Revue D'epidemiologie Et De Sante Publique[JOURNAL]
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200 papers
[Innovative transformation of the health system through a preventive transition].
Stevens N, Cambon L, Alla F
Rev Epidemiol Sante Publique · 2021 Aug · PMID 34053796 · Publisher ↗
Given today's evolution of the healthcare system, organizational transformations, technological developments and major challenges, innovation has taken on primordial importance. In this context and with considerable supp...
Given today's evolution of the healthcare system, organizational transformations, technological developments and major challenges, innovation has taken on primordial importance. In this context and with considerable support, many experimentations have taken place. Unfortunately, few have managed to scale up. What results is a congeries of innovations without a future, possibly avoidable squandering of resources, a number of missed opportunities, and the grim prospect of inventor burnout. As regards prevention, innovation is at the heart of an anticipated "preventive transition" of the health system that has yet to achieve operational status. In this article we attempt to redesign the contours of innovation in health, considering it first and foremost in regard to its social utility. We will go on to explore the limitations of innovative practices that delay the arrival of advances in health. Four types of obstacles appear: faulty evaluation; insufficient dialogue between researchers, stakeholders and decision-makers; lack of visibility and, finally, conceptions and perceptions of innovation characterized by tunnel vision. In the concluding section of this paper, we will present several tracks through which the innovation process could be impelled to drive health system transformation. They consist in: (i) incorporating an evaluative and comprehensive research into innovation processes, (ii) elaborating "bottom-up" approaches giving special consideration to innovations instigated by stakeholders and brought to fruition under real-life conditions, (iii) breaking from standardization by thinking from the outset of the adaptability of innovations and, finally, (iv) tying in the experimental approach with a decision-making process.
Prediabetes and deprivation: A couple at high risk of diabetes.
Jaffiol C, Thomas F, Spira A … +2 more , Pannier B, Danchin N
Rev Epidemiol Sante Publique · 2021 Nov · PMID 34053795 · Publisher ↗
AIM: The higher prevalence of diabetes in deprived populations is well documented but little is known about the risk of diabetes associated with deprivation among pre-diabetic subjects. The aim of the study was to evalua...
AIM: The higher prevalence of diabetes in deprived populations is well documented but little is known about the risk of diabetes associated with deprivation among pre-diabetic subjects. The aim of the study was to evaluate the risk of diabetes in a population of deprived pre-diabetic patients. METHODS: 2743 pre-diabetic subjects identified using the American Diabetes Association (ADA) criteria, 16 to 85 years old, 1656 non-deprived and 1087 deprived, had at least two health check-ups at an interval of 4.95 (2.04) vs 3.20 (1.71) years, P<0.0001, respectively. At the first visit, socioeconomic status was assessed using the EPICES score to differentiate deprived and non-deprived subjects. RESULTS: At the second visit, the prevalence of overt diabetes was 9.5% among deprived vs 5.1% in the non-deprived group (P<0.001). After adjustment on confounding factors, deprivation was found independently associated with occurrence of diabetes [1.70 (1.15-2.51), P=0.01]. Beyond social deprivation, Fasting Plasma Glucose and waist circumference were the main independent predictors of new-onset diabetes. CONCLUSION: After 4 years of follow-up, among subjects with prediabetes, prevalence of diabetes was twice as high among deprived compared with non-deprived subjects. Deprived populations with pre-diabetes may require specific public health approaches to avoid the occurrence of overt diabetes.
[Improving provision of mother-and-child care in Chad at the community level: A quasi-experimental study].
Manoufi D, Kabore WC, Yahannon CN … +2 more , Dumont A, Ridde V
Rev Epidemiol Sante Publique · 2021 Aug · PMID 34030893 · Publisher ↗
BACKGROUND: Chad is among the countries with the highest maternal and infant mortality rates in the world. An initiative aimed at improving mother-and-child health services was implemented from 2016 to 2019 in three rura...
