RESUMO
Objective: As part of the prevention of vector-borne diseases in central Morocco, a study of the seasonal fluctuation of Culicidian biodiversity was conducted from November 2015 to November 2016 on four breeding sites located in the city of Fez in central Morocco (Jnan El Alami, Lgaâda dam, Awinat Elhajaj, Douwar Lhandiya Source). The study aimed to improve the knowledge of seasonal dynamics and activity period of Culicidian mosquitoes, in order to target the period of control. Methods: Larvae were collected by dipping method at a 15-day interval at least once a month. Statistical analyses were performed using version 3.6.1 of the statistical processing software. Results: During this study, nine species were found with high monthly and seasonal variations in numbers of each species and from site to site. Predominant species are vectors of disease: Culex pipiens, Cx. perexiguus, Cx. theileri, known vectors of West Nile virus, followed by Anopheles maculipennis s. l. and An. sergentii that are the main vectors of malaria in Morocco. Cx. pipiens and Cx. perexiguus reached the highest density in September, while Cx. theileri was found in large numbers in February and can therefore emerge in late winter and mid-spring. The lowest number of An. sergentii was collected in November, but increased in September, October and December. An. maculipennis s. l. occurred in June, with recurrences in March and July. Culiseta longiareolata was found in spring and summer and in abundance in June. However, Uranotaenia unguiculata was only present in September and October. Both An. cinereus and Cx. hortensis were present in November and February. Conclusion: The results obtained will be an important tool for management and monitoring Culicidae proliferation and can be used to improve the efficiency of control management.
Assuntos
Anopheles , Mosquitos Vetores , Animais , Larva , Marrocos , Estações do AnoRESUMO
The Moroccan phlebotomine fauna is composed of 24 species whose morphological determination may be difficult for non-taxonomists. The identification keys, presented here, allow the identification of sandflies genera and species in Morocco and will facilitate future studies on these insects of medical importance, Leishmaniasis vectors.
La faune phlébotomienne marocaine est composée de 24 espèces dont la détermination morphologique peut être difficile pour les non-taxonomistes. Les clés d'identification présentées ici permettent l'identification des genres et espèces de phlébotomes du Maroc et faciliteront les études futures sur ces insectes d'importance médicale, vecteurs de leishmaniose.
Assuntos
Leishmaniose Cutânea , Psychodidae , Animais , Humanos , Insetos Vetores , MarrocosRESUMO
Mosquitoes occupy a major health problem, as a potential vector for the transmission of many pathogens, the most important of which in Morocco are Plasmodium parasites and West Nile fever virus. Acquiring knowledge about the biotypology of these mosquitoes is an essential step in any control strategy. Thus, the objective of this study is to draw up an inventory of the culicidian fauna in the Fez region (North-central part of Morocco) and to determine the physicochemical parameters influencing the production of mosquito larvae of aquatic habitats in this area. Mosquito larvae of the extant biotopes were sampled every two months between November 2015 and December 2016, by means of the "dipping" method. The physicochemical parameters of the various larval biotopes were collected six times during the year of follow-up. Mosquito species were identified using morphological criteria. The results were analyzed using ecological indices and the generalized linear model (Poisson model) on R software. The identification of the 1,122 mosquito larvae collected from the various studied breeding areas revealed the presence of 11 species belonging to two subfamilies (Culicinae and Anophelinae) and five genera (Anopheles, Culex, Culiseta, Aedes, and Uranotaenia). Anopheles were observed in small numbers in permanent, stagnant, and shallow habitats. The larvae of An. maculipennis s. l. (major vector of malaria in Morocco) were collected. Culex larvae, especially Cx. pipiens (the main vector of WNV in Morocco), were collected in the majority of the larval habitats and on the different types of environments. Two other species of Culex, which plays a significant role in the transmission of WNV, were also collected, particularly, Cx. perexiguus and Cx. theileri. The results found, via this first study of its kind at the regional level, also made it possible to update the list of Culicidae species reported in the Fez region. Four new species have been recorded: Aedes flavescens, Uranotaenia unguiculata, Culiseta longiareolata, and Culex perexiguus. The results of this study will contribute to the provision of information for entomological surveillance and to better plan and guide vector control activities at local and national levels.
