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The Mediterranean region's agriculture is predicted to be severely impacted negatively by climate change. In the primary production region of southern Tunisia (34°43’N, 10°41’E) in olive orchard submitted to different treatments: Rain-fed, drip irrigation with saline water (FI) : EC = 7.5 dS/m at 100% of crop evapotranspiration (ETc), alternate irrigation (PRD) with saline water at 50% of ETc and switched every 30 days, regular deficit irrigation (RDI) with saline water at 50% of ETc, drip irrigation with tap water (TW) : EC=2.46 dS/m at 100% of crop evapotranspiration (ETc), with predicted temperature increases, the effects of climate change and salinity on the floral performance of olive trees were assessed from 2015 to 2017 and the vegetative growth and yield were evaluated over the period. As results, while conserving water in comparison to FI and TW, PRD produced high values for internodes length (1.68 cm) in 2016 and an annual shoot elongation (2.5 cm) in 2015. When comparing flowering (RF) and fruit-setting (RS) rates, olive trees under PRD outperformed those under RDI and FI with (RF=67.52% and RS=7.81%) in 2015. For olive trees exposed to RDI, PRD, and FI, the fruits per unit length were statistically similar in 2015. The use of the PRD technique (50% ETc) yielded good results with an average of 2.96(kg/m3) in our study both quantitatively and qualitatively.

The evaluation of salt-tolerant olive tree genotypes released from breeding program has become intrinsic in order to develop sustainable agriculture in these regions. The current study aims to i) evaluate the tolerance of two new released olive cultivars (Zeitoun Ennour and Zeitoun Ennwader), issued from a Tunisian breeding program in comparison with the main olive cultivar ‘Chemlali Sfax’, and ii) identify suitable salt-tolerance indicators for this evaluation. The trial was conducted under controlled conditions in a greenhouse, for six months, and plants were irrigated with half-strength Hoagland nutrient solution containing NaCl at various levels (0, 75, 150 and 225 mM). Vegetative growth, biomass allocation and biochemical parameters were considered for the assessment of salt-tolerant capacity. Results revealed that growth and biomass should be considered as useful indicators for early evaluation method of salt-stress tolerance. ‘Chemlali Sfax’ displayed a gradual significant decrease of vegetative growth with increasing salinity. The reduction of shoot elongation and trunk diameter was most evidently at 150 mM with 43.2 % and 80.8 %, respectively. However, the new released cultivars showed unaffected vegetative growth, despite a slight decrease at the salt level of 225 mM. Moreover, results demonstrated the importance of certain physiological and biochemical indicators such as ions contents. The new released cultivars maintained a high K+/Na+ ratio at moderate salinity then a significant decrease occurred at 150 mM. In conclusion, vegetative growth, biomass allocation and K+/Na+ ratio seemed to be the suitable salt-tolerance indicators for early evaluation. Based on these indicators, ‘Zeitoun Ennour’ seems to be the most salt tolerant genotype and ‘Zeitoun Ennwader’ proves to have a similar salt tolerant capacity as ‘Chemlali Sfax’, which is a valuable information for olive growers in arid region.

Introduction In the workplace, a smoke-free environment is crucial to guaranteeing the health of workers and those around them. Understanding the relationship between smoking and work is a prerequisite for implementing effective tobacco control measures. Objectives To assess the prevalence of smoking in an electricity and gas company in Sfax and to determine the relationship between workers’ nicotine dependence and perceived workload. Methods We conducted a cross-sectional survey evaluating the smoking behavior of 100 employees of an electricity and gas company. The survey was carried out from July to December 2022 using a two-part questionnaire. The first part was completed by the participants, and the second was administered by the interviewer. Nicotine dependence was assessed using the Fagerström test, while perceived workload was evaluated using the raw NASA-TLX questionnaire. Results Our study population consisted of 82 male participants. Active smoking was reported by 45.1% of participants. Among smokers, 40.5% had moderate to high nicotine dependence as assessed by the Fagerström test. According to the raw NASA-TLX questionnaire, the mean scores for mental, physical, and temporal demands were 88.8±13.5, 63.6±24.7, and 59.1±28.4, respectively. The mean scores for effort, performance, and frustration were 83.8±14, 85.4±13.1, and 34.5±28.1, respectively. Bivariate analysis indicated an inverse correlation between nicotine dependence and physical demands at work. However, a significant positive correlation was found between nicotine dependence and frustration at work. Conclusions Smoking among electricity and gas company workers is a prevalent issue, highlighting the urgent need for smoking cessation interventions. The association of smoking with perceived workload underscores the importance of preventive measures to reduce work-related stress. Disclosure of Interest None Declared

