Psychological distress among nurses: Exploring the role of support in the work-place in Morocco.

AIM: This study aimed to assess the psychological distress, specifically anxiety and depression, among nurses employed at University Hospital Center of Rabat in Morocco and tested the associations between support in the workplace and nurses' psychological well-being. METHODS: A cross-sectional observational study was conducted at University Hospital Center of Rabat in Morocco, based on a prospective data collection employing an ad-hoc self-report questionnaire. 223 nurses were enrolled with a minimum of 1 year of practice in any care unit. Socio-demographic and professional characteristics of each participant were included. A validated tool was utilized to measure the support from superiors and colleagues in the workplace, while the Hospital Anxiety and Depression Scale (HADS) was employed to evaluate anxiety and depression. Univariate and multivariate analyses were conducted to explore the relationships between different independent and dependent variables. RESULTS: Significant socio-demographic and professional factors associated with increased anxiety included female gender, age over 41 years old, Baccalaureate level of education, intention to leave the hospital, and less support from superiors. Regarding the levels of depression, the Baccalaureate level of education was significantly associated with higher levels of depressive symptoms (ß 2.444; CI [1.203, 3.686]). CONCLUSIONS: Our findings suggested that ensuring support from superiors was crucial for safeguarding the psychological well-being of nurses. Therefore, hospital managers should prioritize addressing the workplace support for professionals, and the organizational enhancement.

Attitudes, practices and perceived barriers toward implementing non-pharmacological management for rheumatoid arthritis among rheumatologists: an online cross-sectional survey.

Introduction: Our study aimed to evaluate the integration level of non-pharmacological management (NPM) for rheumatoid arthritis (RA), analyze attitudes, practices, and perceived barriers towards NPM implementation, and identify factors contributing to the underutilization of non-pharmacological treatment in RA. Material and methods: A descriptive and analytical cross-sectional study was conducted among rheumatologists in Morocco. Rheumatologists received an online questionnaire gathering sociodemographic data, NPM integration level for RA, exploring their attitudes, practices and perceived barriers regarding the integration of NPM for RA, using a Likert scale ranging from 1 to 5. Univariate analyses were conducted to identify risk factors for under-integration of NPM for RA. Results: Out of 440 questionnaires sent, 132 rheumatologists responded to the survey (mean age of 44 ±12 years, 112 (84.8%) females, median professional experience of 15 years [4.7; 26.3]) with a response rate of 30%. All rheumatologists agreed on the importance of NPM integration into their practice with 130 (98.5%) supporting the necessity of tailored recommendations of NPM of RA for the Moroccan context. Sixty-nine (52.3%) reported a lack of NPM integration for RA. Only 36 (27.3%) consistently provided personalized NPM from RA diagnosis and 47 (35.6%) involved patients in decision-making. Comment perceived barriers included difficulties in organizing multidisciplinary care (122; 92.4%), difficulties with time management in consultation (119; 90.2%), and lack of multidisciplinary team members (116; 87.9%). In univariate analysis, lack of suitable training and lack of knowledge on NPM of RA were risk factors of under-integration of NPM of RA with respectively an odds ratio (OR) of 0.09, 95% CI: 0.01-0.86 and OR of 0.34, 95% CI: 0.15-0.76. Conclusions: Our study revealed significant insufficiencies in the integration of NPM of RA among Moroccan rheumatologists. Perceived barriers, including insufficient training, lack of knowledge, and infrastructural limitations, hinder effective implementation. Addressing these through tailored education and multidisciplinary collaboration is essential for improving RA management.

Opinions of Patients, Families and Healthcare Professionals on Family Involvement in the Care of Patients Hospitalized in a Moroccan University Hospital: A Cross-Sectional Observational Survey.

