Contrasting patterns of hepatitis C virus infection in two regions from Tunisia

This report is a population-based study describing the pattern of hepatitis C virus (HCV) infection in two distinct regions in Tunisia. The study included a total of 11,507 individuals sampled in 1996 from both genders, all age groups, urban and rural settings belonging to 2,973 families. HCV infection was assessed by commercial enzyme immunoassay (EIA) and immunoblot assays and detection of HCV RNA by PCR. HCV genotypes and subtypes were determined by sequencing in the 5'-untranslated region (UTR) viral genomic region and the INNO-LiPA HCVII genotyping kit. Genetic relatedness between HCV strains was assessed by sequencing of a portion of the NS5B region. HCV prevalence was significantly higher in the North-Western region than in the Southern one: 1.7% versus 0.2% (P < 10(-3), chi(2) = 8,506). There was no difference in positivity according to gender or living in rural or urban settings; the only significant risk factor was advanced age. HCV prevalence among household contacts of HCV positives was not significantly higher than the prevalence in the whole study population. These results indicate a heterogeneity in the geographical distribution of HCV in Tunisia. An increased HCV transmission occurs in the North-Western region with large predominance of genotype 1b (88%) and low contribution of intrafamilial transmission.     

Incidence and Characteristics of Atypical Femoral Fractures: Clinical and Geometrical Data

Despite the multitude of studies published on atypical femoral fractures (AFFs), a profile for patients at risk does not exist. This study aimed first at estimating AFF incidence over a 19‐month‐period in Quebec City using the ASBMR Task force criteria to define AFF. The medical records of patients hospitalized for hip or femoral fracture between June 1, 2009, and December 31, 2010, were reviewed. Thirty‐six cases of atypical fractures were identified during the 19‐month period, representing an AFF incidence of 7.0 (range, 4.7 to 9.3) cases per 100,000 person‐years. In the second part of the study, data regarding the characteristics suspected of increasing the risks of AFF were collected from medical and pharmacological records, proximal femur radiographs, and patient interviews. The data regarding each patient with an AFF during years 2008‐2011 were compared to two controls with a hip or femoral fragility fracture or a traumatic fracture, paired for age and sex. Twenty patients with AFF were added to the 36 patients with AFF selected in the first part, thereby 56 patients with AFF were investigated. The association between the occurrence of AFF and bisphosphonates (BPs) use was proven statistically significant in multivariate analysis, odds ratio (OR) = 10.39 (95% CI, 2.22 to 48.58; p = 0.0029). Compared to controls, patients with AFF had excessive femoral offset (43.1 mm versus 38.3 mm, p = 0.0007), proximal femoral neck angle in varus (128.9 degrees versus 134.0 degrees, p < 0.0001), and had greater proximal cortical thickness. This retrospective study confirms the low incidence of AFF, confirms its significant association with exposure to BPs, and reveals the possible contribution of proximal femoral geometry in AFF occurrence. © 2016 American Society for Bone and Mineral Research.     

Aspects épidémiologiques et cliniques de la leishmaniose cutanée à Kairouan-Tunisie et particularités chez l’enfant

Cutaneous leishmaniasis (CL) remains highly endemic in Tunisia. The governorate of Kairouan (Center) is one of the most affected particularly by zoonotic form due to Leishmania major. The purpose of this study was to describe the epidemiological, clinical and therapeutic features of the disease in this governorate and to identify any particularities in children. Three hundred and ninety cases were registered over 2 years (2012 and 2013). The average age was 29 years one month [± 22.7] (34.6% of patients were under 15 years). The cumulative incidence of CL was equal to 34.4 per 100,000 per year. It was higher in children (39.6 per 100,000 versus 29, p=0.004). Cases were diagnosed especially in autumn and winter (88.3% of cases between October and January, p<0.001). The average delay of consultation was one month and 22 days [± 2.5] after onset of lesions. The average number of lesions per patient was 2.7 [± 2.3] with a mean diameter equal to 2.2 cm. In addition to a higher incidence of the disease, two other features were found in “Children” group which are the presence of similar cases in the neighborhood (27.7% versus 13.4%, p=0.002) and preferential localization in the face (36.4% versus 11%) while the members were more affected in adults (63.5% versus 46.4%) (p<0.001). Meglumine antimoniate was prescribed for most of our patients (93.1%). The intramuscular route was used more than local one, probably because of high proportions of multiple lesions and facial localization.     

Structure properties and dielectric relaxation of Ca0.1Na0.9Ti0.1Nb0.9O3 ceramic

In this paper, the synthesis of Ca_0.1Na_0.9Ti_0.1Nb_0.9O₃ (CNTN) ceramic by a solid-state reaction method is reported. The results of Rietveld refinement of X-ray diffraction (XRD) patterns at room temperature showed a pure tetragonal perovskite (P4mm space group). Raman spectroscopy analysis, ranging from of 50 to 1000 cm⁻¹, at room temperature, validates the results of XRD. The dielectric properties was studied by complex impedance spectroscopy examined in broad frequency range, 100 Hz to 200 kHz, at different temperatures. The dielectric permittivity for our CNTN compound confirms the typical relaxor behavior. The investigation of the diffuseness of the transition was conducted by fitting the experimental data with modified Curie–Weiss law; Gaussian distribution and Power law confirm the presence of a short-range association between the polar nanoregions (PNRs). The obtained values of the diffuseness coefficient are of the order 1.6, which corresponds to the diffuse phase transition (DPT) ascribed to the existence of various states of polarization, thus various relaxation times in different regions. The value of diffuseness is of the order 85 and the degree of relaxor (ΔT_cm = 65 K) is interesting as far as microelectric applications are concerned. Moreover, based on the frequency dependence of temperature at dielectric maxima using Vogel–Fulcher relationship, a strong evidence for a static freezing temperature with regards to thermally-activated polarization fluctuations was found.

In this paper, the synthesis of Ca_0.1Na_0.9Ti_0.1Nb_0.9O₃ (CNTN) ceramic by a solid-state reaction is reported. The results of Rietveld refinement of X-ray diffraction patterns at room temperature showed a pure tetragonal perovskite (P4mm space group).     

Molecular Epidemiology of SARS-CoV-2 in Tunisia (North Africa) through Several Successive Waves of COVID-19

Documenting the circulation dynamics of SARS-CoV-2 variants in different regions of the world is crucial for monitoring virus transmission worldwide and contributing to global efforts towards combating the pandemic. Tunisia has experienced several waves of COVID-19 with a significant number of infections and deaths. The present study provides genetic information on the different lineages of SARS-CoV-2 that circulated in Tunisia over 17 months. Lineages were assigned for 1359 samples using whole-genome sequencing, partial S gene sequencing and variant-specific real-time RT-PCR tests. Forty-eight different lineages of SARS-CoV-2 were identified, including variants of concern (VOCs), variants of interest (VOIs) and variants under monitoring (VUMs), particularly Alpha, Beta, Delta, A.27, Zeta and Eta. The first wave, limited to imported and import-related cases, was characterized by a small number of positive samples and lineages. During the second wave, a large number of lineages were detected; the third wave was marked by the predominance of the Alpha VOC, and the fourth wave was characterized by the predominance of the Delta VOC. This study adds new genomic data to the global context of COVID-19, particularly from the North African region, and highlights the importance of the timely molecular characterization of circulating strains.