Introduction Job satisfaction is a fundamental pillar of the modern workplace. Recognizing the significance of job satisfaction and actively promoting it has become a strategic imperative in today’s work environment. Objectives The present study aimed to assess job satisfaction and work ability among workers in a confectionery factory. Methods A cross-sectional study conducted in a Sfax confectionery factory included 200 workers. Data were collected between December 2022 and July 2023 using a pre-established questionnaire. This questionnaire encompassed an evaluation of socio-demographic and professional data, measuring the degree of professional satisfaction and the level of work ability using a visual analogue scale ranging from 0 to 10. Results The gender ratio was 0.64. The mean age was 33.2 ± 8.8 years. Among our workers, 77.5% reported being satisfied with their work. The average perceived work ability score was 8.15 ± 2.087. Employees with higher levels of satisfaction were more likely to have increased work capacity (p = 0.000). Elevated job satisfaction not only boosts work capacity but can also reduce stress levels, improve overall mental well-being, and contribute to a healthier workplace environment. These factors collectively lead to higher work ability. Conclusions These findings emphasize the importance of prioritizing employee well-being to enhance overall productivity and company success. Fostering a work environment that prioritizes job satisfaction can lead to a more productive and successful workplace. Disclosure of Interest None Declared

Introduction In operating rooms, the routine use of radiological procedures is commonplace. However, this essential tool brings about significant concerns for healthcare workers due to the associated radiological risks. Understanding healthcare workers’ attitudes and perceptions about ionizing radiation is crucial for addressing these concerns. Objectives This study aims to assess the perceptions and concerns of healthcare workers regarding radiation risks and their practices in the operating room. Methods A cross-sectional study was conducted in February and March 2023 among the operating room staff of Habib Bourguiba University Hospital in Sfax, Tunisia. We used a self-administered questionnaire that included socio-professional data. Self-assessment of exposure risk and protection level against ionizing radiation was evaluated on a scale from 0 to 10, and attitudes were assessed using a 5-item Likert scale. Results Our study population consisted of 92 healthcare workers, with 54.3% being male. When asking operating room workers about the availability, accessibility, and quality of lead aprons, the median scores were 3 (IQR [0;6.5]), 2 (IQR [0;5]), and 2 (IQR [0;5]), respectively. The median self-assessment score for exposure risk was 8 (IQR [5.5; 10]), while the median self-assessment score for protection against ionizing radiation was 1 (IQR [0;3]). Sixty percent of the population had limited knowledge of the harmful effects of ionizing radiation, with a median self-assessment knowledge score of 1.5 (IQR [0;3]). Sixty-two percent reported concerns regarding radiological risks. In terms of practices, 44.5% of the staff maintained a distance from the radiation source during intraoperative radiography, and 21.7% used the apron for protection. Dosimeters were not used by any of the participants. Concerns level was associated with self-assessment of exposure risk (p = 0.027). Conclusions In conclusion, awareness of the risks generates anxiety and concern among staff; however, it alone is insufficient to alter our practices. This underscores the imperative for a proactive approach in implementing robust safety measures and comprehensive training programs. Disclosure of Interest None Declared

Introduction Mental health is a critical factor influencing employee well-being and performance in companies. However, many factors within professional environments can either positively or negatively impact employees’ psychological well-being. Objectives This study aims to assess mental health among workers in a confectionery factory and its association with job satisfaction. Methods We conducted a cross-sectional study among workers in a private confectionery in Sfax. Questionnaires and workplace assessments were collected over a period from December 2022 to July 2023 using a pre-established questionnaire. Mental health assessment was performed using the 21-item Depression, Anxiety, and Stress Questionnaire (DASS21). The degree of job satisfaction was assessed using a visual analog scale ranging from 0 to 10. Results Our study included 200 participants, with 61% being female. Severe to very severe symptoms of depression, anxiety, and stress were found in 4.5%, 17%, and 10.5% of our participants, respectively. Among our workers, 22.5% reported being not very satisfied or not satisfied. Bivariate analysis revealed lower levels of satisfaction among the most anxious (p = 0.000), the most depressed (p = 0.000), and the most stressed (p = 0.000) workers. Conclusions The decline in mental health is closely linked to job dissatisfaction. Implementing measures to enhance employee job satisfaction and providing adequate support resources for mental well-being are essential steps to promote a healthier workplace and improve employee well-being. Disclosure of Interest None Declared