Opinion surveys on family participation in care in non-Western countries are rare. This study aims to assess the opinions of patients, families, and healthcare professionals regarding family involvement in care to identify their preferences and the associated factors. A cross-sectional survey was conducted over eight months involving 717 participants, using structured questionnaires at the Acute Assessment Unit of a university hospital in Morocco. Comparative analyses examined the association between participant characteristics and the preferences of care categories. Poisson regression was applied to determine factors associated with participant preferences. Attitudes toward family participation in care were positive, with an average score of 3.62 ± 0.43 on a 4-point Likert scale. Healthcare professionals were more favorable towards family participation, with an average of 10.6 ± 2.44 types of care, compared to 7.17 ± 1.96 for families and 5.71 ± 2.16 for patients. Participants' opinions converged on a set of simple and less technical care tasks. Factors significantly associated with patient preferences in the final adjustment model (p < 0.05) included frailty, loss of autonomy, length of stay, and regular and continuous (day and night) family presence. This study highlights the strong support of health professionals, patients, and families for family participation in care. Understanding these preferences and related factors is essential to maximize family participation and develop a model of Patient And Family Centered Care adapted to the Moroccan context.

Cross-Cultural Adaptation and Pilot Psychometric Validation of the European Organisation for Research and Treatment of Cancer-Quality of Life Questionnaire-Sexual Health (EORTC QLQ-SH22) Scale, Moroccan Arabic Version.

BACKGROUND: The Sexual Health Scale (QLQ-SH22) is the only cancer-specific measure of sexual health. It has never been translated into Arabic. In order to envisage effective healthcare strategies that improve sexual quality of life, the validation of the Moroccan version of this scale is a crucial step in exploring the influence of cancer and its treatment on patients in the Moroccan context. In this regard, this study aimed to validate a Moroccan Arabic version among patients with cancer. METHOD: A total of 280 Moroccan patients with cancer participated in this study from August 2022 to April 2023. The translation and cross-cultural adaptation of the QLQ-SH22 was performed following the EORTC guidelines. Psychometric validation was explored using the reliability of internal consistency, test-retest reliability, and confirmatory factor analyses (CFA). RESULTS: The analysis revealed a greater internal consistency for both sexual satisfaction (α = 0.83) and sexual pain (α = 0.86). The intraclass correlation coefficient indicated an excellent level of test-retest reliability (from 0.925 to 0.993). The CFA demonstrated high-performing model fit indices (χ2/df = 1.17, SRMR = 0.05, RMSEA = 0.035, GFI = 0.94, CFI = 0.99, TLI = 0.99, IFI = 0.99, NFI = 0.94). The concurrent validity between the QLQ-C30 and QLQ-SH22 confirmed a strong correlation between the fatigue scales in both questionnaires (r = 0.69). This version showed good discrimination between known groups. CONCLUSIONS: The QLQ-SH22 Moroccan Arabic version has demonstrated a high level of reliability and validity, and therefore it is now ready for use.

Prevalence, Reasons, and Perceived Benefits of Complementary and Alternative Medicine Among Patients With Rheumatic Diseases in Morocco: A Monocentric Cross-Sectional Study.

Background In general, rheumatologists often have limited knowledge regarding the use of complementary and alternative medicine (CAM) among patients with rheumatic diseases. Understanding the prevalence, reasons for use, and perceived benefits of CAM can help improve patient care and guide clinical practices. This study aimed to assess the prevalence, reasons for use, and perceived benefits of cupping therapy, apitherapy, and traditional cautery treatments among patients with rheumatic diseases. Additionally, it aimed to explore adverse effects, location and pricing disparities in CAM practices, information sources, and the rate of reporting CAM use to treat rheumatologists and to identify factors associated with the use of these CAM approaches. Methodology This single-center, cross-sectional study was conducted in a Moroccan University Hospital and included patients receiving care for rheumatic diseases during hospitalization or outpatient visits from January 2024 to March 2024. The data were collected using a structured, validated, and pilot-tested questionnaire administered by attending rheumatologists. The questionnaire aimed to gather demographic information and to identify patients using CAM, collecting data related to their utilization. Results A total of 100 patients were enrolled (mean age: 52.3 ± 12.8 years, 75% female). Among them, 43% had chronic inflammatory rheumatism. Additionally, 46% reported using at least one of the three CAM methods studied, with 36% using cupping therapy (specifically the wet method), 9% using apitherapy, and 16% using traditional cautery. The main reason for using CAM was to alleviate their pain (55%). Perceptions of effectiveness were reported by 38% of patients using cupping therapy, 20% using apitherapy, and 5.9% using traditional cautery. The use of CAM was significantly lower in patients with a university education (odds ratio = 0.05, 95% confidence interval = 0.003-0.92). Conclusions Our study revealed a significant prevalence of CAM use among patients with rheumatic diseases in Morocco, with cupping therapy emerging as the most commonly utilized method. These findings underscore the importance of enhancing awareness and understanding of CAM practices among both patients and healthcare providers to promote more structured and informed CAM practices.

