BackgroundBy aging, many changes occur in the different components of the locomotor system, leading to a pathological situation such as osteoarthritis or remaining totally asymptomatic.ObjectivesThe aim of the current study was to compare,via ultrasound, the entheseal changes in two groups of people having different ages by calculating a modified Madrid sonography enthesitis index.MethodsThe study was conducted in the rheumatology department of Mongi Slim hospital in Tunisia, between June 2015 and December 2016, including 17 healthy subjects. We indentified two groups: (G1) 9 persons aged >50 years [51–68] and (G2) 8 persons aged ≤50 years-old [37–50].All the included persons underwent an enthesis ultrasound exploration (EsaoteMyLab 60 machine and a 13–18 MHz linear array transducer) by a rheumatogist experimented in ultrasound. Five enthesis locations bilaterally (distal Achilles tendon, distal andproximal patellar ligaments, distal quadriceps, and brachial triceps tendons) in each person were explored.The following elemental lesions of enthesis were evaluated: thickness, presence of calcifications, erosions,enthesophyte, loss of fibrillar patternand power Doppler signal.The calculated index was compared by Mann-Whitney U test between cases and controls. The significance level was set at 5%.ResultsIn our study population, the median age was 51.8±2.3 years and the median body mass index was 30±1 kg/m2. This last was similar between the two groups. All included subjects were female.The total enthesitis index was higher in G1 (6.67±0.91)than G2 (3.50±0.73) with a statistically significant difference (p=0.01).Considering each evaluated enthesis, the distal patellar ligament score was significantly higher in the G1 (1.67±0.55 vs 0.25±0.16 with p=0.03). For the other enthesis, there was no significantly difference between the 2 groups.ConclusionsThe distal patellar ligament enthesis changes shown in older persons may be the traduction of a silent-stage of knee osteoarthritis.Disclosure of InterestNone declared
Background Hypertension is becoming increasingly frequent mainly in low and middle income countries. We aimed to assess the prevalence, awareness and control of hypertension among Tunisian adults and identify associated factors with hypertension control. Methods Data were obtained from the 2016 Tunisian Health Examination Survey, a household survey stratified at three degrees. Adults (age≥18 years old) were interviewed using an individual questionnaire, then three blood pressure measurement were performed. Participants were considered hypertensive if they were previously diagnosed or had a systolic blood pressure (SBP) ≥140mmhg and/or a diastolic blood pressure (DBP) ≥ 90mmhg during the survey. Were considered under control, treated persons with SBP<140 mmhg and a DBP<90 mmhg. A weighted binary logistic regression was used to assess associated factors with hypertension control. Input model variables were: sociodemographic variables, comorbidities and lifestyle factors. Results In this study, 8908 adults were enrolled with a mean age of 42.8±0.2 years old and a sex ratio (M/F) equal to 0.96. Among respondents, 29.3% (95% CI: 28.2-30.5) had hypertension, 60.7% (95% CI: 58.7-62.6) of them were unaware of their disease and only (29.5%, 95% CI: 28.2-30.5) of treated patients had a controlled hypertension. In multivariate analysis, eating more than five fruits and vegetables per day was independently associated with a better hypertension control (AOR=1.7, 95% CI: 1.1-2.5). In addition, participants living in northern Tunisia were more likely to have a controlled hypertension than those living in the south (AOR=1.9, 95% CI: 1.2-2.9). Conclusions Almost third of Tunisian adults were hypertensive. Low level of awareness and control of hypertension were found in this study. This highlights the urge to reinforce hypertension screening interventions and to strengthen educational programs on this disease with a focus on blood pressure monitoring and healthy lifestyle measures. Key messages Tunisian adults had a low level of awareness and control of hypertension. Reinforcing hypertension screening interventions and increasing awareness about healthy lifestyle measures are recommended.
