Revue D'epidemiologie Et De Sante Publique[JOURNAL]
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200 papers
[The interplay between isolation and precariousness, and hospitalization duration in French Guiana].
Nacher M, Deungoue S, Brousse P … +3 more , Adenis A, Couppié P, Sobesky M
Rev Epidemiol Sante Publique · 2020 Apr · PMID 32035728 · Publisher ↗
BACKGROUND: French Guiana faces singular health challenges: poverty, isolation, structural lag, difficulties in attracting health professionals. Hospital stays exceed the recommended durations. The present study aimed to...
BACKGROUND: French Guiana faces singular health challenges: poverty, isolation, structural lag, difficulties in attracting health professionals. Hospital stays exceed the recommended durations. The present study aimed to model the impact of precariousness and geographic isolation on the hospital duration performance indicator and to recalculate the indicator after incrementing severity by 1 unit when patients were socially precarious. METHODS: Cayenne hospital data for 2017 were used to model the hospital duration performance indicator (IP-DMS) using quantile regression to study the impact of geographic and social explanatory variables. This indicator was computed hypothesizing a 1 unit increment of severity for precarious patients and by excluding patients from isolated regions. RESULTS: Most excess hospitalization days were linked to precariousness: the sojourns of precarious patients represented 47% of activity but generated 71% of excess days in hospital. Quantile regression models showed that after adjustment for potential confounders, patients from western French Guiana and Eastern French Guiana, precarious patients and the interactions terms between residence location and precariousness were significantly associated with IP-DMS increases. Recalculating the IP-DMSafter exclusion of patients from the interior and after increasing severity by 1 notch if the patient was precarious led to IP-DMS levels close to 1. CONCLUSION: The results show the nonlinear relationship between the IP-DMS and geographical isolation, poverty, and their interaction. These contextual variables must be taken into account when choosing the target IP-DMS value for French Guiana, which conditions funding and number of hospital beds allowed in a context of rapid demographic growth.
[Exploratory study on spinal musculoskeletal health of osteopathy students].
Javerliat P, Pizon F, Gerbaud L
Rev Epidemiol Sante Publique · 2020 Apr · PMID 32007330 · Publisher ↗
BACKGROUND: During their training, students in osteopathy regularly undergo spinal manipulation exercises. This exposes the students' spine to unskilled gestures performed by their colleagues learning spinal manipulation...
BACKGROUND: During their training, students in osteopathy regularly undergo spinal manipulation exercises. This exposes the students' spine to unskilled gestures performed by their colleagues learning spinal manipulation. Discomfort, muscle soreness or moderate pain following spinal manipulations lasting two or three days are commonly reported. In addition, some students may have ongoing spinal musculoskeletal disease (SMSD) during their studies. The purpose of this study was to evaluate the prevalence of SMSDs and their maximum intensity in a population of osteopathy students and to determine whether individual differences exist. METHOD: An exploratory cross-sectional study took place over three years. Data were collected by means of a self-administrated standardised questionnaire screening for MSD: the Nordic questionnaire. RESULTS: There were 733 exploitable questionnaires, giving an average response rate of 91.5%. Average prevalence of SMSD was 98.4% during the last 12 months. Average maximum intensity perceived was 6/10 and 45% of students experienced an intense SMSD (scored between 7 and 10/10). Variation of the maximum intensity of SMSD between "before osteopathy studies" and "the last 12 months" was 1.2/10. This variation was influenced by the number of days students were manipulated during a week (p<0.0001). On average, students underwent manipulation three days a week. CONCLUSION: This study confirms the important prevalence of SMSD among osteopathy students. This result led us to carry out a qualitative study for exploring students' conceptions in health and spinal manipulative practices.
[What place for French morbidity registries in the era of big data?].
Francis F, Terroba C, Persoz C … +2 more , Gagliolo JM, Alla F
Rev Epidemiol Sante Publique · 2020 Apr · PMID 31974001 · Publisher ↗
The recent opening of massive health databases, as well as the development of methods and tools adapted to their data processing, questions the French model of "morbidity registry". In France in 2019, nearly 61 health re...