BACKGROUND: Chad is among the countries with the highest maternal and infant mortality rates in the world. An initiative aimed at improving mother-and-child health services was implemented from 2016 to 2019 in three rural health districts in southern Chad, with strong community input, while concomitantly increasing the supply and demand for care. The objective of this study is to evaluate the effects of this program on health service use. METHODS: Interrupted time-series analyses with a control group was used to measure the effects of the intervention by applying a quasi-experimental approach. Monthly attendance data were collected from the registries of the 18 health centres that participated in the program and 18 centres that did not participate (control group), before (18 months) and after (24 months) the start of implementation. RESULTS: On average, there were 10.98 (95% CI: 6.57-15.39, P<0.001) additional paediatric visits and 0.68 additional deliveries (95% CI: 0.42-0.95, P<0.001) each month in the participation group compared to the control group. Community involvement decisively contributed to the change. CONCLUSION: During the 24 months of implementation, the initiative significantly increased the use of essential mother-and-child health services in Chad. This study highlights the benefits of a strong partnership with communities trained and involved in health system activities, with the objective of achieving universal health coverage.
[A short history of the concept of bias in epidemiology].
Brault N
Rev Epidemiol Sante Publique · 2021 Aug · PMID 34030892 · Publisher ↗
BACKGROUND: Bias is a major methodological issue for epidemiology. However, only a few studies have been dedicated to the past and present formulations of the concept of bias. Moreover, the classical definition of bias a...
BACKGROUND: Bias is a major methodological issue for epidemiology. However, only a few studies have been dedicated to the past and present formulations of the concept of bias. Moreover, the classical definition of bias as systematic deviation from the truth of results or inferences, definition which can be found in dictionaries of epidemiology, does not seem to either match the way epidemiologists use it in practice, or correspond to the different definitions given throughout its history. It is consequently important to elucidate this paradox. METHODS: In this historical and conceptual article, we study the different uses of the word "bias" in epidemiological literature, from classic articles in the 1950's about the link between smoking and lung cancer to the most recent epidemiology textbooks, the objective being to analyze the ways in which epidemiologists have defined, applied and modified this concept over time. RESULTS: We show that D.L. Sackett's article on bias in analytic research, published in 1979, put an end, at least temporarily, to reflection in populational epidemiology that started thirty years before. More precisely, we show that Sackett's definition of bias corresponds more to the needs and goals of clinical epidemiology than to those of populational epidemiology. Concomitantly, populational epidemiologists such as K.J. Rothman redefined bias as a threat to the internal validity of a study, and epidemiological study as an "exercise in measurement of an effect rather than as a criterion-guided process for deciding whether an effect is present or not". CONCLUSION: It is thereby important to draw a distinction between two notions pertaining to bias: an epidemiological concept of bias, viewed as the lack of internal validity of an observational study; and a medical concept of bias, defined as deviation from the truth. The former concerns the design and methodology of epidemiological studies; the latter is more general and impels epidemiologists and physicians to be skeptical, and even critical, towards their own inferences.
Diabetes is a major cause of influenza-associated mortality in Mexico.
Gómez-Gómez A, Sánchez-Ramos EL, Noyola DE
Rev Epidemiol Sante Publique · 2021 Aug · PMID 34023186 · Publisher ↗
BACKGROUND: Influenza is a major cause of mortality worldwide. Most influenza-associated deaths are associated with cardiovascular or respiratory disorders. However, a large proportion of influenza-associated deaths do n...
