Health screening strategies in Maghreb countries: Situation Analysis and perspectives

##plugins.themes.academic_pro.article.main##

Mohamed Hsairi
Faouzi Mehdi
Ridha Bellaaj
Mondher Kassis

Abstract

Background: The aim of screening is to improve individual health through an early detection of diseases at a stage where the prognosis of disease could be significantly. However, this kind of intervention is costly and it’s necessary to respect criteria in selection of targeted diseases and screening tests.
Objective: The objective of this study was to describe public health screening policy in the Maghreb countries in order to identify the main barriers to the development of this type of intervention.
Methodology: This study is a literature review of screening practices and policy in Maghreb countries. For this purpose, we conducted a global search in MEDLINE, as well as in the websites of the Ministries of Health of Maghreb countries; we also asked also key persons in the different countries to provide us useful t information concerning screening in their countries.
Results: Antenatal and neonatal screening is generally limited to a few pilot experiments such as screening for congenital hypothyroidism and phenylketonuria and deafness. Regarding school population, screening of certain diseases such as dental disorders, infectious diseases including tuberculosis, overweight and obesity, visual impairment, is carried out during periodic medical visits. Among adults, screening is often opportunist; it is performed in patients who use primary care health centers; the main targeted diseases are cervical, breast cancer and colorectal cancer, pulmonary tuberculosis. Screening coverage, especially for cancers, remains relatively low; for example, in Tunisia, this coverage was 12.7% for at least one cervical smear in the last five years; while for an annual clinical breast examination, this proportion was 33.2%.
Conclusions: It is strongly recommended to improve coverage by screening, especially for cancers through educational actions of the population highlighting the high chances of cure in case of early detection, training of care staff and improvement, access to screening benefits

Keywords:

Mass Screening- Early detection of Cancer - Program Evaluation - Africa, Northern  

