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1

Hmandi, Ons, Mehdi Ben Khelil, Nouha Zoghlami, Hajer Skhiri, and Moncef Hamdoun. "Apport de la dixième révision de la Classification internationale des maladies dans le codage de la mortalité médico-légale." Eastern Mediterranean Health Journal 27, no. 6 (2021): 605–11. http://dx.doi.org/10.26719/2021.27.6.605.

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Contexte : les rapports de mortalité en Tunisie n’incluent pas les causes de décès médico-légaux. Objectif : établir les statistiques sur les causes de décès médico-légaux au nord de la Tunisie en 2015 en se basant sur la Dixième Révision de la Classification internationale des maladies (CIM-10). Méthodes : il s’agissait d’une étude transversale et descriptive portant sur tous les décès autopsiés au nord de la Tunisie en 2015. Les caractéristiques socio-démographiques ont été identifiées, ainsi que les formes médico-légales et les causes de décès. Celles-ci ont été codées selon la CIM-10. Résultats : notre échantillon était composé de 1957 cas. Il y avait une prédominance masculine avec un sex ratio de 3,5. L’âge moyen était de 47,2 (écart type [ET] 20,6) ans. Les morts violentes ont représenté 57,4 % de la mortalité globale, suivies du groupe des maladies de l’appareil circulatoire (24,5 %) et de celui des maladies de l’appareil respiratoire (6,5 %). Les causes de décès les plus fréquentes étaient les accidents de transport terrestre (33,7 %) et les cardiopathies ischémiques (17,9 %). Les accidents de la voie publique étaient à l’origine de 56,1 % des morts accidentelles. La pendaison était le mode suicidaire le plus fréquent (51,5 %). Les homicides étaient le plus souvent secondaires à des plaies par arme blanche (35,8 %). Conclusion : la CIM-10 a permis de mettre en avant la part de la mort violente et ses caractéristiques dans la mortalité médico-légale au nord de la Tunisie, ce qui témoigne de son efficacité dans la standardisation des conclusions des rapports d’autopsie.
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2

Karaoud, M., D. Malouche, and N. Bouafif. "Méthodologie de l’analyse de la relation température–mortalité en Tunisie." Revue d'Épidémiologie et de Santé Publique 62 (August 2014): S141—S142. http://dx.doi.org/10.1016/j.respe.2014.05.066.

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3

Karaoud, M., D. Malouche, and N. Ben Alaya. "Mortalité et température journalière en Tunisie : une étude multi-région." Revue d'Épidémiologie et de Santé Publique 62 (September 2014): S218. http://dx.doi.org/10.1016/j.respe.2014.06.149.

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4

Gobrane, Heger Lazaar-Ben, Said Hajjem, Hajer Aounallah-Skhiri, Noureddine Achour, and Mohamed Hsairi. "Mortalité par cancer en Tunisie : calcul des années de vies perdues." Santé Publique 23, no. 1 (2011): 31. http://dx.doi.org/10.3917/spub.111.0031.

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5

Cattan, Daniel, Alain Mallet, and Josué Feingold. "Mortalité par tuberculose chez les juifs de Tunis (Tunisie) dans la première moitié du XXe siècle." Population 62, no. 3 (2007): 605. http://dx.doi.org/10.3917/popu.703.0605.

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6

Jaziri, F., A. Fraj, W. Helali, et al. "Étude de la mortalité au cours de lupus érythémateux systémique en Tunisie." La Revue de Médecine Interne 39 (December 2018): A105. http://dx.doi.org/10.1016/j.revmed.2018.10.014.

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7

Karâoud, M., N. Bouafif ép Ben Alaya, and D. Malouche. "Les effets de la température sur la mortalité chez les personnes âgées en Tunisie." Revue d'Épidémiologie et de Santé Publique 62 (September 2014): S219—S220. http://dx.doi.org/10.1016/j.respe.2014.06.155.

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8

Abroug, H., M. Ben Fredj, I. Zemni, I. Bouanene, A. Ben Salah, and A. Sriha Belguith. "Maladies non transmissibles : prévalence et mortalité intra-hospitalière dans la région de Monastir, Tunisie." Revue d'Épidémiologie et de Santé Publique 66 (March 2018): S33. http://dx.doi.org/10.1016/j.respe.2018.01.068.

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9

Ben Alaya, N., H. Bellali, F. Diouani, et al. "Les déterminants de la séropositivité et de la mortalité de la leishmaniose canine en Tunisie." Revue d'Épidémiologie et de Santé Publique 56, no. 5 (2008): 305. http://dx.doi.org/10.1016/j.respe.2008.06.164.

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10

Karaoud, M., N. Bouafif, D. Malouche, C. Kouni, and N. Achour. "La mortalité parmi les enfants âgés de moins de 15ans en Tunisie peut être liée à la température." Revue d'Épidémiologie et de Santé Publique 62 (August 2014): S122. http://dx.doi.org/10.1016/j.respe.2014.05.021.

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11

Ben Khelil, Meriem, Olfa Ben Said, Rachid Nefzi, Jamel Ben Abdelmalek, and Patricia Aïss. "Étude expérimentale de l’évolution en microcosme du chrome (VI) dans l’eau de mer et de ses effets sur la macrofaune et les bactéries indigènes de la Lagune de Bizerte (Tunisie)." Revue des sciences de l’eau 25, no. 3 (2012): 221–34. http://dx.doi.org/10.7202/1013104ar.

