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.

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.

Translation and pilot validation of the Moroccan version of Stroke Impact Scale (SIS) 3.0.

INTRODUCTION: The Stroke Impact Scale 3.0 appears to be a promising measure of health-related quality of life for stroke patients. However, the lack of a cross-cultural adaptation in Arabic dialect may limit its use in the Moroccan context. The objective of this study was to carry out a transcultural adaptation and pilote validation of the Stroke Impact Scale 3.0 in Moroccan Arabic dialect, commonly called « Darija ¼. PATIENTS AND METHODS: A cross-sectional design was used for this study. The cross-cultural adaptation of the SIS 3.0 scale into Moroccan Darija was carried out following the guidelines proposed by Beaton et al (2000). Ceiling and floor effects were calculated for all scales. The internal consistency of multi-item scales was assessed using Cronbach's α coefficient. Convergent and divergent validity were evaluated using the Multi-Trait Multi-Method Correlation Matrix method. RESULTS: A total of 102 patients, with a mean age of 49 ± 12.9 years, participated in the study. The results revealed that the dimensions of the translated scale had no floor effect and no ceiling effect. The internal consistency of SIS 3.0 (Cronbach's alpha) was calculated, and all dimensions had good reliability, above the threshold of 0.70 (between 0.705 and 0.945). The results showed that the dimensions and their own items had correlation coefficients greater than 0.4, with good convergent and divergent validity. CONCLUSION: The darija version appears to be culturally acceptable with good psychometric properties and can be used to measure the quality of life of stroke survivors in Morocco.

Prevalence and associated factors of self-medication in worldwide pregnant women: systematic review and meta-analysis.

BACKGROUND: Self-medication during pregnancy is of great interest. The use of drugs during pregnancy requires a careful reflection on the benefits to the mother and the risks to the fetus. Selecting a drug or drugs for treating pregnant women can be difficult for clinicians owing to the various pharmacokinetic and physiological changes encountered during pregnancy. This systematic review and meta-analysis aimed to estimate the pooled prevalence of self-medication and associated factors among women during pregnancy. METHODS: Searches were carried out at PubMed, Science Direct, Web of Science, and Google Scholar. The quality of the studies and the risk of bias were analyzed using the Joanna Briggs Critical Appraisal Checklist for Analytical Cross-Sectional Studies instrument. The extracted data were tabulated and analyzed qualitatively and quantitatively through meta-analysis. RESULTS: The overall prevalence of self-medication among pregnant women was 44.50% (95% CI: 38.92-50.23). Subgroup analyses showed differences in self-medication prevalence influenced by region, county income, and study design. The Heterogeneity, assessed by the statistical test I2 varied from 96 to 99% and was statistically significant. The result of this funnel plot showed that the funnel plot was symmetry with p-value = 0.36, and there is no publication bias. CONCLUSION: The results obtained from this study showed that the prevalence of self-medication among pregnant women is relatively high. This requires effective measures and interventions to reduce self-medication. TRIAL REGISTRATION: ID = CRD42022312333 .

Prevalence and predictive determinants of overweight and obesity in children aged 0-24 months in Morocco: a cross-sectional study.

Background: Preventing overweight and obesity in early childhood is a priority for healthcare systems worldwide due to the harmful effects on health and economy over the medium and long term. Objective: The aim of this study is therefore the identification of the determinants predictive of overweight and obesity during the first 24 months of a child's life. Material and Methods: From May 2021 to January 2022, 1012 mother-child pairs were included in this study and were interviewed at urban and rural health centers in the Skhirat-Temara in Morocco prefecture using a questionnaire. The anthropometric measurements of the children were also taken according to World Health Organization standards. Results: The prevalence of overweight and obesity in children aged 0-24 months was 16.5%. This prevalence increased with age (12.5% for the 0-6 months group, and 15.5% and 21.5% respectively for the 7-12 months and 13-24 months groups). Cesarean delivery (aOR=1.78; 95%CI: 1.26-2.51; p=0.001), more than two living siblings in the household (aOR=1.48; 95%CI: 1.03-2.12; p=0.03), male gender (aOR=1.56; 95%CI: 1.10-2.20; p=0.01), and child age (aOR=0.94; 95%: 0.92-0.97; p <0.001) are significant predictors of overweight and obesity. Paternal smoking (aOR=2.16; 95%CI: 1.15- 4.06; p=0.01), short sleep duration (aOR=4.05; 95%CI: 1.27-12.88; p=0.01) in children aged 7-12 months, and combined breastfeeding (aOR=5.88; 95%CI: 2.07-16.72; p<0.001) during the first six months in children aged 13-24 months are also predictive determinants for this problem. Conclusion: The identification of early predictors of overweight and obesity can be used by public health decision-makers as a roadmap for action to prevent and improve health.

