Background: The COVID-19 pandemic has presented various challenges, one of which is the discovery that after the acute episode, around 30% of patients experience persistent symptoms or develop new ones, now known as long COVID. This new disease has significant social and financial impacts. The objective is to determine the prevalence of long COVID in the Tunisian population and identify its predictive factors. Methods: This was a cross-sectional study conducted among Tunisians who were infected with COVID-19 between March 2020 and February 2022. An online self-administered questionnaire was distributed through social media, radio, and television channels over the course of one month (February 2022). Long COVID was defined as the persistence of existing symptoms or the development of new symptoms within three months after onset, lasting for at least two months, and with no differential diagnosis. We performed univariate and multivariate analyses using binary stepwise logistic regression with a significance level set at 5%. Results: A total of 1911 patients participated in our study, and the prevalence of long COVID was 46.5%. The two most frequent categories were general and neurological post-COVID syndrome, with a prevalence of 36.7% each. The most commonly observed symptoms were fatigue (63.7%) and memory problems (49.1%). In the multivariate analysis, the predictive factors for long COVID were female gender and age of 60 years or older, while complete anti-COVID vaccination was found to be a protective factor. Conclusions: Our study found that complete vaccination was a protective factor against long COVID, while female gender and age of 60 years or older were identified as the main risk factors. These findings are consistent with studies conducted on other ethnic groups. However, many aspects of long COVID remain unclear, including its underlying mechanisms, the identification of which could guide the development of potential effective treatments.

Telemedicine encompasses all medical practices that allow patients to be remotely cared for through new information and communication technologies. This study aims to assess the remote management of patients consulting emergency services and not requiring in-hospital care during both pre-pandemic and pandemic periods of COVID-19. This was a prospective, randomized, controlled study. The telemedicine group received follow-up at home after emergency room discharge according to a predefined protocol, with telephone calls on days 2, 7, 15, and 30. The control group received standard care without regular telephone follow-up (only a call on day 30). The study was conducted with patients consulting the emergency department of FarhatHached Hospital in Sousse. Patient inclusion occurred between November 1, 2019, and April 30, 2020. The primary outcome measures were the re-consultation rate and treatment adherence. The secondary outcome measure was patient satisfaction.SPSS version 23.0 for Windows was used for data analysis. Descriptive statistics calculated frequencies, percentages, means, standard deviations, medians, and range. Analytical study involved Student’s t-test and Pearson chi-square test for mean and frequency comparisons, respectively. Significance threshold (p) for all tests was set at 0.05. A total of 400 patients were included. The average age of patients was 40 years. Both groups were comparable in terms of demographics and clinical characteristics. Diagnoses included mainly benign infectious diseases, trauma, mild decompensations of chronic conditions (asthma, COPD, heart failure), and suspected COVID cases. Patients in the telemedicine group tended to reconsult less in the month following their initial emergency room visit (14% versus 26.5%) (p = 0.004). There was a significant difference in treatment adherence between the telemedicine group and the control group (97.5% versus 92%; p = 0.014). The satisfaction with telemedicine was higher than satisfaction with regard to an in-person consultation at the emergency department (90% versus 37.5%). It is necessary to implement telemedicine in Tunisia, especially in emergency services. It ensures better remote patient care by reducing re-consultation rates, increasing treatment adherence, and improving patient satisfaction.

Introduction The management of healthcare waste is a crucial issue for public health and the environment. To minimise risks, it is essential to ensure that the management of healthcare waste is meticulously applied. Additionally, among the evaluation methods adopted by the hospital hygiene department to monitor the degree of compliance. The aim of this study was to assess the degree of compliance with healthcare waste management before and after a training and support programme. Methods This is a pre-experimental study based on two audits of healthcare waste management at Farhat Hached University Hospital in Sousse, Tunisia. All medical, surgical and laboratory departments were included. The first audit was carried out, followed by training of the responsible staff, which was carried out according to a cycle of training and coaching hygiene technicians, and finally, a second audit was conducted. The compliance rate is compared between 2021 and 2022. Results When comparing the averages of the compliance percentages for the four audit areas, there was a statistically significant improvement between the years 2021 and 2022 in the availability of equipment and consumables required for the management of infectious and sharp healthcare waste (p=0.029) as well as intramural transport (p=0.014). Conclusion The study highlights the central role of effective waste management training in promoting compliance, awareness and responsible practices. Constant attention and training are essential to maintain progress at Farhat Hached University Hospital. This helps create safer care environments, better public health outcomes and long-term sustainability.

