Barriers to Oral PrEP: A Qualitative Study of Female Sex Workers, PrEP Prescribers, Policymakers, and Community Advocates in Morocco.

In 2017, Morocco became the first Arab country to incorporate pre-exposure prophylaxis (PrEP) in its HIV-prevention program. Yet no research has been published on PrEP from Morocco. Although female sex workers are one of the target populations of PrEP in Morocco, their enrollment in PrEP is lower than men who have sex with men. In this study, we conducted 38 semi-structured interviews with female sex workers, physicians who prescribe PrEP, policymakers, and community advocates to identify problems associated with access to and use of PrEP. We also investigated preferences for daily oral, vaginal ring, and long-acting injectable PrEP. A reflexive thematic analysis revealed seven themes: PrEP stigma; stigmatization and criminalization of sex work; one size doesn't fit all; knowledge and misconceptions about PrEP; economic burden; inconvenience of PrEP pills; and preferred PrEP modalities. This paper discusses the implications of the findings for increasing access and use of PrEP in Morocco.

Factors that Influence Uptake of Oral PrEP among Female Sex Workers One of the most recent scientific advancements in the history of the HIV pandemic was the introduction of pre-exposure prophylaxis (PrEP). However, the uptake of PrEP in the Arab world is low. In this paper we interviewed female sex workers, physicians who prescribe PrEP, policymakers, and community advocates to identify problems associated with access to and use of PrEP. Several barriers were identified including stigma attached to PrEP, misconceptions about PrEP, and financial burden. Although most female sex workers in our study were interested in using PrEP, the delivery methods of PrEP should be tailored to fit the lifestyle and personal circumstances of potential users.

Prevalence and risk factors associated with uncontrolled blood pressure in rural areas in Settat City, Morocco.

Introduction: high blood pressure, commonly known as hypertension, is one of the most widespread chronic diseases in the world. It is a serious problem whose management is essential to maintain stable blood pressure levels in the short term, and to prevent neuro-cardio-vascular complications in the long term. This study aims firstly to explore the characteristics of uncontrolled blood pressure among patient´s residents of rural areas in Settat City, and secondly to determine its prevalence and identify associated risk factors. Methods: this is a cross-sectional, descriptive, and analytical study which took place between March and August 2023, and targeted a population of hypertensive patients following up at primary healthcare facilities in rural areas in Settat City. A questionnaire was developed and evaluated to ensure its reliability before being administered to study participants, anthropometric measurements and blood pressure readings were also taken. Results: four hundred hypertensive patients were surveyed, 53% (212) of whom had uncontrolled blood pressure, with a mean age of 56.94 (±13.10 years), and a marked female preponderance, illustrated by 72.3% (289) were female. The risk factors associated with uncontrolled blood pressure were: male gender (aOR: 2.53, 95% CI 1.13-5.65), monthly income (aOR: 5.64, 95% CI 3.04-10.46), diabetes (aOR: 3.16, 95% CI 1.77-5.63), monotherapy (aOR: 8.42, 95% CI 2.85-24.90), poor compliance with medication (aOR: 7.48, 95% CI 4.21-13.29), and stress (aOR: 2.22, 95% CI 1.14-4.33). Conclusion: the level of blood pressure control was unsatisfactory in this population, underscoring the imperative of educating hypertensive patients about management measures and reinforcing the quality of primary health services.

Epidemiological aspects of the association of the hypertriglyceridemic waist phenotype with metabolic syndrome and cardiovascular risk factors in Morocco. Case the Amazigh population from a geographic region called Souss.

