[Part of Chlamydia pneumoniae in atherosclerosis and exacerbation of chronic obstructive pulmonary disease and asthma]. / La part de Chlamydia pneumoniae dans l'athérosclérose et les exacerbations de bronchopneumopathie chronique obstructive et d'asthme.

Chlamydia pneumoniae infection has been often associated with several chronic diseases including asthma and chronic obstructive pulmonary diseases (COPD). The spectrum of Chlamydia pneumoniae infection has been expanded to the association with coronary heart disease (CHD). In Morocco, the implication of Chlamydia pneumoniae infection in these pathologies is unknown. The aim of our study was to determine the relationship between infection with Chlamydia pneumoniae and respiratory pathology and atherosclerosis. The patients were from two departments (department of respiratory disease and of cardiology), and presented exacerbation of COPD and asthma or atherosclerosis. The mean age was 45 years a with a 1.7 sex ratio for the first population and 61 years with a 1.4 sex ratio for the second population. Serological diagnosis of Chlamydia pneumoniae infection has been determined by microimmunofluorescence (MIF). All samples were tested for anti-Chlamydia pneumoniae IgG, IgA and IgM. In the first group, we found 42 % positive for IgG, 11 % for IgA, and no case for IgM. In the second group the presence of anti-Chlamydia pneumoniae IgG was observed in 67.5 % cases, IgA in 16.5 % cases and IgM in 2 % cases, 14 % of patients had negative serology for IgA, IgG, and IgM. Our results are in accord to those reported by other studies. According to these results, it seems that a certain degree of association exists between Chlamydia pneumoniae infection and exacerbation of COPD, asthma and atherosclerosis which should be of importance on a therapeutic point of view.

Direct genotyping and nucleotide sequence analysis of VS1 and VS2 of the Omp1 gene of Chlamydia trachomatis from Moroccan trachomatous specimens.

To determine the range of ocular strains of Chlamydia trachomatis circulating in southern Morocco, where trachoma is endemic, and to compare the value of the molecular methods for genotyping C. trachomatis, ocular specimens were subjected to a direct Omp1 PCR-restriction fragment length polymorphism (RFLP)-based analysis and direct sequencing. PCR-RFLP analysis shows that the Ba genotype represents the most frequent one (63%), followed by genotype A (45%), whereas no B or C genotypes were identified among the 53 out of 108 specimens that were strongly positive in the Omp1 CT1-CT5 PCR. Our results further show that the notion of interfamily and intrafamily transmission is very likely. To confirm the genotype identity of C. trachomatis as determined by PCR-RFLP, 16 selected specimens were sequenced across variable sequence 1 (VS1) and 2 (VS2). No discrepancies were found between PCR-RFLP typing and the genotype identity confirmed by nucleotide sequencing of the PCR product. Our results clearly indicate that both molecular methods of typing chlamydiae (i.e., PCR-RFLP and sequencing) are important and have specific applications for clinical epidemiological purposes. This is the case for individuals infected with more than one clonal population of C. trachomatis. The unambiguous nucleotide sequencing therefore defines an important epidemiologic descriptor for the infected patient whether the source is from a clonal population of organisms or whether it represents a more dynamic process of strain dominance or genetic change. Furthermore, Omp1 genotyping affords the necessary approach to epidemiologic investigations in areas of the world endemic for trachoma, where only one or two serovars are known to predominate.

The prevalence of sexually transmitted pathogens in patients presenting to a Casablanca STD clinic.

The objective of this study conducted at the sexually transmitted diseases (STD) clinic of the Pasteur Institute of Morocco (SCPIM) is to describe clinical complaints and biological findings in patients attending this facility. Two thousand two hundred sixty-four patients had visited the STD clinic from 1992 to 1996. The main reported symptom was genital discharge for men (44.5%) and women (68.6%). Genital eruption and ulcer were more frequent in men. The principal biological result shows a seroprevalence of 0.62% for human immunodeficiency virus (HIV), 3.05% for hepatitis B virus (HBV), 51.5% for chlamydiae and 13.2% for syphilis. Factors associated with clinical findings were age and Gonococcus for men (odds ratio (OR): 1.94 and 5.96, respectively) and Trichomonas and positive TPHA for women (OR: 9.49 and 0.25, respectively). This work describes for the first time the distribution of various germs involved in sexually transmitted diseases in Moroccan population and underlines the importance of studying its sexual behavior as well as determinants of STD incidence.

