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POCT diffusion project

POCT diffusion project. M Ben Hariz . Tunisia MEDICEL. Palermo 2014. Main objective. Diffusion of POCT in schools Children with growth fairlure : « small » children. Why schools. First Because we have a good experience working in school envirenment !.

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POCT diffusion project

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  1. POCT diffusion project M Ben Hariz. Tunisia MEDICEL. Palermo 2014

  2. Main objective Diffusion of POCT in schools Childrenwithgrowthfairlure: « small » children

  3. Whyschools First • Becausewe have a good experienceworking in schoolenvirenment!

  4. First Study : Region of Ariana Ben Hariz M, et al. Prevalence of celiac disease in Tunisia: mass-screening study in schoolchidren. Eur J Gastroenterolhepatol 2007; 19: 687-694. Actual proposed study : Ben Arous Second study : Djerba Ben Hariz M et al. Celiac disease in Tunisian children: A second screening study using a “new generation” rapid test. ImmunolInvest 2013; 42: 356–368

  5. Second • The school is a good choice to start and succeed in our efforts to diffuse POCT • enrollment between 6 -14 years: 100% • Large number of school doctors • generally these same doctors are also primary care physicians lines

  6. why “small“ child? • Frequent situation in Tunisia (5% in our school previous study) • The small height often motivates parents looking for a reason (little refusal to search for celiac disease) • If celiac disease is the cause of the small height, the gluten-free diet is often followed well (unlike asymptomatic child)

  7. selectedregion Governorate of Ben Arous Général population: 700000 Area: 761 Km2 Number of schools Number of pupills: 50000

  8. DESIGN

  9. Selected population: 50000 Mesure of height Selection of childrenwithheight < 2SD (2500) Acceptance. Inclusion refusal POCT Exclusion Negative Positive Suspicion of IgAdeficiency Determination of IgA No IgAdeficency Confirmation IgG anti endomysium ELISA Endoscopy Negative Positive

  10. Stepsplanned • May-June 2014: get the final approval from the Ministry of Health, Department of School Medicine and Ethics Committee • September 2014: training meeting for school doctors • September-November 2014: obtaining and filing the anthropometric measurements of children (only height?) • December 2013: sending mail for parental consent for the selected population (Height <-2SD, n=2500). • January 2015: POCT for all and samples for ELISA for positive or IgA deficiency children • February and March 2015: endoscopy for positives • April 2015: analysis of results

  11. Estimated budget • POCT: 7500 euro • Training (meeting): 3000- euro • equipment to measure the size? • Secretariat (Secretary contract, mail ...): 3000 euro • Displacement: 4000 euro • other: 3000 euro • “Gift for schooldoctors”!!: 5000 euro? • Total: 25500 euro • Budget available for study in 2014: 14000 Euro

  12. expected difficulties • Mostly administrative: Net decrease in administrative efficiency since the revolution (extreme slow, iterative change managers ...) for example, we introduced three times the project at the Ministry!! • enthusiasm school doctors! • need to expand the team of the research unit (now, only me and Nadia Siala!!)

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