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Background: Aging and lifestyle changes had led to an epidemiological transition, with a significant impact on the incidence of cardiovascular diseases in North Africa., Objective: The aim of this study was to determine the prevalence of metabolic syndrome and its associated factors, which were unknown, among an urban population in Algeria., Methods: During 2007-2009, 787 individuals aged 30-64 years, randomly selected from the list of insured persons residing in the city of Oran, participated in a clinical, anthropometric and biological survey. Participants were classified according to the National Cholesterol Education Program - Adult Treatment Panel (NCEP-ATP) III definition of metabolic syndrome., Results: The prevalence of metabolic syndrome was 20%, higher in women than men (25.9 vs 13.7%; P<.0001). Among the components of the syndrome, the most common risk factors observed in women were a low high-density lipoprotein (HDL) cholesterol concentration (60.4% vs 44.2% in men) and abdominal obesity (46.8% vs 30.1% in men) whereas men displayed more high blood pressure (42.5% vs 34.8% in women). In men, metabolic syndrome was more frequent in married and highly educated participants. In contrast, women with a high level of education and who had an intermediate level of physical activity seemed to be protected., Conclusions: Metabolic syndrome, prevalent in the urban population of North Algeria, is associated with a high proportion of low HDL-cholesterol and abdominal obesity, especially among women. There is a need for prevention strategies involving promotion of physical activity for the whole population and screening for hypertension among men.

Aim: The EHUO project of reorganization of medical units into the new activity poles is a complex exercise and a challenge in relation to structural, organizational, and especially cultural barriers. The relationships between the EHUO and the Ministry of Health leave no room for autonomy. Funding continues to be provided through grants. Furthermore, no regulatory and technical support is available to the EHUO actors for development of the local project and even less for restructuring., Methods: The authors describe and analyze the planned new organization from limited material available produced by the administration (notes and instructions) and the services projects analysis document prepared by our team., Results: The proposed poles are based on draft projects integrating the various units, with no reformulation in the context of a shared vision or a coherent point of view including the interactions between all parts of the project. Theoretically expected effects, such as autonomy, and management contracts for instance, are not on the agenda. The internal contract does not appear to be at the heart of the debate. Economies of scale and sharing of resources are only vaguely discussed., Conclusion: Important prerequisites are necessary for this ambitious and highly structuring project. The EHUO actors must strive to reach an agreement on a common vision and values to be protected together as part of a collectively designed project to ensure good governance.

Aim: Quality of care is a strategic priority of any management approach in order to meet users' expectations of health care systems. This study tried to define the role of patient satisfaction surveys and the place of user in the quality of care project., Methods: The results of patient satisfaction surveys conducted between 2010 and 2012 and the draft quality of care project were analysed., Results: Patient satisfaction surveys from 2010 to 2012 focused on logistic shortcomings. No comment was formulated about health care. Comments and suggestions did not provide any contribution in terms of patient involvement in the health care process., Conclusion: The multiple perspectives of quality of care include clinical care and other social objectives of respect for the individual and attention to the patient. User satisfaction as assessed by patient satisfaction surveys or patients' experiences only reflect the health professionals' representation. However, the objective is to measure what the user perceives and feels and his/her representation of the attention provided. These approaches, conducted outside of the quality of care strategic plan, only provide a basis for actions with limited or no effectiveness.

Aim: Oran university hospital has been operating since 2010. It is a public institution that must assess the resources required to achieve institutional goals integrated into the strategic objectives defined in the hospital development project. Implementation of this project could be supported, among other things, by a strong and efficient hospital information system., Methods: Three investigations were conducted: 1- evaluation of the hospital information system, 2- assessment of the quality of the hospital discharge summary reports, 3- assessment of the quality of medical records., Results: The six components of the hospital information system (resources, indicators, sources, management, quality and dissemination and use of data) were clearly present but not satisfactory with a score ranging from 25 to 50% of the total score. The scores by component were as follows: 36% for resources, 37% for indicators, 42% for patient records, 19% for data management and 27% for the dissemination of information. The overall completeness of medical records was 85.2%. Completeness by group of variables gave the following results: 66% for medical information, 54% for the patient's stay and 38% for information relating to the patient's discharge. Hospital discharge summary reports were available in 59.8% of cases, but were blank in 4% of cases. The critical variable, the principal diagnosis was found in 51% of cases. The correct principal diagnosis rate was 33.3%., Conclusion: The deficiencies observed for content and data management raise real questions concerning data management at Oran university hospital as part of a real managerial approach.

Created in 2003 as a profit organization, the University Hospital of Oran (Etablissement Hospitalier Universitaire d'Oran-EHUO) is currently in the process of developing a 'Quality' project aimed at assessing staff perception of quality. 20% of staff members representing the various professional categories working at EHUO (medical, nursing and administrative staff) were selected using quota sampling. Face-to-face interviews were conducted in March 2009 with 117 staff members from 25 medical and 5 non-medical units. The average length of service among medical and administrative staff was higher than the average length of service of nursing staff (8.3 vs 5.8 years; p = 0.9 Kruskal-Wallis H test). In discussing the question of quality, it was found that all categories of staff emphasized their specific professional experiences, standards and frames of reference. All staff members showed a greater preference for the various dimensions of the "are process" (mostly physicians and nurses rather than administrative staff (p=0.01)) than for the "structure" or "organization" components of the quality plan. In this sense, there appears to be a greater focus on technical rather than management aspects, as shown by the fact that two thirds of staff members were ill-informed about the hospital's quality assurance program (quality management, blood safety, complaints management...). While they appeared to be fully supportive of audit and certification procedures, 50% of health staff members were reluctant to support patient involvement in the management of the 'Quality' project. Finally, there appears to be a lack of awareness of quality concepts, standards and methodologies among hospital staff. This study suggests that there is a need for greater awareness, further training, and greater monitoring of practices based on concrete actions.

An outbreak of plague occurred in the region of Oran, Algeria, from June to July 2003. Algeria had not reported this disease for >50 years. Eighteen bubonic cases were identified, and Yersinia pestis was isolated from 6 patients. Except for the index case-patient, all patients recovered. Targeted chemoprophylaxis, sanitation, and vector control played a crucial role in controlling the outbreak. Epidemiologic and biomolecular findings strongly suggested the existence of a local animal reservoir during this period, but its origin (resurgence or re-importation) could not be determined. This sudden and unexpected reemergence of plague, close to an important commercial seaport, is a textbook illustration of a public health event of international importance. It also demonstrates that the danger of plague reoccurrence is not limited to the currently indexed natural foci.