Les moustiques constituent un problème majeur de santé, en tant que vecteur potentiel de la transmission de nombreux agents pathogènes dont les plus importants au Maroc sont le Plasmodium et le virus de la fièvre du West Nile. Acquérir des connaissances sur la biotypologie de ces moustiques est une étape essentielle dans toute stratégie de lutte. Ainsi, l'objectif de ce travail est de dresser l'inventaire de la faune culicidienne dans la région de Fès (Centre Nord du Maroc) et de déterminer les paramètres physicochimiques influençant la production en larves de moustiques des habitats aquatiques dans cette zone. L'échantillonnage des larves a été réalisé tous les deux mois dans les différents biotopes existants, entre novembre 2015 et décembre 2016, à l'aide de la méthode de dipping. Les paramètres physicochimiques des différents biotopes larvaires ont été relevés six fois durant l'année du suivi. L'identification des caractères morphologiques des larves a été déterminée. Les résultats ont été analysés moyennant des indices écologiques et le modèle linéaire généralisé (GLM), suite à un modèle de Poisson sur le logiciel R. L'identification des 1 122 larves de culicidés récoltées au niveau des différents gîtes prospectés a révélé la présence de 11 espèces appartenant à deux sous-familles (Culicinae et Anophelinae) et cinq genres (Anopheles, Culex, Culiseta, Aedes et Uranotaenia). Les anophèles ont été observés en faible nombre dans des habitats permanents, à eaux stagnantes, et peu profondes. Les larves d'An. maculipennis s. l. (vecteur majeur du paludisme au Maroc) ont été récoltées. Les larves de Culex, en particulier de Cx. pipiens (principal vecteur du WNV au Maroc), ont été collectées dans la majorité des gîtes prospectés et dans les différents types de milieux. Deux autres espèces de Culex, dont le rôle dans la transmission du WNV est reconnu, ont été également collectées au cours de cette étude ; il s'agit de Cx. perexiguus et Cx. theileri. Les résultats trouvés via cette étude, première du genre au niveau de la région, ont permis également de mettre à jour la liste des espèces culicidiennes signalées au niveau de la région de Fès par l'ajout de quatre espèces : Aedes flavescens, Uranotaenia unguiculata Culiseta longiareolata et Culex perexiguus. Les résultats de cette étude contribueront à l'apport d'informations pour la surveillance entomologique et pour mieux planifier et orienter les activités de la lutte antivectorielle au niveau local et national.
Assuntos
Culicidae/citologia , Ecossistema , Larva/citologia , Microbiologia da Água , Água/análise , Água/parasitologia , Animais , Contagem de Células , Fenômenos Químicos , Culicidae/crescimento & desenvolvimento , Vetores de Doenças , Humanos , Larva/crescimento & desenvolvimento , Marrocos/epidemiologia , Mosquitos Vetores , Urbanização , Poluição da Água/análise , Poluição da Água/estatística & dados numéricosRESUMO
A list of Phlebotominae from Morocco is presented in alphabetical order. It consists of 24 species divided between two genera (Phlebotomus and Sergentomyia) and seven subgenera (Phlebotomus, Paraphlebotomus, Larroussius, Sergentomyia, Parrotomyia, Grassomyia and Sintonius). A history of the implementation of the current inventory is given by the comments on some species and subspecies quotes during the various researches carried out in Morocco.
Une liste des Phlebotominae du Maroc est présentée par ordre alphabétique. Elle est constituée de 24 espèces réparties entre deux genres (Phlebotomus et Sergentomyia) et 7 sous-genres (Phlebotomus, Paraphlebotomus, Larroussius, Sergentomyia, Parrotomyia, Grassomyia et Sintonius). Un historique de la mise en place de l'inventaire actuel est donné en commentant certaines citations d'espèces et de sous-espèces au cours des différentes recherches effectuées au Maroc.