Awareness, Knowledge and Attitude Regarding Cervical Cancer among Women Living with HIV in the Souss-Massa Region, Southern Morocco: A Cross-Sectional Study.

BACKGROUND: Human immunodeficiency virus- positive women have an increased risk of precancerous lesions and invasive cervical cancer. This study aims to identify the level of awareness/knowledge and attitudes toward cervical cancer among women living with Human immunodeficiency virus in the region of Souss-Massa in southern Morocco.  Methods: This is a multicenter cross-sectional study conducted in the Souss-Massa region (southern Morocco) among women attending Human immunodeficiency virus treatment and care centers between March 2022 and September 2022. A questionnaire was used for data collection. The Chi-square test and logistic regression were deployed to identify factors associated with cervical cancer awareness among the target population. RESULTS: A total of 494 respondents to the questionnaire, 440 (89.1%) are aware of cervical cancer. Nevertheless, 405 (82.0%) and 369 (74.7%) were unaware of cervical cancer risk factors and symptoms, respectively. Only 125 (25.3%) knew the exact frequency of cervical cancer screening among Human immunodeficiency virus positive women, whereas 221 (44.7%) had ever been tested for cervical cancer. Factors associated with women's awareness of cervical cancer are as follows:  level of education (adjusted Odds Ratio = 3.78 with 95% CI, 1.23-11.65), time since diagnosis of Human immunodeficiency virus (adjusted Odds Ratio = 4.31 with 95% CI, 1.12- 16.52), knowledge of women with cervical cancer (adjusted Odds Ratio = 6.30 with 95% CI, 1.87-21.18) and heard the pap- smear/visual inspection with acetic acid (adjusted Odds Ratio = 4.92 with 95% CI, 2.35-10.33). CONCLUSION: The general knowledge of seropositive women regarding cervical cancer remains very low, which justifies the integration of cervical cancer prevention services with Human immunodeficiency virus care, and pinpoints the crucial role of patient education.

Endodontic access cavities: Fears and difficulties of Moroccan dental students related to teachers, self-confidence and technical protocol.

Fears and difficulties of Moroccan dental students regarding endodontic access cavity were evaluated among 3 items: (i) teachers, (ii) student confidence and (iii) access cavity protocol. A three Likert scale was used to rate 24 statements. Specific scores between 1 and 3 and mean scores between 0 and 1 were used to assess statements and items, respectively. Among 116 students, the mean score of difficulty related to teachers (0.48 ± 0.14) was significantly low (p < 0.001) compared to student confidence (0.69 ± 0.12) and cavity protocol (0.68 ± 0.08). The number of teachers was esteemed insufficient, additional training sessions were requested and maxillary teeth and molars were rated the most difficult with specific scores of 1.91 ± 0.80, 2.72 ± 0.61, 2.22 ± 0.67 and 2.47 ± 0.74, respectively. The highest specific score referred to the risk of making ledges (2.8 ± 0.56) or perforations (2.76 ± 0.59). Students expressed a lack of confidence, difficulty with upper molars and fears of making procedural errors.

Physicians' perception of health topics covered by traditional media in Morocco: opinion of physicians as consumers of the media.

