Poct diffusion project
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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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Poct diffusion project

POCT diffusion project

M Ben Hariz. Tunisia

MEDICEL. Palermo 2014


Main objective

Main objective

Diffusion of POCT in schools

Childrenwithgrowthfairlure: « small » children


Why schools

Whyschools

First

  • Becausewe have a good experienceworking in schoolenvirenment!


Poct diffusion project

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


Second

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


Why small child

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)


Selected region

selectedregion

Governorate of Ben Arous

Général population: 700000

Area: 761 Km2

Number of schools

Number of pupills: 50000


Design

DESIGN


Poct diffusion project

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


Steps planned

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


Estimated budget

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


Expected difficulties

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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