RESUMO
BACKGROUND & OBJECTIVES: Prior to their elimination in 1974 and 2004, respectively, Plasmodium falciparum and P. vivax were the main native malaria parasites involved in disease transmission in Morocco. Imported cases of human malaria are still reported from the country. Anopheles labranchiae in northern Morocco and An. sergentii in the southern regions are the main malaria vectors. The bionomics and insecticide susceptibility of An. sergentii are poorly understood and need to be further studied to enhance the epidemiological surveillance of this important malaria vector. METHODS: The adults and larvae of Anopheles sergentii were collected during the mosquito breeding season in 2015 and 2016 and environmental characteristics of their breeding sites were recorded. Blood meals were analyzed using PCR-RFLP. Alongside, the WHO routine susceptibility tests with DDT (4%) and malathion (5%) were conducted and An. sergentii specimens were screened for knockdown resistance (kdr) and acetyl cholinesterase encoding (ace-1) gene mutations. RESULTS: Anopheles sergentii was observed during the summer and autumn seasons, feeding mainly on sheep, cows and also on humans. The WHO bioassays revealed complete susceptibility to DDT and malathion. Analysis of the sequences of the voltage-gated sodium channel gene revealed the absence of the kdr "Leu-Phe" mutation and PCR-RFLP revealed the absence of the G119S mutation in the ace-1. INTERPRETATION & CONCLUSION: With the increasing number of imported cases of human malaria in Morocco, the indiscriminate feeding behavior of this species may pose an infectious medical threat. Fortunately, the absence of insecticide resistance can ensure, for now, the efficiency of insecticides, as a part of the vector control program in controlling An. sergentii in Morocco.
Assuntos
Acetilcolinesterase/genética , Anopheles/genética , Proteínas de Insetos/genética , Resistência a Inseticidas , Inseticidas/farmacologia , Malária/transmissão , Malária/veterinária , Mosquitos Vetores/genética , Acetilcolinesterase/metabolismo , Animais , Anopheles/efeitos dos fármacos , Anopheles/parasitologia , Anopheles/fisiologia , Bovinos , Doenças dos Bovinos/parasitologia , Doenças dos Bovinos/transmissão , Entomologia , Feminino , Humanos , Proteínas de Insetos/metabolismo , Malária/parasitologia , Masculino , Marrocos , Mosquitos Vetores/efeitos dos fármacos , Mosquitos Vetores/parasitologia , Mosquitos Vetores/fisiologia , Mutação , Ovinos , Doenças dos Ovinos/parasitologia , Doenças dos Ovinos/transmissãoRESUMO
Phlebotomine sandflies are bloodsucking insects responsible for the transmission of leishmaniasis. The average annual incidence in Morocco, of this pathology, was approximately estimated in 2014 as 7.8 per 100.000 inhabitants according to the Moroccan health information service records. The study of the composition of the Phlebotomian community and its seasonal dynamics are essential for determining the appropriate and adequate means of control at the prefecture of Meknes in Central Morocco. It is with this in mind that two capture sessions per month using sticky paper traps were conducted at the sites of sandflies. A total of 982 sandflies were captured. The identification of the specimens found via the Moroccan key revealed a percentage of 73.3% belonging to the subgenus Paraphlebotomus, 6.3% to the Phlebotomus subgenus, 16.2% to Larroussius, and 4.2% of Sergentomia subgenus. Phlebotomus sergenti, vector of human cutaneous leishmaniasis, was found as the more abundant with 73.3% followed by Larroussius longicuspis with 8.2%. The largest number of species was harvested in July and September with, respectively, 44.8 ph/m2/night and 48.7 ph/m2/night. This study also unveiled that the two high-risk Leishmanian months are July and September, hence, the need to strengthen efforts to monitor and control this disease during the vector activity period.