BACKGROUND: Influenza is a major cause of mortality worldwide. Most influenza-associated deaths are associated with cardiovascular or respiratory disorders. However, a large proportion of influenza-associated deaths do not have respiratory or cardiovascular disorders declared as the underlying cause of death. Diabetic individuals are at increased risk for influenza-mortality. In this study, we assessed the contribution of diabetes to influenza-associated mortality in Mexico. METHODS: Diabetes influenza-associated mortality was estimated for the Mexican population using National Mortality Databases from the Mexican Ministry of Health from 1998 through 2015. Diabetes influenza-associated mortality was calculated applying Serfling cyclical regression models to weekly mortality rates for persons 20-59 years, 60 and more years, and all ages, and by sex. RESULTS: There was a high correlation between weekly pneumonia and influenza mortality and diabetes-related mortality. Yearly influenza-associated diabetes mortality rates varied between 2.0 and 5.9/100,000. Up until the 2005-2006 season, diabetes-associated mortality rates were higher in females, while after that season rates were higher in males. Yearly influenza-associated diabetes mortality rates for adults 20-59 years of age ranged between 1.7 and 3.4/100,000, while estimates for adults 60 years and older ranged between 16.3 and 46.1/100,000. Approximately one third of estimated diabetes influenza-associated deaths occurred in adults 20-59 years of age. On average, diabetes deaths accounted for 19.6% of estimated influenza-associated all-cause mortality. CONCLUSION: Diabetes is a major cause of estimated influenza-associated mortality in Mexico. Health-care authorities and professionals in countries with high diabetes prevalence should be aware of the potential impact of influenza in individuals with this condition.
[The roles of patients in healthcare provision, training and research: A French perspective].
Merle R, Casagrande A, Pariset A … +5 more , Pépin JL, Palombi O, Debru R, Borel JC, Pison C
Rev Epidemiol Sante Publique · 2021 Oct · PMID 34020854 · Publisher ↗
In 2002, patients were transformed into users of the French health system. As this opinion piece demonstrates, in 2021 they may at least potentially participate more actively than before. They can convey their knowledge...
In 2002, patients were transformed into users of the French health system. As this opinion piece demonstrates, in 2021 they may at least potentially participate more actively than before. They can convey their knowledge of a disease and its treatments, and voluntarily share their experience. They can intervene in user representation and therapeutic patient education, the objective being to increase the autonomy of one and all, patients and public, in the training of professionals, clinical research and evolution of the health system. The rationale for the involvement of patients and their roles in provision of care, training and clinical research are analyzed from a French perspective. The obstacles to overcome and improvements to be achieved are reviewed, the objective being to promote enhanced health democracy through increased patient engagement. In 2021, however, the role of patients in the design and implementation of therapeutic patient education (TPE) and in the development of medical studies curricula remains limited if not restricted; this is due not only to a lack of information, but also to the resistance of health professionals and universities. Patients could and should assume a major role, fostering evolution toward a more just and effective health care system.
[The impact of the COVID-19 pandemic on first-line primary care in southeastern France: Feedback on the implementation of a real-time monitoring system based on regional health insurance data].
Davin-Casalena B, Jardin M, Guerrera H … +8 more , J Mabille, Tréhard H, Lapalus D, Ménager C, Nauleau S, Cassaro V, Verger P, Guagliardo V
Rev Epidemiol Sante Publique · 2021 Jun · PMID 33992499 · Full text
BACKGROUND: Starting in spring 2020, the COVID-19 pandemic markedly impacted the French healthcare system. Lockdown and risks of exposure to the coronavirus induced patients to modify their ways of use. The objective of...
