Plague is not limited to the currently indexed natural foci in Algeria.

<p><strong>Background</strong>: Aging and lifestyle changes had led to an  epidemiological transition, with a significant impact on the incidence of cardiovascular diseases in North Africa. <br /><strong></strong></p><p><strong>Objective</strong>: The aim of this study was to determine the prevalence of metabolic syndrome and its associated factors, which were unknown, among an urban population in Algeria.</p><p><strong>Methods:</strong> During 2007-2009, 787 individuals aged 30-64 years, randomly selected from the list of insured persons residing in the city of Oran, participated in a clinical, anthropometric and biological survey. Participants were classified according to the National Cholesterol Education Program - Adult Treatment Panel (NCEP-ATP) III definition of metabolic syndrome.<br /><strong></strong></p><p><strong>Results</strong>: The prevalence of metabolic syndrome was 20%, higher in women than men (25.9 vs 13.7%; P&lt;.0001). Among the<br />components of the syndrome, the most common risk factors observed in women were a low high-density lipoprotein (HDL) cholesterol concentration (60.4% vs 44.2% in men) and abdominal obesity (46.8% vs 30.1% in men) whereas men displayed more high blood pressure (42.5% vs 34.8% in women). In men, metabolic syndrome was more frequent in married and highly educated participants. In contrast, women with a high level of education and who had an intermediate level of physical activity seemed to be protected.<br /><strong></strong></p><p><strong>Conclusions</strong>: Metabolic syndrome, prevalent in the urban population of North Algeria, is associated with a high proportion of low HDL-cholesterol and abdominal obesity, especially among women. There is a need for prevention strategies involving promotion of physical activity for the whole population and screening for hypertension among men. <em>Ethn Dis</em>. 2016;26(1):99-106; doi:10.18865/ed.26.1.99</p>

The multiple perspectives of quality of care include clinical care and other social objectives of respect for the individual and attention to the patient. User satisfaction as assessed by patient satisfaction surveys or patients' experiences only reflect the health professionals' representation. However, the objective is to measure what the user perceives and feels and his/her representation of the attention provided. These approaches, conducted outside of the quality of care strategic plan, only provide a basis for actions with limited or no effectiveness.

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