Introduction Among young medical practitioners, the exigencies of daily practice entail many challenges concerning both physical and mental dimensions. The study of the interplay between these two dimensions is crucial to provide the necessary care for this population. Objectives This study aims to evaluate the prevalence of back pain and its association with mental health issues in young medical practitioners. Methods A cross-sectional study (January to April 2023) was conducted in the university interns and residents from Sfax. The Nordic questionnaire was used to evaluate back pain. The Generalized-Anxiety-Disorder (GAD -7) and the Patient-Health-Questionnaire (PHQ-9) were used to assess signs of anxiety and depression respectively. Results Our population consisted of 404 young doctors. One-hundred and twenty were males with a sex-ratio of 0.42. Among them, 76 (18.8%) had surgical specialties. Mean age was 28.03±2.89, BMI’s mean was 23.65±3.98. Medical history was reported by 29.2% and psychiatric history by 4.9%. The median of the PHQ-9 and GAD-7 score were 3.5 (IQ: [1;6]) and 2 (IQ: [0; 5]). Signs of depression were found in 11.1% of the population whereas anxiety was found in 8.4% of them. Sixty-seven residents (16.6%) reported having back pain in the previous year. Neck pain, upper-back pain and lower back pain were experienced by 8.7%, 6.4% and 10.1% respectively. Bivariate analysis showed that back pain was associated with PHQ-9 score (p=0.006), GAD-7 score (p=0.018) and it was not associated with BMI (p=0.769) neither with surgical specialties (p=0.824). Lower Back pain was associated with GAD-7 score (p=0.004). Conclusions Our study highlights the link between back pain and mental health problems in young doctors. Interventions englobing a better understanding of these two facets are needed to ensure an optimal care for this young population. Disclosure of Interest None Declared

In Tunisia, agriculture is vulnerable to climate change with harmful impacts subsequent warming and drying trends. In these regions, olive industry plays a key role at regional and national level. Therefore, the identification of adapted olive tree genotypes has become an urgent need to develop sustainable agriculture in arid lands. This study aimed to evaluate the impact of climatic variation on the olive growing systems in arid and sub-arid areas of Tunisia. The phenological behavior of Chemlali and Zalmati, main olive cultivars wide spreading in central and southern Tunisia, respectively, were considered to evaluate their capacity to adapt to contrasting climatic conditions. Over the 2005-2019 period, olive cultivars presented variable flowering dates related to local climatic conditions. Zalmati cultivar bloom in Zarzis seems to be earlier than Chemlali cultivar in Sfax region with average flowering dates of DOY-92 (April-3) and DOY-106 (April-17), respectively. A tendency for advancing the growing season was observed with warmer winters, which leads to disruption of pollination, high risk of insect attack, and consequently harmful effects on the production and product quality. This investigation serves as a basis for making recommendations taking into account the production areas as well as for addressing projected climate change.

The Mediterranean region is facing temperature increases due to climate change. More warm conditions across the fruit and nut growing regions are expected to have a great and negative impact in Tunisian arid regions. Chilling trends among the agricultural production areas and their incidence on flowering and fruiting of typical fruit species were investigated. The results showed important declines in winter chill accumulation over the main arid production areas. This lack of chill jeopardizing the flowering and fruiting of fruit species. However, fruit species and cultivars within each fruit species expressed different flowering and fruiting behaviors to warm climate depending on their chilling and heat requirements. Consequently, thermal requirements are a key factor for sustainable fruit trees’ orchards and to select suitable cultivation area. Adoption of appropriate genetic resources could be used to mitigate the harmful effect of global warming in arid regions.