BACKGROUND: Starting in spring 2020, the COVID-19 pandemic markedly impacted the French healthcare system. Lockdown and risks of exposure to the coronavirus induced patients to modify their ways of use. The objective of this article was to share feedback on the implementation of a real-time monitoring system concerning (a) the activity of private practitioners in southeastern France, and (b) the evolution of reimbursements for drugs prescribed to persons with diabetes, for treatment of mental health disorders, and for performance of some vaccines. METHODS: Data regarding 2019 and 2020 were extracted from regional health insurance databases. They were used to elaborate several indicators relative to the general health insurance scheme, which were calculated and updated each week, starting with week 2. RESULTS: We observed a drop in private physician activity during the lockdown (-23% for general practitioners; -46% for specialist doctors), followed by a return to a semblance of normalcy. Concomitantly, a boom in teleconsultations occurred: at the height of the crisis they represented 30% of medical acts. The initial stage of the lockdown was characterized by peak provisioning for drugs, whereas vaccination strongly declined (-39% regarding measles, mumps and rubella vaccine among children aged less than 5 years; -54% regarding human papillomavirus vaccine among girls aged 10 to 14 years). CONCLUSION: The COVID-19 pandemic could lead to health effects other than those directly attributable to the coronavirus itself. Renouncing care may result in healthcare delays highly deleterious for people and society. Public authorities are preoccupied with these questions; they have set up action plans aimed at encouraging patients to seek treatment without delay. That said, the COVID-19 pandemic crisis has also created opportunities, such as the expansion of telemedicine. Although partial, these indicators can provide useful information enabling public decision makers to be reactive and to implement specific actions to meet the health needs of the population.
[Quality of "crisis communication" media during the COVID-19 pandemic in the Great Maghreb countries].
Ben Abdelaziz A, El Haddad N, Hannachi H … +6 more , Nouira S, Melki S, Chebil D, Chelly S, Quessar A, Boussouf N
Rev Epidemiol Sante Publique · 2021 Jun · PMID 33966926 · Full text
OBJECTIVE: To objectively assess the quality of "crisis communication" media, during the COVID-19 pandemic, in the three Greater Maghreb countries (Tunisia, Algeria, Morocco). METHODS: A compliance audit for press releas...
OBJECTIVE: To objectively assess the quality of "crisis communication" media, during the COVID-19 pandemic, in the three Greater Maghreb countries (Tunisia, Algeria, Morocco). METHODS: A compliance audit for press releases and epidemiological bulletins was analyzed against a quality benchmark, which had been specifically designed by the authors. This framework, made up of five dimensions and 50 items, graded (0/1), was applied by two researchers in preventive medicine. Multiplying the scores by a coefficient of two resulted in a partial score of 20 points for each dimension and a total score of 100 points for the checklist taken as a whole. The quality of the communication media was considered to be good when exceeding the thresholds of 15/20 for the different dimensions and 75/100 for the entire grid. RESULTS: A total of 141 information media were included in this audit (Tunisia: 60; Algeria: 60; Morocco: 21). The overall median quality score for these media was only 56/100 (IIQ: [46-58]), without major variability between countries. The most appreciated dimension was "maintaining the confidence of the population", with an overall median score of 14/20 (12/20 for epidemiological bulletins and 16/20 for press releases). The most poorly rated dimension was "strengthening community participation", with a median score of only 4/20 (6/20 for epidemiological bulletins and 4/20 for press releases). CONCLUSION: The quality of the Maghreb crisis communication media during COVID-19 was insufficient in most of its dimensions and items, particularly from a psychosocial standpoint. Reinforcement of the capacities of communication officers to develop information material and supports during health crises is indispensable and should be considered as an urgent matter.
Differences in the Associations between Body Dissatisfaction and Eating Outcomes by Gender? A Lebanese Population Study.
Zakhour M, Haddad C, Sacre H … +8 more , Tarabay C, Zeidan RK, Akel M, Hallit R, Kheir N, Obeid S, Salameh P, Hallit S
Rev Epidemiol Sante Publique · 2021 Jun · PMID 33965268 · Publisher ↗
BACKGROUND: The objective of this study was to evaluate the impact of the interaction between body dissatisfaction and gender on eating disorders (restrained eating, binge eating, orthorexia nervosa, and emotional eating...