BACKGROUND: The global prevalence of metabolic syndrome (MetS) increases susceptibility to non-communicable diseases such as obesity, type 2 diabetes, and cardiovascular disease, posing significant health risks. Effective prevention and management require objective tools. The hypertriglyceridemic waist (TG+WC+) phenotype is proposed as a less expensive approach to identify individuals with metabolic syndrome and other cardiovascular risk factors. OBJECTIVE: The current aim of this investigation is to study the epidemiological characteristics of the hypertriglyceridemic waist phenotype and their correlations with cardiovascular risk factors and MetS in the Moroccan Amazigh ethnic group from the Souss region of Morocco. MATERIAL AND METHODS: A total of 827 Amazigh adults from the Sousse region of Morocco were divided into four distinct phenotype groups: TG-WC-, TG+WC-, TG-WC+, and TG+WC+ (normal TG- or high TG+ triglycerides/normal WC- or high WC+ waist circumference). The association of the different phenotypes with MetS and other cardiovascular risk factors was established by logistic regression analysis. RESULTS: The prevalence of the TG+WC+ phenotype was 27.7% and varied according to age group and sex. Among subjects with the TG+WC+ phenotype, most were 41-60 years old (53.3%) and in women (74.2%). Participants with the TG+WC+ phenotype had the highest prevalence of dyslipidemia (87.3%), hypoHDLaemia (69.9%), and general obesity (37.12%). The three phenotypes TG-WC-, TG+WC- and TG-WC+ were less associated with MetS and other cardiovascular risk factors. Moreover, people with the TG+WC+ phenotype had a very high odds ratio for MetS. CONCLUSION: These findings suggest that the TG+WC+ phenotype exhibits a robust correlation with MetS and additional variables connected to cardiovascular risk. The TG+WC+ phenotype serves as a valuable clinical instrument for detecting individuals vulnerable to MetS and cardiovascular diseases.

Report of SARS-CoV-2 JN.1 variant in Morocco.

In this study, we report the identification of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) JN.1 variant and the quasi-complete genomic sequencing of four clinical samples in Morocco. Nasopharyngeal swabs were obtained from four patients (one female, three males). The Illumina COVIDSeq Test was used for comprehensive genomic analysis.

Predicting Particulate Matter (PM 10) Levels in Morocco: A 5-Day Forecast Using the Analog Ensemble Method.

Accurate prediction of Particulate Matter (PM 10) levels, an indicator of natural pollutants such as those resulting from dust storms, is crucial for public health and environmental planning. This study aims to provide accurate forecasts of PM 10 over Morocco for five days. The Analog Ensemble (AnEn) and the Bias Correction (AnEnBc) techniques were employed to post-process PM 10 forecasts produced by the Copernicus Atmosphere Monitoring Service (CAMS) global atmospheric composition forecasts, using CAMS reanalysis data as a reference. The results show substantial prediction improvements: the Root Mean Square Error (RMSE) decreased from 63.83 µg/m 3 in the original forecasts to 44.73 µg/m 3 with AnEn and AnEnBc, while the Mean Absolute Error (MAE) reduced from 36.70 µg/m 3 to 24.30 µg/m 3. Additionally, the coefficient of determination (R 2) increased more than twofold from 29.11% to 65.18%, and the Pearson correlation coefficient increased from 0.61 to 0.82. This is the first use of this approach for Morocco and the Middle East and North Africa and has the potential for translation into early and more accurate warnings of PM 10 pollution events. The application of such approaches in environmental policies and public health decision making can minimize air pollution health impacts.

Veterinary perspectives on the urbanization of leishmaniosis in Morocco.