[Chlamydia infection and female low fertility in Morocco]. / Chilamydiose et hypofertilité féminine au Maroc.

Chlamydia trachomatis infection is recognised as the most common asymptomatic sexually transmitted disease, and this may lead to severe complication including infertility. The purpose of this study was to evaluate the part that this pathology takes in the female hypofertility, using serologic, cell culture, and histopathologic tests. Some of the women had undergone biopsies during coelioscopic exam, the others during salpingectomy. Cervical specimens were carried from other women. They had as clinical signs: primary or secondary infertility, ectopic pregnancy, syndrome of synechie, hydrosalpinx, or pelvic pains. 128 of these women had undergone serologic exam, 57 a cell culture, and 47 an histopathologic test. The results showed that 26% had anti Chlamydia trachomatis antibodies and 46% from them with tubal problems confirmed, had anti Chlamydia trachomatis antibodies as well, only 7% had cell culture positive from cervix specimens, none from the biopsies, and 73% of them had inflammatory responses. All women with inflammatory responses had a serologic and/or cell culture positive tests. Our results allow us to conclude that this infection takes a good part in female hypofertility, there is a correlation between a previous Chlamydia trachomatis infection and a tubal histopathology. In front of the difficulties of isolation by cell culture the detection of the microorganism by molecular biology assays may resolve a lot of problems.

[Chlamydial infections and male infertility in Morocco]. / Chlamydiose et infertilité masculine au Maroc.

Chlamydia trachomatis infection of the lower genital is recognised as the most common sexually transmitted disease, is role in male infertility is controversial, the objective of this study was to evaluate the part that this pathogen agent takes in male infertility among maroccan population, to compare serological tests, sperm abnormalities, antisperm-antibodies and DNA research in semen. Microimmunofluorescence (MIF) was done for 139 patients, 124 were checked for sperm abnormalities, 87 for antisperm-antibodies and 92 for DNA research in sperm. The results showed that MIF is positive in 24,5%, 11% of the subjects in antisperm antibodies, 8% of them simultaneously in anti-Chlamydia and antisperm antibodies and 5 of them had sperm abnormalities. Azoospermy was more observed in positives subjects in Chlamydia trachomatis antibodies. C. trachomatis DNA was found in 7,6% and there was no association between the detection of C. trachomatis in semen specimens and the presence of anti-Chlamydia trachomatis, antibodies in serum. We conclude that, because of the complexity of the Chlamydia's physiopathology, association between several tests is necessary in male infertility workup.

[Isolation of Chlamydia trachomatis in trachomatous Moroccan patients]. / Isolement de Chlamydia trachomatis chez des sujets trachomateux marocains.

PURPOSE: Isolation of Chlamydia trachomatis from ocular specimens of subjects living in trachomatous area in south Morocco. METHODS: One hundred and twenty ocular specimen of 60 subjects living in two provinces of a trachoma-endemic area (Errachidia and Ouarzazate) were tested by cells culture. The age range was 2 months to 85 years and the sex ratio was 1.06. RESULTS: The prevalence of positive cases was about 25% with a female predominance of 34% versus 16% for males. In our sample, 70% showed an active clinical trachoma. The most affected age ranges were children between 0 and 10 years old, with a very high frequency of isolation in children younger than 5 years. The intense inflammatory stage alone or associated with follicular stage was the most adequate for isolating Chlamydia trachomatis. CONCLUSION: Reducing or even eradicating trachoma can be realised only through a continuous treatment strategy associated with a sanitary education aiming at the development of hygienic conditions especially among children living in trachomatous communities.

[Seroprevalence of Chlamydia trachomatis infection in STD consultants in Morocco]. / Séroprévalence de l'infection à Chlamydia trachomatis chez des consultants MST au Maroc.

We have conducted a seroepidemiological survey of Chlamydia trachomatis infection among 400 STD consultants in comparison with 400 blood donors. The study was performed by using the indirect microimmunofluorescence technique with Chlamydia trachomatis, Chlamydia psittaci and Chlamydia pneumoniae as antigens. The overall seroprevalences were 60% and 46% for STD consultants and blood donors respectively. The seroprevalences of Chlamydia trachomatis alone were 12.5% for STD consultants and 7.5% for blood donors. No differences were observed according to age in the two groups and people of 20-29 and 30-39 years old, of both sexes were the most concerned. We conclude that Chlamydia trachomatis infection remains an important problem in Morocco.