BACKGROUND: The objective of this study was to evaluate the impact of the interaction between body dissatisfaction and gender on eating disorders (restrained eating, binge eating, orthorexia nervosa, and emotional eating) among a sample of Lebanese adults. METHODS: This cross-sectional study, conducted between January and May 2018, enrolled 811 participants selected randomly from all Lebanese Mohafazat. The mean age of the participants was 27.6±11.8 years. The majority were females (66.5%), had a high level of education (73.2%), and low income (77.9%). This study used the following scales: body dissatisfaction subscale of the Eating Disorder Inventory-second version, binge eating scale, Dutch restrained eating scale, orthorexia nervosa scale (ORTHO-15 scale), emotional eating scale, perceived stress scale, Hamilton Anxiety Rating Scale, and Hamilton Depression Rating Scale. RESULTS: Body dissatisfaction was positively correlated to restrained eating (r=0.293, P<0.001), emotional eating (r=0.073, P=0.042) and binge eating (r=0.250, P<0.001). The interaction between body dissatisfaction and gender was significantly associated with more restrained eating (Beta=0.01, P<0.001) and orthorexia nervosa (Beta=-0.09, P<0.001), but not with emotional (Beta=-0.43, P=0.103) and binge eating (Beta=-0.08, P=0.358). When stratifying the analysis by gender, the results revealed that higher body dissatisfaction was significantly associated with more restrained eating in both genders, but particularly among women. Body dissatisfaction was significantly associated with higher emotional eating in men only and with higher orthorexia nervosa tendencies and behaviors in females only. CONCLUSION: The interaction between body dissatisfaction and gender was significantly associated with orthorexia nervosa and restrained eating but not with binge or emotional eating. Higher body dissatisfaction was significantly associated with higher restrained eating, more pronounced in women, while it was significantly associated with higher orthorexia tendencies (lower ORTO-15 scores) in women only. Body dissatisfaction was associated with emotional eating in men only.
[Not Available].
Giorgi R, Boher JM, Comités scientifique et d’organisation
Rev Epidemiol Sante Publique · 2021 Jun · PMID 33958226 · Publisher ↗
Abstract loading — click title to view on PubMed.
[Physical activity and chronic illness, a theoretical framework].
Mino JC, Perrin C
Rev Epidemiol Sante Publique · 2021 Jun · PMID 33865651 · Publisher ↗
The positive effects of adapted physical activity (PA) in patients with chronic illness are scientifically recognized, and PA promotion is part and parcel of public policy. In this context, one task in public health rese...
The positive effects of adapted physical activity (PA) in patients with chronic illness are scientifically recognized, and PA promotion is part and parcel of public policy. In this context, one task in public health research consists in improving knowledge of PA practice in persons with chronic illnesses. As a complement to studies evaluating the importance of various determinants of PA practice, qualitative research is called for. In this framework, the present article will propose a theoretical analytical framework for study of PA in chronic illness. It will be built around two key concepts, namely the "standards of life" drawn from the notion of health in the philosophy of Georges Canguilhem and the "illness trajectory" drawn from the interactionist sociology of Anselm Strauss. We will attempt to improve understanding of the important yet frangible "labor" of patients at work in transformation of their habits and life standards involving PA professionals.
[Ethnicity and immigration status: How are they associated with work and depressive symptoms?].
Kammogne CL, Marchand A
Rev Epidemiol Sante Publique · 2021 Jun · PMID 33744031 · Publisher ↗
BACKGROUND: The purpose of this research is to determine whether, in the Canadian workforce, cultural identity traits, particularly ethnicity and immigrant status, might modify the association of work with depressive sym...
BACKGROUND: The purpose of this research is to determine whether, in the Canadian workforce, cultural identity traits, particularly ethnicity and immigrant status, might modify the association of work with depressive symptoms. METHOD: Data were derived from the nine cycles of the National Population Health Survey (NPHS) conducted by Statistics Canada. Based on a sample of 6477 workers, multilevel regression models were brought into being. Analyses were adjusted for family-related factors, non-work social support, and personal characteristics. RESULTS: After accounting for potential confounders, ethnicity and work-related factors were distinctly and directly associated with depressive symptoms. Workers belonging to visible minorities had significantly fewer depressive symptoms than their Caucasian counterparts. Unlike Caucasians, they were more often overqualified, less in a position to use their skills, and largely without decision-making authority. On the other hand, all analyses having to do with immigrant status led to inconclusive results. CONCLUSION: Ethnicity seems to have some bearing on the association of work with depressive symptoms among members of the Canadian workforce. It might be beneficial to carry out targeted interventions aimed at improving working conditions according to ethnicity and situations involving professional overqualification.
