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Background: Rotavirus (RV) is the main infectious agent of severe acute gastroenteritis (AGE) in infants and children under 5 years. Given the recent availability of new vaccines, it is important to accurately assess the incidence of rotavirus gastroenteritis (GERV) and their medical and epidemiological consequences., Methods: This work is the French part of study program called SPRIK, a multicenter, prospective, observational study conducted from October 2005 to May 2007 to estimate the annual incidence of GERV within children under 5 years visiting a general practitioner or pediatrician. It presents data collected by 41 general practitioners and 36 paediatricians located throughout the French metropolitan territory. A stool sample was taken for every child. Rotavirus presence was sought by the physician using a rapid immunochromatographic test. French results are presented in this article., Results: A total of 1648 GEA episodes corresponding to 1463 eligible patients were included in the study mainly from December to May (peak in February-March). The incidence rate of GERV leading to consultations in general practice was 1357 cases per 100,000 patient-years (PY) (1.36%), with a 95% confidence interval of [1345-1368]. The peak incidence occurs before 2 years. GERV accounted for 21% of all GEA cases seen by paediatricians and general practitioners. Patients with GERV were younger (14.1 ± 10.8 versus 18.4 ± 13.9 months for other GEA, P<0.0001) and had more severe clinical symptoms: presence of fever (32.6% versus 20.0%, P<0.0001), behavioural symptoms (45.6% versus 20.8%, P<0.0001) and dehydration (48.7% versus 21.2%, P<0.0001). GERV episodes were considered severe in 79.7% of cases, using the Vesikari scale. More than 86% patients received oral rehydration during the episode and 13 patients (5.8%) were hospitalized. Nearly 80% GERV episodes were considered severe using the Vesikari scale. Main genotypes were G1P[8] rotavirus (44%) and G9P[8] rotavirus (35%) types., Conclusion: The incidence rate reported in this study is close to results of previous studies done in Europe. The frequency and severity relative to GERV support vaccination in very young children to reduce the burden associated with this pathology., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Background: In France, Rotavirus infections are responsible for approximately 300,000 cases of acute gastroenteritis (AGE) in children less than 5 years every year, 138,000 outpatient consultations and 18,000 hospitalizations. Surveillance for Rotavirus Infections in Hospitalized Kids (SHRIK) is a European prospective observational study conducted to assess the burden related to Rotavirus gastroenteritis (RVGE) in these children., Methods: Patients less than 5 years visiting emergency rooms for AGE (U-AGE), who were hospitalized (H-AGE) or who developed RVGE 48 hours after hospitalization (N-AGE) were included in the study over a year. A stool sample was collected for every child and analyzed by ELISA., Results: Results are presented for patients enrolled in France. A total of 755 eligible patients with AGE were included (357 for U-AGE, 372 for H-AGE and 26 for N-AGE). Among them, the proportion of RVGE was 49.1% (n=114) for U-AGE and 64.4% (n=186) for H-AGE. Most cases of RVGE (89%) involved children less than 2 years. GERV were frequently more severe than GEA non related to Rotavirus (NRVGE), according to the Vesikari scale, (68.4% against 41.9%, P<0.0001). Oral rehydration was performed for nearly 50% of RVGE patients before coming to hospital, versus 36.2% for NRVGE (P<0.002). All RV-positive strains were genotyped: the most frequent strains were G1P[8] (U-AGE, 42%; H-AGE, 46%) and G9P[8] (U-AGE, 38%; H-AGE, 31%)., Conclusion: SHRIK study followed up all GEA visiting emergency room or requiring hospitalization for one year and showed that the burden of Rotavirus disease is high with a ratio over 70% of all hospital GEA during the winter peak., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Background: The goal of asthma management is to achieve disease control, defined. as the ability to lead a normal life with normal pulmonary function. However, many epidemiological surveys have demonstrated that asthma control is unacceptable in the majority of patients., Objective: To evaluate asthma control in 624 adults with asthma in the Maghreb, participating in the AIRMAG survey., Methods: As part of a general population survey of asthma in the Maghreb conducted by structured telephone interview, information was obtained on asthma control and treatment. Control was determined with the Asthma Control Test (ACT) and using an algorithm based on the GINA control guidelines., Results: The mean ACT score was 16.6 +/- 4.6, corresponding to uncontrolled asthma. Asthma was uncontrolled (ACT score

Background: Bronchial asthma is the most frequent chronic respiratory disease in both adults and children. The prevalence and burden of asthma vary considerably between different regions of the world. Information on asthma in Africa is fragmentary and relatively old., Objective: The objective of this cross-sectional epidemiological survey was to determine the prevalence and burden of asthma in the North African countries of Algeria, Morocco and Tunisia using the methodology developed in the Asthma Insights and Reality (AIR) programme., Methods: A general population sample was generated using a stratified sampling method based on randomly-generated lists of telephone numbers. The target sample consisted of 10,000 households in each country, which were contacted by telephone. A structured interview was proposed. Two screening questions were asked to identify subjects with asthma. Subjects who met these criteria were then questioned in more detail about their asthma., Results: Of 30 350 households contacted, 1090 subjects with asthma were identified of whom 872 provided complete data. The age- and gender-adjusted prevalence of asthma was 3.45% [95% CI: 3.09 3.80%] in Algeria, 3.89% [95% CI: 3.52 4.27%] in Morocco and 3.53% [95% CI: 3.18 3.89%] in Tunisia. Prevalence was highest in children and older adults, and in urban areas. Annual incidence rates ranged between 28/10,000 in Tunisia and 46/10,000 in Algeria. 74.3% of adults reported being handicapped by their asthma all or most of the time, 26.4% reported a visit to a hospital emergency department in the previous year and 23.9% absence from work or school due to asthma. 48.0% reported that their sleep was very or quite disturbed by asthma., Conclusions: The prevalence of asthma in the Maghreb countries is moderate, but its impact is high., ((c) 2009 Elsevier Ltd. All rights reserved.)

Background: Bronchial asthma is the most frequent chronic childhood disease and can have a marked impact on educational development, activities and quality of life. The AIRMAG survey provides an opportunity to assess asthma and its impact in children in North Africa., Objective: To describe the prevalence, burden and management of asthma in children in the Maghreb., Methods: A general population sample was generated using a stratified sampling method based on randomly-generated lists of telephone numbers. The target sample consisted of 10,000 households in each country, which were contacted by telephone. A structured interview was proposed. Two screening questions were asked to identify subjects with asthma. Children who met these criteria were then questioned in more detail about their asthma., Results: Of 30,350 households contacted, 1090 subjects with asthma were identified, of whom 248 were aged under sixteen and interviewed by proxy. The prevalence of paediatric asthma ranged from 3.5% in Tunisia to 4.4% in Morocco. 22.8% of children were rated as severe persistent and 30.9% as intermittent. Asthma control was adequate in 7.6% of children and unacceptable in 46.2%. Control was best in Tunisia and worst in Morocco. 12.2% had been hospitalised for their asthma in the previous year and 32.9% had needed to attend an emergency department. Short-acting beta-agonists were used by 52.8% of children and prophylactic inhaled corticosteroids (alone or in association with long-acting beta-agonists) by 27.0%., Conclusions: Asthma has a major impact on the lives of children with asthma in the Maghreb. This could be improved by offering more appropriate care as recommended in the GINA guidelines., ((c) 2009 Elsevier Ltd. All rights reserved.)