Association of Renin-Angiotensin Pathway Gene Polymorphisms with COVID-19 Susceptibility and Severity in Moroccans: A Case-Control Study.

Infection by the recent SARS-CoV-2 virus causes the COVID-19 disease with variable clinical manifestations ranging from asymptomatic or mild respiratory symptoms to severe respiratory distress and multiorgan failure. The renin-angiotensin system, responsible for maintaining homeostasis and governing several critical processes, has been considered the main system involved in the pathogenesis and progression of COVID-19. Here, we aimed to assess the possible association between variants in the RAS-related genes and COVID-19 susceptibility and severity in a sample of the Moroccan population. A total of 325 individuals were recruited in this study, with 102 outpatients, 105 hospitalized patients, and 118 healthy controls negative for SARS-CoV-2 infection, and subjected to NGS gene panel sequencing containing eleven RAS pathway genes. A total of 65 functional variants were identified, including 63 missenses, 1 splice, and 1 INDEL. Most of them were rare, with 47 (72%) found in a single individual. According to the common disease/common variant hypothesis, five common candidate variants with MAF > 10% were identified (ACE2 rs2285666, TMPRSS2 rs12329760, AGT rs699 genes, ACE rs4341, and ACE rs4343). Statistical analysis showed that the ACE rs4343 AA genotype was associated with a 2.5-fold increased risk of severe COVID-19 (p = 0.026), and the T genotype of the ACE2 rs2285666 variant showed a borderline association with susceptibility to SARS-CoV-2 in males (p = 0.097). In conclusion, our results showed that the RAS pathway genes are highly conserved among Moroccans, and most of the identified variants are rare. Among the common variants, the ACE rs4343 polymorphism would lead to a genetic predisposition for severe COVID-19.

Healthcare Students' Perceptions of the Quality of the Clinical Learning Environment in Morocco: A Cross-Sectional Study.

Background: The clinical learning environment (CLE) is critical for developing the practical skills needed in healthcare professions. This study aimed to evaluate healthcare students' perceptions of the quality of the CLE using the Arabic version of the Clinical Learning Environment, Supervision and Nurse Teacher (ar. CLES + T) scale. The study also aimed to evaluate the tool's measurement invariance and compare perceptions among student groups. Methods: This cross-sectional study was carried out at two health education institutes in Morocco throughout the academic year 2018-2019 among 1550 undergraduate students who had just finished a clinical practicum in a hospital or primary healthcare facility. Data were gathered using the ar. CLES + T scale. Confirmatory factor analysis (CFA) and multigroup CFA were performed. The measurement invariance of the ar. CLES + T scale was assessed across gender, study year, and clinical practicum duration, using configural invariance, metric invariance, scalar invariance, and strict invariance. The t-test and analysis of variance were used to compare the mean scores of the student groups. Results: Students expressed positive perceptions toward the CLE. The "Pedagogical atmosphere on the ward" dimension scored the highest, while the "Role of the nurse teacher" dimension received the lowest scores. The measurement invariance of the ar. CLES + T scale by gender, study year, and clinical practicum duration was established. First-year students and those with an extended practicum period were the most satisfied. Conclusion: To promote effective learning in the clinical environment, nurse teachers might use innovative teaching approaches tailored to their evolving role in these settings. Moreover, extending the duration of clinical practicum can further enhance student learning outcomes.

