2 diabetes prevalence to 2027: validation of a simple model.

Background: Most projections of type 2 diabetes (T2D) prevalence are simply based on demographic change (i.e. ageing).

Cardiovascular risk factor trends in the Eastern Mediterranean region: evidence from four countries is alarming.

Objectives: Many Eastern Mediterranean countries are undergoing dramatic socioeconomic, demographic and life style changes and face noncommunicable disease (NCD) epidemics. We evaluated recent trends in major NCD risk factors in occupied Palestinian territories (OPT), Turkey, Syria and Tunisia.

Methods: We searched published and unpublished sources for systolic blood pressure (SBP), diabetes, smoking, body mass index (BMI), and cholesterol trends for both men and women aged 35-84 in each country from 1995 to 2009.

Analyzing recent coronary heart disease mortality trends in Tunisia between 1997 and 2009.

Background: In Tunisia, Cardiovascular Diseases are the leading causes of death (30%), 70% of those are coronary heart disease (CHD) deaths and population studies have demonstrated that major risk factor levels are increasing.

Objective: To explain recent CHD trends in Tunisia between 1997 and 2009.

Data Sources: Published and unpublished data were identified by extensive searches, complemented with specifically designed surveys.