BACKGROUND: Leishmaniosis caused by Leishmania infantum, L. major and L. tropica is endemic in Morocco. Growing evidence of both human and canine Leishmania infections in urban centres has been reported. Since many forms of the disease are zoonotic, veterinarians play an important role in leishmaniosis control by intervening at the parasite host level. This study aimed to bring together One Health principles to connect canine and feline leishmaniosis epidemiology within urban centres of Morocco (Rabat and Fez) and assess the level of awareness of Moroccan veterinarians about facing this threat. METHODS: A molecular survey was conducted for Leishmania DNA detection in canine (n = 155) and feline (n = 32) whole-blood samples. Three conventional polymerase chain reaction (PCR) protocols were implemented. The first PCR aimed at identifying infected animals by targeting Leishmania spp. kinetoplast minicircle DNA (kDNA). The second and third PCR targeted the Leishmania internal transcribed spacer region (ITS-1) and the Leishmania small subunit ribosomal RNA (SSUrRNA) gene, respectively, aiming at identification of the infecting species after Sanger sequencing-positive amplicons. Total immunoglobulin G (IgG) against Leishmania spp. was evaluated in 125 dogs by enzyme-linked immunosorbent assays (ELISA) using an in-house protocol, including three Leishmania-specific antigens (SPLA, rKDDR and LicTXNPx). Sera from 25 cats were screened for total IgG to Leishmania spp. by an indirect immunofluorescence antibody test (IFAT). An online questionnaire was presented to Moroccan veterinarians addressing their knowledge and practices towards animal leishmaniosis. RESULTS: Overall, 19.4% of the dogs tested positive for Leishmania kDNA and ITS-1 and sequencing revealed infection with L. infantum among PCR-positive dogs. These animals presented a wide range of ELISA seropositivity results (16.7%, 34.9% and 51.6%) according to the tested antigens (rKDDR, SPLA and LicTXNPx, respectively). Use of kDNA-PCR revealed 12.5% cats positive to Leishmania spp. otherwise found to be seronegative by IFAT. CONCLUSIONS: A considerable prevalence of infection was identified in dogs from urban centres of Morocco. Additionally, this is the first report of feline infection with Leishmania spp. in this country and in urban settings. Moroccan veterinarians are aware that animal leishmaniosis is endemic in Morocco, representing a public health threat, and are knowledgeable about canine leishmaniosis diagnosis and treatment.

Prevalence of Tobacco Products' Use and Associated Factors Among Adolescents in Morocco: A Systematic Review.

Introduction: Tobacco use is the major preventable cause of premature death worldwide, responsible for about 8 million deaths per year, mostly in low- and middle-income countries, such as Morocco. Adolescents' tobacco use is a matter of concern, because early initiation increases the risk of becoming a lifelong user. There exists a notable gap in the synthesis of evidence concerning tobacco use among Moroccan adolescents. Thus, the purpose of this study was to provide a comprehensive view of the prevalence of tobacco products' use and associated factors among adolescents in Morocco. Methods: We systematically searched PubMed, Scopus, Web of Science and ScienceDirect for relevant studies reporting prevalence rates of tobacco products' use among Moroccan adolescents, published until June 2024, using inclusion and exclusion criteria in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Additional searches were completed on other sources to reach unpublished reports. The Joanna Briggs Institute Critical Appraisal Checklist was used to assess the quality of included studies. Results: After the final screening, 22 papers met the inclusion criteria. Life-time prevalence of tobacco use ranged from 7.8% to 20.4% for cigarettes smoking, from 10.6% to 21.9% for waterpipe, from 7.9% to 9.1% for chewing tobacco and from 9.2% to 12.4% for snuff. The last 12-month prevalence of cigarette smoking was comprised between 6.9% and 10.8%. As for the prevalence of current use, ranges of (1.8%-16.4%) and (4.9%-8.4%) were noted for cigarettes and waterpipe, respectively. The most commonly highlighted risk factors for tobacco use included male sex, older age, having friends or family members who use tobacco and low perception of risk associated with tobacco use. Conclusion: Our findings reveal an alarming situation of tobacco use among Moroccan adolescents. Therefore, it is crucial that all stakeholders engage in concerted efforts to develop and implement evidence-based preventive interventions among early adolescents.

Comparison of Olea pollen sampling between gravimetric and volumetric traps (NW of Morocco).