Knowledge, Attitudes, and Practices of Moroccan Community Rheumatologists' Regarding the Management of Non-radiographic Axial Spondyloarthritis: A National Cross-Sectional Study.

Introduction Non-radiographic axial spondyloarthritis (nr-axSpA) is within the spectrum of axial spondyloarthritis (axSpA). The emergence of the nr-axSpA concept, defined by the absence of significant erosive damage to the sacroiliac joints, has prompted numerous initiatives aimed at enhancing the early detection and management of this condition. The aim of the study was to assess the knowledge, attitudes, and practices related to the diagnosis and management of nr-axSpA by rheumatologists in Morocco. Methods We conducted a cross-sectional online survey among the rheumatologist community in Morocco. Rheumatologists received via e-mail a structured Google Forms (Google Inc., Mountainview, CA) questionnaire divided into four sections: sociodemographic data of rheumatologists, knowledge, attitudes, and practices related to the diagnosis and treatment management of nr-axSpA. Results A total of 110 rheumatologists (mean age of 44±13 years, 77.3% females, median professional experience of 12 years (4, 75; 26.25 years)) participated in the survey (response rate of 25%). Most responders reported a diagnosis delay issue in spondyloarthritis (SpA) (93.6%); 70.9% of rheumatologists incorrectly regarded the 2009 Assessment of Spondyloarthritis International Society (ASAS) classification criteria for axSpA as diagnostic criteria. Rheumatologists' awareness of recommended magnetic resonance imaging (MRI) sequences for detecting sacroiliac joint inflammation and structural changes in SpA varied significantly, from 69.1% to 14.5%. Their knowledge of additional subchondral edema cases in these joints, beyond SpA, ranged from 48.2% to 87.3%. Almost all rheumatologists believed that the use of sacroiliac MRI would contribute to the early diagnosis of axSpA (97.3%) but could also lead to false positive diagnoses, according to 47.3% of rheumatologists; 73.6% believed that incorrectly using the 2009 ASAS classification criteria as diagnostic criteria in nr-axSpA could also result in false-positive diagnoses. In their practice, 2009 ASAS classification criteria were used as diagnostic criteria in axSpA by 39.1% of rheumatologists. Of the total participants, 91.8% indicated that they approach nr-axSpA similarly to radiographic axial spondyloarthritis, with disparities in recommendations of biological therapies. Conclusion Our survey provides insight into the current status of nr-axSpA management among Moroccan rheumatologists. It also addresses concerns regarding the risk of false positive diagnoses when using the 2009 ASAS classification criteria for axSpA as diagnostic criteria by rheumatologists and the potential risk of misdiagnosis associated with excessive reliance on MRI, despite its utility for early diagnosis.

Prevalence of the protective OAS1 rs10774671-G allele against severe COVID-19 in Moroccans: implications for a North African Neanderthal connection.

The clinical presentation of COVID-19 shows high variability among individuals, which is partly due to genetic factors. The OAS1/2/3 cluster has been found to be strongly associated with COVID-19 severity. We examined this locus in the Moroccan population for the occurrence of the critical variant rs10774671 and its respective haplotype blocks. The frequency of single-nucleotide polymorphisms (SNPs) in the cluster of OAS immunity genes in 157 unrelated individuals of Moroccan origin was determined using an in-house exome database. OAS1 exon 6 of 71 SARS-CoV-2-positive individuals with asymptomatic/mild disease and 74 with moderate/severe disease was sequenced by the Sanger method. The genotypic, allelic, and haplotype frequencies of three SNPs were compared between these two groups. Finally, males in our COVID-19 series were genotyped for the Berber-specific marker E-M81. The prevalence of the OAS1 rs10774671-G allele in present-day Moroccans was found to be 40.4%, which is similar to that found in Europeans. However, it was found equally in both the Neanderthal GGG haplotype and the African GAC haplotype, with a frequency of 20% each. These two haplotypes, and hence the rs10774671-G allele, were significantly associated with protection against severe COVID-19 (p = 0.034, p = 0.041, and p = 0.008, respectively). Surprisingly, in men with the Berber-specific uniparental markers, the African haplotype was absent, while the prevalence of the Neanderthal haplotype was similar to that in Europeans. The protective rs10774671-G allele of OAS1 was found only in the Neanderthal haplotype in Berbers, the indigenous people of North Africa, suggesting that this region may have served as a stepping-stone for the passage of hominids to other continents.