##plugins.themes.academic_pro.article.details##

References

  1. Rose G, Barker D. Epidemiology for the uninitiated. Screening. BMJ 1978;2:1417-18.
  2. J. M. G. WILSON, G. JUNGNER. Principles And Practice Of Screening. Geneva WHO, Public Health Papers No. 34, 1968:163p.
  3. Ben Dridi M.-F, Ben Turkia H, Azzouz H, Ben Chehida A, Ben Abdelaziz R, Tebib N. Les maladies héréditaires du métabolisme en Tunisie: défis, acquis, espoirs. Archives de Pediatrie 2015;22(HS2):3-4.
  4. Elkadri N, May MV FI, M'timet S, Ben Slama C, Khrouf N. Dépistage de l'hypothyroïdie congénitale à tunis. Seuils de rappel et protocole. Available from: http://docplayer.fr/66862824-Depistage-de-l-hypothyroidie-congenitale-a-tunis-seuils-de-rappel-et-protocole.html
  5. Ben Hamida E, Chaouachi S, Bezine A, Hamadi M, Mbarek C, Benlallehom L, Marrakchi Z. Dépistage Systématique de la Surdité en Maternité par Oto-Emissions Acoustiques Provoquées (O.T.E.A.P) : Etude Pilote. Tunis Med 2010 ; 88 : 482 - 485
  6. ONUSIDA. 90-90-90 Une cible ambitieuse de traitement pour aider à mettre fin à l'épidémie du sida. Rapport ONUSIDA, 2014. Available at : http://www.unaids.org/sites/default/files/media_asset/90-90-90_fr.pdf
  7. Direction des Soins de Santé de Base. Stratégie nationale de dépistage de l'infection à VIH en Tunisie. Tunis, Ministère de la santé 2014. Available at : https://aidsfree.usaid.gov/sites/default/files/hts_policy_tunisia.pdf
  8. Alhyas L, McKay A, Majeed A. Prevalence of type 2 diabetes in the States of the co-operation council for the Arab States of the Gulf: a systematic review. PLoS ONE 2012; 8:e40948.
  9. Alhyas L, McKay A, Balasanthiran A, Majeed A. Prevalences of overweight, obesity, hyperglycaemia, hypertension and dyslipidaemia in the Gulf: systematic review. J R Soc Med Sh Rep 2011;2:55.
  10. Habiba Ben Romdhane1*, Samir Ben Ali, Wafa Aissi, Pierre Traissac, Hajer Aounallah-Skhiri, Souha Bougatef, Bernard Maire, Francis Delpeuch and Noureddine Achour. Prevalence of diabetes in Northern African countries: the case of Tunisia. BMC Public Health 2014, 14:86
  11. Saidi O: Résultats de l'enquête « Tunisian Health Examination Survey 2016 ». Tunis, Institut National de la Santé Publique 2018 (sous presse)
  12. Malek R: Épidémiologie du diabète en Algérie: revue des données, analyse et perspectives. Médecine Mal. Métaboliques 2011, 4:29-33.
  13. Tazi MA, Abir-Khalil S, Chaouki N, Cherqaoui S, Lahmouz F, Srairi JE, et al. Prevalence of the main cardiovascular risk factors in Morocco: results of a national survey, 2000. J Hypertension. 2003; 5:897-903.
  14. Ziyyat A, Ramdani N, Bouanani N, Vanderpas J, Hassani B, Boutayeb A, MA, Bnouham M, Legssyer A. Epidemiology of hypertension and its relationship with type 2 diabetes and obesity in eastern Morocco. Springerplus 2014; 3: 644.
  15. Union Européenne. Recommandation du conseil du 2 décembre 2003 relative au dépistage du cancer. Journal Officiel de l'Union Européenne 2003;16 décembre. Available at :https://eur-lex.europa.eu/legal-content/FR/TXT/?uri=OJ%3AL%3A2003%3A327%3ATOC.
  16. IARC. Cervix Cancer Screening. IARC Handbooks of Cancer prevention. Vol 10. Lyon: IARC Press; 2005. Available at : http://www.iarc.fr/en/publications/pdfs-online/prev/handbook7/index.php.
  17. Patnick J. Screening that failed to work. In: Franco E, Monsonego J, editors. New developments in cevical cancer screening and prevention. Oxford: Blackwell Science; 1997. p. 200-2.
  18. International Agency on research on cancer - - World Health organization. Globocan 2012. Estimated Cancer incidence, Mortality and prevalence in 2012. Available at : http://globocan.iarc.fr/Pages/fact_sheets_population.aspx.
  19. Ministère de la santé. Plan national de Prévention et Contrôle du Cancer. Royaume du Maroc. Ministère de la Santé 2010-2019. Available at: http://www.contrelecancer.ma.
  20. Ministère de la santé. Programme de lutte contre le canceren Algérie 2015-2019. Available at : http://www.sante.dz/colloque/docs/plan_cancer_algerie_zitouni.pdf.
  21. Kada MO : Programmes Nationaux de Santé. Alger, Ministère de la santé 2016. Available at ; https://www.hopital-dz.com/upload/09-2017/article/Program_2016.pdf
  22. Ministère de la Santé. Plan Pour La Lutte Contre Le Cancer En Tunisie 2015-2019. Tunis Ministère de la santé 2014. Available at: http://santenabeul.tn/index.php/les-programmes-nationaux/plan-pour-lutte-contre-cancer-tunisie.html).
  23. Ferlay J, Soerjomataram I, Ervik M, et al. GLOBOCAN 2012. Vol 1.0. Estimated cancer incidence, mortality, and prevalence worldwide in 2012. Lyon, France: IARC Press, 2014 Available at: : http://globocan.iarc.fr/default.aspx.
  24. Ferlay J, Bray F, Steliarova-Foucher E, Forman D. CI5 I-X: cancer incidence in five continents, volumes I to X. Lyon, France: IARC Press, 2014. Available at: http://ci5.iarc.fr/cI5I-x/default.aspx.
  25. Sankaranarayanan R, Swaminathan R, Brenner H, et al. Cancer survival in Africa, Asia, and Central America: a population-based study. Lancet Oncol 2010;11:165-73.
  26. Institut Salah Azaiz: Registre des cancers Nord-Tunisie 2007-2009. Ministère de la santé, service d'Epidémiologie des cancers en Tunisie, Institut Salah Azaiz 2017.
  27. Registre du cancer du Grand Casablanca: Registre des cancers de la région du Grand Casablanca -2004. Royaume du Maroc Ministère de la Sante, Association Lalla Salma de lutte contre le cancer. CHU Ibn Rochd; 2008.