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La présente étude vise à comparer au laboratoire l’impact biologique du chrome hexavalent (Cr (VI)) présent dans le ciment non déchromé, et celui du chrome présent dans le ciment déchromé en considérant deux échelons trophiques de la lagune de Bizerte : les bactéries indigènes et la macrofaune représentée par la palourde Ruditapes decussatus. Dans deux types de microcosmes, l’un contenant de l’eau de mer seulement et l’autre contenant de l’eau de mer et du sédiment, la palourde européenne Ruditapes decussatus a été introduite à raison de 20 individus par aquarium. Quatre types d’aquarium ont été mis en place : un témoin (T), un aquarium contaminé par du ciment non déchromé (0,16 mg•L-1 de Cr (VI)), un contaminé par du ciment déchromé (0,05 mg•L-1 de Cr (VI)) et un contaminé par le dichromate de potassium (0,16 mg•L-1 de Cr (VI)). Deux replicats ont été réalisés pour chaque type de microcosme. La concentration du Cr (VI) dans l’eau a été mesurée par un dosage colorimétrique au début et après 96 heures d’expérimentation. La quantification des bactéries hétérotrophes a été évaluée par la méthode du Nombre le Plus Probable. Environ 80 % de la quantité du Cr (VI) présente dans le milieu ont été piégés dans les sédiments. Les ciments déchromés et non déchromés ont provoqué 100 % de mortalité chez les palourdes au bout de trois jours. Cependant, il n’a été observé que 40 % de mortalité dans le microcosme contaminé par le K2Cr2O7. Une diminution de la charge bactérienne totale a été observée au niveau des sédiments pour tous les traitements. On peut dire que la présence du sédiment a entraîné la diminution de la teneur du Cr (VI) dans l’eau et que malgré le déchromage du ciment, les deux types de ciment présentent un effet négatif sur les palourdes et les bactéries indigènes qui est plus marqué pour le ciment non déchromé.
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Hmida, E., M. Craourc, H. Chelli, et al. "Réduction de moitié du taux de mortalité maternelle en Tunisie au cours des dix dernières années : apport de l’épidémiologie clinique à la prise en décision en santé publique." Revue d'Épidémiologie et de Santé Publique 57 (May 2009): S32. http://dx.doi.org/10.1016/j.respe.2009.02.111.

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13

Hajjej, Zied, Kalthoum Ben Mahmoud, Aicha Rebai, Hedi Gharsallah, Iheb Labbene, and Mustapha Ferjani. "PERFORMANCE OF THE SEPSIS‑3 DEFINITIONS IN A MIDDLE INCOME COUNTRY INTENSIVE CARE UNIT." Mediterranean Journal of Hematology and Infectious Diseases 13, no. 1 (2021): e2021052. http://dx.doi.org/10.4084/mjhid.2021.052.

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Background: Since the first publication, of 2016, Sepsis-3 definitions have not been universally accepted, rather, they have become a source of controversy. Because clinical and laboratory parameters used had been derived mainly from patients hospitalized in United States’ Intensive Care Units (ICU). Purpose: the aim of this study was to evaluate the performance of the Sepsis‑3 definitions for the prediction of ICU-mortality in a Tunisian ICU population as compared to 2003 Consensus Definitions (Sepsis-2 definitions) Methods: It was a retrospective study conducted in an 18-bed medical surgical intensive care unit at the military hospital of Tunis (Tunisia). From January 2012 to January 2016, all patients admitted to the ICU for sepsis, severe sepsis or septic shock as defined according to 2003 Consensus Definitions (Sepsis-2 consensus) were eligible for this study. The new Sepsis-3 definition was secondly used to classify included patients. The primary area of interest was ICU mortality defined as death before ICU discharge Results: A total of 1080 patients were included during the recruitment period. . When the Sepsis-2 definitions were used there had been a difference in mortality only between septic shock and sepsis patients. While Sepsis-3 definitions show that mortality increased from 16 % among no-dysfunction-infected patients to 30 % among patients with qSOFA ≥ 2 and 44% or 46% for sepsis or septic shock patients, respectively. Conclusions: Sepsis-3 was better than sepsis-2 definitions at stratifying mortality among septic patients admitted to an ICU of a middle income country (Tunisia).
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Troudi, Azza, Meha Fethi, Mohamed Selim El Asli, Jean Michel Bolla, Naouel Klibi, and Jean Michel Brunel. "Efficiency of a Tetracycline-Adjuvant Combination Against Multidrug Resistant Pseudomonas aeruginosa Tunisian Clinical Isolates." Antibiotics 9, no. 12 (2020): 919. http://dx.doi.org/10.3390/antibiotics9120919.

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The growing number of multidrug resistant strains in Tunisia has become a serious health concern contributing to high rate of mortality and morbidity. Since current antibiotics are rapidly becoming ineffective, novel strategies to combat resistance are needed. Recently, we demonstrated that combination of a tetracycline antibiotic with various polyaminoisoprenyl adjuvants can sustain the life span and enhance the activity of these drugs against Pseudomonas aeruginosa reference strain (PA01). In the context of our continuing studies, the effective approach of antibiotic-adjuvant was investigated against a large panel of P. aeruginosa Tunisian clinical strains collected from the Military Hospital of Tunis. In this paper, we demonstrated that the combination of a farnesyl spermine compound 3 used at concentrations ranging from 2.5 to 10 µM, in the presence of doxycycline or minocycline leads to a significant decrease of P. aeruginosa antibiotic resistance.
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15

Cattan, Daniel, Alain Mallet, and Josué Feingold. "Tuberculosis Mortality among the Jews of Tunis (Tunisia) in the First Half of the Twentieth Century." Population (english edition) 62, no. 3 (2007): 523. http://dx.doi.org/10.3917/pope.703.0523.