Olea pollen is considered one of the most critical causes of respiratory allergic disease in the Mediterranean region, contributing to different symptoms in allergic sufferers. Due to the high increase in the prevalence of olive pollen caused by the expansion of cultivated areas especially in the Mediterranean region, the aim of this study was to examine the Olea pollen sampling efficiency between gravimetric and volumetric pollen traps over the period 2018-2022. Our data demonstrated that Olea pollen season start-date was generally recorded earlier with volumetric trap than shown with gravimetric method. Moreover, the peak dates occurred mainly in May for the years studied. Across the entire period, the greatest pollen concentrations were reached in the week 11th and >60 % of the total Olea pollen were already reached after the ninth week of sampling in 2020. In general, the evolution of pollen sampling for both methods demonstrates similar temporal development. Variations in the seasonal pollen integral could be attributed to the elevation above ground level at which the traps were placed, exposure to regional winds, the influence of long-range transported pollen and the mode of pollen transport. The findings indicate that the gravimetric method was equally practical as the volumetric method in estimating airborne pollen.

Overall adherence in hemodialysis patients and associated factors: A cross-sectional study from Morocco.

INTRODUCTION: Hemodialysis patients' adherence to hemodialysis sessions, medication, diet and, fluid restriction is an essential condition to ensure effective treatment. Therefore, this study aimed to assess the overall adherence of hemodialysis patients in the Marrakech-Safi region of Morocco. METHODS: A quantitative cross-sectional study of hemodialysis patients at the Safi, Youssoufia and Ibn Tofail public hemodialysis centers was conducted in the last trimester of 2023 using a questionnaire (ESRD-AQ), which was completed by analyzing patient records and interviewing patients during the hemodialysis session. RESULTS: A total of 199 patients were included in this study. Women accounted for 53.3% of patients, 73.9% were under 65 years, 55.8% had been on hemodialysis for more than 5 years, and 62.8% had an Inter-dialytic-weight (IDW) ≥ 2.5 kg. Mean scores for adherence to hemodialysis, medication, diet and fluid restriction were 534.92 ± 98.71 out of 600, 113.32 ± 50.86 out of 200, 75.38 ± 42.00 out of 200 and 52.51 ± 53.59 out of 200, respectively. Regarding overall adherence, 24.1% had low adherence, 63.8% had moderate adherence, and 12.1% had good adherence, with a mean score of 793.99 ± 151.28 out of 1200. Our results showed that male gender (p = 0.010, ORa = 5.61), young age (p = 0.004, ORa = 8.48), and short duration on hemodialysis (p = 0.001, ORa = 23.91) were risk factors for low overall adherence. CONCLUSION: Our results justify the increased need for educational programs aimed at improving the overall adherence of hemodialysis patients.

Immersive simulation in nursing and midwifery education: a systematic review.

PURPOSE: Immersive simulation is an innovative training approach in health education that enhances student learning. This study examined its impact on engagement, motivation, and academic performance in nursing and midwifery students. METHODS: A comprehensive systematic search was meticulously conducted in 4 reputable databases-Scopus, PubMed, Web of Science, and Science Direct-following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The research protocol was pre-registered in the PROSPERO registry, ensuring transparency and rigor. The quality of the included studies was assessed using the Medical Education Research Study Quality Instrument. RESULTS: Out of 90 identified studies, 11 were included in the present review, involving 1,090 participants. Four out of 5 studies observed high post-test engagement scores in the intervention groups. Additionally, 5 out of 6 studies that evaluated motivation found higher post-test motivational scores in the intervention groups than in control groups using traditional approaches. Furthermore, among the 8 out of 11 studies that evaluated academic performance during immersive simulation training, 5 reported significant differences (P<0.001) in favor of the students in the intervention groups. CONCLUSION: Immersive simulation, as demonstrated by this study, has a significant potential to enhance student engagement, motivation, and academic performance, surpassing traditional teaching methods. This potential underscores the urgent need for future research in various contexts to better integrate this innovative educational approach into nursing and midwifery education curricula, inspiring hope for improved teaching methods.

Insights into the genomic homogeneity of Moroccan indigenous sheep breeds though the lens of runs of homozygosity.

