A regionally based precision medicine implementation initiative in North Africa:The PerMediNA consortium.

Precision Medicine is being increasingly used in the developed world to improve health care. While several Precision Medicine (PM) initiatives have been launched worldwide, their implementations have proven to be more challenging particularly in low- and middle-income countries. To address this issue, the "Personalized Medicine in North Africa" initiative (PerMediNA) was launched in three North African countries namely Tunisia, Algeria and Morocco. PerMediNA is coordinated by Institut Pasteur de Tunis together with the French Ministry for Europe and Foreign Affairs, with the support of Institut Pasteur in France. The project is carried out along with Institut Pasteur d'Algérie and Institut Pasteur du Maroc in collaboration with national and international leading institutions in the field of PM including Institut Gustave Roussy in Paris. PerMediNA aims to assess the readiness level of PM implementation in North Africa, to strengthen PM infrastructure, to provide workforce training, to generate genomic data on North African populations, to implement cost effective, affordable and sustainable genetic testing for cancer patients and to inform policy makers on how to translate research knowledge into health products and services. Gender equity and involvement of young scientists in this implementation process are other key goals of the PerMediNA project. In this paper, we are describing PerMediNA as the first PM implementation initiative in North Africa. Such initiatives contribute significantly in shortening existing health disparities and inequities between developed and developing countries and accelerate access to innovative treatments for global health.

Anthropometric Assessment of General and Central Obesity in Urban Moroccan Women.

In the last few decades, North African countries have faced the nutrition transition, leading to an increase in obesity, exacerbated by an extremely low rate of physical activity (PA). Particular attention must be paid to abdominal obesity (one of the metabolic syndrome criteria), which has been linked to several health problems. The present study aims to investigate the prevalence of overweight/obesity, particularly abdominal obesity, in a sample of urban Moroccan women and to analyze the anthropometric indicators of metabolic syndrome risk among subsamples with different PA and socio-demographic characteristics. Urban Moroccan women living in Casablanca (n = 304; mean age 37.4 ± 15.6 years) were recruited for this cross-sectional study. Data concerning socio-demographic variables, PA behavior, and anthropometric measures (height, weight, waist, and hip circumferences) were directly collected. Body mass index, waist-to-hip ratio, waist-to-height ratio, and relative fat mass were computed. Comparisons between women with different socio-demographic characteristics were performed through ANCOVA adjusted for age. The results reveal that 39.4% of the women did not practice any PA. The percentage of women above the cutoffs of risk for general and central obesity was more than half for all the indexes, except for waist-to-hip ratio (WHR), and 19.6% were at a very high risk of health issues. Moreover, being female unmarried, childless, graduates, and students were found to be protective against obesity. In conclusion, Moroccan women have a high level of obesity, especially abdominal, and preventive interventions are needed to reduce the health impact of obesity in this population.

Psychosocial health and quality of life among North African women.

Studies on relationships between psychosocial factors and health among North African (NA) women are scarce. This research investigated the self-perceived psychosocial well-being of NA women by a structured questionnaire and anthropometric survey examining the possible explanatory variables of their mental health in comparison to a sample of NA migrants. The association of endogenous stress, psychological well-being, discomfort, and quality of life with migrant/non-migrant status, demographic characteristics, and adiposity indices was examined. Moreover, the internal consistency of the questionnaire was tested using Cronbach's alpha. A sample of 228 women living in Tunis and Casablanca participated in a survey in Tunisia and Morocco. According to multiple regression models, migrant/non-migrant status was the best explanatory variable of well-being and quality of life, marital status, educational level and the number of children were explanatory variables of discomfort and endogenous stress. Among anthropometric variables, central adiposity was a significant explanatory variable of well-being. The comparison with women who migrated mainly from Morocco and Tunisia to Italy (NA migrants) exhibited higher weight status and central adiposity in NA migrants. The perceived stress and discomfort were the same in the two groups; the migrants, despite reporting lower psychological well-being, presented a higher quality of life than residents. Our findings emphasise the potential to promote monitoring of the psychosocial health of NA women, planning effective interventions.

Emigration flows from North Africa to Europe.

The region of North Africa (NA) represents a striking locality regarding migration with several migration patterns, namely emigration in the form of labour export to Europe and North America and, to a lesser extent, to the Arab Gulf area. The latter has increased enormously in the last decade because of the political instability in most of the NA countries. The aim of the present chapter was to explore the patterns of migration stocks and flows in NA countries, based on several websites, systematic review of journals, comparable data available by the United Nations and by the International Organization of Migration. The NA region has become an area of transit migration and labour migration. Emigrant flows from NA countries towards Europe and North America are increasing this decade more than towards the Arab Gulf countries after being replaced by Asian labour. The recent increase in the proportion of women among the migrant population is remarkable. Remittances sent by African migrants have become an important source of external finance for countries of origin. Transient and irregular migration to Egypt originates at the borders with Sudan, Palestine and Libya with destination to the Euro Mediterranean countries. In Tunisia and Morocco, irregular migrants originate from Sub-Saharan Africa to the northern borders. The NA countries serve as departure rather than destination countries, and migration flows to the Euro-Mediterranean countries through legal or illegal routes.