  28. Registre du cancer du Grand Casablanca: Registre des cancers de la région du Grand Casablanca - année 2005-06-07. Royaume du Maroc Ministère de la Sante, Association Lalla Salma de lutte contre le cancer. CHU Ibn Rochd; 2012.
  29. Registre du Cancer d'Annaba : Registre du Cancer d'Annaba: données 2007-2009. CHU d'Annaba; 2011.
  30. Von Karsa L, Dean P, Arrossi S, Sankaranarayanan R. Screening - principles. In: Stewart BW, Wild CP, eds. World cancer report. Lyon, France: IARC Press, 2014:322-
  31. Mittra I, Mishra GA, Singh S, et al. A cluster randomized, controlled trial of breast and cervix cancer screening in Mumbai, India: methodology and interim results after three rounds of screening. Int J Cancer 2010; 126:976-84.
  32. Sankaranarayanan R, Ramadas K, Thara S, et al. Clinical breast examination: preliminary results from a cluster randomized controlled trial in India. J Natl Cancer Inst 2011;103:1476-80.
  33. Pisani P, Parkin DM, Ngelangel C, et al. Outcome of screening by clinical examination of the breast in a trial in the Philippines. Int J Cancer 2006;118:149-54.
  34. Giordano L, Bisanti L, Salamina G, Ancelle Park R, Sancho-Garnier H, Espinas J, Berling C, Rennert G, Castagno R, Dotti M, Jaramillo L, Segnan N, the Euromed Cancer working group (Members listed at the end of the paper). The EUROMED CANCER network: state-of-art of cancer screening programs in non-EU Mediterranean countries. European Journal of Public Health 2016; 26: 83-89
  35. Gueddana N. Breast cancer screening by mammography in Tunisia. UICC World cancer congress 2008. Available at: http://www.worldcancercongress.org/doc/abstracts/S-539%20Gueddana.PDF.
  36. WHO-EMRO (Regional Office for the Eastern Mediterranean Region). Towards a strategy for cancer control in the Eastern Mediterranean Region; 2009. Available at: http://www.emro.who.int/dsaf/dsa1002.pdf.
  37. Ministère de la Santé. Enquête sur la Santé et la Réactivité du Système de Santé-Maroc 2003. Available at: www.sante.gov.ma/Publications/Etudes_enquete/Documents/ESRSSM2003.pdf
  38. Charaka H, Khalis M, Elfakir S, Chami Khazraji S , Zidouh A, Abousselham L, El Rhazi K, Lyoussi B, Nejjari C. Organization and Evaluation of Performance Indicators of a Breast Cancer Screening Program in Meknes-Tafilalt Region, Morocco. Asian Pac J Cancer Prev 2016, 12: 5153-5157.
  39. American Cancer Society. Colorectal cancer screening tests. Updated August 22, 2017 Available at : https://www.cancer.org/content/cancer/en/cancer/colon-rectal-cancer/detection-diagnosis-staging/screening-tests-used.html.
  40. Faivre J, Dancourt V, Lejeune C, et al. Reduction in colorectal cancer mortality by fecal occult blood screening in a French controlled study. Gastroenterology 2004; 126:1674-80.
  41. Grishchenko M, Grieve RD, Sweeting MJ, De Angelis D, Thomson BJ, Ryder SD, Irving WL: Cost-effectiveness of pegylated interferon and ribavirin for patients with chronic hepatitis C treated in routine clinical practice. Int J Technol Assess Health Care 2009, 25:171-180.
  42. Siebert U, Sroczynski G, Rossol S, Wasem J, Ravens-Sieberer U, Kurth BM, Manns MP, McHutchison JG, Wong JB: Cost effectiveness of peginterferon alpha-2b plus ribavirin versus interferon alpha-2b plus ribavirin for initial treatment of chronic hepatitis C. Gut 2003, 52:425-432.
  43. Ombrone D, Giocaliere E, Forni G, et al. Expanded newborn screening by mass spectrometry: new tests, future perspectives. Mass Spectrom Rev 2016; 35:71-84.
  44. Sankaranarayanan R, Gaffikin L, Jacob M, et al. A critical assessment of screening methods for cervical neoplasia. Int J Gynaecol Obstet 2005 , 89, 4-12.
  45. Islam RM, Bell RJ, Billah B, et al. Lack of understanding of cervical cancer and screening is the leading barrier to screening uptake in women at midlife in Bangladesh: Population-based cross-sectional survey. Oncologist 2015, 20, 1386-92.
  46. Hsairi M, Fakhfakh R, Bellaaj R, Achour N. Knowledge, attitudes and behaviours of women towards breast cancer screening.East Mediterr Health J 2003 ; 2:87-98.
  47. Rajaram SS, Rashidi A. Asian-Islamic women and breast cancer screening: a socio-cultural analysis. Women Health 1999; 28, 45-58.
  48. Anderson BO. Understanding social obstacles to early breast cancer detection is critical to improving breast cancer outcome in low-and middle-resource countries. Cancer 2010; 116, 4436-9.
  49. Story HL, Love RR, Salim R, et al. Improving outcomes from breast cancer in a low-income country: lessons from Bangladesh. Int J Breast Cancer, 2012,2012: 1-9.
  50. Garrett JJ, Barrington C (2013). ‘We do the impossible': women overcoming barriers to cervical cancer screening in rural Honduras-a positive deviance analysis. Cult Health Sex 2013; 15: 637-51.
  51. Khazaee-Pool M, Montazeri A, Majlessi F, et al. Breast cancer-preventive behaviors: exploring Iranian women's experiences. BMC Womens Health 2014, 14, 41. Available at http://www.biomedcentral.com/1472-6874/14/41
  52. Islam R M, Billah B, Hossain M N, Oldroyd J. Barriers to Cervical Cancer and Breast Cancer Screening Uptake in Low-Income and Middle-Income Countries: A Systematic Review. Asian Pac J Cancer Prev 2017; 7: 1751-1763.
  53. Shankar A, Rath G, Roy S, et al. Level of awareness of cervical and breast cancer risk factors and safe practices among college teachers of different states in India: do awareness programs have an impact on adoption of safe practices?. Asian Pac J Cancer Prev 2015;16, 927-32.