Sustainable fruit orchard development in arid areas is severely affected by the scarcity of fresh water. To mitigate the lack of fresh water, the use of low-quality water for irrigation is becoming a common practice in several margin areas. However, salinity is considered one of the most important environmental constraints limiting the successful crop production. Therefore, the effects of deficit irrigation strategies using saline water (3.1 dS m−1) on soil water content, soil salinity, and yield of commercial peach orchard were investigated. Three irrigation treatments were considered: a Control, full irrigated (FI); and partial root-zone drying (PRD50); and deficit irrigation (DI) strategies irrigated at 50% ETc. These levels of water supply allowed for contrasting watering conditions with clear distinction between irrigation treatments. The differential pattern in soil moisture was accompanied by that of soil salinity with an increase in all FI treatments (16–25%). The results indicated that soil salinity increased with increasing water supply and evaporative demand during the growing season from January (3.2 dS m−1) to August (6.6 dS m−1). Deficit irrigation strategies (DI, PRD50) induced more soil salinity along the row emitter compared to the Control due to insufficient leaching fractions. By the end of the growing season, the soil salinity under long-term saline drip irrigation remained stable (5.3–5.7 dS m−1). An efficient leaching action seemed to be guaranteed by rainfall and facilitated by sandy soil texture, as well as the high evaporative demand and the important salt quantity supplied, which maintain the deficit irrigation strategies as valuable tools for water saving and improving water productivity. The significant water saving of 50% of water requirements induced a fruit yield loss of 20%. For this reason, DI and PRD50 could be reasonable irrigation management tools for saving water and controlling soil salinity in arid areas and on deep sandy soil.

Introduction The power line workers have a heavy physical workload. It is essential to know the impact of this perceived exertion on their satisfaction with life to improve their mental health. Objectives We aimed to evaluate the associations between perceived exertion at work and satisfaction with life among power line workers. Methods We conducted a study among a group of power line workers from January to June 2022 using a self-administered questionnaire. We evaluated socio-professional characteristics, physical exertion with the Borg CR-10, and the satisfaction with life scale (SWLS). Results Seventy-four male line workers participated in the study. They were married in 67.6% of cases. The mean age was 39.3 ± 10.5 years. The average job tenure was 15.5 ± 11.2 years. The mean of perceived exertion was 6.1±1.9. High to very high exertion was found in 73% of participants. The mean score of satisfaction with life was 26.8 ±6.5. Five (12.6%) participants were dissatisfied to extremely dissatisfied. Fifty-six (75.9%) participants were satisfied to extremely satisfied. High perceived exertion was correlated with higher satisfaction with the lives of line workers (p = 0.03, r = 0.24). Conclusions Power line workers with high perceived exertion were more satisfied with their lives. This can be explained by the positive impact of work on the lives of workers. The work environment is paramount to ensuring good mental health. Disclosure of Interest None Declared

Introduction In Tunisia, tobacco control remains one of the main country’s health strategies. However, it seems that the scourge of tobacco is still a prevalent problem and it’s often associated with other addictive behaviours like alcohol use. Objectives Evaluate the addictive behaviours of the employees of an Electricity company in Tunisia and their impact on their mental health. Methods We conducted a cross-sectional study in May 2022. A pre-established questionnaire was filled out during a sensitization campaign that took place in the company. We used the Fagerstörm test and the AUDIT questionnaire to evaluate tobacco and alcohol dependency respectively. Signs of depression and anxiety were evaluated by the Hospital Anxiety and Depression scale (HAD). Collected data were analyzed using IBM SPSS statistics version 23.0. Results Our population consisted of 83 employees. The average age was 40.79±11.23. Males represented 65.1% of employees. The mean of seniority was 15.23±10.82 years. Forty-one per cent were overweight and 22.9% had obesity. The mean Body Mass Index (BMI) was 27.17±3.92. Twenty-five employees (30.1%) were active smokers and 7 (8.5%) consumed alcohol. All of them were males. The nicotine dependency test’s mean was 4.12±2.78 and 28% of smokers had a high to a very high nicotine dependency. The mean score of the AUDIT questionnaire was 9.71±10.76. Four alcohol consumers (57.1%) had harmful alcohol use and 2 of them (28.5%) had alcohol dependency. The evaluation of the HAD score showed that the mean anxiety score was 7.59±3.13 and the mean depression score was 6.44±3.71. Twelve per cent and 10.8% of employees had elevated anxiety and depression scores respectively. Bivariate analysis showed that depression is significantly associated with the female sex (p=0.023) and with a lower number of service years (p=0.019). Anxiety was significantly associated with a high BMI (p=0.027). Anxiety and depression were not associated with alcohol or tobacco consumption. Conclusions Smoking and drinking are common in our society. Sensibilization campaigns must focus on motivating workers to quit those addictive behaviours and promote a healthier lifestyle. Disclosure of Interest None Declared