Psychological Distress Associated with Enforced Hospital Isolation Due to COVID-19 during the "Flatten the Curve" Phase in Morocco: A Single-Center Cross-Sectional Study.

(1) Background: although much research has highlighted the mental health challenges faced by patients in hospital isolation during the COVID-19 pandemic, data from low-middle-income countries, including Morocco, are lacking. The main objective of this study was to assess the psychological distress of patients undergoing enforced hospital isolation during the initial phase of the COVID-19 pandemic in Morocco. (2) Methods: we conducted a cross-sectional study between 1 April and 1 May 2020, among patients hospitalized in isolation for suspected or confirmed COVID-19 at the Ibn Sina University Hospital of Rabat, Morocco. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). Binary logistic regression was performed to identify variables associated with anxiety and depression, with a cutoff of ≥8 used for both scales to create dichotomous variables. (3) Results: among 200 patients, 42.5% and 43% scored above the cut-off points for anxiety and depression, respectively. Multiple logistic regression identified female gender, a higher education level, a longer duration of isolation, and a poor understanding of the reasons for isolation as significant factors associated with anxiety. Conversely, female gender, chronic disease, a longer duration of isolation, and a poor understanding of the reasons for isolation were factors significantly associated with depression. (4) Conclusions: our study underscores high rates of anxiety and depression among patients forced into hospital isolation during the initial phase of COVID-19 in Morocco. We identified several factors associated with patients experiencing psychological distress that may inform future discussions on mental health and psychiatric crisis management.

Effectiveness of Sinopharm's BBIBP-CorV Booster Vaccination against COVID-19-Related Severe and Critical Cases and Deaths in Morocco during the Omicron Wave.

OBJECTIVE: This study investigates the effectiveness of the 1st booster dose against COVID-19 severe and critical hospitalizations and deaths occurring due to the Omicron wave in Morocco. PARTICIPANTS/METHODS: This study uses nationally representative data on COVID-19 from 15 December 2021 to 31 January 2022. The aim is to investigate the effectiveness of the inactivated COVID-19 vaccine BBIBP-CorV (Sinopharm) 1st booster dose against the Omicron wave in Morocco using real-world data established from nationally representative statistics on COVID-19 cases, deaths and vaccinations. STATISTICAL ANALYSES: The screening method was used to estimate vaccine effectiveness against COVID-19 severe or critical hospitalization and COVID-19-related deaths. The data were grouped by, age subgroup, sex, week, and geographical area and were analyzed using binary logistic regression with an offset for vaccine coverage. RESULTS: The overall BBIBP-CorV VE estimate is 89% (95% CI 85 to 92) effective in curbing COVID-19 deaths, and 81% (95% CI 78 to 84 in curbing COVID-19 severe/critical hospitalizations. Death-related VE estimate was 86% (95% CI 81 to 90) for patients aged ≥65 years, 96% (95% CI 90 to 98) for those aged <65 years, 95% (95% CI 88 to 98) in no-risk factor patients, 91% (95% CI 85 to 94) with 1 risk factor, 90% (95% CI 83 to 95) with 2 risk factors, and 72% (95% CI 52 to 84) in patients with 3 risk factors and more. Severe/critical hospitalization VE estimate was 78% (95% CI 74 to 82) for patients aged ≥65 years, 87% (95% CI 82 to 90) for those aged <65 years, 86% (95% CI 80 to 90) in no-risk factor patients, 80% (95% CI 73 to 84) with 1 risk factor, 80% (95% CI 70 to 85) with 2 risk factors, and 80% (95% CI 68 to 86) in patients with 3 risk factors and more. CONCLUSIONS: BBIBP-CorV boosters are effective in increasing protection against the Omicron variant-related COVID-19 deaths and severe/critical hospitalizations. The protection is reduced with older age and higher risk factors. These findings emphasize the importance of targeted vaccination strategies for different demographic groups and underscore the protective benefits of the first booster BBIBP-CorV vaccine.