[Linking Interventional Cardiology clinical registry data with French hospital administrative data: Development and validation of deterministic record linkage].
Lesaine E, Belhamri NM, Legrand JP … +5 more , Domecq S, Coste P, Lacroix A, Saillour-Glenisson F, ACIRA investigators
Rev Epidemiol Sante Publique · 2021 Apr · PMID 33707007 · Publisher ↗
BACKGROUND: To recreate the in-hospital healthcare pathway for patients treated with coronary angiography or percutaneous coronary intervention, we linked the interventional cardiology registry (ACIRA) and the pseudonymi...
BACKGROUND: To recreate the in-hospital healthcare pathway for patients treated with coronary angiography or percutaneous coronary intervention, we linked the interventional cardiology registry (ACIRA) and the pseudonymized French hospital medical information system database (PMSI) in the Aquitaine region. The objective of this study was to develop and validate a deterministic merging algorithm between these exhaustive and complementary databases. METHODS: After a pre-treatment phase of the databases to standardize the 11 identified linking variables, a deterministic linking algorithm was developed on ACIRA hospital stays between December 2011 and December 2014 in nine interventional cardiology centers as well as the data from the consolidated PMSI databases of the Aquitaine region from 2011 to 2014. Merging was carried out through 12 successive steps, the first consisting in strict linking of the 11 variables. The performance of the algorithm was analyzed in terms of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Strategies complementary to the initial algorithm (change in the order of variables and base preprocessing) were tested. Comparative analysis of merged/unmerged patients explored potential causes of mismatch. RESULTS: The algorithm found 97.2% of the 31,621 ACIRA stays to have sensitivity of 99.9% (95% CI [99.9; 99.9]), specificity of 97.9% (95% CI [97.7; 98.1]), PPV of 99.9% (95% CI [99.9; 99.9]) and NPV of 96.9% (95% CI [96.7; 97.1]). Complementary strategies did not yield better results. The unmerged patients were older, and hospitalized mostly in 2012 in two interventional cardiology centers. CONCLUSION: This study underscored the feasibility and validity of an indirect deterministic pairing to routinely link a registry of practices using hospital data to pseudonymized medico-administrative databases. This method, which can be extrapolated to other health events leading to hospitalization, renders it possible to effectively reconstruct patients' hospital healthcare pathway.
[Neonatal healthcare associated-infections in the Maghreb. A systematic review and meta-analysis].
Zoukal S, Tsoumbou-Bakana G, Traore B … +2 more , Nani S, Hassoune S
Rev Epidemiol Sante Publique · 2021 Apr · PMID 33642130 · Publisher ↗
BACKGROUND: Healthcare-associated infections are a major source of morbidity and mortality in neonatology. Our aim was to describe the epidemiology of Healthcare-associated infections in neonatology (frequency, associate...
BACKGROUND: Healthcare-associated infections are a major source of morbidity and mortality in neonatology. Our aim was to describe the epidemiology of Healthcare-associated infections in neonatology (frequency, associated factors and prognosis). METHODS: Articles were searched in the PubMed, Scopus and Web of Science databases. We included observational studies describing prevalence, incidence or mortality among new-born babies having developed infections more than 48hours after hospitalization. The pooled prevalence, incidence and mortality estimates were analysed using the random effects model. Publication bias was analysed using the funnel plot and Egger's test statistics. Data analysis was carried out using R Studio software v1.2. RESULTS: Among the initially identified 137 studies, ten articles fulfilled the inclusion criteria and were included in the metanalysis. They mainly concerned Morocco, Tunisia and Algeria. Pooled incidence was 10% (95% CI [4%-18%]) and overall mortality was 49% (95% CI [33%-66%]). Heterogeneity between studies was significantly high, with rates of 98% and 90% respectively. CONCLUSION: This review underlined a need to undertake more large-scale multicentric surveys and studies on monitoring systems and the attitudes and practices of relevant caregivers, the objective being to better understand the realities of healthcare-associated infections in Greater Maghreb neonatology units.