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Doggui, Radhouene, Hajer Aounallah-Skhiri, Pierre Traissac, and Jalila El Ati. "An overview on the nutrition transition and its health implications: Tunisia case." North African Journal of Food and Nutrition Research 4, no. 9 (2021): S75—S86. http://dx.doi.org/10.51745/najfnr.4.9.s75-s86.

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Background: In the last decades, Tunisia has undergone major demographic, socio-economic and lifestyle (including diet) changes, with drastic increases in excess adiposity and nutrition related non-communicable diseases (NCDs). This review provides an update of the nutritional situation in Tunisia. Methods: Several Tunisian datasets or international databases were used to assess availability and consumption of foods and health outcomes. Results: Both from national aggregated availability data and individual food consumption data, there was a trend both of increasing food intake and modernization/westernization of the diet (especially in urban areas), towards more consumption of dairy and meat products, sugar, fat and salt. But consumption of fruits and vegetables was still above WHO recommendations. Except for iodine, micronutrients deficiency (iron, vitamin A and D) was markedly, but unevenly, present among specific groups (e.g., a third of adult women had anemia). Among infants, both exclusive and predominant breastfeeding were low, while the minimum diet diversification rate was 63%. Among children, stunting was residual but increase of overweight was a concern. In 2016 17.6% of men and 34.6 % of women over 15 y. were obese and 15.5% had diabetes, a twofold increase in the last decades. These prevalence were much higher in urban and more developed areas. Also, 86% of the mortality rate was attributable to NCDs. Conclusion: Addressing the double burden of malnutrition and NCDs is a priority and should be based on a sustainability framework, involve a diversity of stakeholders and emphasize double duty actions and reduction of nutrition and health inequalities. Keywords: Tunisia, diet, food insecurity, micronutrient deficiencies, nutritional status, obesity, non-communicable diseases.
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Sassi, Samia Ben, Nahla Touati, Hela Baccouche, Cyrine Drissi, Neila Ben Romdhane, and Fayçal Hentati. "Cerebral Venous Thrombosis: A Tunisian Monocenter Study on 160 Patients." Clinical and Applied Thrombosis/Hemostasis 23, no. 8 (2016): 1005–9. http://dx.doi.org/10.1177/1076029616665168.

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Objective: Data regarding cerebral venous thrombosis in North Africa are scarce. This study aims to identify the clinical features, risk factors, outcome, and prognosis of cerebral venous thrombosis in Tunisia. Methods: Data of 160 patients with radiologically confirmed cerebral venous thrombosis, hospitalized in Mongi Ben Hmida National Institute of Neurology (Tunis, Tunisia), were retrospectively collected and analyzed. Results: The mean age was 37.3 years with a female predominance (83.1%). The mode of onset was subacute in most cases (56.2%). Headache was the most common symptom (71.3%), and focal neurologic symptoms were the main clinical presentation (41.8%). The most common sites of thrombosis were the superior sagittal sinus (65%) and the lateral sinus (60.6%). More than 1 sinus was involved in 114 (71.2%) patients. Parenchymal lesions observed in 85 (53.1%) patients did not correlate with cerebral venous thrombosis extent. Major risk factors were obstetric causes (pregnancy and puerperium) found in 46 (38.6% of women aged <50 years) patients, followed by anemia (28.1%) and congenital or acquired thrombophilia (16.2%). Mortality rate was of 6.6%. Good outcome at 6 months (modified Rankin Scale ≤2) was observed in 105 (87.5%)of 120 patients available for follow-up. Predictors of poor outcome were altered consciousness and elevated plasma C-reactive protein levels. Conclusion: Clinical and radiologic presentation of cerebral venous thrombosis in Tunisia was quite similar to other parts of the world with, however, a particularly high frequency of obstetric causes. Plasma C-reactive protein level should be considered as a prognostic factor in CVT.
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Ben Chehida, Faten, Ana M. Lopes, João V. Côrte-Real, et al. "Multiple Introductions of Rabbit Hemorrhagic Disease Virus Lagovirus europaeus/GI.2 in Africa." Biology 10, no. 9 (2021): 883. http://dx.doi.org/10.3390/biology10090883.

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Rabbit hemorrhagic disease (RHD) causes high mortality and morbidity in European rabbits (Oryctolagus cuniculus). In Africa, the presence of the causative agent, the rabbit hemorrhagic disease virus (RHDV), was first confirmed in 1992 (genotype Lagovirus europaeus/GI.1). In 2015, the new genotype Lagovirus europaeus/GI.2 (RHDV2/b) was detected in Tunisia. Currently, GI.2 strains are present in several North and Sub-Saharan African countries. Considerable economic losses have been observed in industrial and traditional African rabbitries due to RHDV. Like other RNA viruses, this virus presents high recombination rates, with the emergence of GI.2 being associated with a recombinant strain. Recombination events have been detected with both pathogenic (GI.1b and GII.1) and benign (GI.3 and GI.4) strains. We obtained complete genome sequences of Tunisian GI.2 strains collected between 2018 and 2020 and carried out phylogenetic analyses. The results revealed that Tunisian strains are GI.3P-GI.2 strains that were most likely introduced from Europe. In addition, the results support the occurrence of multiple introductions of GI.2 into Africa, stressing the need for characterizing complete genome sequences of the circulating lagoviruses to uncover their origin. Continued monitoring and control of rabbit trade will grant a better containment of the disease and reduce the disease-associated economic losses.
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Jebali, Hela, M. Laifi, I. Mami, et al. "Mortality of diabetic on chronic dialysis in Tunisia." Saudi Journal of Kidney Diseases and Transplantation 29, no. 6 (2018): 1386. http://dx.doi.org/10.4103/1319-2442.248283.

