Revue D'epidemiologie Et De Sante Publique[JOURNAL]
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200 papers
Population-based incidence of lymphomas in the French Nord-Pas-de-Calais region between 2001 and 2005: Annual estimations and spatial analysis.
Detourmignies L, Leroyer A, Ligier K … +2 more , Plouvier S, Genin M
Rev Epidemiol Sante Publique · 2019 Sep · PMID 31327522 · Publisher ↗
BACKGROUND: Non-Hodgkin's lymphomas (NHL) are the seventh most commonly diagnosed cancer in France. Nord-Pas-de-Calais is ranked as the region with the highest incidence of cancers and deaths by cancer in France. With it...
BACKGROUND: Non-Hodgkin's lymphomas (NHL) are the seventh most commonly diagnosed cancer in France. Nord-Pas-de-Calais is ranked as the region with the highest incidence of cancers and deaths by cancer in France. With its rich industrial past and its contrasted population densities between urban and rural territories, Nord-Pas-de-Calais represents a geographic area of interest to study the overall incidence of NHL and examine spatial variation of NHL incidence between the 170 cantons of the region. METHODS: LYMPHONOR was a population-based multicentre retrospective study of patients residing in the Nord-Pas-de-Calais region and diagnosed with NHL between January 2001 and December 2005. Spatial distribution of NHL incidence in Nord-Pas-de-Calais was explored using two complementary approaches: adjusted smoothed standardised incidence ratio (SIR) and spatial scan statistics (detection of atypical clusters). RESULTS: Between 2001 and 2005, 2132 new cases of NHL were diagnosed in the Nord-Pas-de-Calais region. In 2005, age-standardised NHL incidence rates were 10.2 and 7.0 cases per 100,000 person-years in male and female residents, respectively. No significant spatial disparities in NHL incidence were found within the Nord-Pas-de-Calais region. The age-adjusted smoothed SIR varied from 0.82 to 1.25 between cantons. Consistently, spatial scan statistics did not detect any significant atypical cluster of high NHL incidence. CONCLUSION: Comparison with national data collected during the same period does not show an overincidence of NHL in the Nord-Pas-de-Calais region. In addition, no evidence for spatial heterogeneity and clustering of NHL incidence was found within this region. Future epidemiological research using large-scale registries is needed to better appraise spatial variation of NHL incidence in France and to investigate possible reasons for significant clusters.
Anthropometric status and body image perception among Moroccan university students.
Boutahar K, Chetoui A, Kaoutar K … +2 more , Najimi M, Chigr F
Rev Epidemiol Sante Publique · 2019 Sep · PMID 31324353 · Publisher ↗
BACKGROUND: University students aged between 18 and 25 undergo several physical changes as a result of transition from adolescence to adulthood. Students do not always accept those changes and sometimes develop dissatisf...
BACKGROUND: University students aged between 18 and 25 undergo several physical changes as a result of transition from adolescence to adulthood. Students do not always accept those changes and sometimes develop dissatisfaction towards their figures. In such cases, it is still not clear how actual body weight status can be affected by socio-cultural factors such as body image perception. The objective of this study was to determine the link between anthropometric status and body image perception among university students. METHODS: Two hundred and forty six (246) university students from the Faculty of Sciences and Technologies within the Beni Mellal-Khenifra region in Morocco, aged 20-24 years were interviewed using face-to-face questionnaires. Anthropometric measurements and Body Mass Index were collected. Body image perception was assessed by Figure Rating Scale, and body size dissatisfaction was calculated as Feel minus Ideal Discrepancy (FID). Data were described using means and proportions. The Student t-test and the chi-square test have been used to assess the statistical significance of group differences. RESULTS: Underweight students represented 16.7% of the investigated sample, while 11.4% suffered from overweight and obesity, higher in females students (14.4%) than in males (7.9%). Regarding body image perception, 43.9% of participants considered themselves underweight; whereas only 4.2% considered themselves overweight with no significant differences related to gender. Of note, the total prevalence of body image dissatisfaction was around 69.8%. Finally, among overweight/obese students, 88.9% of females and 71.4% of males expressed the wish to become thinner while 28.6% of the overweight/obese males wanted to get heavier. CONCLUSION: The results of this study indicate a high rate of body image dissatisfaction and a tendency of participants to underestimate their body weight. This behavior may be a reflection of a real influence of social and psychological factors occurring during this critical period and may make university students vulnerable to many risk-taking behaviors. Thus, there is a need for suitable interventional programs and innovative strategies to ensure the understanding of the health consequences of overweight and obesity and to prevent associated comorbidities.
Mental health among university students with eating disorders and irritable bowel syndrome in France.
Spillebout A, Dechelotte P, Ladner J … +1 more , Tavolacci MP
Rev Epidemiol Sante Publique · 2019 Sep · PMID 31288955 · Publisher ↗
BACKGROUND: University students are subject to stress due to academic pressure, empowerment and transition from adolescence to adulthood. This young population may have a higher risk of functional disorders as eating dis...