Factors associated with psychological burden of breast cancer in women in Morocco: cross­sectional study.

BACKGROUND: Depression and anxiety are among the psychological diagnoses impacting individuals diagnosed with breast cancer. This study aims to estimate the prevalence, as well as the predictors, of anxiety and depression in women with breast cancer. MATERIALS AND METHODS: This was a cross-sectional, multi-center study conducted over an eight-month period among women with breast cancer in oncology centers in southern Morocco. Anxiety and depression were assessed using the validated Moroccan dialectal version of the Hospital Anxiety and Depression Scale (HADs). To identify the predictors of anxiety and depression in the study population. Multiple linear regression analyses were performed, including variables for which univariate analyses were significant with a p < 0.05 value. Statistical analyses were performed using Jamovi software version 2.2.3. RESULTS: A total of 230 participant responses were collected. The prevalence of anxiety and depression was 77.4% and 62.6%, respectively. Multiple linear regression analysis revealed the following factors increased anxiety: being younger than 50 years old, not having studied beyond elementary school, having children aged between 10 and 18 and having TNM stage III and IV. The following factors decreased anxiety in patients with breast cancer: good physical functioning (Karnofsky score), satisfaction with social support and financial support. Regarding depression, the following factors decreased depression: good physical functioning (Karnofsky score), a minimum of 2.5 h per week of physical activity, active occupational status, satisfaction with social support and financial support. In contrast, the recurrence of breast cancer was an associated factor with increased depression. CONCLUSION: The prevalence of anxiety and depression in women with breast cancer is very high in our context. Therefore, routine screening tests for depression and anxiety as well as psychosocial management care are necessary for patients with breast cancer in Morocco.

Factors associated with recognition at work among nurses and the impact of recognition at work on health-related quality of life, job satisfaction and psychological health: a single-centre, cross-sectional study in Morocco.

OBJECTIVES: To describe the sociodemographic, occupational and health factors that influence nurses' recognition at work and to examine a recognition pathway model to assess the relationship between recognition at work and health-related quality of life (HRQOL), job satisfaction, anxiety and depression. DESIGN: This is a cross-sectional observational study with prospective data collection based on a self-report questionnaire. SETTING: University hospital centre in Morocco. PARTICIPANTS: The study included 223 nurses with at least 1 year of practice at the bedside in care units. MEASURES: We included the sociodemographic, occupational and health characteristics of each participant. The Fall Amar instrument was used to measure job recognition. HRQOL was measured using the Medical Outcome Study Short Form 12. The Hospital Anxiety and Depression Scale was used to assess anxiety and depression. Job satisfaction was measured using a rating scale (ranging from 0 to 10). Path analysis was used to examine the nurse recognition pathway model to assess the relationship between nurse recognition at work and key variables. RESULTS: The participation rate in this study was 79.3%. Institutional recognition was significantly correlated with gender, midwifery specialty and normal work schedule: ß=-5.10 (-8.06, -2.14), ß=-5.13 (-8.66, -1.60) and ß=-4.28 (-6.85, -1.71), respectively. Significant correlations were found between recognition from superiors and gender, mental health specialisation and normal work schedule: ß=-5.71 (-9.39, -2.03), ß=-5.96 (-11.17, -0.75) and ß=-4.04(-7.23, -0.85), respectively. Recognition from coworkers was significantly associated with mental health specialisation: ß=-5.09 (-9.16, -1.01). The trajectory analysis model found that supervisor recognition had the best impact on anxiety, job satisfaction and HRQOL. CONCLUSIONS: Recognition from superiors is important in maintaining nurses' psychological health, HRQOL and job satisfaction. Therefore, managers in hospitals should address the issue of recognition at work as a potential personal, professional and organisational lever.