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Chellai, Fatih, and Naima Boudrissa. "Excess Infant Mortality of Twins Over Singletons in Arab Countries: The Evidence of Relative Survival Methods." Twin Research and Human Genetics 22, no. 4 (2019): 255–64. http://dx.doi.org/10.1017/thg.2019.30.

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AbstractThere are no studies and only limited data that compare the difference in mortality between twins and singletons in the Arab world. We studied the survival of 306,966 children, including 9,280 twins, over the period 1970–2013 in six Arab countries (Algeria, Egypt, Iraq, Mauritania, Sudan and Tunisia) based on the Multiple Indicator Cluster Survey (MICS) database. With the use of relative survival models, we estimated the mortality of twins relative to singletons by including socioeconomic and demographic variables. This study confirms the results of previous studies on the excess risk of death of twins compared to singletons. There is evidence that excess mortality decreases with follow-up; in addition, male twins have a higher risk of death compared to females for all countries except Tunisia. Wealth index and education levels of women are factors that influence the risk of mortality. It is recommended that these findings are considered when performing future health and population strategies in these Arab countries.
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Ben Cheikh, A., H. Ghali, M. Ben Rejeb, S. Chelly, S. Khefacha, and H. Said Latiri. "Mortality in a Tunisian intensive care unit." Revue d'Épidémiologie et de Santé Publique 66 (July 2018): S417. http://dx.doi.org/10.1016/j.respe.2018.05.494.

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Ammar, Saloua, Sahla Sellami, Imen Sellami, et al. "Risk factors of early mortality after neonatal surgery in Tunisia." Journal of Pediatric Surgery 55, no. 10 (2020): 2233–37. http://dx.doi.org/10.1016/j.jpedsurg.2020.05.035.

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Abid, Dorra, Anis Elloumi, Leila Abid, et al. "Congenital heart disease in 37,294 births in Tunisia: birth prevalence and mortality rate." Cardiology in the Young 24, no. 5 (2013): 866–71. http://dx.doi.org/10.1017/s1047951113001194.

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AbstractAim: To investigate the previously unknown birth incidence, treatment, and mortality of children with congenital heart disease in Tunisia. Methods: We undertook a retrospective review of medical records of all patients who were born in 2010 and 2011, and were diagnosed in Sfax (Tunisia) with congenital heart defect. Results: Among 37,294 births, 255 children were detected to have congenital heart disease, yielding a birth incidence of 6.8 per 1000. The most frequently occurring conditions were ventricular septal defects (31%), ostium secundum atrial septal defects (12.9%), and pulmonary valve abnormalities (12%). Coarctation of the aorta, tetralogy of Fallot, univentricular physiology, pulmonary atresia with ventricular septal defect, and transposition of the great arteries were found in 4.3%, 6.2%, 3.4%, 2.7%, and 2.7%, respectively. During the follow-up of 1 year, 23% of the children died. About three-quarters of those deaths happened before surgery. Conclusion: The present study is in line with the general estimates in the world. It has revealed a high case of mortality among the patients awaiting corrective surgery. These children need more facilities.
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Kadri, Hasna, Sondes Marouani, Mahamed Nejmeddine Bradai, Abderrahmen Bouaïn, and Eric Morize. "Age, growth, longevity, mortality and reproductive biology of Dipturus oxyrinchus, (Chondrichthyes: Rajidae) off the Gulf of Gabès (Southern Tunisia, central Mediterranean)." Journal of the Marine Biological Association of the United Kingdom 95, no. 3 (2014): 569–77. http://dx.doi.org/10.1017/s0025315414000551.

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The age, growth, longevity, mortality and reproductive parameters were estimated for Dipturus oxyrinchus from the Gulf of Gabès (Southern Tunisia, central Mediterranean Sea), collected monthly during 2007 from commercial fisheries. The present study provides the first data on age and growth of this species in Tunisian waters, as well as additional data on its reproduction. A total of 240 females (16.5–105 cm total length (TL)) and 280 males (15.5–95 cm TL) were examined to study the reproductive cycle. A subsample of 285 specimens (175 females and 110 males, ranging from 15.5 to 105 cm TL) were analysed to study the age and growth. The oldest female in this study was 25 yr and 105 cm TL, whereas the oldest male was 22 yr and 95 cm. The annual deposition of growth bands was verified by marginal increment and edge analysis. The von Bertalanffy growth parameters were L∞ = 123.9 ± 2.56 cm, K = 0.08 ± 0.004 yr−1 and t0 = −1.26 ± 0.04 10−1 yr for females and L∞ = 102.1 ± 3.23 cm, K = 0.12 ± 0.007 10−3 yr−1 and t0 = −1.18 ± 0.03 10−1 yr for males. Growth was not significantly different between sexes. The maturity size was 72.05 cm for males and 82.1 cm for females. The maturity age was estimated to be 11.95 and 13.96 years, respectively, for males and females. Size and age at maturity were not significantly different between sexes. The estimated longevity was 26.18 and 38.84 yr for males and females, respectively. Based on life history parameters, natural mortality was estimated at 0.53 yr−1 for females and 0.41 yr−1 for males.
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HAMMAMI, SONIA, OLFA EZZINE, SAMIR DHAHRI, CLAIRE VILLEMANT, STEFAN SCHMIDT, and MOHAMED LAHBIB BEN JAMÂA. "PUPA MORTALITY OF ORGYIA TRIGOTEPHRAS BOISDUVAL, 1829(EREBIDAE LYMANTRIINAE) IN TUNISIA." Redia 102 (December 15, 2019): 107–11. http://dx.doi.org/10.19263/redia-102.19.16.

