Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic tick-borne disease, caused by an arbovirus of the genus Orthonairovirus and the family Nairoviridae. Crimean-Congo hemorrhagic fever virus (CCHFV) is widespread in several regions of the world. While the virus is not pathogenic to all susceptible livestock and wild mammals, it can lead to severe hemorrhagic fever in humans. In this review, we compiled published data on CCHFV infections in humans, animals, and ticks in Tunisia. Based on that, we discussed the epidemiology and the distribution patterns of CCHFV infections highlighting the risk factors for this virus in the country. CCHF infection prevalence in humans was estimated to 2.76% (5/181) and 5% (2/38) in Tunisian febrile patients and Tunisian slaughterhouse workers, respectively. Concurrently, seroprevalence in domestic ungulates (sheep, goats, cattle, and dromedaries) ranged from zero to 89.7%, and only one Hyalomma impeltatum tick specimen collected from dromedaries in southern Tunisian was positive for CCHFV by reverse transcriptase-polymerase chain reaction (0.6%; 1/165). As Tunisian studies on CCHFV are geographically scattered and limited due to very small sample sizes, further studies are needed to improve the knowledge on the epidemiology of CCHF in Tunisia.

BACKGROUND: Arthropods parasites of bats play a crucial role in both ecological and public health contexts, as they have the potential to transmit zoonotic agents. The study aims to identify the distribution, and host-parasite associations of bat ectoparasites in the Grand Maghreb region (Algeria, Libya, Mauritania, Morocco and Tunisia), which has been largely understudied.
METHODS: A thorough analysis of published records was conducted and we included our own field data.
RESULTS: The checklist reveals a total of 43 ectoparasite species, encompassing a range of taxa. The list comprises 9 tick species, 11 mite species (including a chigger-mite), 11 bat fly species, 3 species of bugs, and 9 species of fleas. Extensive research efforts uncovered 141 host-parasite associations. Our data presents several new country records, documenting for the first time the presence of Carios vespertilionis and Raymondia huberi in Tunisia, Ixodes simplex and Spinturnix plecotinus in Algeria.
CONCLUSIONS: By compiling and analysing available information, we have provided for the first time an up-to-date checklist of bat ectoparasites and their host associations in the region. This knowledge contributes to a better understanding of the epidemiological implications associated with bat ectoparasites, emphasizing their ecological and public health importance. The study\'s findings call for continued investigations and monitoring of bat ectoparasites to mitigate potential risks and safeguard both human and animal populations.

Groundwater vulnerability and pollution hazard in the Braga shallow aquifer were assessed through an integrated GIS-based multicriteria analysis and Artificial Neural Network (ANN) approach, using DRASTIC and DRASTIC-LU models. The DRASTIC model integrates seven geological parameters. The DRASTIC-LU model includes an eighth parameter in addition to the previous ones. This parameter is the land use that represents the human source of groundwater pollution. The DRASTIC map showed four classes: very low (12.06%), low (81.88%), moderate (5.16%) and high (0.9%), where the vulnerability index ranged between 43 and 159. The DRASTIC-LU vulnerability index ranged between 53 and 204 and showed five classes: very low (3.10%), low (14.06%), moderate (17.11%), high (27.08%) and very high (38.65%). The DRASTIC-LU vulnerability map indicated that the high pollution risk is imposed by the intensive vegetable cultivation and the domestic wastewater. The pollution hazard index (PHI) was calculated based on the ANN modelling, using the land-use as an input and the vulnerability as a hidden layer. The DRASTIC model-based PHI map showed six classes: rare hazard (8.6%), very low (30.97%), low (6.18%), moderate (51.45%), high (2.43%) and very high (0.37%). While, The DRASTIC-LU model-based PHI map (PHILU) showed seven classes: rare hazard (2.91%), very low (11.9%), low (12.33%), moderate (13.78%), high (9.23%), very high (15.46%) and extremely hazardous (34.39%). The validation of these maps indicated that the DRSTIC-LU-based PHI is more reliable as it accurately identifies the hazardous zones.

Undernutrition (stunting, wasting and underweight) among children remains a public health concern in North Africa, especially following recent conflicts in the region. Therefore, this paper systematically reviews and meta-analyses the prevalence of undernutrition among children under five in North Africa to determine whether efforts to reduce undernutrition are on track to achieving the Sustainable Development Goals (SDGs) by 2030. Eligible studies published between 1st January 2006 and 10th April 2022 were searched for, using five electronic bibliographic databases (Ovid MEDLINE, Web of Science, Embase (Ovid), ProQuest and CINAHL). The JBI critical appraisal tool was used, and a meta-analysis was conducted using the \'metaprop\' command in STATA, to estimate the prevalence of each undernutrition indicator in the seven North African countries (Egypt, Sudan, Libya, Algeria, Tunisia, Morocco, and Western Sahara). Due to the significant heterogeneity among studies (I2 >50%), a random effect model and sensitivity analysis were conducted to examine the effect of outliers. Out of 1592 initially identified, 27 met the selection criteria. The prevalence of stunting, wasting and being underweight were 23.5%, 7.9% and 12.9%, respectively. Significant variations between the countries with the highest rates of stunting and wasting were reported in Sudan (36%, 14.1%), Egypt (23.7%, 7.5%), Libya (23.1%, 5.9%), and Morocco (19.9%, 5.1%). Sudan also had the highest prevalence of underweight (24.6%), followed by Egypt (7%), Morocco (6.1%), and Libya (4.3%) with more than one in ten children in Algeria and Tunisia having stunted growth. In conclusion, undernutrition is widespread in the North African region, particularly in Sudan, Egypt, Libya, and Morocco, making it challenging to meet the SDGs by 2030. Nutrition monitoring and evaluation in these countries is highly recommended.

