Despite the worldwide growing attention to patient safety, Tunisia has no data on the magnitude and consequences of hospital adverse events (AEs). To estimate the incidence, nature and consequences of AEs and preventable AEs in a university hospital in Tunisia. We opted for a two-stage retrospective medical record review of 620 inpatients admitted during 2005 based on the use of 18 screening criteria. Records were reviewed by a trained medical student, then by an expert physician when one or more criteria were identified. We determine the incidence, preventability and consequences of the AEs. Patients and admissions characteristics were also recorded. Among 620 inpatients, 62 inpatients experienced an AE with an incidence of 10% (95% CI [7.6–12.3]). Surgical/invasive procedures and therapeutic errors were the most common AEs (55 and 21%, respectively). Among the confirmed events 60% were judged to be highly preventable and 21% led to patient death. All ages and both genders experienced equal rates of AEs. However, patients who experienced these events were significantly more exposed to extrinsic risk factors (all surgical interventions and invasive procedures that were listed in the revue form 2 of the questionnaire). Physician reviewers estimated that a total of 570 additional hospital days were associated with AEs. This study confirms that preventable AEs were not rare in our context. They caused human harm and consumed a significant part of hospital resources. Thus, targeted interventions are needed.

A study in Monastir, Tunisia estimated the prevalence of smoking and analysed the determinants of tobacco use among adolescents aged 10-19 years. An observational cross-sectional study was performed in the 8 colleges and high schools of Monastir city in 2004. The mean age of the 900 respondents was 15.8 (SD 2.2) years and 47.7% were aged under 16 years. The overall prevalence of cigarette use during the past year was 16.0% (30.2% among males and 4.6% among females). The first smoking experience was initiated by friends in 45.8% of cases, at a mean age of 13.8 (SD 2.3) years. One-fifth of smokers (21.5%) had used other forms of tobacco. In multivariate analysis, male sex, academic failure, poor family management, antisocial behaviour and addictive behaviour were the main predictors of adolescent smoking status. The prevalence of smoking among adolescents in Monastir is high and requires targeted action.

Breast cancer remains a worldwide public health problem. In Tunisia, it is considered to be the primary women’s cancer and causes high morbidity and mortality. This study aimed to investigate female knowledge, attitudes and practice of breast cancer screening in the region of Monastir (Tunisia). We conducted a descriptive cross-sectional design exploring knowledge, attitudes and practices of women in the region of Monastir on breast cancer screening. The study was conducted in health centres of this region from 1 March 2009 to 30 June 2009. Data were collected via a structured questionnaire containing 15 items on demographic status, knowledge of risk factors and screening methods and attitudes towards the relevance and effectiveness of breast cancer screening. A scoring scheme was used to score women’s responses. A total of 900 women agreed to take part in the study. Their mean age was 41.6 ± 12.4 years and 64% did not exceed the primary level of education. According to the constructed scores, 92% of participants had poor knowledge of the specific risk factors for breast cancer and 63.2% had poor knowledge of the screening methods. Proper practice of breast cancer screening was observed in 14.3% of cases. Multiple logistic regression analysis showed that good knowledge of risk factors and screening methods, higher level of education and positive family history of breast cancer were independently correlated with breast cancer screening practice. This study revealed poor knowledge of breast cancer and the screening methods as well as low levels of practice of breast cancer screening among women in the region of Monastir. Results justify educational programs to raise women’s adherence to breast cancer screening programs in Tunisia.

We sought to investigate the relationship between social violence and adult overweight/obesity and the role of common mental disorders (CMD) in mediating this relationship. A cross-sectional study was conducted from January to June 2016 in Tunisia. Participants were selected from randomly selected Primary Health Care Centers. The Arabic version of the Adverse Childhood Experiences-International Questionnaire (ACE-IQ) was used. A total of 2120 participants were included. Women exposed to social ACEs had higher rates of overweight/obesity than men (13.5 versus 9.5%; P = 0.004). For women, statistically significant partial mediation effects of CMD were observed for exposure to community violence (% mediated = 17.7%). For men, partial mediation was found for the exposure to peer violence (% mediated = 12.5%). Our results provide evidence of the independent increase of overweight/obesity after exposure to social ACEs. Efforts to uncover and address underlying trauma in health care settings may increase the effectiveness of obesity interventions.