Introduction: In Morocco, the traditional media allows messages of non-scientific prescriptions for the treatment of diseases and statements criticizing doctors to pass, which are considered by doctors as defamation and attacks on the honor of the medical profession. The aim of this study was to analyze physicians' perception in Morocco regarding health topics in the traditional media (TM). Methods: This is a descriptive transversal study of physicians practicing in Morocco. The data were collected using a questionnaire that included questions on reliability, speed, up-to-dateness and influence of TM, also trust and interest in TM, quantity, and quality of health messages in TM. Results: A total of 417 physicians responded, among them 234 (56.1%) had little or no interest in health topics in TM; 248 (59.5%) considered the quantity of transmitted messages to be low; 234 (56.1%) considered that health messages in TM are of low quality; 248 (59.5%) had little or no trust in health topics in TM. Also, three-quarters, 314 (75.3%), of the physicians recognized a moderate to strong influence of TM on health behaviors. Conclusions: Our results show that physicians have a perception that seems negative towards TM. This may partially explain the chronic tension situation between physicians and journalists/media in Morocco. To better understand this situation and improve this relationship in favor of health promotion, it is necessary to conduct a research addressing the opinion of journalists and the propositions of solutions of both parties.

COVID-19 in Morocco's region: Observational study of prevalence in symptomatic adults using the PANBIOS® rapid antigen test September 2021.

Background: Rapid antigen tests have emerged to deal with the COVID-19 pandemic. Rapid diagnosis of SARS-CoV-2 infection is essential to reduce the spread of the disease. The aim of this study was to estimate the prevalence of COVID-19 infection and test the sensitivity and specificity in Temara-Skhirat in symptomatic adults through PANBIOS® test. Methods: A prospective observational study was conducted in mid-September 2021. Two investigators conducted data collection from symptomatic adult patients. The diagnostic performance of the PANBIOS®, and the PCR was assessed to calculate sensitivity and the specificity. Results: Among 206 symptomatic participants, the mean age was 38 ± 12 years, and the majority were women (59%). In our population, 80% had benefited from the anti-COVID vaccine. The median duration of symptoms was 4 days; the most common symptoms were fatigue (62%), headache (52%), fever (48%), cough (34%), loss of smell (25%), loss of taste (24%), and sore throat (22%). Results revealed 23% of cases tested positive with PANBIOS® test versus 30% with the PCR test. The calculated medical decision between PCR versus PANBIOS® test showed high specificity of 95.7% and a sensitivity of 69.4%. There was concordance between the PANBIOS® test and the PCR. Conclusion: The prevalence tested remain high, and the sensitivity and specificity of the PANBIOS® versus PCR test are similar to other literatures and close to value described in WHO recommendations. PANBIOS® is a useful test for controlling the spread of COVID-19 allowing identification of active infection.

Gene Panel Sequencing Analysis Revealed a Strong Contribution of Rare Coding Variants to the Risk of Parkinson's Disease in Sporadic Moroccan Patients.

Parkinson's disease (PD) is a neurodegenerative movement disorder which can be either familial or sporadic. While it is well known that monogenic mutations are not a very common cause of PD, GWAS studies have shown that an additional fraction of the PD heritability could be explained by rare or common variants. To identify the rare variants that could influence the risk of PD in the Moroccan population, a cohort of 94 sporadic PD patients negative for the LRRK2 G2019S mutation was subjected to NGS gene panel sequencing, and gene dosage using the MLPA method. Mean age of onset at enrollment was 51.7 ± 11.51 years, and 60% of patients were men. We identified 70 rare variants under 0.5% of frequency in 16 of the 20 genes analyzed, of which 7 were novel. Biallelic disease-causing variants in genes with recessive inheritance were found in 5 PD cases (5.31%), whereas 13 patients (13.8%) carried likely pathogenic variants in genes with dominant inheritance. Moreover, 8 patients (8.5%) carried a single variant in MAPT or POLG, whereas co-occurrence of rare variants involving more than one gene was observed in 28 patients (30%). PD patients with variants in recessive genes had a younger mean age at onset than patients with dominant ones (33.40 (12.77) vs. 53.15 (6.63), p < 0.001), while their clinical features were similar. However, patients with rare variants in the risk factor genes or in more than one gene tended to have less resting tremor (p < 0.04), but more dystonia (p < 0.006) and dementia (p < 0.002) than those without any rare variants in known PD-associated genes. Our results showed a significant enrichment of rare variants particularly in LRRK2, VPS13C, POLG, and MAPT and underline their impact on the risk of sporadic form of the disease.