[When school meets health prevention, collaboration and confrontation co-occur].
Gaborit E, Haschar-Noé N
Rev Epidemiol Sante Publique · 2021 Apr · PMID 33640198 · Publisher ↗
BACKGROUND: The French social security system has initiated a nutritional education program in nursery schools. On the basis of empirical data and a nursery school model compelling the application of specific standards,...
BACKGROUND: The French social security system has initiated a nutritional education program in nursery schools. On the basis of empirical data and a nursery school model compelling the application of specific standards, we analyze the conditions under which the program is implemented. METHODS: A socio-ethnographic study was conducted during the 2012-2017 period in 16 classrooms in 6 nursery schools that implemented the nutritional program. This article presents the results of a monographic analysis drawn from data collected through interviews and the observation of nutritional sessions at school. RESULTS: The pedagogical tools and the rationalization of tasks involving teachers and dietitians furthered adaptation to the constraints of nursery school functioning in accordance with the dietitians' vision of the school. With the teachers' feedback in mind, the nutritional program is called upon to evolve, but its evolution will not stand in the way of program rationalization and uniformization. Teachers will nevertheless implement the program in different ways, according to the realities of their classrooms. CONCLUSION: We studied and analyzed the conditions favorable to collaboration between nursery schools and the French social security system. Results showed how the "sanitarization" of nursery schools requires anticipation of the constraints imposed by the nursery school model. Conditions for organizing collaborative work necessitated both transformation of the health program and satisfactory coordination at school between the protagonists, thereby highlighting reciprocal influence and adjustment between two (dietitians and teachers) work cultures.
[Editorial].
Rey G
Rev Epidemiol Sante Publique · 2021 Apr · PMID 33610337 · Full text
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[Advocacy for the measurement and reduction of COVID-19 disparities according to migratory status and ethnic category in France].
Melchior M, Desgrées du Loû A, Gosselin A … +4 more , Datta GD, Carabali M, Merckx J, Kaufman JS
Rev Epidemiol Sante Publique · 2021 Apr · PMID 33610336 · Full text
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[Time trends and age-period-cohort effects on the incidence of the most frequent cancers in Oran, Algeria, 1999-2018].
Raiah M, Ahmed Fouatih Z
Rev Epidemiol Sante Publique · 2021 Jun · PMID 33583656 · Publisher ↗
BACKGROUND: Cancer is currently one of the major public health problems in Algeria. The aim of this study was to examine time trends and the effects of age, period and cohort on incidence at the major cancer locations fr...
BACKGROUND: Cancer is currently one of the major public health problems in Algeria. The aim of this study was to examine time trends and the effects of age, period and cohort on incidence at the major cancer locations from 1999 to 2018 in Oran, Algeria. METHODS: Data on the five most frequent primary cancer locations among patients aged 20-79 years were collected from the Oran cancer registry. Annual percentile changes in incidence rates were evaluated using the Joinpoint regression program. Age-period-cohort models were designed to examine the effects of age, period and birth cohort on cancer incidence. RESULTS: From 1999 to 2018, there were 12,278 incident cases at the five major cancer locations. Unfavorable trends in incidence were observed regarding lung and colorectal cancers in both sexes, as well as breast cancer in women. Age-period-cohort analysis showed that age, period and birth cohort yielded different effects at different cancer locations. CONCLUSION: The observed trends primarily reflect lifestyle changes in Algeria over the course of recent years.