Numerous studies have indicated that Morocco's indigenous sheep breeds are genetically homogenous, posing a risk to their survival in the challenging harsh climate conditions where they predominantly inhabit. To understand the genetic behind genetic homogeneity through the lens of runs of homozygosity (ROH), we analyzed the whole genome sequences of five indigenous sheep breeds (Beni Guil, Ouled Djellal, D'man, Sardi, Timahdite and Admixed).The results from principal component, admixture, Fst, and neighbour joining tree analyses consistently showed a homogenous genetic structure. This structure was characterized by an average length of 1.83 Mb for runs of homozygosity (ROH) segments, with a limited number of long ROH segments (24-48 Mb and > 48 Mb). The most common ROH segments were those ranging from 1-6 Mb. The most significant regions of homozygosity (ROH Islands) were mostly observed in two chromosomes, namely Chr1 and Chr5. Specifically, ROH Islands were exclusively discovered in the Ouled Djellal breed on Chr1, whereas Chr5 exhibited ROH Islands in all breeds. The analysis of ROH Island and iHS technique was employed to detect signatures of selection on Chr1 and Chr5. The results indicate that Chr5 had a high level of homogeneity, with the same genes being discovered across all breeds. In contrast, Chr1 displays some genetic variances between breeds. Genes identified on Chr5 included SLC39A1, IL23A, CAST, IL5, IL13, and IL4 which are responsible for immune response while genes identified on Chr1 include SOD1, SLAMF9, RTP4, CLDN1, and PRKAA2. ROH segment profile and effective population sizes patterns suggests that the genetic uniformity of studied breeds is the outcome of events that transpired between 250 and 300 generations ago. This research not only contributes to the understanding of ROH distribution across breeds but helps design and implement native sheep breeding and conservation strategies in Morocco. Future research, incorporating a broader sample size and utilizing the pangenome for reference, is recommended to further elucidate these breeds' genomic landscapes and adaptive mechanisms.

Breast cancer treatment and its impact on survival in Morocco: a study over a decade.

BACKGROUND: In Morocco, much progress has been made in breast cancer treatment. However, there is limited information on survival outcomes of breast cancer patients according to their therapeutic management. METHODS: A pattern-of-care study was conducted in Morocco's two main oncology centres: Rabat and Casablanca and has shown that major progress has been made in the quality of care with survival rates comparable to those in developed countries. The present study focuses on the different therapeutic strategies used in breast cancer and their impact on prognosis. Patients were classified into two categories: those considered as appropriately managed and those who were not. RESULTS: A total of 1901 women with stage I to III breast cancer were included in this study, the majority (53%) were adequately managed and had better disease-free survival (DFS) rates than those who were not: DFS at 3 years (88% versus 62%) and at 5 years (80% versus 50%). Potential significant determinants of better management were: treatment in Rabat's oncology centre, treatment between 2008 and 2012, being aged younger than 60 years, and early TN stage. CONCLUSION: This study demonstrated the value of proper integrated and coordinated management in a comprehensive cancer centre, to improve breast cancer survival.

ANCA and ASCA Profiles in a Moroccan Population With Inflammatory Bowel Diseases.

Introduction: Diagnosing inflammatory bowel disease (IBD) is hindered by the invasive procedures required for accurate classification as Crohn's disease (CD) or ulcerative colitis (UC). As alternatives, non-invasive tests using anti-Saccharomyces cerevisiae antibodies (ASCA) and anti-neutrophil cytoplasmic antibodies (ANCA) have gained significance. This study evaluated ANCA and ASCA antibody frequencies in IBD and their role in disease characterization in a Moroccan population. Methods: Conducted at Marrakech's Mohammed VI University Hospital from 2014 to 2018, this cross-sectional study included patients with suggestive symptoms or confirmed IBD diagnosis based on clinical, endoscopic, and histological criteria. Immunological investigations detected p-ANCA, c-ANCA, and ASCA using immunofluorescence and immunodot assays. Results: Among 60 participants (mean age: 33.1 ± 11.75 years), the 20-30-year age group was most affected (31.67%). CD, UC, and indeterminate colitis (IC) were diagnosed in 46.67%, 45%, and 8.33% patients, respectively. Gastrointestinal symptoms were prevalent (98.3%), with ANCA+/ASCA-profile in 41% of UC patients versus 11% in CD, and ANCA-/ASCA + profile exclusive to CD (50%). ANCA positivity was significantly associated with UC, rectal syndrome, and inflammatory syndrome, whereas ASCA positivity was significantly associated with CD and König's syndrome (p < 0.05). Conclusion: This study highlighted demographic and phenotypic particularities of IBD in a Moroccan population. Non-invasive tests using ASCA and ANCA antibodies offer valuable alternatives to invasive procedures, facilitating personalized management strategies. Variations in ANCA and ASCA profiles provide insights into disease characterization and inform tailored treatment approaches.