Prevalence and predictive determinants of adherence to vaccination against COVID-19 among mothers who gave birth in the last two years in Morocco.

Background and aim: Vaccination against COVID-19 was one of the most important resolute to stop the spread of the pandemic; however, its acceptance was controversial especially by pregnant and lactating women. This study aims to assess the prevalence of vaccination among participants as well as to explore the determinants of reluctance or adherence to vaccination among this population, and to investigate the intention towards vaccination among the unvaccinated. Method: This is a cross-sectional study conducted among mothers (n = 458) residing in the prefecture of Skhirat-Temara in Morocco, and who have children aged between one month to 2 years, the survey was conducted on the basis of a semi-structured questionnaire. Result: The prevalence of vaccination among the participants was 61.8%, although they were all vaccinated after their delivery. Among the unvaccinated, 64% wanted to be vaccinated either because they believed the vaccines were useful or because they wanted to get the vaccine pass, while 36% absolutely refused to be vaccinated due to lack of sufficient information on the efficacy and safety of new vaccines against COVID-19. The age of the last child (p < 0.001) and no gestational diabetes during pregnancy (p = 0.016) were found to be positive predictors of vaccination adherence; however, the average or the high monthly income (p = 0.003) and the lack of medical coverage (p = 0.046) were predictive factors limiting adherence to vaccination. Conclusion: The results of this study suggest that public health decision-makers need to increase awareness of the benefits of vaccination and to address the economic and social factors limiting access to COVID-19 vaccination.

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.

Cervical cancer in Morocco: A systematic review.

BACKGROUND: This systematic review aims to determine the epidemiological profile, etiology and risk factors, prevention, diagnosis, treatment, cost-effectiveness, survival, and quality of life related to cervical cancer in Morocco. METHODS: This study was conducted according to the recommendations of the "preferred reporting items for systematic reviews and meta-analysis." The PubMed, ScienceDirect, Springer, Web of Science data bases were used, as was Google Scholar for the grey literature. The review protocol was registered in the PROSPERO register (CRD42021235241). RESULTS: Fifty studies were selected. The mean age was 49.31 ±6.3 years. HPV infection prevalence ranged from 13.30% to 76%, with a peak in HIV-positive women. Acceptability of the HPV vaccine was higher among parents (35% and 82%) than among adolescents (16.9% to 46.6%). Knowledge of the vaccine and its price are two key factors related to vaccine acceptability among parents. This systematic review highlights that the fact that few eligible women (not more than 11%) were participating in the cervical cancer screening program. Moroccan women's level of knowledge and awareness regarding cervical cancer screening was low, negatively impacting their use of such screening tools, as illustrated by the high percentage (mean 76.32% ± 17.21) of women who had never been screened for cervical cancer. Treatment was the most significant component of the global care budget (95.87%), with an annual cost of $13,027,609. Five-year overall survival ranged from 41.3% to 73.6%, with higher survival rates for patients diagnosed at an earlier stage (77.3-85% for stage I). Lastly, low quality of life was observed in women with tumors at an advanced stage who had received brachytherapy and lacked social support. CONCLUSIONS: Subjects that require further investigation include Moroccan women's knowledge, attitudes, and awareness, especially among those at high risk of developing cervical cancer, and its impact on their quality of life and survival.

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.

Active tuberculosis infection in moroccan patients with rheumatic diseases under biologic therapy: A multicenter national study.