Comparison of the psychological health of students at the higher institutes of nursing and health techniques: A Moroccan multicentre study.

BACKGROUND: Mental health is essential to students' academic success as well as their ability to participate fully and meaningfully throughout all aspects of their lives and throughout their lifespan. AIMS: This study aims to determine the psychological health status of Moroccan nursing and technique health students. In doing so, it also seeks to compare differences based on sociodemographic factors. METHOD: A multicenter cross-sectional study with a convenience sample was conducted with 2,054 participants in the academic year of 2018/2019. A set of socio-demographic information were collected, and The General Health Questionnaire-12 (GHQ-12) was used. RESULTS: The mean GHQ-12 score was 4.33 ± 2.61, and 58.7% respondents scored 4 and above in the GHQ-12 scores and thus were considered to be in psychological distress. Students' psychological distress was associated with female gender (60.4% for female compared to 52.4% for men, p = .003); living in parental residence (61.6% compared to 54.7% living away parental residence; p = .02 ), the second and the third training level year respectively (64.6%; 59.2%) compared to first-year (55.2%, p = .001), and midwifery and nursing students (61.6%; 60.3%) as compared to technique health students (43.6%, p = .001). CONCLUSIONS: It appears that a substantial number of students have psychological distress and this is likely to have negative effects on students' educational attainment and wider wellbeing.

The burden of healthcare-associated infection in Moroccan hospitals: Systematic review and meta-analysis.

Healthcare-associated infections (HAI), also referred to as nosocomial infections, is defined as an infection acquired in a hospital setting. This infection is considered a HAI if it was not present or incubating at the time of admission. This includes infections acquired in the hospital but appearing after discharge, and also occupational infections among staff of the facility. HAI are a major patient safety measure to be considered in hospitals.

Long term effectiveness of inactivated vaccine BBIBP-CorV (Vero Cells) against COVID-19 associated severe and critical hospitalization in Morocco.

BACKGROUND: We provide national estimates of the real-world Vaccine effectiveness (VE) based on nationally available surveillance data. The study aimed to estimate the effectiveness of the inactivated Covid-19 vaccine BBIBP-CorV (Vero Cells) Sinopharm vaccine currently deployed in Morocco against SARS- CoV-2 severe disease/ hospitalization" within 9 months after vaccination. METHODS: We conducted a test-negative, case-control study among a population aged 18 years or older who were tested by rt-PCR for SARS-CoV-2 infection from February to October 2021 in Morocco. From the national laboratory COVID-19 database; we identified cases who were rt-PCR positive amongst severe and critical COVID-19 cases and controls who had a negative rt-PCR test for SARS-CoV-2. From the national vaccination register (NVR); individuals vaccinated with COVID-19 Vaccine (Vero Cell) and those unvaccinated were identified and included in the study. The linkage between databases was conducted for the study of Vaccination status based on the timing of the vaccine receipt relative to the SARS-CoV-2 rt-PCR test date. For each person, who tested positive for SARS-CoV-2, we identified a propensity score-matched control participant who was tested negative. We estimated vaccine effectiveness against SARS- CoV-2 severe disease/ hospitalization using conditional logistic regression. RESULTS: Among 12884 persons who tested positive and 12885 propensity score-matched control participants, the median age was 62 years, 47.2% of whom were female. As a function of time after vaccination of second dose vaccination, vaccine effectiveness during the first month was 88% (95% CI, 84-91), 87% (95% CI: 83-90) during the second and third month, 75% (95% CI: 67-80) during the fourth month, 61% (95% CI: 54-67) during the fifth month, and 64% (95% CI: 59-69) beyond the sixth month. VE remained high and stable during the first three months in the two-age subgroup. In the fourth month, the VE in the older population aged 60 years and above (64%) was reduced by 20 points compared to VE in the younger population (84%). CONCLUSION: A Sinopharm vaccine is highly protective against serious SARS-CoV-2 infection under real-world conditions. Protection remained high and stable during the first three months following the second dose and decreases slightly beyond the fourth month especially beyond 60 years.