The recent opening of massive health databases, as well as the development of methods and tools adapted to their data processing, questions the French model of "morbidity registry". In France in 2019, nearly 61 health registries were operating. As defined by law, these registries identify exhaustively all patients with a given disease in a given territory. Established several decades ago, these registries are part of the French surveillance system that is used for research and evaluation purposes. Since the advent of recent technological progress, large-scale databases are made available to researchers and it is possible with these databases to answer questions initially assigned to the registries. What is the place of such registries in this new context: are they obsolete or still useful? Should they be opposed to the new tools or are they complementary to them, and if so, what is their place in the new French public health ecosystem? The objective of this work was to assess the roles and missions of existing registries and to reflect on their positioning in this new environment. The French model of registry is sometimes questioned because of the complexity of its circuits, requiring a significant amount of human resources. However, the data that constitute them, validated by cross-checking information from several sources, are of very high quality, and make it possible to validate the data in the new databases (National Health Data System (NSDS) or Hospital Data Warehouses). Registries and new databases are in fact complementary, and far from jeopardizing this model, the recent opening of these databases represents an opportunity for registries to modernize their operations and respond to new missions.
[Epidemiology profil of fever typhoid in Meknes (Morocco) 2013-2016].
Essayagh M, Rhaffouli AE, Essayagh S … +1 more , Essayagh T
Rev Epidemiol Sante Publique · 2020 Feb · PMID 31917023 · Publisher ↗
INTRODUCTION: Twenty million cases of typhoid and paratyphoid fever (TF) are observed annually worldwide with more than 200,000deaths. These fevers occur in areas where hygiene is precarious, mainly in developing countri...
INTRODUCTION: Twenty million cases of typhoid and paratyphoid fever (TF) are observed annually worldwide with more than 200,000deaths. These fevers occur in areas where hygiene is precarious, mainly in developing countries. The objective of this study was to describe epidemiological patterns of TF in Meknes, Morocco in order to improve preventive measures. METHODS: We conducted a case series study based on data from 2013 to 2016 in the Meknes TF surveillance system. Data collected included socio-demographic variables, place of residence, season, mode of water supply, and food consumed. Diagnosis of TF was confirmed with the Widal test. Data were analyzed with Epi-info version 7 and mapping was done with Qgis version 2.18.1. RESULTS: Three hundred and twenty-two cases were reported with a male/female sex ratio of 0.9. Average age was 26±20years. Incidence increased from 13 per 100.000inhabitants in 2013 to 8 per 100.000 inhabitants in 2016. Two hundred and seventy-nine (87%) cases occurred in urban areas and 174 (54%) cases developed in summer. One death was recorded. CONCLUSION: Public awareness campaigns on health education for hygiene are needed. Focus should be placed on transmission by food handlers.
High temperature effect on daily all-cause mortality in Tunis 2005-2007.
Bettaieb J, Toumi A, Leffondre K … +2 more , Chlif S, Ben Salah A
Rev Epidemiol Sante Publique · 2020 Feb · PMID 31874725 · Publisher ↗
BACKGROUND: The relationship between thermal stress and health has been only marginally investigated in North Africa. This study aimed to estimate the short-term effect of heat on total mortality, in the city of Tunis in...
BACKGROUND: The relationship between thermal stress and health has been only marginally investigated in North Africa. This study aimed to estimate the short-term effect of heat on total mortality, in the city of Tunis in 2005-2007, using time series analysis. METHODS: The study period was restricted to the summer season (May-October) and heat effect was assessed using maximum temperature as exposure variable. We estimated the breakpoint above which heat-related mortality begins to increase using a segmented linear regression. A Poisson Generalized Estimating Equations (GEE) model was then used to estimate the impact of heat on daily mortality. Models were adjusted for nitrogen dioxide (NO), trend, calendar month, day of the week, the Ramadan period, and holidays. RESULTS: The estimated breakpoint was 31.5°C (standard deviation: 0.9°C). After adjustment for potential confounders, the daily mortality increased significantly by 2.00% [95% confidence interval: 0.68-3.16] for a 1°C increase in daily maximum temperature above the breakpoint. An increase of 10mg/m in NO was associated with a significant increase in daily mortality (0.48% [0.08-0.88]). CONCLUSION: There is an important effect of heat on daily mortality in the city of Tunis. This is the first evaluation of such an association in a North African city with hot and dry summers and a lower middle economy.
Multi-sectorial research is paramount for preventing and controlling emerging infectious diseases.
Le Turnier P, Leport C, Martin P … +3 more , Jadand C, Hoen B, Guégan JF
Rev Epidemiol Sante Publique · 2020 Apr · PMID 31862272 · Full text
The social, economic and political consequences of emerging infectious disease (EID) may escape the sphere in which they first arise. In recent years, many EIDs have revealed the close links between human, animal and pla...