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Jameleddine, Mouna, Hela Grati, Asma Ben Brahem, et al. "PP168 Combination Therapy Versus Intensification Of Statin Monotherapy." International Journal of Technology Assessment in Health Care 33, S1 (2017): 143–44. http://dx.doi.org/10.1017/s0266462317002975.

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INTRODUCTION:Coronary heart disease (CHD) is the most common cause of mortality globally. The burden of CHD is a challenge for Tunisia causing 27.14 percent of total mortality (1).Statins are the leading molecules used to prevent CHD in Tunisia. The amount paid by the national insurance fund for statins in 2015 represents 9 percent of total drug expenditures (2).INASanté has launched a Health Technology Assessment (HTA) study to compare the intensification of statin monotherapy versus a combination therapy for the CHD prevention in patients with moderate to high cardiovascular risk. The aim of this contextualized HTA report is to diminish prescription variability and not justified therapies.METHODS:Research was carried out in the following databases: CRD, NICE search evidence, Cochrane, Belgian Health Care Knowledge Centre (KCE), Canadian Agency for Drugs and Technologies in Health (CADTH), Adelaide Health Technology Assessment (AHTA), Institut National d'excellence En Santé et en Services Sociaux (INESS), Euroscan International Network, National Institute for Health Research (NIHR), Agency for Healthcare Research and Quality (AHRQ) and Haute Autorité de Santé (HAS) from 2006 to 2017. Title, abstract and full text screening were performed by two independent reviewers relying on prespecified eligibility criteria. Critical appraisal of literature was conducted using INAHTA and PRISMA checklists, FLC 2.0 and The European Network for HTA (EUnetHTA) adaptation toolkit. One review from AHRQ was retained.An adaptation process has been launched. Data on lipid lowering agents intake from key institutions have been gathered and a qualitative study has been started through interviews with thirty-three cardiologists and general practitioners from public, private sector and scientifc societies. Interviews have been analysed using NVivo. After results discussion with the working group, the report will be synthesized and validated.RESULTS:According to the AHRQ report, all evidence for clinical outcomes were graded insufficient when comparing the therapies. Results on lowering low density lipoprotein (LDL-C) depend on the combination agent Ezetimibe has shown remarkable results (3).The Tunisian context shows that there is no standardized method to assess the cardiovascular risk according to the preliminary results. The only combination therapy reported is with fibrates, mainly in case of associated hypertriglyceridemia. Ezetimibe has not yet obtained the marketing authorization.CONCLUSIONS:There are significant differences between contexts and among practitioners prescriptions. This can be related to the lack of common guidelines and inequitable access to drugs and healthcare resources in general.
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Faouzi, Nouira, Jlidi Said, Charieg Aouatef, et al. "Intestinal volvulus: Aetiology, morbidity and mortality in Tunisian children." African Journal of Paediatric Surgery 8, no. 2 (2011): 147. http://dx.doi.org/10.4103/0189-6725.86050.

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Smiti Khanfir, M., M. H. Houman, I. Ben Ghorbel, M. Lamloum, and M. Miled. "P181 Mortality in systemic lupus erythematosus in Tunisian patients." European Journal of Internal Medicine 14 (September 2003): S83. http://dx.doi.org/10.1016/s0953-6205(03)91444-0.

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Nouaili, Emira Ben Hamida, Sihem Chaouachi, Imen Ayadi, Amel Ben Said, Béchir Zouari, and Zahra Marrakchi. "Risk factors for perinatal mortality in a Tunisian population." International Journal of Gynecology & Obstetrics 111, no. 3 (2010): 265–66. http://dx.doi.org/10.1016/j.ijgo.2010.07.009.

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Farhat, Essia Ben, Mohamed Chaouch, Hela Chelli, et al. "Reduced maternal mortality in Tunisia and voluntary commitment to gender-related concerns." International Journal of Gynecology & Obstetrics 116, no. 2 (2011): 165–68. http://dx.doi.org/10.1016/j.ijgo.2011.10.010.

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Ben Ayed, Houda, Jihène Jedidi, Sourour Yaich, et al. "Les maladies non-transmissibles au Sud tunisien : profil de morbi-mortalité et tendances chronologiques." Santé Publique 31, no. 3 (2019): 433. http://dx.doi.org/10.3917/spub.193.0433.