Les phlébotomes sont des insectes hématophages vecteurs de la leishmaniose. L'incidence moyenne annuelle de cette affection au Maroc a été approximativement estimée en 2014 à 7,8 pour 100 000 habitants selon les registres du service de l'information sanitaire marocaine. L'étude de la composition du peuplement phlébotomienne et celle de la dynamique saisonnière des espèces locales sont indispensables pour déterminer les moyens de lutte contre cette pathologie. Dans cette optique, deux séances de capture par mois en utilisant des pièges adhésifs ont été effectuées pour déterminer les espèces phlébotomiennes et leurs fluctuations saisonnières dans la préfecture de Meknès au centre du Maroc. Neuf cent quatre-vingt-deux phlébotomes ont été identifiés, dont 73,3 % du sous-genre, Paraphlebotomus, 6,3 % du sous-genre Phlebotomus, 16,2 % du sous-genre Larroussius et 4,2 % du sous-genre de Sergentomia. Phlebotomus sergenti, vecteur de la leishmaniose cutanée humaine, est le plus abondant avec 73,3 % suivi par Larroussius longicuspis avec 8,2 %. Le maximum d'espèces a été récolté aux mois de juillet et septembre avec respectivement 44,8 et 45,8 phlébotomes/m2 par nuit (ph/m2 par nuit). Cette étude montre que les deux mois à haut risque leishmanien se situent en juillet et septembre, d'où la nécessité de renforcer les efforts de lutte contre cette maladie durant ces périodes.
Assuntos
Leishmaniose Cutânea/epidemiologia , Phlebotomus , Animais , Mordeduras e Picadas/epidemiologia , Humanos , Insetos Vetores/crescimento & desenvolvimento , Marrocos/epidemiologia , Phlebotomus/crescimento & desenvolvimento , Dinâmica Populacional , Vigilância da População , Psychodidae/classificação , Psychodidae/crescimento & desenvolvimento , Sistema de Registros , Estações do AnoRESUMO
In Morocco, leishmaniases are a major public health problem due to their genetic diversity and geographical distribution. Cutaneous leishmaniasis caused by L. tropica is endemic in the center of the country; it has a high risk of transmission, with Phlebotomus sergenti as vector. This study aimed to identify the vectors of Leishmania and the epidemiological trends of cutaneous leishmaniasis in Afourer, Morocco. The entomological study used both adhesive and CDC miniature light trap to capture six different species: P. sergenti (50.21 %), P. papatasi (18.45 %), P. longicuspis (17.17 %), P. perniciosus (12.02 %), S. minuta (1.93 %) and P. chabaudi (0.21 %). The life cycle of sand flies in this area is characterized by a biphasic trend with two activity peaks, in May and November. Hence, the highest transmission levels are likely to occur from early summer to the end of autumn. However, the epidemiological status of leishmaniasis in Afourer between 2009-2013 showed a significant decreasing trend - of 87.7 %.
Assuntos
Insetos Vetores/parasitologia , Leishmaniose/epidemiologia , Leishmaniose/parasitologia , Animais , Feminino , Humanos , Leishmaniose/transmissão , Masculino , Marrocos/epidemiologia , Phlebotomus/parasitologia , Psychodidae/parasitologia , Estações do AnoRESUMO
Cutaneous leishmaniasis (CL) is a major public health problem in Morocco. Three distinct parasites are involved; Leishmania tropica, Leishmania major and Leishmania infantum. The objective of this study is to investigate the epidemiological and the clinical features of endemic foci of CL in Sidi Kacem and Ouazzane provinces in the north of Morocco including molecular identification of parasites. We studied the evolution and the distribution of 1,656 CL cases coming from 39 sectors in these provinces between 1997 and 2012. The causative agents of CL in these areas were identified by using the ITS1-PCR-RFLP method. A tendency of seasonality in incidence was observed, showing a peak in April. Most infected patients were from Ouazzane province. The patients' ages ranged from 6 months to 85 years; 54% of them were females. The highest rate lesions were found in the age group of 9 years or less and most lesions were localized in the face (79.6%). The movement of populations from neighboring endemic areas and establishment of habitation in areas where housing conditions are unfavorable favored the emergence of the disease.
