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.

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.

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.

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.

Suicide, suicide attempts and self-harm in Moroccan prisons.

PURPOSE: High rates of suicide and self-harm are reported in prisons in Western countries, while fewer studies exist from a non-Western context. This study aims to identify rates of suicide, non-fatal suicide attempts and self-harm in Moroccan prisons and to better understand the context, methods, tools, predictors and profile of persons engaged in the acts. DESIGN/METHODOLOGY/APPROACH: The authors report findings from a mixed-methods study carried out before an intervention project. The study consists of a systematic literature review, an analysis of suicide case files, a quantitative survey on suicide attempts and self-harm, as well as interviews and focus group discussions. The authors calculate suicide, suicide attempt and self-harm rates and present descriptive data on the incidents. The authors use regression models to explore the association between the number of incidents per individual and selected predictors, adjusting for clustering by institution. FINDINGS: Over a four-year period, 29 detained persons in Morocco died by suicide (average annual suicide rate 8.7 per 100,000). Most were men under the age of 30. Hanging accounted for all but one case. In one year, 230 suicide attempts were reported. Over a three-months period, 110 self-harm cases were reported from 18 institutions, cutting being the most common method. Self-harm was significantly more prevalent among persons with a life sentence or repeated incarcerations. RESEARCH LIMITATIONS/IMPLICATIONS: To make the study manageable as part of an intervention project, the authors collected data on suicides and suicide attempts from all prisons, while data on self-harm were collected from fewer prisons and over a shorter time period. The authors did not collect comparable information from detained persons who did not die by suicide, attempt suicide or self-harm. This prevented comparative analyses. Further, it is possible that self-harm cases were not reported if they did not result in serious physical injury. Data were collected by prison staff; thus, the voice of incarcerated persons is absent. PRACTICAL IMPLICATIONS: This study provided a solid basis for designing an intervention project including the development of a national prison policy and guidelines on suicides, suicide attempts and self-harm and a country-wide training program for prison staff. It also led to a better surveillance system, allowing for trend analysis and better-informed policymaking. The qualitative results helped create an understanding of how staff may trivialize self-harm. This was integrated into the training package for staff, resulting in the creation of prison staff trainers who became the strongest advocates against the notion that self-harm was best ignored. ORIGINALITY/VALUE: To the best of the authors' knowledge, this is the first published data on suicide and self-harm in Moroccan prisons. It underscores the necessity for the intervention project and gives valuable insights into suicide and self-harm in a non-Western prison context. Further research is needed to assess whether the findings are typical of the region.

[Phytoplankton population dynamics along the Casablanca - El Jadida Atlantic coast]. / Dynamique du peuplement phytoplanctonique le long de l'axe côtier Casablanca ­ El Jadida.

Our taxonomic study from March 2014 to November 2015 along the atlantic coast between Casablanca and El Jadida revealed that phytoplanktonic structure is mainly represented by Diatoms (Bacillariophyceae), Dinoflagellates (Dinophyceae), Silicoflagellates (Dictyophyceae) and Euglenophyceae with a clear dominance of Diatoms and Dinoflagellates. A total of 101 taxa of planktonic algae have been identified revealing a relatively diversified taxocenosis. In terms of respective diversity, the Diatoms are represented by 62 taxa (61.4%), the Dinoflagellates by 36 taxa (35.6%) whereas the other two groups of Silicoflagellates and Euglenophyceae are only represented by 3 species (3.0%). Regarding potentially toxic species, more than fifteen taxa have been identified, most of which were Dinoflagellates and Diatoms (Pseudo-nitzschia australis and Pseudo-nitzschia cuspidata). The total phytoplankton densities exhibited great spatial and temporal variations as shown by analyses of diversity (H') and equitability (E) indices at the different coast sites investigated throughout the 2014-2015 years. Massive proliferation of some toxic species (e.g. Pseudo-nitzschia australis and Pseudo-nitzschia cuspidata, Lingulodinium polyedrum, Karenia mikimotoi) was also noticed. In addition, our study revealed the presence of opportunistic species (e.g. Eutreptiella, Thalassiosira, Prorocentrum scutellum) and of the new ectoparasite Dinoflagellate Amyloodinium ocellatum for the first time in Morocco. The detection of such diversity of toxic species, sometimes with alarming concentrations, should prompt the competent authorities to broaden the spectrum and frequency of biomonitoring to uncontrolled seafood harvesting sites.

