[Epidemiological transition and health impact of cardiovascular disease in Tunisia].
OBJECTIVE
We aim at analysing the increase of CVDs in the Tunisian hospitals in order to assess the burden of NCDs in the transitional context.


METHODS
Data are recorded through the Tunisian National Morbidity and Mortality Survey (TNMMS). In order to assess the CVDs (CHDs vs RHDs) trend, two representative samples of Cardiology Departements patients were compared one is selected from the TNMMS and the second from the hospitalisations recorded in 1992. Causes, stay duration, status at the end of the hospitalisation, transfer to another hospital and patients socio-demographic characteristics are recorded and compared for the two periods. All the diagnosis are coded referring to the DMC 10. To analyze the determinant of the epidemiological transition, we have elaborated the CVD causal pattern and we have documented all their determinants.


RESULTS
CHD rate has dramatically increased, while RHD has decreased especially on men. In 1992, 39.2% of men and 11.8% of women were admitted for CHD. In 2002, these rate are respectivly 58.8% and 38.2% while RHD rates were, in 1992, 11.8% on men and 25.3% on women vs 4.4% and 11.7% respectively.


CONCLUSIONS
This study has confirmed that so far controlling transmitted diseases seems to be successful, Tunisian people are about to face a new problems as hypertension, obesity, diabetes and tobacco smoking. The new challenge with the burden of diseases requires the implementation of a national strategy relevant to the epidemiological, social and economical transition. Population needs and cost effectiveness of interventions assessment is crucial to set the national priorities.
Ben Romdhane
Habiba
H
Institut National de Santé Publique.
Haouala
Habib
H
Belhani
Ali
A
Drissa
H
H
Kafsi
Nacer
N
Boujnah
Rachid
R
Mechmèche
Rachid
R
Slimane
Mohamed Lotfi
ML
Achour
N
N
Nacef
Taoufik
T
Gueddiche
Mohamed
M
D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D014416:Tunisia / Q000453:epidemiology