The social, economic and political consequences of emerging infectious disease (EID) may escape the sphere in which they first arise. In recent years, many EIDs have revealed the close links between human, animal and plant health, highlighting the need for multi-scale, multisectorial EID management. Human beings play a dual role in EID because they can promote their development through numerous human-environment interfaces and expanding international trade. On the other hand, their ability to analyze, interpret and act on the determinants of EID allows them to access the expertise necessary to control these EIDs. This expertise must be constantly adapted to remain relevant as the EID evolves, particularly in its virulence or transmission channels. Flexibility should become an inherent part of the expertise-based decision-making process even if it means going backwards. A certain degree of transparency and feedback to citizens is necessary for the acceptability of political decisions basing on expertise. A key step in the management of EID is the appropriate management of the early signal of infectious emergence. This step combines multidisciplinary skills allowing access to the best pathway for containing EID by implementing early countermeasures adapted to the situation. New digital technologies could significantly improve this early detection phase. Finally, experts have a fundamental role to play because they are located at the interface between operational actors and decision-makers, which allows multidirectional feedback, ideally in real time, between professional actors and decision makers. To combat current and future EIDs, expertise should be based on a multi-sectorial approach, promotion of collegiality and continuously adaptation to the evolving nature of EIDs.
[Occupational factors associated with suicide among French employees from the special agricultural social security scheme (MSA) working between 2007 and 2013].
Klingelschmidt J, Chastang JF, Khireddine-Medouni I … +2 more , Chérié-Challine L, Niedhammer I
Rev Epidemiol Sante Publique · 2020 Feb · PMID 31843361 · Publisher ↗
BACKGROUND: Work and related exposures may play a role in suicide and there has been evidence in the literature that some occupational factors may be associated with suicide. The identification of occupational risk facto...
BACKGROUND: Work and related exposures may play a role in suicide and there has been evidence in the literature that some occupational factors may be associated with suicide. The identification of occupational risk factors of suicide mortality among employees affiliated to the French special agricultural social security scheme (MSA), an understudied population, appears important. The objective of this study was to identify the occupational factors associated with suicide mortality among French employees from the MSA working between 2007 and 2013. METHODS: The study population included all the employees affiliated to the MSA working between 1st January 2007 and 31st December 2013, i.e. 1,699,929 men and 1,201,017 women. The studied occupational factors included: economic activity, skill level, and work contract. Survival analyses (Cox models) stratified on gender were performed using age as time scale and region and year of contract as adjustment variables. RESULTS: Among men, the factors associated with an elevated suicide risk were: economic activities of forestry, agriculture and related activities, and manufacture of food products and beverages (e.g. meat, wine), low-skilled level and working in the regions of Brittany, Burgundy Franche-Comté, Pays de la Loire, Normandy, Grand Est and Centre-Val-de-Loire. No association was observed among women. CONCLUSION: These results suggest that economic activity and low-skilled level may be associated with suicide among men affiliated to the MSA and may contribute to the implementation of prevention interventions. Further studies are needed to confirm and better understand these associations.
[Terminology of patient engagement for French healthcare organizations].
Michel P, Brudon A, Pomey MP … +10 more , Durieu I, Baille N, Schott AM, Dadon I, Saout C, Kouevi A, Blanchardon F, Volta-Paulet B, Reynaud Q, Haesebaert J
Rev Epidemiol Sante Publique · 2020 Feb · PMID 31839377 · Publisher ↗
BACKGROUND: The establishment of a common pragmatic terminology represents the first step in structuring patient engagement initiatives in healthcare facilities. However, none is currently available in French. As part of...
BACKGROUND: The establishment of a common pragmatic terminology represents the first step in structuring patient engagement initiatives in healthcare facilities. However, none is currently available in French. As part of the deployment of patient engagement within a French University Hospital Center, we propose a terminology of patient engagement. METHODS: We conducted a scoping review of the international literature that aimed at identifying the main conceptual and terminological frameworks for the engagement of patients, users and citizens in the healthcare system until 2019 in the PubMed and Cairn.info databases for English and French language articles. Additionally, we identified concepts and practices in the leading organizations of countries where this approach was implemented (United States, Canada and especially the province of Quebec, United Kingdom) and completed this approach by close exchanges and reflections with the team that developed the Montreal model. RESULTS: In total, 75 references and Internet resources were consulted. Patient, interaction, patient experience, experiential knowledge, patient engagement, patient partner and its variations as a resource patient, peer-supporter, trainer, researcher and coach have been defined. CONCLUSION: This terminology of patient engagement proposes an initial stabilization of the vocabulary, using a pragmatic approach. This contribution is a first step aiming at promoting the development of a new model of care and more broadly of healthcare system management, involving scientific and experiential knowledge.
[Information around organized breast cancer screening. Do INCa and Cancer Rose meet criteria for decision aids?].