Background: The aim of this study was to evaluate the prevalence of active tuberculosis (TB) infection in Moroccan patients with rheumatic diseases under biologic therapy, and to describe the demographic characteristics of these patients as well as to explore potential risk factors. Methods: This 14-year nationally representative multicenter study enrolled Moroccan patients with rheumatic diseases who had been treated with biologic therapy. Patient medical records were reviewed retrospectively for demographic characteristics, underlying rheumatic diseases, associated comorbidities, and TB-related data. Results: In total, 1407 eligible patients were studied, detailed records were obtained for only 130 patients; 33 cases with active TB were identified at an estimated prevalence rate of 2.3%. The mean age was 42.9 ± 12 years and 75.8% were males. Ankylosing spondylitis accounted for 84.8% of active TB cases, and the majority of the cases (31/33) occurred among antitumor necrosis factor-alpha (TNF-α) users. A total of 8 out of 33 patients were positive at initial latent TB infection (LTBI) screening by tuberculin skin test and/or interferon-gamma release assay. Consumption of unpasteurized dairy products (odds ratio [OR], 34.841; 95% confidence interval [CI], 3.1-389.7; P = 0.04), diabetes (OR, 38.468; 95% CI, 1.6-878.3; P = 0,022), smoking (OR, 3.941; 95% CI, 1-159.9; P = 0.047), and long biologic therapy duration (OR, 1.991; 95% CI, 1.4-16.3; P = 0.001) were identified as risk factors for developing active TB. Conclusion: Moroccan patients with rheumatic diseases under anti-TNF-α agents are at an increased TB risk, especially when risk factors are present. Strict initial screening and regular monitoring of LTBI is recommended for patients living in high TB prevalence areas.

The cultural epidemiology of stigma among people with schizophrenia : Adaptation and cross-cultural validation of the Explanatory Model Interview Catalogue (EMIC), in Dialectal Arabic (Darija), Morocco.

INTRODUCTION: Stigma underlies the violation of certain social, economic, and cultural rights of patients with schizophrenia, including their access to treatment and care. Measurement of stigma remains as complex and multifaceted as the phenomenon itself. Several measurement tools are available to assess the prevalence, intensity and qualities of stigma. The aim of the study was to carry out a cross-cultural adaptation of the Explanatory Model Interview Catalogue (EMIC), in the Moroccan Arabic dialect commonly known as "Darija". PATIENTS AND METHOD: The study was conducted in three psychiatric departments of public hospitals in the Souss-Massa region, located in southern Morocco. For the diagnosis of schizophrenia, the study was based on the decisions of the psychiatrists practicing at the study sites. The cross-cultural adaptation in Moroccan Darija of the stigma scale developed by Michel Weiss in the EMIC was carried out according to the six-step scientific method developed by Dorcas et al. RESULTS: Cronbach's alpha (internal consistency) was 0.845. Convergent validity determined by Pearson's coefficient showed a significant inter-item correlation and the intra-class correlation coefficient (test-retest) was 0.975 (0.993; 0.991). The item added in relation to the COVID-19 situation presented psychometric values similar to the others. CONCLUSION: The Darija version is culturally acceptable and can be used to approach the phenomenon of stigmatization in Morocco.

Post-Validation Survey in Two Districts of Morocco after the Elimination of Trachoma as a Public Health Problem.

Trachoma is the leading infectious cause of blindness. In 2016, Morocco was validated by WHO as having eliminated trachoma as a public health problem. We evaluated two previously endemic districts in Morocco for trachomatous inflammation-follicular (TF), trachomatous trichiasis (TT), and antibodies against Chlamydia trachomatis, the causative agent of trachoma. Community-based cross-sectional surveys in the districts of Boumalene Dades and Agdez included 4,445 participants for whom both questionnaire and serology data were available; 58% were aged 1-9 years. Participants had eyes examined for TF and blood collected for analysis of antibodies to the C. trachomatis antigen Pgp3 by both a multiplex bead assay (MBA) and lateral flow assay (LFA). Seroconversion rates (SCR) per 100 people per year were used to estimate changes in the force of infection using Bayesian serocatalytic models. In Agdez, TF prevalence in 1-9-year-olds was 0.3%, seroprevalence ranged from 9.4% to 11.4%, and SCR estimates ranged from 2.4 to 3.0. In Boumalene Dades, TF prevalence in 1-9-year-olds was 0.07%, and modeling data from the different assays indicated a decrease in transmission between 20 and 24 years ago. The TF data support an absence of active trachoma in the two districts examined. However, seroprevalence and SCR in younger people were higher in Agdez than Boumalene Dades, showing that there can be differences in serology metrics in areas with similar TF prevalence. Data will be included in multicountry analyses to better understand potential thresholds for serological surveillance in trachoma.

