Evaluating the Effectiveness of the COPD Assessment Test (CAT) in Screening for Chronic Obstructive Pulmonary Disease.

Background: Chronic obstructive pulmonary disease (COPD) is a major public health problem that remains largely under-diagnosed, mainly due to the under-use of spirometry to establish the diagnosis. The aim of this study is to evaluate the effectiveness of the Moroccan Arabic dialect version of the COPD Assessment Test (CAT) in screening for COPD. Methods: This was a cross-sectional study carried out in primary care facilities in Morocco, involving participants aged 40 and over. The performance of CAT in detecting cases of COPD was measured with reference to the results of spirometry, considered to be the gold Standard. Results: A total of 477 participants were included in the study. The prevalence of COPD was 6.7%. Internal consistency of the Moroccan Arabic dialect version of the CAT was high, with a Cronbach's alpha of 0.89. The total score of the CAT and of each item was significantly higher in subjects with COPD than in those without (P=0.000). Significantly negative correlations were found between CAT total score and FEV1 (r = -0.33, p=0.000), CAT and FVC (r = -0.22, p=0.000), CAT and FEV1/FVC ratio (r = -0.22, p=0.000). The receiver operating characteristic curve showed an area under the curve of 0.93. A CAT score of 10 was the optimal cut-off value for COPD screening, with a sensitivity, specificity, positive predictive value, and negative predictive value of 78.1%, 93.9%, 48.1% and 98.4%, respectively. Conclusion: The results of the present study showed that the CAT could be used as a screening tool for COPD. The use of this tool by healthcare professionals in primary care settings will improve and promote early diagnosis of this chronic disease.

Genetic variability characterization of the Moroccan Houbara Bustard (Chlamydotis undulata undulata) inferred from pedigree analysis.

A Moroccan Houbara Bustard pedigree was analyzed to evaluate the genetic variability in captive breeding population using genealogical approaches. The whole Houbara breeding flock (WP) for the period 1993-2004 was made up of 531 birds comprising 346 females and 185 males. The reference population (RP) comprised 198 individuals ready for reproduction from 2000 to 2004 cohorts. The corresponding percentage of known ancestors was estimated as 98.23% for the parent generation, 41.19% for the grandparent generation and 7.00% for the great grandparents generation. The average generation interval for Houbara was computed as 4.64 years. Genetic variability loss per generation was ascertained using the effective population size (Ne), the founder genome equivalent (fge), the effective number of ancestors and founders (fa) and (fe), respectively, for the RP and across each cohort. The results showed no bottleneck events in the breed but some loss of genetic variability just after the initiation of the conservation program. However, the annual effective population size based on the realized increase in inbreeding (ΔF) was estimated to be 207 for the RP and 1,000 for the WP. With regard to conservation breeding schemes, the genealogical evidence presented here is very useful as it revealed the positive effect of migration on Houbara breeding. The mating strategies will assist in the future control and management of the genetic variability of this population.

Mortality and morbidity assessment attributed to short- and long-term exposure to fine particles in ambient air of Agadir city, Morocco: The AirQ model approach.

It is well established that respiratory mortality and morbidity are associated with high concentrations of fine particles such as PM2.5. The aim of this study was to evaluate the long- and short-term impacts of PM2.5 on the population of Agadir, Morocco, using AirQ 2.1.1 software. The mean PM2.5 values were obtained from data collected at three sites. Baseline incidence data were obtained from the literature, and relative risk (RR) values were referenced from the World Health Organization. This study quantified long-term total mortality (LT-TM), lung cancer mortality (LT-LC), morbidity from acute lower respiratory tract infections (LT-ALRI), and morbidity from chronic obstructive pulmonary disease (LT-COPD), as well as short-term total mortality (ST-TM). The attributable proportions (AP) of LT-TM and LT-LC were estimated to 14.19% and 18.42%, respectively. Their excess deaths were estimated to 279 and 11 persons, respectively, and their RRs to 1.16 (95% CI: 1.10-1.22) and 1.23 (95% CI: 1.12-1.37), respectively. Furthermore, the AP of LT-ALRI and LT-COPD were estimated to 14.36% and 15.68%, respectively, their excess deaths to 33 and 4, and their RRs to 1.17 (95% CI: 1.11-1.31) and 1.19 (95% CI: 1.00-1.02), respectively. In comparison, the AP of ST-TM was estimated to 1.27%, with a 25-person excess death rate. This study was conducted to inform decision-making and to promote local policies on ambient air quality.