BACKGROUND: University students are subject to stress due to academic pressure, empowerment and transition from adolescence to adulthood. This young population may have a higher risk of functional disorders as eating disorders (ED) and irritable bowel syndrome (IBS). Our objective was to determine the prevalence of ED, IBS and both and the associated behaviours. METHODS: A cross sectional study was conducted in Rouen University (France). Participating students filled an anonymous self-questionnaire with items on socio-demographics, depression (Duke score), stress (Cohen score), emotional exhaustion (Maslach Inventory), insomnia (Insomnia Severity Index), cyberaddiction (Internet Addiction Test), ED (SCOFF-F test) and IBS (Rome III). RESULTS: This study included 731 students (male/female ratio=0.43). The prevalences of ED, IBS and co-existing ED-IBS were respectively 16.7%, 7.8% and 2.7%. ED and IBS were more common in female students. Depression, stress, emotional exhaustion, insomnia and cyberaddiction were significantly associated with ED and IBS or both. Students with ED had a higher risk of having IBS (Adjusted Odds Ratio (AOR)=2.42, 95% CI: 1.30-4.51), and conversely students with IBS had a higher risk of having ED (AOR=2.46, 95% CI: 1.32-4.55) and were more likely to be in the third year of academic study or above (AOR=2.95, 95% CI: 1.50-5.76). CONCLUSION: Students (female especially) suffer from ED and IBS, with a significant risk of co-existing ED-IBS. ED and IBS are related to multiple mental health symptoms, which could lead to negative academic consequences. Screening, using simple and quick tests as SCOFF questionnaire and ROME IV criteria (update of ROME III in 2016), is essential in this population of university students.
[Elaboration and psychometric properties of a well-being scale at work. The Serenat study among employees in occupational medicine unit].
Servant D, Drumez E, Raynal S … +9 more , Demarty AL, Salembier A, Deschepper MH, Bizet MA, Pisanu-Zimny A, Culem JB, Labreuche J, Duhamel A, Vaiva G
Rev Epidemiol Sante Publique · 2019 Sep · PMID 31262608 · Publisher ↗
BACKGROUND: Well-being at work is nowadays a major public health challenge. It includes, among others, absence of psychological (anxio-depressive) symptoms, perceived positive work conditions (environment and organizatio...
BACKGROUND: Well-being at work is nowadays a major public health challenge. It includes, among others, absence of psychological (anxio-depressive) symptoms, perceived positive work conditions (environment and organization), happiness and good quality of life at work. Many studies have shown that social support and control at work protect mental health while high job demands and effort-reward imbalance are risk factors for anxiety and depression. There is currently no global indicator to measure both the state of mental health and social working conditions. The main objective of this work is to construct and explore the psychometric properties of scale of well-being at work called "Serenat" in order to validate it. METHODS: The Serenat Scale is a self-report questionnaire composed of 20 items. All items are scored on a four-point Likert scale ranging from 0 (strongly disagree) to 3 (strongly agree) resulting in a range of 0 to 60. It was constructed from data collected from the literature and from consultations in an Occupational Health Unit. From January 2014 to May 2017 193 subjects who have consulted an occupational doctor are included in this cross sectional survey. Validation included item quality and data structure diagnosis, internal consistency, intraobserver reliability evaluation and external consistency. RESULTS: The Serenat scale showed very good item quality, with a maximal non-response rate of 0.01 % per item, and no floor effect. Factor analysis concluded that the scale can be considered unidimensional. Cronbach's alpha of internal consistency was 0.89. The intraclass correlation coefficient for intraobserver reliability was 0.89. Serenat scale was correlated with HADS (r=-0.54; P<0.001), STAI-Y (r=-0.78; P<0.001) and BDI-13 (r=-0.57; P<0.001). CONCLUSION: Serenat's well-being at work scale shows good psychometric properties for final validation. It could be useful to occupational physicians for individual and collective screening. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT02905071.
[Factors associated with low maternal weight gain during pregnancy].
Tebbani F, Oulamara H, Agli A
Rev Epidemiol Sante Publique · 2019 Jul · PMID 31255432 · Publisher ↗
OBJECTIVES: Study weight gain in pregnant women according to the recommendations of the American Institute of Medicine (IOM 2009) and identify the associated factors with inadequate weight gain in pregnant women in Const...