Assuntos
Leishmaniose Cutânea/epidemiologia , Leishmaniose Cutânea/parasitologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , DNA de Protozoário/análise , Feminino , Humanos , Lactente , Leishmania infantum/genética , Leishmania major/genética , Leishmania tropica/genética , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Especificidade da Espécie , Adulto JovemRESUMO
In Morocco, Culex pipiens plays a role in the high annoyance experienced by most urban cities, suburban and rural areas, especially since it was strongly suspected as the most likely vector in the transmission of West Nile virus epidemics that have hit Morocco in 1996. Chemical insecticides are generally the way in which they use the programs against harmful mosquitoes and disease vectors. However, the repeated and excessive use of these products regularly led to the emergence of the phenomenon of insect resistance. At the center of Morocco, information on the susceptibility or resistance to insecticides in mosquitoes (larvae and adults) vectors of diseases or pests, are almost nonexistent. This article reports the results of studies conducted between 2007 and 2010 with sensitivity tests WHO on larvae local populations of Culex pipiens collected in three lodging in the city of Fez, towards the insecticide mostly used by hygienic services: temephos. Five concentrations of insecticide (0.0025 mg/l, 0.005 mg/l, 0.0125 mg/l, 0.025 mg/l, 0.0625 mg/l) in addition to control, were used to determine the LC50 and LC 90 of Culex pipiens species towards temephos. Sensitivity tests were carried out at the entomology unit and monitoring of insect sensitivity towards insecticides installed at the Regional Diagnostic Laboratory Epidemiological and Environmental Hygiene (LRDEHM), Fez, under the Regional Directorate of Health in Fes Boulemane Region. The LC50 and LC90, concentrations corresponding to 50 and 90% mortality were determined graphically, by the linear relationship between the decimal logarithm of insecticide concentrations (x-axis) and the percentage of mortality transformed into probit values (ordinate) on logarithmic gausso paper. Resistance rates were determined on the basis of the sensitivity of a reference strain (S-Lab). The bioassay results affirmed the presence of resistance in larvae Culex pipiens towards temephos and that this species has also equally developed resistance levels similar and comparable in the three lodging studied, resistance rates recorded varying between 12.17 and 14.34. Facing such a situation, the surveillance of susceptibility of mosquitoes to insecticides used in mosquito control and anti-malarial fight has become imperative. This would undoubtedly allow a good management of the products available and consequently to adopt suitable measures for the best management of this resistance which must be an integral part of any program of vector control.
Assuntos
Culex , Resistência a Inseticidas , Inseticidas/farmacologia , Controle de Mosquitos , Temefós/farmacologia , Animais , Culex/crescimento & desenvolvimento , Relação Dose-Resposta a Droga , Humanos , Larva/efeitos dos fármacos , MarrocosRESUMO
Malaria resurgence risk in Morocco depends, among other factors, on environmental changes as well as the introduction of parasite carriers. The aim of this paper is to analyze the receptivity of the Loukkos area, large wetlands in Northern Morocco, to quantify and to map malaria transmission risk in this region using biological and environmental data. This risk was assessed on entomological risk basis and was mapped using environmental markers derived from satellite imagery. Maps showing spatial and temporal variations of entomological risk for Plasmodium vivax and P. falciparum were produced. Results showed this risk to be highly seasonal and much higher in rice fields than in swamps. This risk is lower for Afrotropical P. falciparum strains because of the low infectivity of Anopheles labranchiae, principal malaria vector in Morocco. However, it is very high for P. vivax mainly during summer corresponding to the rice cultivation period. Although the entomological risk is high in Loukkos region, malaria resurgence risk remains very low, because of the low vulnerability of the area.
RESUMO
This bibliographical study, based on published works, ministry of Health Reports, exploitation of the database relative to the entomological surveillance conducted in the framework of the National Malaria Control Program, as well as unpublished results obtained within the framework of the European project "Emerging disease in a changing European environment", summarizes and completes with new data current knowledge on the systematics, the distribution and the vectorial competence of moroccan anophelines.