A Rare Case of Tinea Capitis in Morocco Due to Trichophyton tonsurans.

Tinea capitis is a frequent reason for dermatology consultation in Morocco. In this work, we report a case of Tinea capitis caused by Trichophyton tonsurans (T. tonsurans), an unusual anthropophilic dermatophyte in Morocco. This pathogen was identified for the first time in our hospital, affecting a young Moroccan judoka. The patient was a 25-year-old man. He was a member of the Moroccan national judo team. He was sent to the parasitology and mycology laboratory for suspicion of tinea capitis. The anamnesis found an almost annual participation in international tournaments and competitions. The clinical examination revealed erythematous-squamous scalp plaque associated with hair loss and two localized squamous lesions on the right wrist and the left knee. We sampled the lesions separately. Direct examination in potassium hydroxide preparation of collected samples (skin scrapings, hair fragments) from the patient's lesions was negative, and cultures grew T. tonsurans in Sabouraud Agar. We identified this pathogenic fungal species based on the colonies' macroscopic and microscopic morphological characteristics, establishing the diagnosis of T. tonsurans  tinea capitis. The young judoka presented an unusual fungal infection of the scalp in Morocco. We suppose it to be our country's first case of T. tonsurans tinea capitis. Screening international combat sports practitioners and optimizing hygiene conditions in our sports environments remains necessary to avoid any epidemic of T. tonsurans.

First Insight into the Whole Genome Sequencing Whole Variations in Mycobacterium bovis from Cattle in Morocco.

Six cattle heads which tested positive against bovine tuberculosis (bTB) in Morocco were investigated to confirm the disease and to determine the source(s) of infection. Polymerase Chain Reaction (PCR) was directly performed on tissue samples collected from slaughtered animals. All investigated animals tested positive to PCR for the Mycobacterium bovis sub-type. Bacteriological isolation was conducted according to the technique recommended by WOAH for the cultivation of the Mycobacterium tuberculosis Complex (MBTC). Whole genome sequencing (WGS) was carried out on six mycobacterial isolates and the phylogenic tree was constructed. The six Moroccan isolates fit with clades II, III, IV, V and VII and were confirmed to belong to the clonal complexes Eu2, Unknown 2 and 7 as well as to sublineages La1.7.1, La1.2 and La1.8.2. The significant Single Nucleotide Polymorphism (SNPs) ranged from 84 to 117 between the isolates and the reference M. bovis strain and from 17 to 212 between the six isolates. Considering the high resolution of WGS, these results suggests that the source of infection of the bTB could be linked to imported animals as five of the investigated reactor animals were imported a few months prior. WGS can be a useful component to the Moroccan strategy to control bTB.

Molecular investigation and infection patterns of seven viruses of honey bee (Apis mellifera L, 1758) populations from southeastern Morocco.