OBJECTIVES: Study weight gain in pregnant women according to the recommendations of the American Institute of Medicine (IOM 2009) and identify the associated factors with inadequate weight gain in pregnant women in Constantine (Algeria). MATERIALS AND METHODS: A prospective and longitudinal study of a cohort of 217 pregnant women aged 19 to 43 years was carried out during the entire period of pregnancy at antenatal consultation and monitoring centers in Constantine (Algeria) from December 2013 to July 2016. Their weight was measured in the first, second and third trimester. Gestational weight gain was classified as lower or meeting the IOM recommendations. Factors associated with gestational weight gain (GWG), such as pre-gestational body mass index, women's knowledge of GWG, sympathetic signs, eating habits and consumption, and maternal stress were studied. Statistics were performed using Statview™ and SPSS software. RESULTS: The majority of women (65.4 %) had inadequate total GWG and only 34.6 % of them had GWG consistent with IOM recommendations. Inadequate weight gain was more frequent in women obese before pregnancy (p<0.0001), women who reported not knowing the ideal GWG (p=0.01), had sympathetic signs (p=0.01), food aversions (p=0.0086), and insufficient vitamin, and mineral intakes (p<0.01). Inadequate GWG was also common among women with insufficient duration of sleep and living in a stressful environment. CONCLUSION: GWG is associated with a number of factors and variable relationships for each trimester of pregnancy.
Inequities in occupational diseases recognition in France.
Gehanno JF, Letalon S, Gislard A … +1 more , Rollin L
Rev Epidemiol Sante Publique · 2019 Jul · PMID 31235191 · Publisher ↗
BACKGROUND: In France, complex cases of occupational disease (OD) are submitted to regional committees who are in charge of accepting, or rejecting, the claim. Their mean annual acceptance rate varies from one region to...
BACKGROUND: In France, complex cases of occupational disease (OD) are submitted to regional committees who are in charge of accepting, or rejecting, the claim. Their mean annual acceptance rate varies from one region to another, which may reflect differences in the cases, or discrepancies between committees. The objective of this study was to assess the comparability of the decisions of the committees on the basis of standardized cases. METHODS: Three experienced occupational physicians specialized in OD were asked to develop 28 clinical cases representative of claims for compensation usually seen in these committees. The cases, in the form of short vignettes, were submitted to the 18 French regional committees, asking if they would recognise each case as an OD. RESULTS: All committees participated. The acceptance rate (recognition of the case as an OD) varied, ranging from 18% to 70%. All the committees took the same decision for only 7 out of the 28 cases, but half accepted and half refused for 3 cases. For 10 cases, one quarter of the committees gave a decision different than the other 75%. The highest discordance rates were observed for the cases concerning musculoskeletal disorders and asbestos related diseases. CONCLUSION: The committees take very different decisions in terms of recognition of OD, especially for the most frequently compensated OD in France, i.e. musculoskeletal disorders and asbestos related diseases. This is a major source of injustice for the employees who seek compensation and there is a need to develop methods to harmonize decisions between committees.
[Factors associated with intrapartum and very early neonatal mortality at the materniry of University hospital Mohamedd VI, Marrakech, Morocco. Case-control study].
Ouahid H, Adarmouch L, Belouali R … +2 more , Mouwafaq S, Soummani A
Rev Epidemiol Sante Publique · 2019 Jul · PMID 31235190 · Publisher ↗
BACKGROUND: Per-partum stillbirth continues to represent a public health burden despite the efforts of countries around the world. Prevention of this mortality can only be effective with a better knowledge of factors tha...
BACKGROUND: Per-partum stillbirth continues to represent a public health burden despite the efforts of countries around the world. Prevention of this mortality can only be effective with a better knowledge of factors that are life-threatening to the fetus or newborn. This work aims to determine associated factors with intrapartum and very early neonatal mortality. METHODS: A case-control study was carried out at the maternity of the university hospital in Marrakech, where 290 subjects were selected: 145 cases of intrapartum fetal death or a very early neonatal death, and 145 controls of surviving newborn weighing 2500g or more at birth. Data were collected from obstetric, partogram and death records for the year 2016. The factors that were compared between the two groups were factors before admission to maternity, factors related to the management during labor and to the care of newborn. RESULTS: Statistically significant associations were found between these deaths and several factors including: multiparity versus primiparity adjusted OR=2.27 [1.17-4.42], pregnant women referral from another health facility adjusted OR=2.11 [1.12-3.99], care for women during the transfer adjusted OR=0.21 [0.9-0.49] and prenatal follow-up of pregnancy adjusted OR=0.22 [0.12-0.4]. Were also associated: fetal monitoring during labor adjusted OR=0.22 [0.08-0.62], neonatal respiratory distress adjusted OR=18.48 [7.60-44.98] and Apgar score (⩽7) adjusted OR=6.05 [2.51-14.62]. CONCLUSION: Intrapartum and very early neonatal mortality is closely related to the newborn's condition at birth, fetal monitoring during labor, pregnancy monitoring, and the organization of the referral system.
[The perception of liaison psychiatry by the medico-chirurgical services].
