Meta-Analysis and Systematic Review of Micro- and Macro-Nutrient Intakes and Trajectories of Macro-Nutrient Supply in the Eastern Mediterranean Region

The Eastern Mediterranean Region (EMR) is experiencing a nutrition transition, characterized by the emergence of overnutrition and micro-nutrient deficiencies. No previous study has comparatively examined nutrient intake in adults across countries in the EMR. This review examined the adequacy of nutrients in adults living in the EMR. Moreover, it analyzed the food balance sheets (FBS) for 1961–2018 to identify the trajectory of energy supply from macro-nutrients in the EMR. A systematic search was conducted from January 2012 to September 2020. Only observational studies were retained with a random sampling design. An assessment of the methodological quality was conducted. Levels of nutrient daily intake and their adequacy compared to the daily reference intake of the Institute of Medicine were reported across the region. No studies were identified for half of the region’s countries. Although nutrient energy intake was satisfactory overall, fat and carbohydrate intake were high. Intake of vitamin D, calcium, potassium, zinc, and magnesium were below that recommended. The analysis of the FBS data allowed for the identification of four linear patterns of trajectories, with countries in the EMR best fitting the ‘high-energy-supply from carbohydrate’ group. This systematic review warrants multi-sectorial commitment to optimize nutrient intake.     

Attitude to cervical cancer screening of women residing in two regions of northern Tunisia

The objective of this survey to describe knowledge, attitudes and behaviours of women residing in two regions of the North of Tunisia, towards cervical cancer screening methods. 936 women residing to the Ariana (urbanized region) and 993 women residing to Zaghouan (region to farming predominance) were included; they were chosen according to the method of quotas while taking like criteria's, the of area residence (urban or rural), age and the level of education. Every woman should have answered to a questionnaire. Data collected were related to women perception of the severity of the cervical cancer, of their vulnerability for this cancer, of screening efficiency and the recourse of women to this service. The recourse to the cervical cancer screening was significantly more frequent in Ariana (24,6% vs. 13,8% p <0,001); the half of women is optimistic towards the therapeutic progress recorded in Tunisia in the domain of cancer. A better organization of cervical cancer screening including the individual invitations of women and a better sensitization and implication of physicians of the first line in the two sectors public and private, are indispensable to improve the frequency of recourse to cervical cancer screening.