Trends in the consumption and cost of antiepileptics in Morocco between 2008 and 2018.

INTRODUCTION: Epilepsy is one of the most common chronic neurological diseases. In Morocco, it is the second most common reason for consulting a neurologist. Its prevalence was estimated in Casablanca in 1998 at 1.1%. This study was carried out with the aim of evaluating, on the one hand, the consumption of antiepileptics and, on the other hand, the impact of their generic drugs on the pharmaceutical market between 2008 and 2018 in Morocco. MATERIALS AND METHODS: We used sales data for antiepileptic drugs collected from the Moroccan subsidiary of IQVIA, a multinational healthcare data science company, and we converted them into a defined daily dose (DDD/1000 inhabitants). RESULTS: The consumption of antiepileptic drugs increased from 442 to 641 DDD/1000 inhabitants between 2008 and 2018, all molecules combined, recording a 45% increase in the period studied. From an economic point of view, the calculation of the average cost of DDD, all molecules combined, gives an average cost of 2.42 dollars/DDD in 2018 versus 3.53 dollars/DDD in 2008 (1 dirham = 0.11 dollar), which corresponds to a decrease of -30%. This is due mainly to the introduction of generic drugs. CONCLUSION: These results show that while the average cost of a DDD has decreased, the consumption of antiepileptics has increased in Morocco over the years. Several events that have marked the drug market in Morocco have contributed to this trend, including the arrival on the market of several new molecules indicated for the treatment of epilepsy, the decrease in drug prices in 2014 and the policy of promoting generic drugs.

University students' perceptions and factors contributing to obesity and overweigh in Southern of Morocco.

BACKGROUND: Weight load is a cosmopolitan health problem. In Morocco, women are the most affected by the phenomenon since obesity has risen from 26.8% to 29.0%. OBJECTIVE: To determine the prevalence of weight load and associated factors among female students in higher education. METHODS: Data were collected by a questionnaire. Anthropometric measurements were made using a scale and a wall-mounted scale. Data were analysed by the statistical software SPSS version 13.0. Quantitative variables were described in mean ± standard deviation. Factors associated with obesity were determined by binary logistic regression. RESULTS: About two-thirds of the students had a normal weight, 21% were overweight and 3% were obese. In addition, 58% of students were physically inactive and 77% ate cake and fast food. In addition, 63% of students were dissatisfied with their weight. A significant relationship is found between level of primary education, type of establishment, cake and fast food consumption and weight load. CONCLUSION: The results revealed that 24% of participants were weight load and had behavioral risk factors such as a sedentary lifestyle and an unbalanced diet, which requires the promotion of a healthy lifestyle among these students as well as psychological support for those dissatisfied with their body image.

Evolution of acute lower respiratory infection in children aged < 5 years in Morocco from 2005 to 2014.

BACKGROUND: Acute lower respiratory infection is a major cause of death in children aged < 5 years in Morocco. The 13-valent pneumococcal conjugate vaccine (PCV) was introduced to the Moroccan National Immunization Programme in 2010. AIMS: To investigate the trend in the incidence of acute lower respiratory infection in children aged < 5 years during 2005-2014 in Morocco. METHODS: Data on acute lower respiratory infection in children aged < 5 years were obtained from the data published annually by the Moroccan Ministry of Health. We used joinpoint regression analysis to estimate the trend in incidence of acute lower respiratory infection during the study period. RESULTS: The incidence of acute lower respiratory infection increased significantly between 2005 and 2011: by 3.08% annually in children aged < 5 years and by 3.24% annually in children aged 1 to < 5 years. However, the incidence was stable after 2011 as the observed trends were not significant, although the incidence decreased from 2011 to 2014 by 4.26% annually in children aged < 5 years, by 3.57% annually in children aged 1 to < 5 years and by 5.14% annually in urban areas. CONCLUSIONS: Our results suggest a probable influence of the PCV on the trend in incidence of acute lower respiratory infection in Morocco.