Introduction Eating disorders are serious medical conditions labelled by severe disturbances to one’s eating behaviours. These disorders can affect employees’ physical and mental health. Objectives This study aimed to evaluate the association between eating disorders and workers’ mental health. Methods The study was conducted among a group of workers from an electricity society. Data were gathered between January-June 2022 using a self-administered questionnaire including socio-professional characteristics, eating disorders evaluation, and mental health assessment using the Hospital anxiety and depression scale (HADS). Results Our study included 92 workers. Their mean age was 43.8 ± 11.7 years and 73 were male (79.3%). The average job tenure was 17.6 ± 11.2 years. Thirty-eight participants (41.3%) had eating disorders. With the reference to HADS, 47 (51.1%) and 16 (17.4%) participants presented symptoms of anxiety and depression, respectively. Regarding the patients’ anxiety levels, it was found that 82.6%, 12%, and 5.4% appeared to have mild, moderate, and severe anxiety, respectively. As for the depression levels of patients, 45 were mildly depressed (48.9%), 31 were moderately depressed (33.7%), and 16 were severely depressed (17.4%). Participants with eating disorders had higher scores of anxiety and depression p=0.001 and p=0.003 respectively. Conclusions According to our study, eating disorders had a significant association with the mental health of workers. Therefore, it is important to provide training for workers to have a healthy balanced diet to guarantee good mental health. Disclosure of Interest None Declared

Introduction The work conditions of electricians have been associated with heavy physical and psychological workloads. It is essential to know the impact of this perceived workload on the mental health of workers. Objectives This study aimed to assess the relationship between perceived workload on the mental health of workers. Methods The study was conducted among a group of electricians. Data were gathered between January-June 2022 using a self-administered questionnaire including socio-professional characteristics and Kessler Psychological Distress Scale (K6). To assess the perceived workload, we choose the National Aeronautics and Space Administration Task Load Index (NASA-TLX). In this study, we evaluated raw NASA-TLX scores. Results Seventy-four workers participated in the study. They were married in 67,6% of cases. The mean age was 39,3 ± 10,5 years. The average job tenure was 15,5 ± 11,2 years. The mean score of K6 was 5,4±4,8. The proportion of respondents with high levels of psychological distress (K6 score of 13 or greater) was 9.5 %. The mean score of mental demand, physical demand, performance, effort, frustration level and temporal demand were respectively 88.8±14, 60.8±23.6, 85.2±13.1, 82.7±15.4, 34.3±29.3 and 61.8±29.2. The frustration level was correlated with high levels of K6 (p = 0.002, r = 0.36). Conclusions A high perceived workload was correlated with the altered mental health of workers. Hence, practices and policies should focus on improving working conditions to enhance the mental health of the employees. Disclosure of Interest None Declared

Introduction The healthcare environment is a special work environment. It exposes the staff to physical and psychological constraints. Interns starting their careers during this pandemic were exposed to additional stressors in the time of the COVID-19 pandemic. Objectives We aimed to screen for depression and generalized anxiety disorder among medical interns during the COVID-19 pandemic. Methods We conducted a cross-sectional study, through a pre-established anonymous questionnaire for Tunisian medical interns. This questionnaire was shared online on social networks in April 2022. Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) were used. The collected data were processed and analyzed by IBM SPSS statistics software. Results Our population consisted of 82 interns. The average age was 25.47±1.84 and 76.8% were female. Sixty-one per cent of our population had priors of COVID-19 infection. The mean of the PHQ-9 score was 10.90±6.34. Only 12.2% had a normal PHQ-9 score and nearly one-third of interns had self-harm and suicidal thoughts. Symptoms of moderate to severe depression were observed in 25.6% of interns. The mean of the GAD-7 score was 9.17±5.20. A further specialized evaluation was required in 39.1% of interns who scored 10 or greater. Bivariate analysis showed that the PHQ-9 and GAD-7 scores were correlated (p=0.002, r= 0.78). They were not associated with sex, age, or medical history. Conclusions Medical interns, who just started their professional careers during an important COVID-19 wave, suffered greatly in terms of mental health. Serious attention and evaluation are needed for this fragile young category of healthcare professionals. Disclosure of Interest None Declared