An epidemiological survey of honey bee viruses was conducted on 87 clinically healthy beehives located in southeastern Morocco. The sampled colonies were analyzed by reverse transcriptase (RT)-PCR / Real Time RT-qPCR with the aim of detecting and / or quantifying the following viruses: acute bee paralysis virus (ABPV), chronic bee paralysis virus (CBPV), deformed wing virus (DWV), sacbrood virus (SBV), black queen cell virus (BQCV), Kashmir bee virus (KBV) and Israeli acute paralysis virus (IAPV). With the exception of the last two of these viruses, all the other five were detected with different prevalence rates. DWV showed the highest prevalence rate (89.65 %), followed by BQCV (17.24 %), ABPV (8.04 %), CBPV (4.59 %), and SBV (2.29 %). This study represents the first molecular detection of BQCV in the country. Among all investigated colonies, only eight were virus free (9.2 %). By contrast, single infection was detected in 64.37 % of colonies, 21.8 % showed mixed infection with two viruses, while 4.6 % showed three. Nucleotide sequences of a portion of the DWV polyprotein gene obtained for six honey bee samples showed the greatest nucleotide identity with sequences of DWV from Sweden and Ireland. The negative effect of migratory beekeeping as opposed to stationary beekeeping was highlighted given that stationary beehives showed infection with up to three viruses only, while migratory beehives showed up to five viruses. The results of this study are of crucial importance as they shed light on the current status of honey bee health in southeastern Morocco.

Exploring food consumption patterns in the province of Kenitra, Northwest of Morocco.

BACKGROUND: Morocco is currently undergoing rapid changes in diets and lifestyles, influenced by globalization and urbanization, leading to a shift away from the Mediterranean diet (MedDiet) toward Western diets. OBJECTIVE: Describe and explore the food consumption patterns of the population of Kenitra province and their adherence to the MedDiet using a validated survey. METHOD: The current cross-sectional study involved 442 respondents from Kenitra province, comprising individuals aged 18 and above. The survey included a combination of closed and open-ended questions regarding food consumption patterns and socio-demographic characteristics. Adherence to the MedDiet was assessed using the Panagiotakos method to calculate the MedDiet score (MDS). Additionally, each participant's adherence to the MedDiet was evaluated using a method based on Martínez-González's approach. RESULTS: The results indicate that 31% of the participants eat vegetables, 28% eat fruits, and 19% eat wholegrain bread daily. Furthermore, 58% regularly use olive oil in their cooking. Eating out of home (OOH) was high, with popular places being restaurants and cafes (70%), fast food outlets (20%), and workplace canteens (7%). Overall, participants showed moderate adherence to the MedDiet, with a mean MDS of 36.3 ± 19.7. CONCLUSIONS: Promoting healthy eating habits is crucial in Kenitra. With moderate consumption of nutrient-dense foods and the popularity of the MedDiet, targeted interventions and educational initiatives can promote healthy dietary behaviors, improving overall public health.

Prevalence of postmenopausal osteoporosis in Morocco: a systematic review and meta-analysis.

INTRODUCTION: This systematic review and meta-analysis was conducted as part of the update of Moroccan recommendations for the management of postmenopausal osteoporosis. Its aim was to estimate the prevalence of postmenopausal osteoporosis in Morocco, based on available bibliographic data. METHODS: We conducted a systematic search of the Medline/PubMed, Scopus, and Embase databases to identify articles published between January 2000 and January 2024. We included all observational studies reporting the prevalence of osteoporosis in postmenopausal women in Morocco. Two reviewers independently contributed to the study selection and data extraction. We assessed the risk of bias in the included studies using the Joanna Briggs Institute tool. Statistical analyses were performed using Stata with the Freeman-Tukey double arcsine transformation. Heterogeneity was assessed using the I2 test statistic. Meta-regression analysis was used to investigate the effect of the date on the prevalence. Publication bias was assessed by DOI plots and the LFK index. RESULTS: An electronic search found a total of 161 citations from the databases. After excluding the irrelevant articles, 17 eligible studies were included. This meta-analysis included 5097 postmenopausal women. The pooled prevalence of postmenopausal osteoporosis was 32% (95% CI 28-36). Heterogeneity was statistically significant (I2 = 89.67%). There was no significant difference between subgroup analyses performed by risk of bias and sample size. The prevalence rate was significantly higher in 2006-2012 (36%; 95% CI 31-42; I2 = 88.7%; p < 0.001) than in 2013-2019 (27%; 95% CI 22-32; I2 = 85.9%; p < 0.001). Meta-regression showed that the prevalence of osteoporosis decreases very slightly (0.016% per year). This decrease becomes nonsignificant if only studies with a low risk of bias are included in the meta-regression (coefficient - 7.77, p = 0.667, I2 0%). No publication bias was detected in this meta-analysis. CONCLUSION: Our results indicate that postmenopausal osteoporosis is prevalent in Morocco, which is a developing country; however, the prevalence of this disease is aligned with that of industrialized countries.