Title: Dynamique du peuplement phytoplanctonique le long de l'axe côtier Casablanca ­ El Jadida. Abstract: Notre étude taxonomique entre mars 2014 et novembre 2015 le long de la côte atlantique entre Casablanca et El Jadida a permis de déceler une flore phytoplanctonique représentée par les Diatomées, Dinoflagellés, Silicoflagellés et Euglenophycées avec une nette dominance des Diatomées et des Dinoflagellés. Au total, 101 taxons d'algues planctoniques ont été identifiés, témoignant d'une taxocénose relativement diversifiée. Dans cet ensemble, les Diatomées sont représentées par 62 taxons (61,4 %), les Dinoflagellés par 36 taxa (35,6 %) et les deux autres groupes (Silicoflagellés et Euglénophycées) ne sont représentés que par 3 espèces seulement (3,0 %). En ce qui concerne les espèces potentiellement toxiques, plus d'une quinzaine de taxons ont été identifiés dont la plupart sont des Dinoflagellés et des Diatomées (Pseudo-nitzschia australis et Pseudo-nitzschia cuspidata). L'analyse de l'évolution spatiotemporelle des indices de diversité (H') et d'équitabilité (E) révèle des fluctuations saisonnières prononcées sans montrer, pour autant, une grande analogie entre les différents sites prospectés. Par ailleurs, les densités phytoplanctoniques totales présentent de grandes variations à la fois spatiales et temporelles (sur les deux cycles annuels). La présence de proliférations massives de certaines espèces potentiellement toxiques (Pseudo-nitzschia australis et Pseudo-nitzschia cuspidata, Lingulodinium polyedrum, Karenia mikimotoi), d'une nouvelle espèce de Dinoflagellé ectoparasite pour le Maroc (Amyloodinium ocellatum) et d'autres espèces opportunistes (Eutreptiella, Thalassiosira, Prorocentrum scutellum) a été notée au cours de cette étude. La détection des espèces potentiellement toxiques, parfois à des concentrations alarmantes, devrait inciter les autorités compétentes à élargir le spectre et la fréquence de biosurveillance aux sites non contrôlés.

Assessment of Vitamin D Status in the Drâa-Tafilalet Population (Morocco) Based on Sociodemographic, Health, and Nutritional Factors.

The purpose of this study was to evaluate the vitamin D status and determine the factors influencing it in the Drâa-Tafilalet community (southeastern Morocco). Sociodemographic factors, health, cognitive status, sun exposure, and nutritional conditions were examined to help us understand their association with vitamin D status. Vitamin D data were gathered through laboratory testing, while demographic and health information was collected through interviews with participants in 2023. The study involved 100 participants aged 60 and above, most of whom were women (85%) rather than men (15%). The majority of participants were Arabs (90%), with a minority being Amazigh (10%). The average vitamin D level was 31.83 ± 10.55 ng/mL, varying based on participants' age, education, and gender. Sun-exposed individuals exhibited significantly higher mean vitamin D levels (33.56 ± 11.99 ng/mL) compared to those with limited sun exposure (28.97 ± 9.28 ng/mL). Moreover, the time spent outdoors, seasonal changes, and the duration of sun exposure affected the levels of vitamin D. These findings depict the vitamin D status of the elderly population of Drâa-Tafilalet, recognized as one of Morocco's poorest regions, shedding light on the significant influencers. Nonetheless, additional research is necessary to explore the correlation between dietary habits, sunlight exposure, and vitamin D levels in both young and elderly populations.

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.

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.

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.

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.

Litho-structural interpretation of aeromagnetic anomalies reveals potential for mineral exploration in Tizi n'Test Region, Western High Atlas, Morocco.

This study interprets aeromagnetic data from the Tizi n'Test area in the High Atlas massif of Morocco, aiming to gain insights into its litho-structural architecture and implications for mineral exploration and mining. We employed six different analytical techniques to the residual magnetic field data, including reduction to the pole (RTP), upward continuation, total horizontal derivative, Tilt angle, Centre for Exploration Targeting (CET) analysis, and Euler deconvolution. Our analyses differentiated the study area into three magnetic domains: the eastern Ouzellarh block, characterized by positive anomalies, a central domain characterized by a negative magnetic signature demarcating the transitional zone between the Anti-Atlas and the High Atlas separated by the Ouchden fault: and the western domain, represented by the Tichka massif. The application of total horizontal derivative, tilt angle, and a combination of filters in ternary image formats (Tilt angle, upward continuation 1000 + Tilt angle and upward continuation 3000 + Tilt angle) revealed both known and previously unidentified geological lineaments, mapping structural complexity across various orientations (NE-SW, NNE-SSE, E-W, NW-SE, and N-S). The CET grid analysis method unveiled the structural complexity, highlighting the geodynamic evolution of the region. Particularly, the Ouchden fault delineates a magnetic domain divide between the ancient High Atlas and the Ouzellarh block (Anti-Atlas). Furthermore, Euler deconvolution indicated magnetic source depths ranging from 52 m in the western domain of the Tichka massif to 6560 m in the Ouzellarh block. A comprehensive structural scheme, classified by C-A fractal analysis, identified zones favourable for exploration and mining, particularly along the Ouchden fault, Tizi n'Test, NE-SW trending lineaments in the northwestern domain, as well as along the Tichka granite's margin.

Evaluation of Bait Acceptance and Immune Response in Local Dogs during an Oral Rabies Vaccination Field Study in Morocco.