Tabril T, Ouazzani Y, Chekira A … +3 more , Aarab C, Berraho M, Aalouane R
Rev Epidemiol Sante Publique · 2019 Sep · PMID 31204150 · Publisher ↗
INTRODUCTION: Research addressing the perception of liaison psychiatry by caregivers is still limited in Morocco. Collaboration between practitioners in liaison psychiatry is necessary, and the perception of physicians i...
INTRODUCTION: Research addressing the perception of liaison psychiatry by caregivers is still limited in Morocco. Collaboration between practitioners in liaison psychiatry is necessary, and the perception of physicians influences their implications in liaison psychiatry. OBJECTIVES: To evaluate the perception of this activity among the various medical and surgical units, determine the involvement, level of collaboration and expectations of practitioners, as well as the difficulties and constraints encountered. METHODOLOGY: A survey was carried out among medical personnel at the Hassan II University Hospital Centre in Fez in 2016, through a self-questionnaire determining the perception and position of carers with regard to liaison psychiatry. The data are collected using an anonymous self-administered questionnaire, consisting of 27 items. We included in this study a targeted population: interns, residents and professors. RESULTS: The total population of caregivers participating in this survey was 615 physicians, including 111 professors, 436 residents, and 68 interns. The participation rate was 80.32%. The average age was 30.25 years, with 47.6% (236) women and 52.4% (258) men. The percentage of doctors who obtained their doctorates in medicine in Morocco was 89.3% (85.9% at the Faculty of Medicine in Fez) and 92.3% had received a unique internship in the psychiatry department during their university studies, while 98.7% never received any continuing training in the field of psychiatry. Half of responding physicians reported difficulties in managing psychiatric disorders diagnostically, and 59.5% (292) reported difficulties in treating patients with psychiatric disorders, while 90% (444) reported that they are unable to provide therapeutic follow-up. Only 35.6% of the doctors surveyed were informed about the establishment of liaison psychiatry, but only 10% of these doctors were informed about the procedure for requesting a psychiatric opinion. Faced with a psychiatric disorder, 98% of doctors managed the situation by seeking psychiatric advice, 87.1% considered this request urgent. The reasons for not soliciting q psychiatrist were divided between difficulties in identifying a psychiatric disorder (51%) and difficulties in requesting an opinion (49%). CONCLUSION: Our study showed several difficulties perceived by practitioners, whether in the diagnosis, treatment or follow-up of patients with psychiatric manifestations. Collaboration between different practitioners is an indispensable element of patient management. Improving knowledge through awareness-raising and the organization of scientific days bringing together the different specialties will help to improve doctors' perceptions.
[Quality of the diagnoses' coding (main or associated diagnoses) in the medico-administrative database for psychiatric care (RIM-P) in 2015 and 2016, France].
Richaud-Eyraud E, Ellini A, Clément MC … +2 more , Menu A, Dubois J
Rev Epidemiol Sante Publique · 2019 Sep · PMID 31204149 · Publisher ↗
BACKGROUND: Based on the observation of the misuse of ICD-10 to code the diagnoses in the RIM-P (lack of completeness, conformity and diversity), the Technical Agency for information on Hospital Care (ATIH), which provid...
BACKGROUND: Based on the observation of the misuse of ICD-10 to code the diagnoses in the RIM-P (lack of completeness, conformity and diversity), the Technical Agency for information on Hospital Care (ATIH), which provides tools for collecting medical information, conducted two actions in 2016. First, a chapter devoted to the instructions of coding has been written in the methodological guide of production of the RIM-P, second, a variable "type psy" was added to the ICD-10 nomenclature's file framing ICD-10 coding in the RIM-P. The purpose of this study is to describe the quality of diagnosis coding using ICD-10 in the RIM-P in 2015 and 2016. METHODS: The quality of diagnosis coding using ICD-10 in the summaries of activity of the RIM-P national databases was described in 2015 and 2016. The study focused on the completeness, the conformity and the diversity of coding. RESULTS: Between 2015 and 2016, the percentage of summaries without primary diagnosis ("DP") decreased slightly for full-time (5.2% vs. 3.8%), part-time (6.3% vs. 4.9%) inpatient stays and outpatient care (9.9% vs. 8.9%). ICD-10 codes used to code DP or associated diagnosis ("DA"), while prohibited, mainly belong to Chapter V Mental and behavioral disorders. Per year, only one-third of the summaries and one-half of patients had two or more ICD-10 codes reported for inpatient stays (one-fifth of the summaries and one-fourth of the patients for outpatient care). In addition, per year and per facility, the average number of distinct ICD-10 codes used to fill "DP" or "DA" was approximately half as important in part-time hospitalization, as in full-time hospitalization or for outpatient care. Moreover, 90% of the health facilities used<550 distinct ICD-10 codes in full-time inpatient stays,<270 in part-time inpatient stays and<950 for outpatient care to code the "DP" or the "DA". The diversity of ICD-10 codes used was low and similar between 2015 and 2016, especially to describe the socio-economic environment, resistance to treatment or non-compliance. CONCLUSION: This study emphasizes the need for a collective effort to improve the diversity of the diagnoses' coding in the RIM-P.
