Paper Title
Epidemiological Study of Food borne Disease in Tunisia from 2010 to 2014

Background: Foodborne disease (FBD) represent a worldwide scourge. In Tunisia, they are notifiable diseases, but available epidemiological information would be underestimated because of underreporting of FBD outbreaks. The aim of our study was to analyze the epidemiological profile of FBD in Tunisia from 2010 to 2014 and describe the surveillance system. Methods: We realized a descriptive, retrospective and exhaustive epidemiological study of all the outbreaks of FBD reported in Tunisia from 2010 till 2014. The criteria of statement of the FBD were based on an operational definition. We drew from databases archived in the Directorate of Basic Health Care of Tunisian Ministry of Health. Results: During the period of study, 295 outbreaks of FBD were reported in Tunisia and involved 3071 illnesses. The annual average was 59 outbreaks and 614.2 illnesses. The doctors of public health represented the first source of reporting. The median time limit of reporting was one day. The median size of outbreaks was five illnesses. The average age of the patients was 28.3 years. The men were more concerned than the women (50.3% versus 49.7%). The rate of hospitalization was 9.5% and lethality 0.09%. The family circle was the most concerned (65.1%). The peaks of outbreaks were recorded during March and the summer season. Ready-made meal represented 58.3% of the mentioned contaminant food. Salmonella was at the origin of 48% of outbreaks documented bacteriologically. The time between preparation and consumption of food was incriminated in 55% of the FBD outbreaks where the favoring factor was mentioned. Conclusion: The data of our study, representing an important base of indicators of FBD in Tunisia, should be used to direct and target the prevention. It is essential to pursue the surveillance of FBD while mitigating the limits of this system to improve its performances. Keywords - Foodborne disease, epidemiology, investigation, public health, Tunisia