Gocko X, Fondacci M, Dibi C … +1 more , Plotton C
Rev Epidemiol Sante Publique · 2020 Feb · PMID 31839376 · Publisher ↗
BACKGROUND: Controversies around organized breast cancer screening emphasize the need for information for women. In France, the institute of cancer (INCa) is in charge of conveying this information. Cancer Rose's website...
BACKGROUND: Controversies around organized breast cancer screening emphasize the need for information for women. In France, the institute of cancer (INCa) is in charge of conveying this information. Cancer Rose's website (CR) provides complementary information considering INCa's incomplete. The objective of this study was to identify if these informations meet criteria for decision aid. METHODS: Information documents were selected and analyzed using International Patient Decision Aid Standards (IPDAS). Each item was noted A (absent), P (present) or I (present but incomplete). RESULTS: Information booklet and press kit for INCa and studies section for CR were the document meeting most criteria. The document meeting fewer criteria were the INCa's video and information leaflet for CR. Videos are more accessible tools for people with lower levels of health literacy. INCa's video did not present the risks of screening and CR's emphasized the risks. CONCLUSION: These documents have not been evaluated for intelligibility, clarity and readability. Addressing these criteria limits social inequities and improves health literacy.
Human papillomavirus (HPV) vaccination: What can be found on the Web? Qualitative analysis of the Doctissimo.fr forum data.
Bruel S, Peyrard-Chevrier K, Ginzarly M … +2 more , Frappé P, Savall A
Rev Epidemiol Sante Publique · 2020 Feb · PMID 31718831 · Publisher ↗
BACKGROUND: Vaccine hesitancy is a major issue in general practice. Regarding human papillomavirus, less than 20% of young French girls are vaccinated. With widespread availability of health information, the Internet see...
BACKGROUND: Vaccine hesitancy is a major issue in general practice. Regarding human papillomavirus, less than 20% of young French girls are vaccinated. With widespread availability of health information, the Internet seems to be a place of choice to discuss this reluctance. The main objective of this study was to explore perceptions of human papillomavirus vaccination through an analysis of the Doctissimo.fr forum data. METHODS: Using Nvivo software, a qualitative study was carried out from October 2017 to May 2018 on the Doctissimo.fr discussion forum. Online discussion threads not having any message since 2010 were excluded. All threads were analyzed by two independent evaluators. RESULTS: Faced with the doubt that emanated from the discussions and the confusion about the role of the vaccine, Internet users used multiple references in order to develop a reliable discourse. The general practitioner remained a trusted person. While the vaccine was perceived as risky, the cervical smear was approved and encouraged. Although the vaccine remained a feminine concern, males also entered this debate. Through their shared experiences, Internet users tried to influence others about whether or not to get vaccinated. CONCLUSION: Changing the sexual image of the vaccine could help to establish a collective vaccination policy. Public health policies play an essential role by working with general practitioners and by increasing visibility on the web. The usefulness of the vaccine in 2019 seems to be questioned by Internet users as shown by their major approval of cervical smears. However, these two methods remain complementary in the fight against cervical cancer.
[Children's consultations for dental emergency. Retrospective study in Île-de-France].
Tenenbaum A, Sarric M, Bas AC … +3 more , Toledo R, Descroix V, Azogui-Levy S
Rev Epidemiol Sante Publique · 2020 Feb · PMID 31668991 · Publisher ↗
BACKGROUND: In France, the children oral health status has improved but the use of care remains insufficient. The complexity of the acts, the access to care difficulties and the programs of prevention and care for childr...
BACKGROUND: In France, the children oral health status has improved but the use of care remains insufficient. The complexity of the acts, the access to care difficulties and the programs of prevention and care for children lack of knowledge contribute to late care and often, in emergency. This study aims to describe the young patients' characteristics consulting in dental emergency and analyse the modalities of recourse. METHODS: A retrospective study was conducted on medical records. An extraction of data was carried out concerning all children under the age of 16, admitted to the Dental Emergency Functional Unit of the Pitié-Salpêtrière Hospital Group in 2015. Several variables of interest were analysed: socio-demographic characteristics, the time of the visit and the diagnostic category (tooth pathologies, facial trauma, infections, periodontal diseases and other emergencies). Descriptive and bivariate analyses were conducted. RESULTS: On the 62,500 dental emergency consultations in 2015, 5359 were for patients under 16 years of age (8%). Data were available for 5044 children. Among these, children aged 6 to 11 accounted most of consultations (43.9%). There were more boys (57.2%). The most frequent emergency diagnoses were related to a tooth pathology (42.9%) and traumatic event (38.4%). Consultations were more held on the evening schedule on weekdays and the day on weekends. Patients aged 0 to 5 years consulted more at night (P<10) and were, proportionally, the most affected by traumatic events (39.2%). Children aged 6 to 11 and 12 to 16 years consulted more often during the day (P<10), for emergencies related to a carious event (43.9% and 43.6%). Patients residing in Seine-Saint-Denis accounted for 22.6% of total visits and those living in Paris accounted for 20.8%. CONCLUSION: A large proportion of children presenting for dental emergencies, have most of the time, only the need for usual care. An offer of dental care, adapted to the territory needs, is necessary for the children dental health management. Preventive measures from an early age and early recourse would be favourable.