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Saidi, Olfa, Nadia Ben Mansour, Martin O’Flaherty, Simon Capewell, Julia A. Critchley, and Habiba Ben Romdhane. "Analyzing Recent Coronary Heart Disease Mortality Trends in Tunisia between 1997 and 2009." PLoS ONE 8, no. 5 (2013): e63202. http://dx.doi.org/10.1371/journal.pone.0063202.

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33

Ben Helel, Khaled, Mohamed Ben Rejeb, Zakia Habboul, et al. "Risk factors for mortality of children with zoonotic visceral leishmaniasis in Central Tunisia." PLOS ONE 12, no. 12 (2017): e0189725. http://dx.doi.org/10.1371/journal.pone.0189725.

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34

Saidi, Olfa, Martin O’Flaherty, Nada Zoghlami, et al. "Comparing Strategies to Prevent Stroke and Ischemic Heart Disease in the Tunisian Population: Markov Modeling Approach Using a Comprehensive Sensitivity Analysis Algorithm." Computational and Mathematical Methods in Medicine 2019 (January 29, 2019): 1–11. http://dx.doi.org/10.1155/2019/2123079.

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Background. Mathematical models offer the potential to analyze and compare the effectiveness of very different interventions to prevent future cardiovascular disease. We developed a comprehensive Markov model to assess the impact of three interventions to reduce ischemic heart diseases (IHD) and stroke deaths: (i) improved medical treatments in acute phase, (ii) secondary prevention by increasing the uptake of statins, (iii) primary prevention using health promotion to reduce dietary salt consumption. Methods. We developed and validated a Markov model for the Tunisian population aged 35–94 years old over a 20-year time horizon. We compared the impact of specific treatments for stroke, lifestyle, and primary prevention on both IHD and stroke deaths. We then undertook extensive sensitivity analyses using both a probabilistic multivariate approach and simple linear regression (metamodeling). Results. The model forecast a dramatic mortality rise, with 111,134 IHD and stroke deaths (95% CI 106567 to 115048) predicted in 2025 in Tunisia. The salt reduction offered the potentially most powerful preventive intervention that might reduce IHD and stroke deaths by 27% (−30240 [−30580 to −29900]) compared with 1% for medical strategies and 3% for secondary prevention. The metamodeling highlighted that the initial development of a minor stroke substantially increased the subsequent probability of a fatal stroke or IHD death. Conclusions. The primary prevention of cardiovascular disease via a reduction in dietary salt consumption appeared much more effective than secondary or tertiary prevention approaches. Our simple but comprehensive model offers a potentially attractive methodological approach that might now be extended and replicated in other contexts and populations.
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35

Ben Bnina, Enis, Hafedh Hajlaoui, Ikbal Chaieb, Moncef Ben Said, and Hichem Ben Jannet. "Chemical composition, antimicrobial and insecticidal activities of the tunisian Citrus aurantium essential oils." Czech Journal of Food Sciences 37, No. 2 (2019): 81–92. http://dx.doi.org/10.17221/202/2017-cjfs.

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The chemical composition of volatile fractions from leaves, flowers and peels of Citrus aurantium growing in Tunisia obtained by hydrodistillation were analysed using GC and GC-MS. Furthermore, the isolated essential oils were evaluated for their in vitro antimicrobial activity against eight bacteria, eight phytopathogenic and nine human pathogenic fungi. The essential oils from peels and its main compound limonene have been found to possess strong contact toxicity against four storage-grain insects. The highest mortality rate was observed when the essential oil was applied against Cryptolestes ferrugineus, Liposcelis bostrychophila and Tribolium castaneum.
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36

Ali, InsafHadj, Ezzeddine Abderrahim, Samia Barbouch, et al. "Morbidity and mortality in Tunisian patients with post-transplant diabetes mellitus." Saudi Journal of Kidney Diseases and Transplantation 24, no. 3 (2013): 583. http://dx.doi.org/10.4103/1319-2442.111073.

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37

Zgueb, Y., R. Jomli, A. Ouertani, et al. "La mortalité à l’hôpital psychiatrique de Tunis : étude rétrospective sur 11ans." L'Encéphale 40, no. 5 (2014): 416–22. http://dx.doi.org/10.1016/j.encep.2014.07.007.

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38

Ben Saad, Chaker, Nesrine Bouhamed, Aymen Ghédira, and Karim Kammoun. "Analysis of road mortality in digital age using Bayesian ecological model: the case of Tunisia." World Review of Intermodal Transportation Research 9, no. 4 (2020): 393. http://dx.doi.org/10.1504/writr.2020.10033081.

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39

Kammoun, Karim, Aymen Ghédira, Chaker Ben Saad, and Nesrine Bouhamed. "Analysis of road mortality in digital age using Bayesian ecological model: the case of Tunisia." World Review of Intermodal Transportation Research 9, no. 4 (2020): 393. http://dx.doi.org/10.1504/writr.2020.111063.

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40

Echwikhi, Khaled, Imed Jribi, Mohamed Nejmeddine Bradai, and Abderrahmen Bouain. "Interactions of loggerhead turtle with bottom longline fishery in the Gulf of Gabès, Tunisia." Journal of the Marine Biological Association of the United Kingdom 92, no. 4 (2011): 853–58. http://dx.doi.org/10.1017/s0025315411000312.