Real-world study of the effectiveness of BBIBP-CorV (Sinopharm) COVID-19 vaccine in the Kingdom of Morocco.

BACKGROUND: The Kingdom of Morocco approved BBIBP-CorV (Sinopharm) COVID-19 vaccine for emergency use on 22 January 2021 in a two-dose, three-to-four-week interval schedule. We conducted a retrospective cohort study to determine real-world BBIBP-CorV vaccine effectiveness (VE) against serious or critical hospitalization of individuals RT-PCR-positive for SARS-CoV-2 during the first five months of BBIBP-CorV use in Morocco. METHODS: The study was conducted among adults 18-99 years old who were tested by RT-PCR for SARS-CoV-2 infection between 1 February and 30 June 2021. RT-PCR results were individually linked with outcomes from the COVID-19 severe or critical hospitalization dataset and with vaccination histories from the national vaccination registration system. Individuals with partial vaccination (< 2 weeks after dose two) or in receipt of any other COVID-19 vaccine were excluded. Unadjusted and adjusted VE estimates against hospitalization for serious or critical illness were made by comparing two-dose vaccinated and unvaccinated individuals in logistic regression models, calculated as (1-odds ratio) * 100%. RESULTS: There were 348,190 individuals able to be matched across the three databases. Among these, 140,892 were fully vaccinated, 206,149 were unvaccinated, and 1,149 received homologous BBIBP-CorV booster doses. Unadjusted, full-series, unboosted BBIBP-CorV VE against hospitalization for serious or critical illness was 90.2% (95%CI: 87.8-92.0%). Full-series, unboosted VE, adjusted for age, sex, and calendar day of RT-PCR test, was 88.5% (95%CI: 85.8-90.7%). Calendar day- and sex-adjusted VE was 96.4% (95%CI: 94.6-97.6%) for individuals < 60 years, and was 53.3% (95%CI: 39.6-63.9%) for individuals 60 years and older. There were no serious or critical illnesses among BBIBP-CorV-boosted individuals. CONCLUSIONS: Effectiveness of Sinopharm's BBIBP-CorV was consistent with phase III clinical trial results. Two doses of BBIBP-CorV was highly protective against COVID-19-associated serious or critical hospitalization in working-age adults under real-world conditions and moderately effective in older adults. Booster dose vaccination was associated with complete protection, regardless of age, although only a small proportion of subjects received booster doses.

Clinical learning environment, supervision and nurse teacher (CLES+T) scale: Translation and validation of the Arabic version.

AIM: This study aimed to translate the Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) scale into Arabic and to evaluate its psychometric properties in the context of Morocco. BACKGROUND: The CLES + T scale is internationally valid and reliable instrument used to evaluate the quality of the clinical learning environment for students in the health professions. DESIGN: Transcultural validation study METHODS: The present study was carried out between March and May 2019 at two public nursing education institutions in Morocco. The sample included 1550 undergraduate students enrolled in the first, second and third year of nursing, midwifery and health-techniques degree program and who have just completed a course of clinical practicum in hospital ward or primary healthcare settings. The CLES + T scale was translated into Arabic and back-translated. Internal consistency reliability and construct validity using exploratory and confirmatory factor analysis were conducted. RESULTS: The CLES+T scale showed alpha coefficients ranging from 0.71 to 0.92 and the five factors identified explained 55% of the variance, with "Role of nurse teacher" and "Supervisory relationship" as the two main factors explaining 41% of the variance. Confirmatory factor analysis approved the factor structure of the Arabic version of the instrument. CONCLUSION: The Arabic version of CLES+T displayed suitable psychometric properties for using it in evaluating the quality of clinical learning environment of nursing students in Morocco and likely in other Arabic speaking countries.