[Diabetes mellitus and high blood pressure over risk in HIV-infected people followed at Souro Sanou University Hospital Day Hospital, Bobo-Dioulasso 2018].
Hema A, Poda A, Tougouma JB … +9 more , Meda C, Kabore F, Zoungrana J, Kamoule E, Sore I, Bado G, Ouedraogo AS, Sawadogo AB, Millogo A
Rev Epidemiol Sante Publique · 2021 Apr · PMID 33563493 · Publisher ↗
BACKGROUND: Non-communicable diseases (NCDs) represent the leading causes of death worldwide. HIV also increases the risk of developing NCDs including diabetes mellitus and hypertension. METHODS: A cross-sectional study,...
BACKGROUND: Non-communicable diseases (NCDs) represent the leading causes of death worldwide. HIV also increases the risk of developing NCDs including diabetes mellitus and hypertension. METHODS: A cross-sectional study, based on an analysis of the cohort database of the day hospital of the Souro Sanou teaching hospital in Bobo-Dioulasso (Burkina Faso). Diabetes mellitus was defined by the undergoing of anti-diabetic treatment or two successive measurements of fasting blood sugar above 7mmol/l and high blood pressure by the undergoing of antihypertensive treatment or two successive measurements of blood pressure above 140/90mmHg. Comparison of the frequency of diabetes and hypertension in the people living with HIV/AIDS (PLWHA) population on antiretroviral therapy (ART) with that of the general population of Burkina Faso was made by indirect standardization according to age and gender. RESULTS: A total of 4259 patients including 3148 women (73.9%) were included in this study. The median age of the patients was 45 years (IQR: 38-52); the median body mass index (BMI) was 19.6kg/m (IQR: 15.4 - 22.7) and 48.3% of patients had a BMI≥25kg/m. The median CD4 count was 590 cells/mm (IQR: 417-785). The median ART duration was 8.2 years (IQR: 4.7-11.2). The majority of patients (82.9%) were on treatment combinations consisting in 2 INTI+1 NNRTI. Prevalence of hypertension was 39.8%; it was statistically higher in men than in women (45.8% versus 37.8%). Prevalence of hypertension was 87.0% higher in the PLWHA population than among same-sex and same-age subjects in the general population. Prevalence of diabetes mellitus was 7.3%. Diabetes mellitus was more common in men than in women (10.1% versus 6.3%; P<10). Prevalence of diabetes mellitus was 36.0% higher in the PLWHA population than among same-sex and same-age subjects in the general population. CONCLUSION: Prevalence of diabetes mellitus and hypertension was higher among PLHWA undergoing ART than in the general population. Care for the PLHWA population should more widely include NCD treatment.
[The social to the test, the test of the social. Or the art of accommodating patients' social position in preventive work in general medicine].
Bloy G, Richerand N, Rigal L
Rev Epidemiol Sante Publique · 2021 Feb · PMID 33531167 · Publisher ↗
AIM: This article examines the way in which private general practitioners take into account the social position of their patients in their preventive work. METHODS: After a review of the main normative constructs suppose...
AIM: This article examines the way in which private general practitioners take into account the social position of their patients in their preventive work. METHODS: After a review of the main normative constructs supposed to equip the general practitioners to grasp the social dimension of their practice, the article used two surveys on the provision of preventive care, one epidemiological (PrevQuanti) and the other sociological (PrevQuali). RESULTS: Deontology, training and recommendations make it difficult to shape the social dimensions of health that pratitioners have to deal with. The PrevQuanti survey, however, revealed that the provision of preventive care is subject to almost systematic but variable social gradients. The analysis, based on the PrevQuali interview study, makes the ways in which pratitioners mobilise the social position of their patients and whether or not they adapt to it. CONCLUSION: The positionings of general practitioners can be modelled in a typology of six postures between which some oscillate.
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