Prevalence and Risk Factors of Chronic Obstructive Pulmonary Disease Among Users of Primary Health Care Facilities in Morocco.

Background: Chronic obstructive pulmonary disease (COPD) is a major public health problem. In Morocco, few studies have focused on COPD in primary health care facilities, whose main mission is prevention. The aim of our work is thus to assess the prevalence of COPD and to study the factors associated with this silent disease among users of health care facilities in Morocco. Methods: This is a cross-sectional observational study of participants aged 40 and over. Data were collected by questionnaire. Pulmonary function testing was conducted using a spirometer before and after administration of a bronchodilator. COPD was defined as fixed ratio of the post-bronchodilator forced expiratory volume in 1 second / forced vital capacity less than 0.7. Logistic regression models were applied to define factors associated with COPD. Results: From 550 participants aged 40 and over, we selected only 477 patients with exploitable spirometry results for inclusion in the final analysis. The mean age of participants was 54.91±11.92 years, and the female/male ratio was 1.59. The prevalence of COPD was 6.7% (95% CI; 4.6 to 9.3%), and was higher in men than in women (11.4% vs 3.8%, p=0.002). The prevalence of COPD increased significantly with age, from 3.3% in those aged 40 to 49 to 16.9% in those aged 70 and over (p=0.001). Current smokers had a higher prevalence of COPD than former and never smokers. Age, smoking, asthma diagnosis and childhood hospitalization for lung disease were risk factors associated with the development of COPD. Only 6.25% of participants identified as having COPD had previously been diagnosed with COPD. Conclusion: COPD remains largely under-diagnosed among primary care consultants in Morocco. Efforts for early detection and promotion of prevention of the main risk factors need to be intensified in order to reduce the burden of this silent pathology on a national scale.

Relationship between Sleep Quality and Anxiety-Depressive Disorders in Moroccan Women with Breast Cancer: A Cross-Sectional Study.

Background: Breast cancer is the most common female cancer in the world. Sleep disruption is one of the major problems of breast cancer patients. This study aimed to evaluate the quality of sleep in a group of Moroccan women with breast cancer and analyze the association between sleep quality, depression, and anxiety. Methods: This cross-sectional study was carried out among 337 Moroccan women treated for breast cancer at the Mohammed VI Cancer Treatment Center in Casablanca in 2019. A questionnaire was designed for this purpose based on two scales: Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety Depression Scale (HADS). Results: 71.5% of the participants had significant sleep disturbances; the subjective quality of patients' sleep was considered to be quite poor (20.8%) and 43.9% of participants need more than 60 minutes to fall asleep. The average sleep duration was 6.16 h/night and 84.3% of patients had not taken sleep medicines in the last month. The most common reasons for sleep disturbances were getting up to use the bathroom (67.4%) and waking up in the middle of the night or early morning (54%). Anxiety and depression were positively correlated with PSQI scores. Conclusion: The present study highlights how much breast cancer patients are vulnerable to psychological disorders and then incites the decision makers in oncology departments to implement rigorous psychological health care strategies in order to ameliorate mental health and sleep quality of breast cancer patients.