Assuntos
Culicidae , Insetos Vetores , Animais , Culicidae/fisiologia , Marrocos , Dinâmica PopulacionalRESUMO
In Morocco, the resistance monitoring of Anopheles labranchiae larvae to temephos is done using discriminating concentration of 0.125 mg, which is half of the WHO recommended dose for Anopheles. However, this dosage seemed to be too high to allow an early detection of the resistance and its revision was found necessary. The present study was carried out during May-June 2008 and 2009 in nine provinces from the north-west of the country. The aim was to determine the lethal concentrations LC100 of temephos for the most susceptible populations and to define the discriminating dosage as the double of this value. The bioassays were conducted according to WHO standard operating protocol to establish the dose-mortality relationship and deduct the LC50 and LC95. The results of this study indicated that the LC100 obtained on the most susceptible populations was close to 0.05 mg/L. Therefore, the temephos discriminating dosage for susceptibility monitoring of An. labranchiae larvae in Morocco was set to be 0.1 mg/L.
RESUMO
To evaluate the risk of malaria transmission resumption in Morocco, we have studied the current level of receptivity of the region of the last malaria focus in the country. Anopheles (Anopheles) maculipennis labranchiae and Anopheles (Cellia) sergentii, the major vectors of malaria in Morocco, are still presents but their anthropopathic index was low and no parasite positive samples were detected. An. labranchiae was very rare; only 34 females were caught over all the study period. The human biting rate was nil and none of its blood meal was human. An. sergenti was more abundant but its low human aggressiveness and its zoophilic behaviour would not attribute to this species an important vectorial capacity. Thus, the receptivity of Chefchaouen province, the region of the last malaria focus in Morocco, under the current vector control measures undertaken by Public Health services, is low and despite the likely presence of Plasmodium vivax gametocyte carriers, the malariogenic potential appears to be low and the risk of malaria resumption is, at this time, unimportant.
Assuntos
Anopheles/crescimento & desenvolvimento , Insetos Vetores/crescimento & desenvolvimento , Malária/parasitologia , Animais , Humanos , Mordeduras e Picadas de Insetos , Malária/epidemiologia , Marrocos/epidemiologiaRESUMO
Anopheles (cellia) d'thali is generally classified as a mosquito of arid areas in the South and East Morocco. The northernmost station of this species at present in Morocco is the Moulouya valley. However we found An. d'thali during entomological investigations in the north of the country in the subhumid area of Chefchaouen. In Morocco, An. d'thali is therefore no longer a strictly desert species.
Assuntos
Anopheles/classificação , Insetos Vetores/classificação , África do Norte , Animais , Feminino , Geografia , Marrocos , Estações do AnoRESUMO
To assess the malaria reintroduction risk in Morocco, we analyzed the malariogenic potential of a rice cultivation area in the north of the country. Our results showed that the receptivity of this area is very high during all the period of the rice cultivation, from May to October, the vectorial capacity of An. labranchiae, malaria vector in Morocco, is considerably high during the summer which corresponds to the rice cultivation period. The risk of autochthonous malaria resumption is important because of the possible presence of gametocytes carriers in the last malaria focus which is bordering the study area. The risk of a tropical malaria introduction is unimportant seen the low vulnerability of the area and the uncertain competence of its vectors considered. However, this risk must be considered with a more attention.
Assuntos
Anopheles/parasitologia , Insetos Vetores/parasitologia , Malária/epidemiologia , Controle de Mosquitos , Oryza , Animais , Feminino , Humanos , Malária/transmissão , Masculino , Marrocos/epidemiologia , Fatores de Risco , Estações do AnoRESUMO
A study of Anopheles labranchiae resistance in Morocco was conducted in the provinces of Kénitra, Khouribga, Larache, Khémisset and Salé during 2005. An. labranchiae was susceptible to propoxur, fenitrothion and permethrin and resistant to varying degrees to DDT. Genetically there was no change to the target site common to DDT and pyrethroids, the voltage gated sodium channel. The resistance seemed to be due to detoxification mechanisms specific to DDT. In principle, there should be no obstacle to the substitution of DDT by pyrethroids in Morocco. Resistance can then be detected and supervised by more reliable molecular tools in the Laboratory of Medical Entomology of the National Institute of Hygiene.
