From December 1989 to December 1993, 90 children under 15 years were admitted to our department for end-stage renal disease; 9 children were less than 5 years and 28 were aged between 5 and 10 years. The sex ratio (M/F) of the children was 2.1. The estimated incidence of pediatric end-stage renal disease in Tunisia is 7 new cases per year and per million child population under 15 years. The chief etiologies of end-stage renal disease are glomerulonephritis (19%), hereditary nephropathies (29%), and malformative uropathies (13%); 26% of the end-stage renal diseases are of unknown etiologies. Our findings, compared with the European data, show a particularly high frequency of primary hyperoxaluria (13.5%) and an unusual proportion of male subjects.

The composition of urinary stones in children depends on socioeconomic conditions and hygiene, geographical area, and dietary habits. We analyzed urinary stones from 120 consecutive Tunisian children (81 males, 39 females) aged 5 months to 15 years. The stone was located in the upper urinary tract in 91 cases (76%). Stone analysis included both a morphological examination and an infrared analysis of the nucleus and the inner and peripheral layers. The main components of bladder calculi were whewellite (69%) and struvite (22%), whereas the main component of upper urinary tract calculi was whewellite (67%). The nucleus of bladder stones was composed of ammonium urate (45%), struvite (28%), cystine (10%), and carbapatite (7%). The nucleus of kidney and ureteral calculi was mainly composed of ammonium urate (38%), whewellite (24%), carbapatite (13%), or struvite (11%). Based on stone composition, urinary tract infection was involved in the nucleation or growth of a third of calculi. Endemic urolithiasis involving simultaneous nutritional, metabolic, and infectious factors, and defined by its nucleus composed of ammonium urate without struvite, represented 40% of cases. Exclusive metabolic factors - including genetic diseases such as primary hyperoxaluria, cystinuria, and hypercalciuria - were responsible for less than 25% of cases.

No abstract

Objective: In order to investigate human leukocyte antigen (HLA) genes predisposing to primary Sjögren syndrome (pSS), we conducted an association study using HLA loci (A, B, and DRB1) and 9 polymorphic microsatellite markers spanning the HLA region in pSS patients as compared to healthy individuals. Subjects and Methods: Forty-four patients fitting the European criteria of pSS and 123 healthy controls were analyzed for their HLA class I and class II alleles. HLA class I typing was performed using a standard microlymphocytotoxicity method followed by PCR-SSP. HLA-DRB1 genotyping was performed using PCR-SSP. We studied the polymorphism of 9 microsatellite markers for both groups. Microsatellite genotyping was performed using the PCR fluorescent technique. Results: We observed a positive association between HLA-B15 and pSS in the Tunisian population (p = 0.004, OR 7.57). The comparison of the frequencies of DRB1 alleles in pSS patients and controls confirmed the association of the DRB1*03 allele with pSS (p = 0.02, OR 2.36). On the other hand, the association study of microsatellite markers showed that the a9 allele of D6S265 marker and the a20 of C1.2.C were found to be positively associated with pSS as compared to controls (p =0.0003, OR 10.29, and p =0.001, OR 4.79, respectively). Using the “Haplo.stats” software analysis, we found that the most associated region was located in the HLA class I region and limited by HLA-A and D6S265 loci (p = 0.00056). Conclusion: The results of this study support the hypothesis of the existence of a susceptibility gene for pSS located in the HLA class I and III regions.

No abstract

The results provide useful information for further studies of Tunisian population evolution, anthropology and for resolving HLA frequencies when searching for HLA-compatible donors in transplantation and for the analysis of disease associations.

Some clinical features of CD and UC may be influenced by specific MICA-TM alleles. In our South Tunisian population, MICA plays a disease modifying role, rather than being an important gene in the susceptibility for developing IBD.

This study of the evolution of food consumption among urban and rural populations in Tunisia is based on the results of household consumption and budget surveys. To make sure that any differences observed in such a sutdy actually reflect the consequences of urbanization and are not attributable to mere chance, it is essential that the surveys should meet a number of criteria:-They should have a national sampling framework that ensures a proper distribution of households, taking into account both seasonal variations and geographical differences.-Recording of household budgets, showing the amounts of money spent on foods, goods, and services, should be supplemented by actual weighing of food commodities on various days, particularly in those countries where home-produced, homeconsumed foods are an important part of the diet.-For any study of the evolution of consumption over time, the methods of data collection, the concepts followed, and the way of expressing the results should be identical from one survey to the next, lest distortions be introduced that might appear to reflect behavioural differences.