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In the Gulf of Gabès (Tunisia), a fleet of bottom longliners operates in summer and in the beginning of autumn targeting groupers. This fleet interacts with loggerhead turtles. During twenty trips in which 48,020 hooks were deployed, a total of 16 loggerheads were captured, most of them were juveniles, and direct mortality was estimated to be 43.75%. During the fishing operation, the hauling of the gear started one to three hours after and sometimes occurred immediately after setting. Results obtained show that the soak time did not affect the capture of turtles and target species, whereas it influenced the mortality rate of turtles. Bottom longline should be studied more in depth throughout the Mediterranean Sea, as well as parameters related to the interaction with sea turtles. However, mitigation measures to reduce turtle by-catch are urgently needed. In this way, we propose: (i) reducing the fishing soak time; (ii) experimenting with gear modification such as the use of circle hooks; and (iii) conducting an awareness campaign aimed at fishermen to show them how to deal with turtle by-catch.
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41

Bellali, H., K. Talmoudi, W. Ettoumia, C. Harizi, N. Ben Alaya, and M. Chahed. "Impact of mean temperature on daily mortality in seven different bioclimatic regions in Tunisia, 1991–2011." Revue d'Épidémiologie et de Santé Publique 66 (July 2018): S246. http://dx.doi.org/10.1016/j.respe.2018.05.035.

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42

El Mhamdi, Sana, Ines Bouanene, Amel Mhirsi, Asma Sriha, Kamel Ben Salem, and Mohamed Soussi Soltani. "Women’s knowledge, attitudes and practice about breast cancer screening in the region of Monastir (Tunisia)." Australian Journal of Primary Health 19, no. 1 (2013): 68. http://dx.doi.org/10.1071/py11123.

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Breast cancer remains a worldwide public health problem. In Tunisia, it is considered to be the primary women’s cancer and causes high morbidity and mortality. This study aimed to investigate female knowledge, attitudes and practice of breast cancer screening in the region of Monastir (Tunisia). We conducted a descriptive cross-sectional design exploring knowledge, attitudes and practices of women in the region of Monastir on breast cancer screening. The study was conducted in health centres of this region from 1 March 2009 to 30 June 2009. Data were collected via a structured questionnaire containing 15 items on demographic status, knowledge of risk factors and screening methods and attitudes towards the relevance and effectiveness of breast cancer screening. A scoring scheme was used to score women’s responses. A total of 900 women agreed to take part in the study. Their mean age was 41.6 ± 12.4 years and 64% did not exceed the primary level of education. According to the constructed scores, 92% of participants had poor knowledge of the specific risk factors for breast cancer and 63.2% had poor knowledge of the screening methods. Proper practice of breast cancer screening was observed in 14.3% of cases. Multiple logistic regression analysis showed that good knowledge of risk factors and screening methods, higher level of education and positive family history of breast cancer were independently correlated with breast cancer screening practice. This study revealed poor knowledge of breast cancer and the screening methods as well as low levels of practice of breast cancer screening among women in the region of Monastir. Results justify educational programs to raise women’s adherence to breast cancer screening programs in Tunisia.
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43

Damak, Hassen, Kamilia Chtara, Mabrouk Bahloul, et al. "Clinical features, complications and mortality in critically ill patients with 2009 influenza A(H1N1) in Sfax,Tunisia." Influenza and Other Respiratory Viruses 5, no. 4 (2011): 230–40. http://dx.doi.org/10.1111/j.1750-2659.2011.00196.x.

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44

Vitale, S., S. Ragonese, L. Cannizzaro, F. Fiorentino, and S. Mazzola. "Evidence of trawling impact onHoplostethus mediterraneusin the central–eastern Mediterranean Sea." Journal of the Marine Biological Association of the United Kingdom 94, no. 3 (2014): 631–40. http://dx.doi.org/10.1017/s0025315413001884.

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The silver roughy,Hoplostethus mediterraneusis a benthopelagic cosmopolitan fish regularly caught as by-catch of the deep-water crustacean trawl fishery (CTF) in the central–eastern Mediterranean. Monthly samples of silver roughy were sampled from the catches of four commercial trawlers in 2004. Each trawler operated in different fishing grounds (FGs), located off Northern Tunisia, South of Sicily, Malta Islands and in South Levant, for which different exploitation levels are reported. The overall length–frequency distribution (LFD) was constructed, and fishing impact indices (length as percentage of LFD, optimum and maximum length, percentage of mega-spawners and total mortality/von Bertalanffy curvature ratio) were calculated. In spite of an overall acceptable status (juveniles, matures and mega-spawners were present in the catch), sampling data revealed significant differences in LFD shape and status indices between FGs. Those FGs traditionally considered more exploited (Northern Tunisia and South of Sicily) showed a dominance of juveniles, a rarefaction of mega-spawners, a reduction in maximum and asymptotic length and a higherZ/Kratio. Considering the general homogeneity of Mediterranean deep-water habitats, the pelagic dispersal of eggs and the poor swimming capabilities of silver roughy, the present results indicated that deep-water trawling may induce a slow and subtle, although significant, erosion of the older, late maturing and slow growing component of the stocks in the Mediterranean (so-called longevity-overfishing).
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45

Younsi, Moheddine, and Mohamed Chakroun. "The conditional effect of income distribution on mortality risk of men in Tunisia: Poverty effect or wealth effect?" Social Science Journal 57, no. 1 (2020): 101–14. http://dx.doi.org/10.1016/j.soscij.2019.01.002.