[Unexpected pregnancy, experience of sexual violence and contraception among women who use cannabis or other illegal substance in the Great Paris Region: Data from the 2016 Health Barometer].
Embersin-Kyprianou C, Yermachenko A, Massari V … +2 more , El-Khoury-Lesueur F, Melchior M
Rev Epidemiol Sante Publique · 2020 Feb · PMID 31662285 · Publisher ↗
BACKGROUND: Women who use psychoactive substances could have higher levels of unplanned pregnancy and of difficulties accessing long-term contraceptive methods than those who do not use these substances. General populati...
BACKGROUND: Women who use psychoactive substances could have higher levels of unplanned pregnancy and of difficulties accessing long-term contraceptive methods than those who do not use these substances. General population data on this topic are rare, particularly in France. METHODS: This study is based on data from the French Health Survey 2016, collected from women aged 15 to 49 years and living in the Great Paris region (N=1626). Use of illegal psychoactive substances (cannabis, substances used via intranasal or intravenous administration) were evaluated over the lifecourse and, for cannabis, over the 12 months preceding the study. Unplanned pregnancies were ascertained over the preceding 5 years, emergency contraception, abortion, and the experience of sexual violence during the lifecourse. We also studied the number of sexual partners in the preceding 12 months, as well as current contraception. Data were analyzed using weighted logistic regression models, adjusted for participants' sociodemographic characteristics and tobacco use. RESULTS: Women who use illegal substances have a higher probability than non-users to experience an unplanned pregnancy in the preceding 5 years (OR associated with lifecourse cannabis use: 1.61, 95% CI 1.00-2.58), to have used emergency contraception (ORs between 2.20 to 2.90), to have had an abortion (OR associated with lifecourse cannabis use: 1.77, 95% CI 1.26-2.49), and to have experienced sexual violence (ORs between 1.87 to 3.14). They also had more sexual partners than non-users, but did not differ in terms of contraception. CONCLUSION: In the general population, there is a relationship between women's use of illegal substances and their probability of experiencing sexual violence. These results should be brought to the attention of health professionals in contact with women, to help identify those who have addictive behaviors and identify their sexual and reproductive health needs.
Economic challenges of using innovative medical devices in major public health pathologies: Example of acute ischemic stroke management by mechanical thrombectomy.
Nativel F, Detraz L, Mauduit N … +3 more , Riche VP, Desal H, Grimandi G
Rev Epidemiol Sante Publique · 2019 Nov · PMID 31662284 · Publisher ↗
BACKGROUND: Activity-based Funding can induce financial imbalances for health institutions if innovative medical devices (MD) used to perform acts are included in Diagnosis Related Groups (DRG) tariff. To be reimbursed i...
BACKGROUND: Activity-based Funding can induce financial imbalances for health institutions if innovative medical devices (MD) used to perform acts are included in Diagnosis Related Groups (DRG) tariff. To be reimbursed in addition to the DRG tariff, innovative MD must have received a favorable evaluation by the French National Authority for Health (Haute Autorité de Santé) and be registered on the positive list. The aim of this study was to evaluate the expenses and incomes generated by each scenario (before and after the reimbursement of MD), and the financial reports. This study concerned the management of ischemic stroke by mechanical thrombectomy devices, in high-volume French hospital. METHODS: All patients who have had an acute ischemic stroke and admitted to the interventional neuroradiology unit between January 2016 and December 2017 were included retrospectively in this monocentric study. They were divided into four subgroups based on the severity of the DRG. The cost study was carried out using the French National Cost Study Methodology adjusted for the duration of the stays and by micro-costing on MD. RESULTS: A total of 267 patients were included. Over the study period, the average cost of the hospital stay was €10,492±6364 for a refund of €9838±6749 per patient. The acts performed became profitable once the MD were registered on the positive list (€-1017±3551 vs. €560±2671; P<0.05). Despite this reimbursement, this activity remained in deficit for DRG lowest severity (level 1) patients (€-492±1244). Specific MD used for mechanical thrombectomy represented 37% of the total cost of stay. CONCLUSION: The time required to evaluate MD reimbursement files is too long compared to their development. As a result, practitioners are in difficulty to be able to carry out acts according to the consensual practices of their learned societies, without causing any financial deficit of their institutions.