Introduction The workplace environment influences employees’ health. Authors widely recognise job dissatisfaction as a workplace. Work satisfaction can influence employees’ psychological health statuses. Objectives We aimed to assess the impact of satisfaction at work on the mental health of electricians. Methods The study concerned a group of electricians who agreed to answer a face-to-face interview concerning working conditions and mental health status. Data was collected using a pre-designed questionnaire that included socio-professional characteristics, a 10-point scale of job satisfaction, and the Kessler Psychological Distress Scale (K6) between January and June 2022. Results Our study included 74 male electricians. The mean age was 39.3 ± 10.5 years. The average job tenure was 15.5 ± 11.2 years. The mean score of K6 was 5.4±4.8 (range = 0–22). The proportion of respondents with high levels of psychological distress (K6 score of 13 or greater) was 9.5 %. The mean score of satisfaction at work was 7.7±1.8. Low satisfaction at work was correlated with high levels of psychological distress (p = 0.012; r = -0.29). Conclusions High job satisfaction was correlated with low levels of psychological distress. Policies and practices should focus on improving working conditions to enhance the mental health of employees. Disclosure of Interest None Declared

Introduction The medical field is very stressful. To reduce stress, healthcare workers may resort to different habits, including smoking and drinking. Objectives We aimed to assess the smoking and drinking habits of interns and fellows in Tunisian hospitals. Methods A cross-sectional study was conducted in April 2022 through online platforms. A pre-established questionnaire was sent to Tunisian medical interns and fellows, working in public hospitals, and collected sociodemographic and occupational data. The Fagerstörm test was used to evaluate nicotine dependence. Results Our population consisted of 182 Tunisian interns and fellows. Their mean age was 26.38±2.03 years. Females represented 71.4% of the total population. One hundred of them (54.95%) were fellows, out of which 18% specialized in surgery. Sixty-one per cent of these young doctors were single. Twenty-two individuals were smokers with male predominance (59.1%). Smoking was associated with age (p

Introduction Medical studies are known for being difficult and hard. They require a lot of dedication and hard work from students. This takes a toll on their mental health over the years. Objectives Detect signs of anxiety, depression, and stress levels in 5th-year medical students. Methods This study was cross-sectional through a self-administered pre-established questionnaire for medical students during September and October 2022. We used the General Anxiety Disorder-7 (GAD-7) questionnaire, the Patient Health Questionnaire-9 (PHQ-9) and the Perceived Stress Scale-10 (PSS-10). The satisfaction level with the choice of the medical field as a career was assessed on a scale ranging from 1 to 10. Results Our population consisted of 54 5th-year medical students. The average age was 22.94±0.78 and 64.8% were female. All our population were singles. Active smokers represented 9.3% and alcohol consumption was reported by 9.3% of the participants. More than half of the population (51.9%) had a regular leisure activity. Most of the students had no medical history (72.2%) or psychiatric history (94.4%). The mean satisfaction level from choosing the medical field was 7.43±1.84. The mean GAD-7 and PHQ-9 scores were respectively 3.50±3.80 and 4.70±4.42. The PSS-10 score had a mean of 14.07±5.29. Five students (7.4%) presented self-harm thoughts. Students who were less satisfied with their choice of the medical field as a career had significantly higher scores of PHQ-9 (p

Abstract Background Cystic echinococcosis (CE) has a worldwide distribution and is especially prevalent in North African countries. With a mean annual surgical incidence (ASI) of CE of 12.7 per 100,000 inhabitants, Tunisia is one of the most CE endemic countries in the Mediterranean area. Tataouine governorate is considered to be the most CE hypoendemic region in Tunisia (ASI = 0.92) despite favourable socioeconomic conditions that enable maintenance of the Echinococcus granulosus sensu lato (s.l.) life-cycle and a significant environmental contamination with E. granulosus s.l. eggs. The aim of this study was to assess human CE seroprevalence, prevalence of CE in food animals and environmental contamination by E. granulosus s.l. eggs in different districts of Tataouine governorate. Methods This study was conducted from January to December 2018. A total of 374 human sera samples were tested for the presence of immunoglobulin G antibodies against E. granulosus using a commercial ELISA kit. Specimens were also collected from animals slaughtered at the Tataouine abattoir (n = 8609) and examined for the presence of hydatid cysts; 111 hydatid cysts were genotyped. Eggs of E. granulosus s.l. were identified by PCR and DNA sequencing from dog faecal samples (n = 288). Results Serological tests showed that 8.5% of the sera samples tested were positive for E. granulosus-specific antibodies. The average prevalence of hydatidosis in livestock was 1.6%, and CE infection was more prevalent in cattle than in sheep, goats and dromedaries. The contamination rate of dog faeces by E. granulosus sensu stricto eggs varied significantly from 0 to 23.5% depending on the collection area. Molecular analyses only revealed the presence of the G1 genotype for cysts and eggs. Conclusions Based on our findings, CE is likely to be more endemic in the Tataouine governorate than previously described. Thus, to implement an effective control programme against CE, a national survey should be carried out to determine human CE prevalence in the different Tunisian governorates. Graphic Abstract