According to the sixth assessment report of the Intergovernmental Panel on Climate Change (IPCC), global climate change is now unequivocal. Tunisia, like many other countries, has been affected by climate changes, including rising temperatures, intense heatwaves, and altered precipitation regimes. Tunisia\'s mean annual temperatures has risen about +1.4 °C in the twentieth century, with the most rapid warming taking place since the 1970s. Drought represents a primary contributing factor to tree decline and dieback. Long-term drought can result in reduced growth and health of trees, thereby increasing their susceptibility to insect pests and pathogens. Reported increases in tree mortality point toward accelerating global forest vulnerability under hotter temperatures and longer, more intense droughts. In order to assess the effect of these climate changes on the current state of forest ecosystems in Tunisia and their evolution, an investigative study was required. Here, we review the current state of knowledge on the effects of climate change on sclerophyllous and semi-deciduous forest ecosystems in Tunisia. Natural disturbance during recent years, as well as the adaptability and resilience of some forest species to climate change, were surveyed. The Standardized Precipitation Evapotranspiration Index (SPEI) is a multi-scalar drought index based on climate data that has been used to analyse drought variability. The SPEI time scale analysis showed a negative trend over the 1955-2021 period in Tunisian forest regions. In 2021, Tunisia lost 280 km2 of tree cover to fires, which is equivalent to 26% of the total lost area between 2008 and 2021. Changing climate conditions have also affected phenological parameters, with an advance in the start of the green season (SOS) of 9.4 days, a delay at the end of the green season (EOS) of 5 days, with a consequent extended duration of the green season (LOS) by an average of 14.2 days. All of these alarming findings invite us to seek adaptation strategies for forest ecosystems. Adapting forests to climate change is therefore a challenge for scientists as well as policymakers and managers.

Taxa belonging to the genus Odontura have been studied since the former half of the 19th century. Species of the group are distributed across the western Mediterranean Basin and the central Mediterranean area, including the Iberian Peninsula and the Balearics, Sardinia, the countries of the Maghreb that border the Basin, Sicily and Malta. The present work examines a sizeable series of specimens of the genus Odontura, collected in Italy, Malta, Algeria and Tunisia, including type material of some of the species, and establishes synonymisations and a newly described species. Odontura borrei (described on a female from Constantine, Algeria) is synonymized with Odontura algerica (described on both sexes from Algeria), while Odontura arcuata (described on both sexes from west Sicily) is synonymized with Odontura stenoxypha (described on a female from Sicily), a sub-endemic to Sicily and Malta. Records of the latter from Sardinia belong to Odontura calaritana, while the female recorded from Majorca, previously identified as O. stenoxypha, remains unidentified. On the basis of a wide-ranging assessment of preserved specimens (from museums and private collections) and living material, this contribution describes a new species, Odontura martae sp. nov., from the island of Lampedusa (Italy) and Tunisia, and addresses patterns of geographical distribution in the context of biogeographical processes and associated dynamics.

Peritonitis is a major complication of peritoneal dialysis (PD) and due to its gravity, it remains the primary reason to switch from PD to hemodialysis. Elizabethkingia meningoseptica, a non-fermentative Gram-negative bacillus, is rarely encountered as a pathogen causing peritonitis in adults. We present here a case report of an acquired infection with this organism in adult on PD. To the best of our knowledge, this is the first report of infection with this organism in a continuous ambulatory PD patient in Tunisia.

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Charcoal burning (CB) suicide is an old method that revived and has clearly become prevalent across several countries, as considered \"soft\" and \"painless\". This alarming spread is induced by the contagious effect of suicidal behaviors. Internet and suicide web forums may play, unfortunately, a crucial role in promoting this suicide\'s method. In this paper, we present the first documented case of CB suicide in Tunisia and probably in all African countries. Thereupon, we report a case of a young man suicide and we detail the forensic investigation findings. In order to prevent a potential epidemic spread, this form of suicide should require further attention not only in regions where it is already recognized but also in countries where it is not yet prevalent.

OBJECTIVE: Acute movement disorders (AMD) are frequent in neurological and pediatric emergencies. Few studies analyzed AMD in children, none in Tunisia or other African country. The purpose of this study was to describe the peculiarities of AMD in a Tunisian pediatric population with a literature review.
METHODS: We conducted a retrospective descriptive study over 8 years including 80 children (sex ratio, 1.05; mean age of onset, 4.8 years) with AMD, followed in tertiary referral Child Neurology Department in North Tunisia.
RESULTS: Acute movement disorders were mainly hyperkinetic (n = 67 with dystonia (n = 33; mostly due to inherited metabolic diseases (IMD) in 11; with status epilepticus in 10 children), chorea (n = 14; with Sydenham chorea in 5); myoclonus (n = 14; mostly with opsoclonus-myoclonus syndrome in 10) and tremor (n = 6; of posttraumatic origin in half). Hypokinetic movement disorder (MD) included acute parkinsonism in 5 children of infectious (n = 3), postinfectious (n = 1, malaria) and posttraumatic origin (n = 1). Mixed MD, found in 8 children, were mainly due to IMD in half of them, and to familial lupus in two. Paroxysmal MDs were seen in 2 children, one with multiple sclerosis and one of idiopathic origin. Psychogenic MDs were found in 7 patients mainly of dystonic type. Management of AMD comprised symptomatic treatment according to the phenomenology of the MD and causative treatment depending on its etiology.
CONCLUSIONS: Our study illustrated the broad range of AMD in children and the wide spectrum of their etiologies. In our series, we described some exceptional findings and etiologies of AMD in children. These findings may denote a specific profile in of AMD in our country with predominant infectious, postinfectious, and IMD.