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46

Marouani, Sondes, Hasna Kadri, and Mohamed Nejmeddine Bradai. "First data on the age, growth and sexual maturity of the piked spurdog, Squalus megalops (Chondrichthyes: Squalidae), in the Gulf of Gabès (central Mediterranean Sea)." Marine and Freshwater Research 67, no. 5 (2016): 578. http://dx.doi.org/10.1071/mf14356.

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The occurrence of the piked spurdog (Squalus megalops) in the Gulf of Gabès (Tunisia, central Mediterranean Sea) was recently confirmed. The present study is the first to report the age, growth, longevity, natural mortality and size and age at maturity of this species in the Mediterranean Sea, precisely in the Gulf of Gabès. Marginal increment and edge analysis suggested annual band formation. Age estimates ranged from 0 to 26 and from 0 to 29 years for males and females respectively. Von Bertalanffy growth parameters derived from length-at-age data were: the theoretical asymptotic length L∞=82.31±1.55cm, the growth-rate coefficient k=0.06±0.003 years–1, the theoretical age at length zero t0=–3.89±0.25 years for females; and L∞=68.55±0.98cm, k=0.08±0.003 years–1, t0=–4.65±0.25 years for males. Males and females reached maturity at 44.36- and 56.41-cm total length, corresponding to 8.39 and 15.38 years respectively. Longevity estimates were 32.85 and 46.11 years for males and females respectively. On the basis of life-history parameters, natural mortality estimation M ranged from 0.14 to 0.17.
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47

Bettaieb, J., A. Toumi, K. Leffondre, S. Chlif, and A. Ben Salah. "High temperature effect on daily all-cause mortality in Tunis 2005–2007." Revue d'Épidémiologie et de Santé Publique 68, no. 1 (2020): 37–43. http://dx.doi.org/10.1016/j.respe.2019.09.007.

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48

Rachdi, Haifa, Amina Mokrani, Rim Batti, et al. "Gestational Trophoblastic Neoplasia: A Tunisian Multicenter Study." Asian Pacific Journal of Cancer Care 4, no. 2 (2019): 59–64. http://dx.doi.org/10.31557/apjcc.2019.4.2.59-64.

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Gestational trophoblastic disease (GTD) develops from abnormal cellular proliferation of trophoblasts following fertilization. It includes benign trophoblastic disease (hydatidiform moles (HM) and the malignant trophoblastic diseases or gestational trophoblastic neoplasia (GTN). The frequency of the GTD in Tunisia is one per 918 deliveries. The aim of this study is to analyze the clinical characteristics, treatment and outcomes of GTD at Salah Azaiez Institute (ISA). Medical records of women diagnosed with GTD at ISA from January 1, 1981 to December 31, 2012 were retrospectively reviewed. FIGO (International Federation of Gynecology and Obstetrics) score was determined retrospectively for patients treated before 2002 One hundred and nine patients with GTN were included. Patients presented with metastases at 43% of cases. The most common metastatic sites was lung (30%) and vagina (13%). 56 (51%) patients had low-risk and 21 (19%) cases had high-risk, the FIGO score was not assessed in 32 cases. After a median follow-up of 46 months, 21 patients were lost to follow-up, 12 patients died, 19 progressed and 8 relapsed. At 10 years, the OS rate was 85% and the PFS rate 79%. OS was significantly influenced by the presence of metastases at presentation (M0 100 % vs. Metastatic 62 %; p < 0.0001), FIGO stage (I-II 100% VS 61% and 65% for stage III and IV; p < 0.001), FIGO score (low-risk 99 % vs. high-risk 78 %; p < 0.001). GTN is a significant source of maternal morbidity with increased risk of mortality from complications if not detected early and treated promptly.
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Gaddour, Amor, Sghaier Najari, Mouldi Abdennebi, and Mabrouk Ouni. "Reproductive Performances and Kid’s Mortality of Pure Breeds and Crossed Caprine Genotypes in the Coastal Oases of Southern Tunisia." Pakistan Journal of Biological Sciences 10, no. 14 (2007): 2314–19. http://dx.doi.org/10.3923/pjbs.2007.2314.2319.

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50

Abid, Leila, Salma Charfeddine, Ikram Kammoun, et al. "Epidemiology of heart failure and long-term follow-up outcomes in a north-African population: Results from the NAtional TUnisian REgistry of Heart Failure (NATURE-HF)." PLOS ONE 16, no. 5 (2021): e0251658. http://dx.doi.org/10.1371/journal.pone.0251658.

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The NATURE-HF registry was aimed to describe clinical epidemiology and 1-year outcomes of outpatients and inpatients with heart failure (HF). This is a prospective, multicenter, observational survey conducted in Tunisian Cardiology centers. A total of 2040 patients were included in the study. Of these, 1632 (80%) were outpatients with chronic HF (CHF). The mean hospital stay was 8.7 ± 8.2 days. The mortality rate during the initial hospitalization event for AHF was 7.4%. The all-cause 1-year mortality rate was 22.8% among AHF patients and 10.6% among CHF patients. Among CHF patients, the older age, diabetes, anemia, reduced EF, ischemic etiology, residual congestion and the absence of ACEI/ ARBs treatment were independent predictors of 1-year cumulative rates of rehospitalization and mortality. The female sex and the functional status were independent predictors of 1-year all-cause mortality and rehospitalization in AHF patients. This study confirmed that acute HF is still associated with a poor prognosis, while the mid-term outcomes in patients with chronic HF seems to be improved. Some differences across countries may be due to different clinical characteristics and differences in healthcare systems.
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