The objective of this study was to evaluate the bait preference of three selected bait types by local dogs and the induced immunogenicity of the oral rabies vaccine strain SPBN GASGAS in Morocco. The vaccine strain, combined with different bait types, has been tested in many different settings, but not yet in northern Africa. Overall, bait consumption and preference were similar in other studies using the same materials (bait type and sachet). The intestine bait had the highest acceptance rate (97.6%, 95%CI: 87.4-99.9), followed by the egg bait (83.0%, 95%CI: 69.2-92.4). Only 52% (95%CI: 37.4-66.3) of the dogs showed an interest in the fish meal bait. However, considering the successful release of the contents of the sachet (blue-dyed water) into the oral cavity, the egg bait (65.7%, 95%CI: 47.8-80.9) scored better than the intestine bait (51.7%, 95%CI: 32.5-70.6). The dogs selected for the immunogenicity study were offered the egg bait containing a sachet filled with SPBN GASGAS (3.0 mL, 107.5 FFU/mL) or were given the same dose by direct oral administration (d.o.a.). In addition, several dogs were vaccinated by the parenteral route (s.c.) using a commercially available inactivated rabies vaccine. Unfortunately, due to the COVID-19 pandemic and subsequent travel restrictions, it was not possible to collect blood samples directly after vaccination. The blood samples were collected pre-vaccination and on five occasions between 450 and 1088 days post vaccination. The seroconversion rate, as determined for rabies-virus-neutralizing antibodies by the FAVN test, was significantly lower than that found for binding antibodies, as determined by ELISA, for all blood samples collected post vaccination. No treatment effect (bait, d.o.a., s.c.) could be seen in the seroconversion rate. At 15 months post vaccination, 84.2% of the dogs offered vaccine bait still tested sero-positive in ELISA. Only after 3 years was a clear drop in the seroconversion rate observed in all three treatment groups. This study confirms the long-term immunogenicity of the oral rabies vaccine SPBN GASGAS in dogs under field conditions.

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.

Lead in umbilical cord blood and associated factors in Casablanca Morocco: A preliminary results.

BACKGROUND: Lead is the most common toxic metal to which Moroccans are exposed. Given the susceptibility of the fetus to lead, it is crucial to assess prenatal lead exposure. However, in Morocco, no study has assessed prenatal exposure to lead. The main goals of the present study are to determine lead concentration in umbilical cord blood and identify risk factors for prenatal lead exposure in Casablanca, Morocco. METHODS: To achieve these purposes, 87 cord blood lead samples were collected from mothers-baby pairs from January to December 2019. Indeed, a structured questionnaire was used to collect socio-demographic characteristics, obstetric data, leisure, cultural habits, and environmental information. Cord blood lead level was analyzed by inductively coupled plasma-mass spectrometry. RESULTS: The median lead concentration was 4.902 µg/dl with a minimum and maximum of 0.833 µg/dl and 23.593 µg/dl, respectively. A high proportion of the newborns (65.52 %) had cord blood lead levels above the Centers for Disease Control (CDC) allowable threshold limit (3.5 µg/dl). Statistical analysis was performed to assess the association between blood levels and the above factors. Lead levels in cord blood were significantly associated with the maternal educational level, anemia history, delivery mode, passive smoking during pregnancy as well as with the frequency of consumption of tea. CONCLUSION: This study provides the first data on lead levels in newborns. Cord blood lead levels were high in the majority of the participants, these results reinforce the need to establish health surveillance programs in Morocco.

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.

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.

Impact of COVID-19 on child tuberculosis hospitalization.

INTRODUCTION: Morocco has made remarkable progress in the fight against tuberculosis, but the Covid-19 pandemic has affected tuberculosis control worldwide, with notable fluctuations in tuberculosis epidemiology during and after the pandemic. AIM: To describe the impact of the Covid-19 pandemic on the rate of hospitalization for tuberculosis and its different localizations in children. METHODS: We conducted a retrospective study based on the analysis of medical records of TB patients hospitalized within the Children's Hospital in Casablanca, during the periods before (2018-2019), during (2020) and after (2021-2022) Covid-19 quarantine. RESULTS: Throughout the study period (2018-2022), the total number of patients hospitalized in our department was 7390, including 283 children were hospitalized for tuberculosis, with a mean age of 6 years. Before the Covid-19 pandemic, the average number of tuberculosis cases was 49 per year, of which the percentage of pulmonary tuberculosis was 32% and extra-pulmonary tuberculosis 68%. The number of cases was 23 per year during the quarantine period, with a percentage of pulmonary tuberculosis of 26% and extra-pulmonary tuberculosis of 74%. After the quarantine period, this number rose to 81 cases per year, of which 21% were pulmonary tuberculosis and 79% extrapulmonary tuberculosis (pleural tuberculosis was predominant in 44.1% of cases). CONCLUSION: These results are consistent with data published by the World Health Organization, and with the findings of another study we carried out on the impact of COVID-19 on hospital admissions for acute lower respiratory tract infections. It is very likely that the reduction in the number of tuberculosis cases during the quarantine period is due to social distancing, which leads to a reduction in the transmission of tuberculosis between people as well as to the disruption of the national tuberculosis control program in Morocco, when positive cases are identified.

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.