In the 1980s, Tunisia was considered a country of high endemicity for hepatitis A virus (HAV). Since 2000, an epidemiologic shift has led to an increased incidence of symptomatic and severe forms of HAV infection. In 2015, we conducted a cross-sectional nationwide household-based hepatitis A virus (HAV) seroprevalence study in the total population regardless of age, sex, or geographic origin using a stratified sampling design to make an overview of the HAV epidemiologic situation in Tunisia before vaccine implementation. A total of 6,322 individuals were enrolled. The HAV prevalence was 78.8%. The anti-HAV IgG seropositivity rate increased from 16% for ages 5-9 years to 45% for ages 10-14 years, 67% for ages 15-19 years, 87% for ages 20-24 years, and >90% for older age groups, which suggested an age at midpoint of population immunity (AMPI) in late adolescence. It was significantly higher in rural areas (P < 10^-3) and varied significantly between and within regions (P < 10^-4). In this study, although the overall AMPI suggestsintermediate endemicity, the regional AMPI varies from intermediate to very high endemicity profiles attributable to different socioeconomic determinants and conditions of sanitation and hygiene. In addition, it provides insights for the best decisions in terms of vaccination strategies.

Good knowledge, attitudes and practices towards Blood Exposure Accidents (BEA) are essential for their prevention with a significant correlation found between e-health literacy and KAP levels. We aimed to assess the knowledge, attitudes and practices (KAP) and e-health literacy levels towards BEA and their potential associations among medical students at a Tunisian medical school. We conducted a comprehensive cross-sectional study among undergraduate medical students at Ibn Al Jazzar Medical School in Sousse, Tunisia, using an anonymous, self-administered questionnaire. Students' e-health literacy was assessed using the validated French version of the Electronic Health Literacy Scale (eHEALS). A total of 580 medical students were enrolled with a mean age of 21.6 ± 1.2 years and female predominance (sex ratio = 0.36). Most respondents (70%) had received no BEA training, and almost the quarter (24.3%; CI 95%:20.7-27.9%) reported having been victims of BEA. Overall, the mean score of medical students' KAP was 19.98 with almost half (49.1%, CI95%:45-53.2%) achieving a good score. The mean eHEALS score was 28.22 ± 6.85. More than half (55.7%, CI95%:51.7-59.7%) achieved a high level of e-health literacy. Being enrolled in the second cycle of medical studies (AOR = 2.50, 95%CI: 1.40-4.30), and having inadequate knowledge of standard precautions (AOR = 1.58, 95%CI: 1.04-2.39) were the predictors of BEA, while having good KAP regarding BEA was a negative determinant (AOR = 0.59, 95% CI: 0.39-0.89). In addition, having adequate knowledge of standard precautions (AOR = 1.57, 95% CI: 1.10-2.23) and having good knowledge of BEA (AOR = 1.63, 95% CI: 1.17-2.27) were the determinants of high levels of e-health literacy on BEA. Similarly, being adequately informed about the risks of BEA (AOR = 1.44, 95% CI: 1.01-2.06) was a positive determinant, whereas having a history of BEA (AOR = 0.63, 95% CI: 0.43-0.93) was a negative determinant of high levels of KAP. Medical students showed good levels of e-heath literacy and KAP. E-health literacy appears to play a critical role in preventing BEA by understanding standard precautions and follow-up protocols.

Background: Otosclerosis is a primary dystrophy affecting the otic capsule bone. Computed Tomography (CT) has crucial role in its management.Aim: To assess the diagnostic value of CT scan by comparing its results to operating data, to define the imaging use in the preoperative anatomic assessment and to assess the prognostic input of CT scan.Patients and Methods: A retrospective study from January 2012 to December 2019 at the Ear Nose and Throat (ENT) department of Farhat Hached Hospital in Sousse, Tunisia. It included patients explored by CT scan for otosclerosis. We sought to verify CT scan findings during middle ear exploration and concordance or disaccordance between both was recorded.Results: A total of 50 patients were included and 56 were operated. Mean age of the patients was 38 years (15-64 years). A female predominance was noted with 39 women (78%) and 11 men (22%). Hearing loss was the dominant symptom. The sensitivity of CT scan for the diagnosis was 87.5%. CT scan had a statistically significant value in the diagnosis of a thickening footplate with a sensitivity of 63% and a specificity of 88% (p = 0.001). The extent of otosclerosis represented a poor prognostic factor with a statistically significant value (p=0.030).Conclusion: CT scan not only confirms the diagnosis of otosclerosis and eliminates differential diagnoses, but also establish a precise anatomical review and assess the prognosis in cases of planned surgery.