Introduction Tunisia as a developing country is passing through an epidemiologic changing with less infectious diseases and the occurrence of several other chronic diseases.Cancer is becoming a major problem of public health. The registry of cancer in Tunisia started in 1997 by the creation of the cancer registry of Northern Tunisia (CRNT), a population registry involving about half the population. This study aimed to present data of the CRNT including the epidemiologic profile and the evolution of the incidence rate of most cancers sites during a 10 year period (1994e2003) in the north of the country. Methods Referring to the CRNT data,we were able to determine the repartition of cancer according to sex,to calculate the brut and standardised incidence rate with a direct method on the basis of a world reference population. We could also find the incidence evolution and the cancer number of cases between 1994 and 2003. The results were compared to other registries data.Results From 1999 to 2003, the CRNT registered the average of 5049 cases per annum of invasive cancers. This average was about 3744 in 1994. The increase was about 36% in a 10 year period. The brut incidence rate was 120.2 in men and 94.8 in women. If standardised on age according to a referent world population, the result stayed the same (133.2 v/s101.4). Lung cancer occurred first in men and then bladder cancer. In women, the increased brut incidences concerned breast cancer and colon cancer, cervical cancer occupied the fourth position after the skin cancer. Over the period (1994e2003), the increase of 36% in cancer occurrence is due in men to the 60% increase of lung, colon and prostate cancer cases and in women the increase of 50% of breast cancer new cases and then 10% of colon cancer cases. Conclusion It seems that there is a continuous increasing of some cancers in Tunisia: breast cancer in women and lung cancer in men, colon cancer for both.
Breast cancer is the most frequent cancer localisation in Tunisian women. With ageing of population, combined to a generation effect, it is very likely that we will see in near future an important rise in breast cancer incidence. Also all the Tunisian data have always shown a high rate of young patients (ages below 35 years) around 11%. This study is designed to establish a forecast of the level of the incidence and of a numbers of cases of breast cancer until 2024 in Northern Tunisia. We also try to foresee the evolution of the percentage of young women.MethodsData given by the Cancer Registry of Northern Tunisia (CRNT) from 1994 to 2003 are used as a baseline for further prediction. This cancer register is covering half of the Tunisian population. Data of the incidence have estimated for the periods 2004–2008; 2009–2013; 2014–2018; 2019–2024. Predictions were based on a Bayesian Age-Cohort model. The implementation of this trial has been carried out by sampling after Gibbs method using WinBugs software.ResultsThe number of cases is growing continuously over the four periods. Thus, in 2019–2024, nearly 2000 cases/year are expected in the Northern part of the country. The standardised incidence will grow from 21.6 cases/100 000 women in 1994–1998 to 46.4 cases/100 000 women in 2019–2024, an increase of 80%. Until the age of 59 the specific rates par age rise moderately, beyond we can observe acceleration. Finally the projection allows a follow-up of the percentage of young women < 35 years in step with the periods. The ageing of the population and the cohort effect let us prevue a clear tendency to fall.ConclusionThe evolution of the percentage of young women show that the modification of the ages pyramid of the general population paired to a cohort effect (the future generations will have a higher risk), will lead to a lowering of this percentage over years. Thus it is very likely that we can't keep the genetic hypothesis (Tunisian women would have a higher risk due to genetic state).
Objectives To assess the current management of diabetic patients and benchmark the results against international standards. Materials and Methods A retrospective medical record review of 87 registered diabetic patients was conducted in diabetes clinics, primary healthcare centers. Records were searched for the last 2 years of Audit implementation in Dubai concerning HbA1c, lipid, BMI, Systolic Blood pressure and diastolic blood pressure indicators in comparison with the standard auditing requirements as indicated by CDC, ICSI. Results HBA1C was taken two or more times a year in 80.4% of the sample which meet the international standard recommendation and only one time in 16.6% of the sample per each year period, 67.82% of patients showed abnormal HBA1C results, 11% of the sample showed HBA1C >9.5 and 32.18% of patients showed HBA1C <7. BMI analysis showed that 89% of the patients were more than normal level (>25), 35% were overweight while (25e30) and 54% were obese according to BMI definition (>30). The study showed that 46% of patients have systolic blood pressure >130 mm Hg, and 29% showed diastolic blood pressure >80 mm Hg. Lipid assessment was conducted on 93% of patients in the sample. The study showed significant difference (p>0.05) from international standards in documentation for foot examination (22%) of the sample, vision assessment (40%) of the sample and documentation of advises on diet and exercise (35%). As the international reference for good care and (60%) for documentation. Recommendation 1. Strengthening the healthcare delivery system in diabetes management to achieve the recommended standards as related to control the severity of the disease (which can be done through further investment in manpower, materials, logistics and whole management system. 2. Bringing down the level of. Objectives This study aimed to compare the work practices and health effects of pesticide exposure between full time and part time vegetable farmers. Methods Data gathering was done via structured personal interview using a nine page questionnaire, physical examination and blood extraction for complete blood count and serum creatinine. Results Pyrethroid was the top pesticide type used by both groups. The risk for full time was related to both the amount of exposure and the type of pesticide the group is exposed to. There were more full time farmers who complained of getting or who fell ill because of work. This difference was statistically significant (p¼0.05). This health seeking behaviour was significantly different for both groups (p¼0.01). In assessing for the individual component of the neurologic exam, 5.22% from full time farmers, and 8.63% from part time farmers had abnormal cranial nerve function, 22 (5.7%) and 9 (6.47%) have abnormal motor strength. All farmers tested for reflexes, meningeals, and autonomics from both groups were normal. For the haematologic examination, the full time farmers had higher mean values for creatinine, white blood cell, red blood cell, haemoglobin, and haematocrit. The activity o...
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