IntroductionTobacco use among youth is a real public health concern in most developing countries. To provide recent epidemiological data regarding tobacco use among this specific population, a national survey was conducted in Tunisia in 2021. We aimed to determine cigarette smoking prevalence in Tunisian adolescents and assess associated factors.ObjectivesWe aimed to determine cigarette smoking prevalence in Tunisian adolescents and assess associated factors.MethodsData from the Mediterranean school survey on alcohol and other drugs (MedSPAD 2021) were used. Based on three-stage stratification sampling method, first and second grade high school students were enrolled. A self-administered standardized questionnaire was used and weighted prevalence estimates for cigarette smoking “at least once in a lifetime” were studied. Binary logistic regression model was used to assess associated factors and Adjusted Odds Ratios (AORs) were presented. The independent factors included were: sex, area of residence, private or public sector, alcohol and cannabis use, and being exposed to tobacco smoking in family and peer’s environment. Epidata and STATA software were used for data entry and statistical analysis, respectively.ResultsAmong 6.201 participants with a mean age of 16.8 years, 60.4% were girls; the prevalence of cigarette smoking was 24,75% 95% CI [23.24,26.32], significantly higher among boys (41.1% versus 14.2%, p<10-3). Univariate analysis revealed a significant difference in cigarette smoking by region (p-value< 10-4). The highest prevalence of cigarette smoking was observed in the capital city. Cigarettes were perceived as easily accessible by less than a third of the students (38.46% and 20.94% of boys and girls respectively, p=10-4). In multivariable analysis, the only independently associated factor to this behaviour was male sex (AOR=1.5[0.15 – 2.9], p-value=0.03).ConclusionsOur study revealed a high prevalence of smoking among students with male sex as an associated factor. Developing a healthy school environment and implementing school-based intervention programs are therefore, highly required.Disclosure of InterestNone Declared
IntroductionNon-Medical Use of Anxiolytics (NMUA) and sedatives is a focus of scientific interest worldwide. In Tunisia, no national epidemiological data related to this issue, are published.ObjectivesWe aimed to determine the prevalence of NMUA in Tunisian adolescents and assess specificities from a gender scope.MethodsData from the 2021-Mediterranean school Survey on Alcohol and other Drugs (MedSPAD) were used. Based on random sampling method (three-stage stratification), high school teenagers in first and second year of secondary education, were enrolled. Data were collected using a self-administered standardized questionnaire assessing socio-demographic characteristics, and specific questions related to NMUA (among adolescents and close environment), perceived accessibility and initiation age. We studied weighted prevalence estimates of NMUA at least once in a lifetime, presented with 95% Confidence Interval (CI). Epi data software was used for data entry and statistical analysis was performed with STATA software.ResultsThe survey included 6.201 adolescents with a mean age of 16.8 years and sex ratio F/M equal to 1.5. Only half of surveyed adolescents, perceived accessibility to NMUA as “impossible” and almost 20% had at least one family member or friend using a nonmedical prescription of anxiolytics. The overall prevalence of NMUA was (8.4%; 95% CI [7.6-9.2]), significantly higher among girls (9.8% Vs 6.1%, p-value<10-4). Initiation age was over 13 years for almost 70% of consumers.ConclusionsOur study highlighted high prevalence of NMUA, mainly among girls. Although COVID mental health impact might have a role in explaining our findings; however, decisions makers should be aware of non-medically prescribed anxiolytics accessibility especially among this vulnerable population. Audit prescription monitoring programs should be reinforced, and multisectoral collaboration should be reinforced to promote adolescents mental well being and avoid falling into addiction trap.Disclosure of InterestNone Declared
IntroductionDespite its well-known acute and long-term harmful effects on a person’s mental health and well-being, alcohol remains the most commonly used psychoactive substance among adolescents after tobacco products in many countries.ObjectivesWe aimed at studying the prevalence of alcohol use, and identify associated factors in Tunisian high school adolescents.MethodsWe used national data from the 2021-Mediterranean School Survey Project on Alcohol and Other Drugs (MedSPAD). Based on a clustered two-stage stratification sampling method, a representative sample of teenagers aged 16 to 18 years, was selected. Data collection was performed using a self-administered standardized questionnaire, assessing socio-demographic characteristics and risky behaviours, and including questions about alcoholic beverages patterns of use. Binary logistic regression model was used to assess associated factors and adjusted Odds Ratios (AORs) were presented with 95% confidence intervals (CI). Cspro software was used for data entry and all statistical analysis were performed with STATA software.ResultsA total of 6201 adolescents with a mean age of 16.8 years and a sex ratio female/male of 1.5 were enrolled.Lifetime prevalence of alcoholic beverages consumption was 8.0%, 95% CI [7.0, 9,1] (n=6196). The prevalence of alcohol consumption during the previous year and month were 5.1 % and 1.7% respectively. Cocktails and beer were the most frequently consumed beverages.Prevalence of alcohol use was significantly associated with tobacco, cannabis and e-cigarettes use (AOR 9.5, 6.0 and 1.9 respectively; p≤10-3), a higher frequency of nights spent away from home, school absenteeism for non-medical reasons and enrolment in the private sector.Alcohol intoxication was reported by 2.9% of respondents during their lifetime.Early onset was reported by 17.2% of respondents for alcohol use and 10.1% for alcohol intoxication.ConclusionsAlthough the prevalence of alcohol use was relatively low among Tunisian adolescents compared to European adolescents, early onset- indicating an increased risk of developing an alcohol use disorder- warrant the implementation of primary prevention interventions through mental health promotion and life skill trainings to halt these trends and avert the raising burden of morbidity and mortality attributable to alcohol use.Disclosure of InterestNone Declared
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