[Recurrence of dengue epidemics in Burkina Faso: Community preference for an intervention to prevent the disease].
Ouédraogo S, Degroote S, Barro SA … +3 more , Somé PA, Bonnet E, Ridde V
Rev Epidemiol Sante Publique · 2019 Nov · PMID 31645291 · Publisher ↗
BACKGROUND: Community-based interventions have proven effective in several Latin American countries in controlling dengue vector Aedes aegypti and reducing the burden of the disease. However, we did not find any study re...
BACKGROUND: Community-based interventions have proven effective in several Latin American countries in controlling dengue vector Aedes aegypti and reducing the burden of the disease. However, we did not find any study reporting the assessment or implementation of such interventions in Sub-Saharan Africa. This article presents local communities' preferences for activities as part of the implementation of a community-based intervention for dengue prevention in Ouagadougou (Burkina Faso) where dengue epidemics are recurrent during the rainy season. METHODS: A mixed-method study combining qualitative and quantitative data collection was conducted. Information from 983 households and their preferences for community-based activities for dengue prevention were collected in five neighborhoods of the city using a quantitative questionnaire. Then, 15 qualitative focus groups were organized in one of the neighborhoods that was randomly selected to receive a community-based intervention for dengue prevention. These groups were made up of 216 people representing the different socio-cultural categories: community leaders, men, women, young girls and boys. RESULTS: More than 95% of household respondents to the quantitative questionnaire found community-based interventions acceptable and/or useful: to raise awareness of mosquito-borne disease transmission, to identify and remove the mosquito breeding sites and areas favorable to the development of the adult vectors. Most participants in the focus groups, preferred outreach activities such as video/debate sessions, school and home education sessions, focus groups. They also preferred the implementation of community working groups, responsible for identifying and eliminating mosquito breeding sites in the neighborhood. However, many participants had reservations about sending preventive text messages to residents. They found it feasible but not useful since most people cannot read. CONCLUSION: This study shows that it is important to get the local communities involved in the formulation of health prevention activities in sub-Saharan Africa where some interventions are often implemented using strategies from other continents.
[Epidemiological Evolution of Type 1 Diabetes in Children: Data from the Register of the Department of Oran, Algeria, 1973-2017].
Touhami M, Zennaki A, Bouchetara A … +6 more , Naceur M, Aoui A, Gharnouti M, Latroch C, Bouziane-Nedjadi K, Boudraa G
Rev Epidemiol Sante Publique · 2019 Nov · PMID 31645290 · Publisher ↗
BACKGROUND: Diabetes in children is undergoing a profound change in terms of frequency and age at onset worldwide. Algeria is particularly impacted by the epidemic to the point of appearing in the "top 10" 2016 of countr...
BACKGROUND: Diabetes in children is undergoing a profound change in terms of frequency and age at onset worldwide. Algeria is particularly impacted by the epidemic to the point of appearing in the "top 10" 2016 of countries with very high incidence of T1D. Our study was aimed to present the epidemiological evolution of T1D in children using data from the register of the department of Oran. METHODS: New cases of T1D are children under 15 years old coming from primary care units and pediatric departments. Registration was centralized at the level of the "C" pediatric unit of Oran University Hospital since 1973 with an assessment close to 100%. RESULTS: From 1973 to 2017, 2358 T1D new cases aged less than 15 years at T1D diagnosis have been registered. The average annual incidence under 15 years old for the last 5 years 2013-2017 is 31.12±3.60 cases per 100,000 and 22.62±5.18, 36.92±6.88 et 37.93±6.53 for children 0-4, 5-9 et 10-14 years old, respectively. The average annual evolution was at 12.78% in the last 25 years for the whole group and 15.03, 15.50 and 9.10% for children of 0-4, 5-9 and 10-14 years old, respectively. The estimated prevalence on December 31st 2017 was 207 per 100,000 equivalent to 1 T1D for 482 children under 15. The sex ratio for all cases is 0.94 with non-significant fluctuations. The winter/summer seasonality, significant from 1973 to 2013 in favor of winter months is no longer present starting from 2013. CONCLUSION: We confirm, in agreement with other teams, the outsized increase in the incidence of T1D and the younger age at onset in children under 15 in our country. This evolution, mainly related to environmental problems poses new difficulties to families and teams in charge of the disease.