[Study of the factors associated with the delay of health consultation of victims of rape in Senegal].
Leye MMM, Diouf AA, Diongue M … +2 more , Seck I, Dia AT
Rev Epidemiol Sante Publique · 2019 Sep · PMID 31204148 · Publisher ↗
INTRODUCTION: Rape remains one of the most serious forms of sexual violence because of its negative impact on the physical and mental health of victims. The objective of this study is to identify the factors associated w...
INTRODUCTION: Rape remains one of the most serious forms of sexual violence because of its negative impact on the physical and mental health of victims. The objective of this study is to identify the factors associated with the delay in rape victims seeking medical assistance from healthcare professionals in Senegal. METHODOLOGY: A retrospective, descriptive and analytical observation study was conducted. The study population consisted of all the court files of girls or women victims of rape recorded by the investigators at the 11 high courts of Senegal during the period from 2006 to 2015. An exhaustive recruitment of the full records of rape victims meeting the inclusion criteria were completed. The uni and multivariate analyses were carried out with Epi Info 2000 and R 2.2.9 software respectively. RESULTS: At the end of the collection, 1,037 cases of rape were included in the study population. The average age of the victims was 16.3±7.9 years (range 1-72). Minors (<18 years) accounted for 24.8 %. The median time from rape to consultation at a health facility was 24hours. Long delay in consultation (>24hours) was noted for 38.6 % of victims. Risk of late consultation after rape was higher among victims residing in the southern areas (ORaj=4.31 [1.15-16.14]), or northern areas (ORaj=4.22 [1.26-14.14]), who were major (ORaj=1.67 [1.04-2.68]) or married (ORaj=3.44 [1.58-7.5]) or who were pregnant after the aggression (ORaj=34.03 [15.47-74.85]) or had an abortion (ORaj=5.45 [1.04-24.47]). CONCLUSION: Medical and judicial assistance are more difficult if there is a long delay between the aggression and consultation. Thus, it is important for the health and judicial authorities to raise awareness about the harmful consequences of sexual violence, and to put forward the benefits of therapeutic care, compensation for the harm suffered by rape victims, as well as the availability of holistic care services 24hours a day.
Prosthetic treatment in the adult French population: Prevalence and relation with demographic, socioeconomic and medical characteristics.
Fauroux MA, Germa A, Tramini P … +1 more , Nabet C
Rev Epidemiol Sante Publique · 2019 Jul · PMID 31204147 · Publisher ↗
BACKGROUND: The aim of this study was to estimate the prevalence of dental prosthetic treatment and to investigate the demographic, social, economic and medical factors associated with the use of fixed and removable dent...
BACKGROUND: The aim of this study was to estimate the prevalence of dental prosthetic treatment and to investigate the demographic, social, economic and medical factors associated with the use of fixed and removable dentures in a representative sample of adults living in France. METHODS: The data were obtained from the 2002-2003 Decennial Health Survey, a cross-sectional study of a representative sample of the population living in France, which included 29,679 adults. Information was collected by interview. The variables collected were fixed denture, removable denture, age, gender, number of children, area of residence, nationality, educational attainment, family social status, employment status, annual household income per capita, supplementary insurance, chronic disease, eyesight problems/glasses, hearing problems/hearing aids. Multinomial logistic regression models were used to study the relationship between prosthetic treatment and demographic, socioeconomic and medical characteristics unadjusted, adjusted for age and adjusted for all the characteristics. RESULTS: The prevalence of prosthetic treatment was 34.6% (95% confidence interval (CI): [34.1; 35.2]) for fixed prosthetic dentures and 13.8% (95% CI: [13.4; 14.2]) for removable prosthetic dentures. We showed a gradient between educational attainment and removable dentures; the odds ratio adjusted for all the variables (aOR) associated with no or primary education compared to post-secondary education was 2.56; 95% CI: [2.09; 3.13]. When annual household income per capita was low, subjects were less likely to report fixed dentures (aOR=0.68; 95% CI: [0.62; 0.75]) than those with high annual household income per capita. Individuals without insurance less often reported fixed dentures than those with private insurance. Those reporting chronic disease were less likely to report fixed dentures (aOR=0.87; 95% CI: [0.79; 0.95]) but more likely to report removable dentures (aOR=1.29; 95% CI: [1.17; 1.43]) than those without chronic disease. CONCLUSION: This study reveals social, economic and medical inequalities in fixed and removable prosthetic treatment among adults in France.
[Determinants of time required by medical information technicians for quality control of hospital activity coding, in French medico-administrative system].
