Severity of neuromeningeal tuberculosis in Morocco: a critical evaluation of epidemiological trends and treatment efficacy.

Introduction: neuromeningeal tuberculosis (NMT) is a significant public health challenge in Morocco because of its acute severity and high mortality rates. This study aims to comprehensively evaluate the epidemiological, clinical, therapeutic, and disease progression characteristics of NMT in the Kenitra province. Methods: a retrospective analysis was conducted on the medical records of patients diagnosed with NMT at the Diagnostic Center of Tuberculosis and Respiratory Diseases in Kenitra from 2014 to 2017. Results: among the 33 identified NMT cases, predominantly males (57.6%) were affected, with an age range of 4-76 years and a median age of 25 years. Extrapulmonary manifestations were prevalent, constituting 78.8% (n=26) of all cases, with meningeal localization in 45.5% (n=15) of confirmed cases. Furthermore, 9.1% (n=3) of cases were associated with unconfirmed cerebral tuberculosis (TB), and 12% (n=4) exhibited miliary TB. Familial transmission and comorbidities were identified as significant factors in disease progression. More than half of the patients received standardized antibacillary treatment during hospitalization, which lasted between 9 and 12 months. Treatment outcomes were generally positive (73%), but a 12% case fatality rate and 15% loss to follow-up were observed. Conclusion: this study highlights the complex clinical and public health challenges posed by NMT in Morocco. It emphasizes the need for improved health strategies that not only increase public awareness but also enhance the accessibility and quality of diagnostic services and treatment options.

Association of Co-Living and Age on the Type of Sports Practiced by Older People.

Introdution: The environment and the type of co-living of older people are crucial to understanding how the nature of their context influences a healthy lifestyle. However, no studies have investigated to what extent their type of co-living may be associated with the sports and the profile practice according to their age. Objective: This study aimed to assess the association between the types of co-living and the age of the physically active elderly and the sports they practice. Hypothesis: It is thought that the age, situation, and satisfaction with the way of living in physically active older people differ according to the type of sport they practice. Methods: Cross-sectional study. We included 358 individuals aged between 61 and 93 years old (M = 69.66, SD = 4.74). Type of co-living was classified as living alone or living with others. The sports activities evaluated were: gym, dance, water activities, and yoga/pilates. Differences in the type of co-living and sports practiced were evaluated by ANOVA or Chi2. Results: Among the elderly who practice gymnastics, most of them live alone and in a tight core (p < 0.001) (Phi = 0.244). Furthermore, those who practice aquatic activities are more frequently the youngest (p < 0.001) (Phi = 0.198). Conclusion: Older people who do gymnastics have smaller living groups, those under 69 opt for gymnastics and aquatic activities, while those aged 70 and over prefer dance, yoga, and pilates.

Factors Associated with Psychological Distress and Physical Activity During the COVID-19 Pandemic.

In Morocco, as in many countries, COVID-19 spread nationwide causing a public health emergency. Strict quarantine measures implemented as a result of the pandemic have disrupted many aspects of people's lives, triggering psychological distress. A total of 256 participants were recruited through a convenience sample. Data were collected through snowball sampling, an assessment of distress symptoms using the Brief Symptoms Inventory, and an assessment of leisure-time physical activity using the Godin-Shephard Leisure-Time Physical Activity Questionnaire. Bivariate and multivariate analyses were performed. Significant changes in paranoid ideation (z = -2.45, P = .01) and interpersonal sensitivity (z = -2.01, P = .04) dimensions were noted between those who were and those who were not authorized to leave their homes during quarantine. Similarly, for physical activity, significant changes in depression (z = -2.15, P = .03), anxiety (z = -2.13, P = .03), interpersonal sensitivity (z = -1.95, P = .05), and somatization (z = -2.11, P = .03) were reported among the insufficiently active group compared with the more physically active group. From multiple regression analysis, variables correlated with general distress were type of quarantine, gender, age, education level, chronic disease, and smoking (R2 = .80). With some variables, leisure-time physical activity domains appeared to be associated only with interpersonal sensitivity and somatization. Having to leave one's home during the outbreak was linked to distress, especially symptoms like suspiciousness, hostility, fearful thoughts of losing autonomy, and feelings of inadequacy, uneasiness, and discomfort during interpersonal interactions. Individuals who were moderately or sufficiently active physically reported less psychological distress.