Sport injury prevalence and risk by level of play and sports played among a representative population of French adolescents. A school-based study.
Luiggi M, Griffet J
Rev Epidemiol Sante Publique · 2019 Nov · PMID 31561942 · Publisher ↗
BACKGROUND: Sports practice has both benefits and physical risks. In France, data related to adolescent sports injury are rare. The main purpose of this article is to study the prevalence and risk of injuries by level of...
BACKGROUND: Sports practice has both benefits and physical risks. In France, data related to adolescent sports injury are rare. The main purpose of this article is to study the prevalence and risk of injuries by level of play and sports in the southeast of France. METHODS: Data collection was conducted in French schools among adolescents in 2015 and 2017 (n=1849; aged 14-19). Only sports players were included (n=1366). Two level of play were created. The low-level group included adolescents playing sport either outside or within a club, at the local level of competition or below. The high-level group included adolescents playing sport within a club at the state (regional) level of competition or higher. Odds-ratios and their 95% confidence intervals adjusted for variables selected using stepwise regression procedures were calculated to determine the injury risk of high-level athletes compared with those at low-level, in each sport. We also calculated the injury risk of each sport compared to all the other sports, by level of play. RESULTS: In almost all sports activities, the prevalence of injured athletes was higher in the high-level of play than in the low-level of play. The increase in injury risk was the highest in tennis, basketball, dance, athletics and volleyball. When comparing sports, at the lowest level, handball, boxing, soccer and gymnastics practitioners were more at risk than the rest of the sample. At the highest level of play, only basketball players were more at-risk. Dancing is the less dangerous sport in terms of injury outcome, regardless the level. CONCLUSION: From the state level of competition, injury risk increases significantly across most of the sports. Meanwhile, differences appeared regarding the prevalence, severity and nature of the sustained injuries. It would be useful to perform such analysis on a greater sample size, ideally representative of the national population of adolescents.
Hepatitis B knowledge, attitudes and practices among Moroccan college students.
Bentouhami MR, Chakib A, El Fane M
Rev Epidemiol Sante Publique · 2019 Nov · PMID 31561941 · Publisher ↗
BACKGROUND: Viral Hepatitis B (HBV) prevalence in Morocco is estimated at 1.81%. University students are an exposed population due to their risky behaviors. Their knowledge about HBV is still unknown. The aim of our stud...
BACKGROUND: Viral Hepatitis B (HBV) prevalence in Morocco is estimated at 1.81%. University students are an exposed population due to their risky behaviors. Their knowledge about HBV is still unknown. The aim of our study was to assess the knowledge, attitudes and practices of college students in Casablanca about HBV. METHODS: A cross-sectional study was carried out in January 2015 among the students of the eight schools of Hassan II University in Casablanca using a self-administered questionnaire. A knowledge score was calculated to compare the groups with sufficient and insufficient knowledge. A logistic regression adjusted on gender was performed to explore the factors associated with a sufficient knowledge about HBV (P<0.05). RESULTS: The response rate was 90.2% (n=652). The median age was 21 years old. From our sample, 97.5% knew the existence of "hepatitis". The main means of information were media and relatives. The most known way of infection was blood transmission (50.3%) while 11.5% believed in the effectiveness of the traditional methods of treatment. Eating with an HBV infected person was thought to be a risky behavior for 38% of the students. A knowledge level that was deemed to be sufficient was scored by 31.1% of the students. The sufficient knowledge was correlated to being a health care student, being vaccinated and being married. CONCLUSION: Casablanca's student knowledge about HBV remains limited. We believe that improvements in awareness and access to immunization are needed. These measures would likely help decreasing HBV incidence in students and ensure a better social integration of patients.
Is menarche occuring earlier among Lebanese girls?
Abdou LW, Daou KN, Bou-Orm IR … +1 more , Adib SM
Rev Epidemiol Sante Publique · 2019 Nov · PMID 31519350 · Publisher ↗
BACKGROUND: Early menarche is associated with increased risks for several diseases such as cardiovascular diseases and breast cancer. This analysis aimed at generating evidence on a historical trend towards younger age a...