Evaluating the Effectiveness of Maternal, Neonatal, and Child Healthcare in Moroccan Hospitals and SDG 3: Using Two-Stage Data Envelopment Analysis and Tobit Regression.

Maternal, neonatal, and child health play crucial roles in achieving the objectives of Sustainable Development Goal (SDG) 2030, particularly in promoting health and wellbeing. However, maternal, neonatal, and child services in Moroccan public hospitals face challenges, particularly concerning mortality rates and inefficient resource allocation, which hinder optimal outcomes. This study aimed to evaluate the operational effectiveness of 76 neonatal and child health services networks (MNCSN) within Moroccan public hospitals. Using Data Envelopment Analysis (DEA), we assessed technical efficiency (TE) employing both Variable Returns to Scale for inputs (VRS-I) and outputs (VRS-O) orientation. Additionally, the Tobit method (TM) was utilized to explore factors influencing inefficiency, with hospital, doctor, and paramedical staff considered as inputs, and admissions, cesarean interventions, functional capacity, and hospitalization days as outputs. Our findings revealed that VRS-I exhibited a higher average TE score of 0.76 compared to VRS-O (0.23). Notably, the Casablanca-Anfa MNCSN received the highest referrals (30) under VRS-I, followed by the Khemisset MNCSN (24). In contrast, under VRS-O, Ben Msick, Rabat, and Mediouna MNCSN each had three peers, with 71, 22, and 17 references, respectively. Moreover, the average Malmquist Index under VRS-I indicated a 7.7% increase in productivity over the 9-year study period, while under VRS-O, the average Malmquist Index decreased by 8.7%. Furthermore, doctors and functional bed capacity received the highest Tobit model score of 0.01, followed by hospitalization days and cesarean sections. This study underscores the imperative for policymakers to strategically prioritize input factors to enhance efficiency and ensure optimal maternal, neonatal, and child healthcare outcomes.

Psychoactive substance use and associated factors among Mohammed first university students, Oujda, Morocco: a cross-sectional study.

BACKGROUND: The use of psychoactive substances, including tobacco, alcohol, and others, remains a major public health problem. However, few studies have been conducted on Moroccan university students. This study aimed to assess the prevalence and associated factors of substance use among students at Mohammed First University, Oujda, Morocco. METHODS: We conducted this cross-sectional study with students enrolled at one of the Mohammed First University of Oujda's institutes as part of the 2021-202 academic year. We used a self-administered survey to collect data anonymously. We cleaned the data and then entered it into IBM SPSS Statistics 21 for analysis. Data analysis involved descriptive statistics as well as univariate and multivariate analysis. We considered a P value < 0.05 as the level of significance. RESULTS: In this study, out of 500 students we asked to complete the survey, 478 responded; the response rate was 95.6%. The average age was 21.1 ± 3.0, and the M/F sex ratio was 0.97. The lifetime prevalence of psychoactive substance use among Oujda University students was 28.7%. The most commonly used substances were tobacco (24.1%), alcohol (15.9%), cannabis (13.4%), sedatives (6.9%), stimulants (5.2%), and cocaine (4.4%). Male sex, age > 20 years, self-financing, school failure (one year repeated or more), the practice of a leisure activity, the presence of a personal medical or psychiatric history, and the presence of a family medical history were all significantly associated with the use of psychoactive substances. CONCLUSION: Our study revealed a significant prevalence of psychoactive substance use among university students in Oujda, highlighting the need for interventions at various levels. Further analytical studies are necessary to better understand the initiation and maintenance of psychoactive substance use and to identify all associated factors to enhance prevention strategies against substance use disorders.