ObjectiveNon-respiratory long-coronavirus disease 2019 (COVID-19) symptoms are mainly related to a long-lasting endothelial dysfunction and microcirculation impairment. We hypothesized that Sulodexide, a purified glycosaminoglycan mixture with a beneficial endothelial effect in arterial and venous peripheral diseases, may be effective in a subset of patients with long COVID-19.Approach and ResultsWe conducted a multicenter prospective quasi-experimental study. A total of 290 patients from the TUN-EndCOV study with long-COVID-19 symptoms and endothelial dysfunction were included. The endothelial function was clinically assessed using a post-occlusive reactive hyperemia protocol with finger thermal monitoring device. Endothelial quality index (EQI) was assessed at inclusion and at 21 days later. The study population was assigned to a sulodexide group (144 patients) or a no-medical treatment group (146 patients). Clinical characteristics were similar at inclusion in the two groups. Fatigue, shortness of breath, and chest pain were the most common symptoms, respectively, 54.5, 53.8, and 28.3%. At 21 days, the sulodexide group improved significantly better than the no-medical treatment group in chest pain (83.7 vs. 43.6%, p < 10−3), palpitations (85.2 vs. 52.9%, p = 0.009), and endothelial function [median delta-EQI 0.66 (0.6) vs. 0.18 (0.3); p < 10−3]. Endothelial function improvement was significantly correlated with chest pain and palpitations recovery (AUC, i.e., area under the curve = 0.66, CI [0.57– 0.75], p = 0.001 and AUC = 0.60, CI [0.51– 0.69], p = 0.03, respectively).ConclusionSulodexide significantly improves long-lasting post-COVID-19 endothelial dysfunction and alleviates chest pain and palpitations.

OBJECTIVES In 2017, the incidence of human brucellosis in Tunisia was 9.8 per 100,000 population. In the Douz district, 2 cases were reported in March 2018. Prior to that date, the last indigenous cases to be reported in Douz had been in 2015. This study aimed to identify the source of this new contamination and recommend control interventions. METHODS This case-control study included residents of Douz who presented with clinical symptoms of brucellosis and had a subsequent Wright test antibody titer ≥ 1/160. The controls were neighbors of the infected cases who had a negative Rose Bengal test. Univariate and multivariate analyses were performed to estimate the odds ratios of risk factors. Goats belonging to the cases and controls were actively screened. RESULTS Twenty-five infected cases and 52 uninfected controls were enrolled. All infected cases had consumed goat milk and 92% had purchased it from the same breeder. Consumption of goat milk from this breeder (adjusted odds ratio [aOR], 30.78; 95% confidence interval [CI], 6.47 to 235.91) and overall consumption of raw goat milk (aOR, 14.84; 95% CI, 2.04 to 310.44) were independent risk factors for brucellosis. The breeder had 18 goats, 5 of which were smuggled from a neighboring country. Three of those goats were diagnosed with brucellosis. CONCLUSIONS Consumption of raw milk from smuggled sick goats was the main risk factor in this outbreak. The sick goats were slaughtered and an education campaign was conducted. Vaccination, control of cross-border animal movements, and control of goat milk sales must be strengthened to prevent the spread of brucellosis in southwestern Tunisia.