BACKGROUND: Early menarche is associated with increased risks for several diseases such as cardiovascular diseases and breast cancer. This analysis aimed at generating evidence on a historical trend towards younger age at menarche among Lebanese girls. METHODS: A secondary analysis was conducted on data consolidated from three serial cross-sectional national surveys of women in Lebanon (2007, 2009 and 2012). A total of 6150 women were included in order to study the association between date of birth intervals and age at menarche. RESULTS: The mean age at menarche was 13.06 years, with a peak of the distribution at age 12. Women born before 1950 had a significantly higher mean age at menarche (13.21) compared to those born in 1970 and thereafter (12.95). A stratified analysis showed that women living outside the metropolitan Greater Beirut (GB) area were characterized by an older mean age at menarche (13.11) in all date of birth intervals compared to those in GB (12.89). However, age at menarche declined more significantly over the last two decades among women outside GB, compared to those living in GB. CONCLUSIONS: Epidemiological figures emerging from this study confirm that trends in Lebanon are in line with a global pattern of decreasing age at menarche. Urban-rural differences suggest that higher caloric content of diet and consequent early overweight, more evident in urban areas, are likely determinants of younger menarche. Evidence from this study calls for an urgent implementation of comprehensive multisectoral obesity prevention in children in Lebanon.
[Do caregivers of non-dependent elderly have specific characteristics? Study among 876 elderly-caregiver dyads].
Arlotto S, Bonin-Guillaume S, Denicolai S … +2 more , Durand AC, Gentile S
Rev Epidemiol Sante Publique · 2019 Nov · PMID 31495459 · Publisher ↗
BACKGROUND: The increase in life expectancy and the aging of the population have a significant impact on the informal care provided by caregivers. Protecting caregivers against excessive burden has become a public health...
BACKGROUND: The increase in life expectancy and the aging of the population have a significant impact on the informal care provided by caregivers. Protecting caregivers against excessive burden has become a public health priority. The majority of studies target only those providing care for dependent elderly people. The aim of this study was to describe the characteristics of informal caregivers of non-dependent elderly persons, their difficulties and their level of burden. METHODS: A cross-sectional study was conducted among 876 dyads: elderly people (over 70 years of age, non-dependent, living at home and having requested assistance from CARSAT South-East) and their caregivers. Two questionnaires were administered: one for the elderly (including the Frailty Group Iso-Resource Evaluation) and one for caregivers (including the Mini-Zarit Scale). A multi-component analysis and a logistic regression were performed. RESULTS: The elderly were mainly women (77.6%) with a mean age of 82.2±5.8 years and most were frail (94.7%). Most of the caregivers were women (64.5%) with a mean age of 62.7±13.7 years. The multi-component analysis showed three categories of caregivers: spouses, children and others. Among them, spouses performed the most tasks (4.8±2.6) and had the greatest burden. Caregivers in the "others" category were the least burdened and were the least impacted in their daily life. The children category caregivers were divided into two subgroups: those with characteristics similar to "others" caregivers and those with characteristics similar to "spouse" caregivers. Heavy burden was related to greater impact on daily life, poor relationships with the elderly and caregivers' difficulties in performing their role. CONCLUSION: This study confirms the heterogeneous nature of informal caregiver profiles. It also shows that the characteristic features and the burden of these caregivers are similar whether the elderly person is dependent or non-dependent but frail.
[Characteristics associated with depression and post-traumatic stress disorder among childhood sexual abuse women].
Lemieux S, Tourigny M, Joly J … +2 more , Baril K, Séguin M
Rev Epidemiol Sante Publique · 2019 Sep · PMID 31353238 · Publisher ↗
BACKGROUND: A significant proportion of childhood sexual abuse victims suffer from psychological sequelae in adulthood. Factors that provide a better understanding for the reasons why some victims develop these sequelae...
BACKGROUND: A significant proportion of childhood sexual abuse victims suffer from psychological sequelae in adulthood. Factors that provide a better understanding for the reasons why some victims develop these sequelae remain under-explored. In this context, the main objective is to examine the specific contribution of the contextual characteristics of childhood sexual abuse, multitype childhood maltreatment and adolescent suicide attempts on the development of depression and post-traumatic stress disorder in adulthood among sexually abused women as children. A secondary objective aimed to establish the prevalence of various forms of childhood maltreatment, adult onset post-traumatic stress disorder and depression among those women. METHODS: The sample included 479 women victims of childhood sexual abuse who participated in two separate surveys taken by women in the province of Quebec. RESULTS: More than half of these women reported at least one other form of childhood maltreatment, 30% of them presented post-traumatic disorder and 40% suffered from depression in adulthood. Regression analysis indicates that post-traumatic stress disorder was associated with early onset childhood sexual abuse and intergenerational continuity of sexual victimization, as well as childhood physical maltreatment and negligence. Depression was associated with childhood psychological maltreatment and negligence, a non-supportive response following child sexual abuse related disclosure and suicide attempt in adolescence. CONCLUSION: These results confirm the need to consider the cumulative effects of various childhood adversity factors in the psychosocial assessment of sexually abused women in early life, thus helping to better understand and treat their psychological sequelae.
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