Space-time COVID-19 monitoring in Morocco.

INTRODUCTION: In Morocco, the first case was detected on March 02, 2020. Few days later, new cases are notified, followed by deaths. The government decided to adopt large-scale drastic measures against the epidemic. This study aims to describe and analyse the COVID-19 distribution in Morocco, according to key measures taken to curb this health problem. METHODS: An observational study of all cases daily reported by the Ministry of Health of Morocco from 02 March to 05 May 2020, was carried out. A mapping was performed. RESULTS: Before the implementation of the state of health emergency, 86 confirmed cases out of 471 biological examinations carried out have been reported and the highest cumulative incidence (0.43 cases per 100,000 inhabitants) was recorded in Fes-Meknes region. During the 1st quarantine, 2,960 positive cases out of 15,915 examinations carried out have been detected. Marrakech-Safi region was the most affected (15.33 cases per 100,000 inhabitants). Halfway through extended quarantine, 2,173 confirmed cases out of 49,570 biological examinations realized have been notified, the highest cumulative incidence has observed in Draa-Tafilalet region (27.45 cases per 100,000 inhabitants). The highest mortality was observed in Marrakech-Safi region (1.05 deaths per 100,000 inhabitants) and the highest case fatality rate (13.46%) was registered in Souss-Massa region. CONCLUSION: The strategy adopted by Morocco has enabled it to avoid a health catastrophe. But, it's not over yet. Morocco should continue the massive efforts and reinforce the existing measures against the virus, especially in regions very affected by the epidemic.

Polyunsaturated Fatty Acids and Chronic Pain: A Systematic Review and Meta-analysis.

BACKGROUND: Chronic pain is one of the most frequent disease symptoms and represents a global health problem with a considerable economic burden. The role of polyunsaturated fatty acids (PUFA) in chronic pain conditions was debated during the last decade with conflicting results. OBJECTIVE: To assess whether polyunsaturated fatty acids intake is useful as a preventive or curative tool in chronic pain. STUDY DESIGN: Systematic review and meta-analysis. SETTING: This study examined all published studies, either preventive or curative, on PUFA supplementation and chronic pain. METHODS: We retrieved studies published in any language by searching systematically Medline, Embase, Conference Proceedings Citation Index, dissertations databases, and the 5 regional bibliographic databases of the World Health Organization until May 2015. We included both observational and intervention studies reporting effect measures and their confidence intervals of polyunsaturated fatty acids intake in the regular diet or supplementation and pain. Two investigators selected studies; extracted data independently on baseline characteristics, exposure, and outcomes; and rated the quality of interventional studies using Jadad score. We calculated pooled standardized mean differences (SMDs) of pain indexes such as the Visual Analogue Score. We further carried out subgroup analyses by disease, type of PUFA, outcome scale, quality index, dose, and time of supplementation. RESULTS: We retrieved 5 observational and 46 intervention studies. Only one observational study showed a protective effect of PUFA. On the contrary, the interventional studies yielded a pooled random effects SMD of -0.40 (95% CI -0.58, -0.22), which indicates improvement, as 0 is the value that indicates absence of effect. The largest effect was found for dysmenorrhea (SMD -0.82, 95% CI -1.21, -0.43), Ω-3 supplementation (-0.47, 95% CI -0.68, -0.26) and composite scores (-0.58, 95% CI -1.07, -0.09). Mitigation of pain was stronger for low doses (-0.55, 95% CI -0.79, -0.30) and short supplementation periods (-0.56, 95% CI -0.86, -0.25). LIMITATIONS: While the number of curative studies was large, that of preventive studies available was limited. CONCLUSION: Our results suggest that Ω-3 PUFA supplementation moderately improves chronic pain, mainly that due to dysmenorrhea. Further investigation on the preventive potential of PUFA supplementation is needed, as the amount of evidence is scarce. Key words: Meta-analysis, systematic review, chronic pain, PUFA, supplementation, Ω-3, dysmenorrhea.