The COVID-19 disease is a multisystem disease due in part to the vascular endothelium injury. Lasting effects and long-term sequelae could persist after the infection and may be due to persistent endothelial dysfunction. Our study focused on the evaluation of endothelial quality index (EQI) by finger thermal monitoring with E4 diagnosis Polymath in a large cohort of long COVID-19 patients to determine whether long-covid 19 symptoms are associated with endothelial dysfunction. This is a cross-sectional multicenter observational study with prospective recruitment of patients. A total of 798 patients were included in this study. A total of 618 patients (77.4%) had long COVID-19 symptoms. The mean EQI was 2.02 ± 0.99 IC95% [1.95–2.08]. A total of 397 (49.7%) patients had impaired EQI. Fatigue, chest pain, and neuro-cognitive difficulties were significantly associated with endothelium dysfunction with an EQI

Water scarcity is the main limiting factor for fruit trees in arid regions of Tunisia. In this area, almond is widespread, but severe conditions are a key issue for nuts production and kernel quality. In this study, phenological features and kernel quality of local and foreign almond cultivars irrigated with low water quality were investigated. Local cultivars presented an early flowering and seemed to be more appropriate to regional conditions and water salinity. All almond cultivars performed respectable kernel nutritional quality. In conclusion, local cultivars showed better adaptation with early bloom and higher fruit quality under warm conditions.

The peach (Prunus persica L.) is one of Tunisia’s major commercial fruit crops and is considered one of the biggest water consumers of all crops. In warm and arid areas of southern Tunisia, irrigation is necessary to ensure orchard longevity and high yield and fruit quality. Nevertheless, under water-scarcity conditions and low water quality, water management should rely on efficient deficit irrigation strategies. In this study, sustained deficit irrigation (DI) and partial root-zone drying (PRD50) at 50% of crop evapotranspiration (ETc) were evaluated for their impact on the primary and secondary metabolites of the peach fruit of early cultivar Flordastar grown in the Tataouine region. A full irrigation (FI) treatment at 100%, etc., was used as a control treatment. Color, dry-matter content, firmness, organic acids, sugars, phenolic compounds, vitamin C, β-carotene and minerals were assessed on harvested mature fruits. Dry-matter content and firmness increased significantly under DI and PRD50 (13% and 15.5%). DI fruit had the highest soluble-solid content (SSC), reaching Brix values of 14.3°. Fruit sorbitol and sucrose contents were not affected by Di and PRD50. Higher glucose in fruit juice was observed in PRD50 (23%) and DI (21.5%) compared to FI, which had the highest malic acid content (33.5–37%). Quinic and citric acids decreased with DI and PRD50, while almost all individual phenolic compounds increased with deficit irrigation. Hydroxycinnamates and anthocyanins were significantly higher in fruits harvested from DI and PRD50 treatments. Proanthocyanidins (catechin and epicatechin) were only improved by DI, while flavone compounds and vitamin C were not affected by irrigation restrictions. β-carotene was higher in fruits yielded under FI (0.71 mg/100 g DM) than DI and PRD50 (0.21–0.43 mg/100 g DM). Macro- and micronutrients significantly increased in DI and PRD50 fruit. A significant difference between DI and PRD50 fruits was observed for Zn and Fe concentrations. This research highlights the positive impact of reduced irrigation on bioactive-fruit quality attributes and the suitability of PRD50 and DI as tools for irrigation management in arid areas of southern Tunisia, contributing to water-saving in orchards and the improvement of fruit commercial value.

We report the study of sandfly Leishmania infection in an area of low incidence of visceral leishmaniasis in Tunisia. Sandflies were collected monthly using CDC light-traps set in houses and animal shelters during May–November 2016 and 2017. All males were identified at the species level. A sample of 878 females including all gravid specimens was subjected to kDNA qPCR for Leishmania detection and parasite load estimation. Leishmania species were determined by ITS1 PCR sequencing, and species identification of infected sandflies was performed by DNA barcoding. Phlebotomus perfiliewi and P. perniciosus were the dominant species during the two-year period. However, comparison of their relative abundances showed that P. perniciosus was more abundant during peaks of 2017 with longer activity duration. Real-time kDNA PCR did not detect Leishmania infection in 2016, although it identified four positive specimens (0.7%) in 2017. All four infected specimens were identified as P. perniciosus. ITS1 PCR sequencing allowed L. infantum identification in one kDNA qPCR-positive specimen. This was a P. perniciosus gravid female with a high parasite load caught during the long-lasting peak of 2017. This work highlights the usefulness of multi-seasonal studies of sandfly dynamics and kDNA qPCR in screening Leishmania infection and determining L. infantum vectors in hypo-endemic foci of human leishmaniasis.