Collonnaz M, Bethune B, Weisslinger C … +3 more , Faulon M, Fiore P, Goetz C
Rev Epidemiol Sante Publique · 2019 Jul · PMID 31196581 · Publisher ↗
BACKGROUND: Since 2008, in France, hospital funding is determined by the nature of activities provided (activity-based funding). Quality control of hospital activity coding is essential to optimize hospital remuneration....
BACKGROUND: Since 2008, in France, hospital funding is determined by the nature of activities provided (activity-based funding). Quality control of hospital activity coding is essential to optimize hospital remuneration. There is a need for reliable tools to allocate human resources wisely in order to improve these controls. METHODS: The main objective of this study was to identify the determinants of time needed by medical information technicians to control hospital activity coding in a Regional Hospital Center. From March 2016 to the beginning of January 2017, medical information technicians reported the time they spent on each quality control, and the time they needed when they had to code the entire stay. Multiple linear regressions were performed to identify the determinants of quality control or coding duration. A split sample validation was used: model was created on one half of the sample and validated on the remaining half. RESULTS: Among the controls, 5431 were included in the analysis of determinants of control duration (2715 kept aside for model validation). Seven determinants have been identified (stay duration, level of complexity, month of control, type of control, medical information technician, rank of classing information, and major diagnostic category). The correlation coefficient between predicted and real control duration was 0.71 (P<10); 808 stays were included in the analysis of determinants of coding duration (404 kept aside for model validation). Two determinants have been identified. The correlation coefficient, between predicted and real coding duration, was 0.47 (P<10). We performed the same multiple regression, on 2017 activity data, to estimate the weight of each hospital activity pole, regarding quality control of hospital activity coding. CONCLUSION: We succeeded in modeling time needed for quality control of hospital stays. These results helped to estimate human resources required for quality control of each hospital pole. Nevertheless, the second analysis did not give satisfactory results: we failed in modeling time needed to code hospital stays.
Completeness of a newly implemented general cancer registry in northern France: Application of a three-source capture-recapture method.
Plouvier SD, Bernillon P, Ligier K … +4 more , Theis D, Miquel PH, Pasquier D, Rivest LP
Rev Epidemiol Sante Publique · 2019 Jul · PMID 31146902 · Publisher ↗
BACKGROUND: Completeness, timeliness and accuracy are important qualities for registries. The objective was to estimate the completeness of the first two years of full registration (2008/2009) of a new population-based g...
BACKGROUND: Completeness, timeliness and accuracy are important qualities for registries. The objective was to estimate the completeness of the first two years of full registration (2008/2009) of a new population-based general cancer registry, at the time of national data centralisation. METHODS: Records followed international standards. Numbers of cases missed were estimated from a three-source (pathology labs, healthcare centres, health insurance services) capture-recapture method, using log-linear models for each gender. Age and place of residence were considered as potential variables of heterogeneous catchability. RESULTS: When data were centralized (2011/2012), 4446 cases in men and 3642 in women were recorded for 2008/2009 in the Registry. Overall completeness was estimated at 95.7% (95% CI: 94.3-97.2) for cases in men and 94.8% (95% CI: 92.6-97.0) in women. Completeness appeared higher for younger than for older subjects, with a significant difference of 4.1% (95% CI: 1.4-6.7) for men younger than 65 compared with their older counterparts. Estimates were collated with the number of cases registered in 2014 for the years 2008/2009 (4566 cases for men/3755 for women), when additional structures had notified cases retrospectively to the Registry. These numbers were consistent with the stratified capture-recapture estimates. CONCLUSION: This method appeared useful to estimate the completeness quantitatively. Despite a rather good completeness for the new Registry, the search for cases among older subjects must be improved.
[Prevalence of hepatitis B markers and vaccination status of healthcare personnel: Experience of the Tunis Military Hospital].
Zayet S, Osman M, Besghaier H … +3 more , Ben Moussa M, Belhadj A, Bellaaj R
Rev Epidemiol Sante Publique · 2019 Jul · PMID 31060884 · Publisher ↗
BACKGROUND: Hepatitis B is the main cause of liver disease in the world. Chronic hepatitis B may lead to cirrhosis, liver insufficiency or liver cancer. Tunisia is considered as a country with intermediate endemicity, wh...