Assuntos
Anopheles , DDT , Insetos Vetores , Resistência a Inseticidas , Inseticidas , Animais , Anopheles/classificação , Anopheles/genética , Anopheles/parasitologia , Fenitrotion , Genética Populacional , Humanos , Insetos Vetores/classificação , Insetos Vetores/genética , Insetos Vetores/parasitologia , Resistência a Inseticidas/genética , Malária/epidemiologia , Malária/parasitologia , Malária/prevenção & controle , Malária/transmissão , Epidemiologia Molecular , Marrocos/epidemiologia , Controle de Mosquitos , Mutação/genética , Avaliação das Necessidades , Permetrina , Propoxur , Canais de SódioRESUMO
INTRODUCTION: Thoracic outlet syndromes are expressed by various clinical manifestations. Treatment is mainly rehabilitation. We aimed to identify factors predicting long-term functional rehabilitation in patients with this treatment and recurrence of symptoms. PATIENTS AND METHODS: We performed a descriptive retrospective analysis of 84 patients who underwent rehabilitation for thoracic outlet syndrome as defined by Revel and colleagues. Data collection involved a questionnaire exploring personal information, risk factors for developing thoracic outlet syndrome, clinical signs, and x-ray results. Long-term results of treatment were evaluated by telephone questionnaire. Data analysis involved use of Stata 6 software. RESULTS: Univariate analysis: predictive factors of negative results with treatment were ligament hypermobility, sensitive disturbances at the time of diagnosis, and a positive Adson's test result. Predictive factors of positive results were absence of paresthesia at the end of the treatment, and a negative "bell sign" at the end of the treatment. Predictive factors of nonrecurring symptoms were age younger than 34, bilateral positive Adson test result, and need for a supplementary number of sessions. MULTIVARIATE ANALYSIS: predictive factors of positive results with treatment were absence of sensitive impairment at the time of diagnosis, compliance with home exercises, initial negative Adson's test result, absence of hypermobility, and absence of paresthesia at the end of treatment. Predictive factors of recurring symptoms were age younger than 34, the need for a supplementary number of sessions and bilateral positive Adson's test result. CONCLUSION: A larger number of subjects are needed to further explore the predictive factors of rehabilitation and recurring symptoms in thoracic outlet syndrome for better validity and significance.
Assuntos
Avaliação de Resultados em Cuidados de Saúde , Síndrome do Desfiladeiro Torácico/reabilitação , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente , Recidiva , Estudos RetrospectivosRESUMO
Culex pipiens gonotrophic cycle has been studied, for the first time in Morocco, under experimental conditions. Its average duration was estimated at 5.54 +/- 1.73 days.
Assuntos
Culex/crescimento & desenvolvimento , Insetos Vetores , Vírus do Nilo Ocidental , Animais , Feminino , MarrocosRESUMO
Anopheles belonging to Anopheles maculipennis complex, collected from February to June 2002 in eight provinces of Morocco (Khouribga, Taounate, Alhouceima, Chefchaouen, Fes, Khemisset, Kalaa Sraghna and Benslimane), were identified with characterization of the ribosomal DNA by PCR and ITS2 sequence analysis. The results of this study showed that all the identified specimens belong to the Anopheles labranchiae species.
Assuntos
Anopheles , Animais , Anopheles/classificação , Anopheles/genética , Anopheles/crescimento & desenvolvimento , DNA Ribossômico/genética , Feminino , Insetos Vetores/classificação , Insetos Vetores/genética , Larva , Marrocos , Plasmodium , Especificidade da EspécieRESUMO
The malaria transmission level of Plasmodium vivax was monitored in four high-risk provinces in Morocco. Intensive mosquito collection by light traps and manual catches resulted in the capture of four species: Anopheles labranchiae, An. sergenti, An. cinereus, and An. claviger. All An. sergenti and An. labranchiae females collected were tested for the presence of two phenotypes of P. vivax (PVK210 and PVK247) antigen by enzyme-linked immunosorbent assay (ELISA). No P. vivax antigen was detected in 1347 mosquitoes analysed. A parallel parasitological investigation was conducted. Of 2665 slides examined from a population of 4343 people for detection of P. vivax, no slide was positive. The results confirm the break in malaria transmission in residual foci. The use of ELISA is recommended in future epidemiological studies of human malaria.