Polymorphisms in the Tumor Necrosis Factor Genes Are Associated with Breast Cancer in the Moroccan Population.

Background: The multifunctional cytokines of the tumor necrosis factor (TNF) family have been found to be involved in the promotion of inflammatory responses, and to play critical roles in the pathogenesis of inflammatory, autoimmune, and malignant diseases. The aim of the present study was to assess the associations among the TNFα -238 G > A (rs361525), TNFα -308 G > A (rs1800629), and TNFß +252 A>G (rs909253) polymorphisms, and the breast cancer (BC) susceptibility in the Moroccan population. Materials and Methods: We conducted a case-control study, including 492 participants made up of 264 pathologically confirmed BC subjects, and 228 healthy women as controls. The samples were genotyped by means of polymerase chain reaction-restriction fragment length polymorphism analyses. Results: The TNFα -238 G > A and TNFα -308 G > A polymorphisms were significantly associated with increased risk of BC for the AA genotype, while, the AG genotype of TNFß +252 A>G may offer a protective effect in this population. Haplotypic analyses showed that the GAA and AAG haplotypes increased the risk significantly for BC. Moreover, a significant association was observed between polymorphisms at the TNFα -238 A>G locus and the clinical profiles of the patients with regard to their estrogen-and progesterone-positive receptor status. Conclusion: These findings indicate that TNF gene polymorphisms are linked with the risk of BC in the Moroccan population. Further studies implementing a larger sample size are needed to support our findings.

Genetic Distribution of the LTA +252 A>G and TNFA -308 G > A Polymorphisms in the Moroccan Population.

Introduction: The LTA and TNFA genes encode key proinflammatory cytokines with diverse activities in the immune responses. Single nucleotide polymorphisms (SNPs) in the LTA rs909253 (+252 A > G) and TNFA rs1800629 (-308 G > A) genes have been associated with susceptibility to many complex diseases. The aim of this study was to assess the frequency for these two key polymorphisms in the Moroccan population. Materials and Methods: A total of 338 unrelated healthy Moroccan subjects were genotyped for the two alleles using a restriction fragment length polymorphism-polymerase chain reaction method. Results: The LTA (+252 A > G) and TNFA (-308 G > A) were the most common alleles with 67.9% and 74.8% frequencies, respectively. In addition to the linkage disequilibrium between the two SNPs, significant differences in allele frequencies were observed in Moroccan population compared with Mediterraneans, Europeans, Africans, South Americans, and Asians (p < 0.05). Finally, genetic proximities between Moroccan, European, and West African populations were found by means of the principal component analysis. Conclusion: The LTA +252 A>G and TNFA -308 G > A polymorphisms among Moroccan population follow the patterns commonly encountered in other Mediterranean, European, and African populations. The result of this study could contribute in developing a genetic database on the healthy Moroccan population.

Mitochondrial control region diversity of the houbara bustard Chlamydotis undulata complex and genetic structure along the Atlantic seaboard of North Africa.

The houbara bustard, Chlamydotis undulata, is a declining cryptic desert bird whose range extends from North Africa to Central Asia. Three subspecies are currently recognized by geographical distribution and morphology: C.u.fuertaventurae, C.u.undulata and C.u.macqueenii. We have sequenced 854 bp of mitochondrial control region from 73 birds to describe their population genetic structure with a particular sampling focus on the connectivity between C.u.fuertaventurae and C.u.undulata along the Atlantic seaboard of North Africa. Nucleotide and haplotypic diversity varied among the subspecies being highest in C.u.undulata, lowest in C.u.fuertaventurae and intermediate in C.u.macqueenii. C.u.fuertaventurae and C.u.undulata are paraphyletic and an average nucleotide divergence of 2.08% splits the later from C.u.macqueenii. We estimate that C.u.fuertaventurae and C.u.undulata split from C.u.macqueenii approximately 430 000 years ago. C.u.fuertaventurae and C.u.undulata are weakly differentiated (FST = 0.27, Nm = 1.3), indicative of a recent shared history. Archaeological evidence indicates that houbara bustards have been present on the Canary Islands for 130-170 000 years. However, our genetic data point to a more recent separation of C.u.fuertaventurae and C.u.undulata at around 20-25 000 years. Concordant archaeological, climatic opportunities for colonization and genetic data point to a scenario of: (i) initial colonization of the Canary Islands about 130 000 years ago; (ii) a period of secondary contact 19-30 000 years ago homogenizing any pre-existing genetic structure followed by; (iii) a period of relative isolation that persists today.