BACKGROUND: Hepatitis B is the main cause of liver disease in the world. Chronic hepatitis B may lead to cirrhosis, liver insufficiency or liver cancer. Tunisia is considered as a country with intermediate endemicity, where hepatitis B presents a real public health problem. The aims of this study were to evaluate the prevalence of viral biomarkers of hepatitis B in healthcare personnel; to look for potential risk factors associated with HbS antigen carriage and to evaluate the prevalence of vaccination in this particular population. METHODS: Sero-epidemiological, prospective and descriptive study, among 2411 healthcare personnel in the Military Hospital of Tunis, during a 5-month period from September 2013 to January 2014. RESULTS: Blood samples were collected from 1497 volunteers among the hospital staff. Two hundred and seventy-one individuals had a positive HbC antibody titer (prevalence 18.1%), including 229 who were positive for HbC and HbS antibodies (prevalence 15.3%), 12 positive for only HbC antibody (prevalence 0.8%), and 30 positive for HBsAg (prevalence 2%). Among HbS Ag carriers, 56.6% reported needle stick and sharp object injuries during their professional careers. Among HbS Ag carriers, there were three patients with a history of acute viral hepatitis with jaundice, and 27 patients (90%) who were asymptomatic and were diagnosed during our study. Among healthcare workers in the hospital, 56.1% were immunized through vaccination (positive HbS antibodies without HbC antibodies), of whom 66% had durable protective immunity (HbS antibodies>100mU/mL). Lastly, 25.8% of the hospital workers remained without any protection against hepatitis B (serology entirely negative) and were then offered a complete vaccination. CONCLUSION: Hepatitis B vaccine is the mainstay of hepatitis B prevention. Safe injection practices, blood safety and promoting wider access to monitoring and screening, care and treatment services for hepatitis B are the best guarantees to prevent and control this disease.
Pharmacological and residual effects in randomized placebo-controlled trials. A structural causal modelling approach.
Mouchart M, Bouckaert A, Wunsch G
Rev Epidemiol Sante Publique · 2019 Jul · PMID 31056218 · Publisher ↗
BACKGROUND: Distinguishing between pharmacological and residual effects, this paper considers the problem of causal assessment in the case of a particular model, namely a Sure Outcome of Random Events (SORE) model develo...
BACKGROUND: Distinguishing between pharmacological and residual effects, this paper considers the problem of causal assessment in the case of a particular model, namely a Sure Outcome of Random Events (SORE) model developed for the analysis of data from a randomized placebo-controlled double-blind trial of a drug. METHOD: This model takes into account two kinds of observable effects, a therapeutic effect and a side-effect. For each observable effect, two latent factors are considered, i.e. a pharmacological (or explained) factor and a residual (or unexplained) one. RESULTS: The model presents a plausible mechanism generating the observed and latent outcomes, recursively decomposed into an ordered sequence of sub-mechanisms. CONCLUSIONS: The characteristics of this model leads to a novel assessment of causality that evaluates the effect of latent variables and of the bias resulting from ignoring the structural features of the data generating process. This approach is illustrated by a numerical example, along with a case study based on a secondary analysis of real data.
[COP21 - Organization and activity of a medical cover under "pressure"].
Chanzy E, Gentile M, Nahon M … +7 more , Paty AC, Stibbe O, Tourtier JP, Petrovic T, Goix L, Adnet F, Lapostolle F
Rev Epidemiol Sante Publique · 2019 May · PMID 31006583 · Publisher ↗
INTRODUCTION: The United Nations Climate Conference (COP21) gathered in France for delegations from all around the world, with 20,000 delegates from 195 countries every day, including 150 heads of states during the first...
INTRODUCTION: The United Nations Climate Conference (COP21) gathered in France for delegations from all around the world, with 20,000 delegates from 195 countries every day, including 150 heads of states during the first 48hours. A specific medical cover was organized in a particular "post-attacks" context and with harsh constraints due to delimitation of an inner zone under the sole UN authority ("blue zone"). OBJECTIVE: To evaluate medical means involved and medical activity. METHODS: Medical cover was managed by SAMU 93 in collaboration with zonal SAMU and regional health agency for the entire site including the "blue zone". End-points: engaged workforce, number of visits, including transfers and medicalized transfers. RESULTS: In "France zone" (operational headquarters): an emergency physician dispatcher and an assistant for 20 days. In "blue zone": 20 rescuers, mobile intensive care unit H24 and two emergency physicians (consultations) 12/24hours for 16 days. A total of 47 doctors, 25 nurses, 25 paramedics and 20 assistants participated in the medical service. This corresponded to three emergency physician full medical time equivalents (FMTE) for 16 days. Consultations performed: 1238 or 97/day resulting in 34 (3%) transfers including seven medicalized. Patients were 706 (57%) men and 495 (43%) women, with mean age of 43±1 years. Trauma patients were most numerous (20%). CONCLUSION: Medical means involved were consistent for 16 days. The medical activity was sustained, but medicalized transfer rarely required.
[Comorbidity schizophrenia and diabetes mellitus in Algeria - A study of risk factors].
Benharrats SS, Bencharif MA
Rev Epidemiol Sante Publique · 2019 May · PMID 31005354 · Publisher ↗
BACKGROUND: The combination of schizophrenia and diabetes mellitus presents a public health problem in the world. Several studies have been carried out for the analysis of this comorbidity, including prognostic factors....
