A. Sriha

Women’s knowledge, attitudes and practice about breast cancer screening in the region of Monastir (Tunisia)

Breast cancer remains a worldwide public health problem. In Tunisia, it is considered to be the primary womens 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 womens 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 womens adherence to breast cancer screening programs in Tunisia.

Predictors of smoking relapse in a cohort of adolescents and young adults in Monastir (Tunisia)

BackgroundSmoking prevalence in adolescents and young adults is substantially elevated in Tunisia. Moreover, there is a lack of knowledge regarding the effectiveness and associated factors in smoking cessation interventions among adolescents and young adults. This study aims at identifying the major factors leading to smoking relapse among adolescents and young adults in the region of Monastir, Tunisia.MethodsWe carried out a prospective cohort study at the smoking cessation center of the University hospital of Monastir, Tunisia. The population study consisted of all adolescents and young adults (15–30 years) consulted during a period of two years (2009 – 2010). A questionnaire was used to explore the patient’s sociodemographic characteristics, smoking history, nicotine dependence (Fagerstrom test) and anxiety / depression (Hospital Anxiety and Depression Scale). A telephone survey was conducted in July 2011 to assess smoking cessation results. A multivariate Cox regression was used to identify predictors of smoking relapses.ResultsA total of 221 adolescents and young adults were included in this study with a mean age of 25.5 ± 3.9 years. At follow up, 59 study participants (26.7%) were abstinent and the overall median abstinence was 2 months. In the multivariate analysis smoking relapse was associated with being an adolescent patient (HR 2.16; 95% CI: 1.54-3.05), medium or higher nicotine dependence at baseline (HR 2.66, 95% CI: 1.06-7.05 and HR 3.12, 95% CI: 1.20-8.12 respectively), not receiving treatment (HR 1.70, 95% CI: 1.25-2.33) and have friend who is a smoker (HR 1.63; 95% CI: 0.96-2.79).ConclusionThe results of this study provide important information about beneficial effect of smoking cessation support for adolescent and young adults. More efforts must be deployed to deal with contributing factors to smoking relapse.