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.

[Epidemiological profile and diagnostic and evolutionary features of TB patients at the Diagnostic Centre for Tuberculosis and Respiratory Diseases in Settat, Morocco]. / Profil épidémiologique, aspects diagnostiques et évolutifs des patients tuberculeux au centre de diagnostic de la tuberculose et des maladies respiratoires de Settat, Maroc.

Introduction: tuberculosis is a public health problem in Morocco. This study aims to examine the epidemiological profile as well as the evolutionary and diagnostic features of tuberculosis in Settat, Morocco. Methods: we conducted a retrospective descriptive and analytical study of data from the medical records of TB patients managed at the Diagnostic Centre for Tuberculosis and Respiratory Diseases in Settat, Morocco from 1st January 2015 to 31 December 2019. Results: we identified 1270 cases of tuberculosis. Lung involvement was more common than extrapulmonary involvement. Ganglionic tuberculosis mainly occurred in patients with extrapulmonary tuberculosis. Severe forms included tuberculous meningitis (10 cases) and miliary tuberculosis (10 cases). Diagnosis was bacteriologically confirmed in the majority of patients (84.09%). Extreme ages and female sex were mainly affected by extrapulmonary tuberculosis. Recovery was reported in 35.12% of patients and its rate was higher in pulmonary TB patients than in extrapulmonary TB patients (62.18% vs 0.37%; P<0.001). Patients with pulmonary tuberculosis (19.33% vs 10.81%; P<0.001) were mainly lost to follow-up. Death occurred to almost the same extent in patients with pulmonary and extrapulmonary tuberculosis (2.52% vs. 2.56%). Conclusion: efforts on all fronts are still needed if the country is to achieve the goal of eliminating TB by 2030.