BACKGROUND: The combination of schizophrenia and diabetes mellitus presents a public health problem in the world. Several studies have been carried out for the analysis of this comorbidity, including prognostic factors. OBJECTIVE: The objective of our study is to determine the risk factors associated with the comorbidity schizophrenia and diabetes mellitus. METHODS: From a sample of 200 cases of schizophrenic patients hospitalized at the Sidi Chami psychiatric hospital of Oran in Algeria, we carried out a descriptive transversal and analytical study during the period of one year. RESULTS: Our results are consistent with those of the different studies carried out in neighboring countries. Among the risk factors recorded in our study, we mention the age of 40 and over, divorce, dyslipidemia, high blood pressure, overweight and severe and moderate obesity, the age of schizophrenia of 30 to 40 years, the first-generation neuroleptic treatment and family history related to diabetes. While the male sex, celibacy and second-generation neuroleptics were found in the study as protective factors against the onset of diabetes mellitus in schizophrenic patients. CONCLUSION: The factors associated with comorbidity schizophrenia and type 2 diabetes are manifold. These factors must be taken into account when introducing preventive behaviors that must be multidisciplinary in order to ensure better patient care.
[12-months efficacy of option B+ for prevention of mother-to-child transmission of HIV in Yaoundé, Cameroon].
Njom Nlend AE, Nguedou Marcelle K, Koki Ndombo P … +1 more , Brunelle Sandié A
Rev Epidemiol Sante Publique · 2019 May · PMID 30992178 · Publisher ↗
BACKGROUND: Cameroon has adopted the option B+ for the prevention of mother-to-child transmission (MTCT) program of HIV in August 2014 in order to eradicate MTCT of HIV. OBJECTIVE: To analyze in routine life settings, ef...
BACKGROUND: Cameroon has adopted the option B+ for the prevention of mother-to-child transmission (MTCT) program of HIV in August 2014 in order to eradicate MTCT of HIV. OBJECTIVE: To analyze in routine life settings, efficacy of option B+ for PMTCT and associate factors. METHODS: We conducted a cross-sectional study over a 6-month period in the ESSOS hospital center. Study population comprised HIV-positive mothers and their infants aged 0-24 months. Variables included were : moment of HIV maternal testing, timing of commencement of maternal antiretroviral therapy (ART) and self-reported adherence to ART. Efficacy was measured through early and late MTCT rate and associated factors. RESULTS: We included 200 mothers and 124 infants. Under option B+, the rate of transmission was at 4.20% at 6 weeks and 5.83% at 12 months. The rate of HIV transmission in breastfed infants stood at 3.7%. In unadjusted analysis, bottle-feeding, term at birth, early screening and management during pregnancy were associated with lower risk of HIV transmission. After adjustment, term at delivery after 37 weeks adjusted odds ratio (AOR) [0.059; (0.0061; 0.56)] was protective; while lack of prophylaxis was among HIV-exposed infants emerged as the main factor associated with residual transmission of HIV [AOR 117.23 ; (3.55 ; 3874.9)]. CONCLUSION: In this setting of Yaoundé, routine option B+ posted laudable results at 12 months even amongst breastfed children and should therefore be made sustainable.
[Interval between two smear tests for cervical cancer screening and characteristics of women with a short interval: Study in the department of Isère].
Caporossi A, Olicard C, Seigneurin A … +1 more , Garnier A
Rev Epidemiol Sante Publique · 2019 May · PMID 30981595 · Publisher ↗
AIMS: In France, guidelines for cervical cancer screening recommend that women between the ages of 25-65 have a smear test performed once every three years. However, some women are screened significantly more frequently....
AIMS: In France, guidelines for cervical cancer screening recommend that women between the ages of 25-65 have a smear test performed once every three years. However, some women are screened significantly more frequently. In this study, we used a data-driven approach as opposed to a traditional hypothesis-driven approach to characterise the population of women who are screened more frequently than advised. METHODS: Data came from an organised cervical cancer screening programme of a French department in the Alps (Isère). We retrospectively selected women aged between 25 to 65 years old who had at least two smear tests during the follow up period (2011-2015). We used a data-driven clustering approach to compare the population of over-screened women with other populations. We then performed a descriptive analysis of the over-screened population using univariate (Chi test) and multivariate (logistic regression) methods. RESULTS: A total of 10,000 patients were randomly chosen from a population of 54,073. In our univariate analysis, women in the over-screened population were significantly younger, participated less in organised screening, were more likely to be followed by a gynaecologist and had more smear test results showing inflammation than the other populations. Patient location (urban v.s. rural area) was not significant for this population. The multivariate analysis confirmed these results. CONCLUSION: This data-driven approach based on an unsupervised learning method enables us to more accurately characterise the over-screened population. These data invite to improve communication with the youngest women and the gynecologists to recall the benefit of an interval between two normal smears complying with the recommendations. This approach could help to improve the prevention and have a real impact on this Public Health issue.
[Not Available].
Andrieu S, Filleron T, Comités scientifique et d’organisation
Rev Epidemiol Sante Publique · 2019 May · PMID 30955996 · Publisher ↗
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