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INTRODUCTION: Older adults were among those who suffered most from the COVID-19 pandemic. In Morocco, where 64.4 percent of older adults suffer from a form of chronic illness, the main challenge facing local authorities was how to maintain essential care for this population group in the context of the pandemic. PURPOSE OF THE RESEARCH: The aim of the study was to determine the effects of the COVID-19 pandemic on older adults’ access to primary healthcare in the Essaouira Province (Morocco), with a view to ensuring the ongoing provision of healthcare for older adults during health emergencies. A longitudinal retrospective survey was conducted from October to December 2021 based on a structured questionnaire with a sample of 196 people aged sixty and above. The data obtained were compiled and analyzed using SPSS software (version 20.0). RESULTS: The COVID-19 pandemic has adversely affected older adults’ access to primary healthcare. Older adults’ use of primary healthcare services fell by 51.6 percent during the pandemic compared with the same periods in previous years. In addition, the measures taken to control the pandemic have had a negative impact on the quality of services offered to the survey participants. CONCLUSION: The COVID-19 pandemic resulted in significant changes in the operation of primary healthcare for older populations. The findings of this study provide a basis for anticipatory actions to improve the ongoing provision of healthcare for older adults in the context of health emergencies.
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COVID-19 , Acessibilidade aos Serviços de Saúde , Atenção Primária à Saúde , Humanos , Marrocos/epidemiologia , COVID-19/epidemiologia , Atenção Primária à Saúde/estatística & dados numéricos , Idoso , Feminino , Masculino , Estudos Retrospectivos , Idoso de 80 Anos ou mais , Pessoa de Meia-Idade , Estudos Longitudinais , Pandemias , Inquéritos e QuestionáriosRESUMO
This study assessed the bioaccumulation patterns of five trace metals (Cd, Cr, Co, Cu, and Zn) in two edible snail species, Theba pisana and Otala spp., collected from a dumpsite in Safi City, Morocco. The results indicated that bioaccumulation might be species-specific, as metal concentration profiles varied between the two snail species. Additionally, higher metal levels in the dumpsite snails confirmed their potential as bioindicators of trace metal pollution in terrestrial environments. However, the distribution of trace elements within the edible parts of the snails showed marked unevenness, with the viscera accumulating more metals than the foot. The study also evaluated the potential human health risks associated with consuming these snails. Trace metal levels in the edible parts exceeded most international safety thresholds. The estimated daily intakes (EDIs) of trace metals through snail consumption were below the provisional tolerable daily intakes (PTDIs) for both children and adults, suggesting that daily consumption is generally safe. Nonetheless, the hazard index (HI) indicated that children might face health risks from long-term consumption of contaminated snails (HI > 1), while adults are less likely to experience such complications (HI < 1). The total target carcinogenic risk (TTCR) was below 1E-04 for both children and adults, indicating negligible to acceptable carcinogenic risks for all consumer groups.
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Caramujos , Animais , Marrocos , Humanos , Medição de Risco , Bioacumulação , Metais , Contaminação de Alimentos , Monitoramento Ambiental , Oligoelementos/análiseRESUMO
BACKGROUND: Persons living with HIV experience many challenges, such as premature aging and geriatric syndromes. Frailty has become an important determinant of a series of adverse health outcomes. This research aimed to evaluate the prevalence and risk factors for frailty in this population. METHODS: A cross-sectional outpatient investigation was conducted in an urban HIV clinic. Patients aged 50 and older living with HIV were included. Frailty phenotype was evaluated using the original Fried criteria, and we calculated the Veterans Aging Cohort Study (VACS) index, Charlson Comorbidity Index, Fracture Risk Assessment Tool scores, and Mini-mental State Exam scores. RESULTS: One hundred and nine individuals were studied. Ninety-two (84.4%) were men, with a mean age of 57.65.2 years. Fourteen (12.8%) participants were frail. Frail participants were older (P = 0.001) and less likely to be virally suppressed (P = 0.01). Having ≥3 comorbidities, VACS index, polypharmacy, and 5-year mortality risk was significantly greater in the frail group. Frailty was significantly associated with poorer quality of life (P = 0.02). The cognitive impairment, falls, and malnutrition risk were significantly associated with a risk to manifest a frail phenotype. CONCLUSION: Frailty is common among Moroccans with HIV, and it is associated with greater morbidity and mortality rates. Our findings should serve as a warning sign to standardize frailty and geriatric syndrome screening in this population.
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Fragilidade , Infecções por HIV , Humanos , Masculino , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/complicações , Fragilidade/epidemiologia , Pessoa de Meia-Idade , Prevalência , Estudos Transversais , Idoso , Fatores de Risco , Marrocos/epidemiologia , Qualidade de Vida , Comorbidade , Avaliação Geriátrica , População do Norte da ÁfricaRESUMO
Following the introduction of rotavirus vaccination into the Moroccan National Immunization Program, the prevalence of the disease has decreased by nearly 50%. However, evidence on the economic value of rotavirus vaccinations in Morocco is limited. This health economic analysis evaluated, from both country payer and societal perspectives, the costs and the cost-effectiveness of three rotavirus vaccines using a static, deterministic, population model in children aged < 5 years in Morocco. Included vaccines were HRV (2-dose schedule), HBRV (3-dose schedule) and BRV-PV 1-dose vial (3-dose schedule). One-way and probabilistic sensitivity analyses were conducted to assess the impact of uncertainty in model inputs. The model predicted that vaccination with HRV was estimated to result in fewer rotavirus gastroenteritis events (-194 homecare events, -57 medical visits, -8 hospitalizations) versus the 3-dose vaccines, translating into 7 discounted quality-adjusted life years gained over the model time horizon. HRV was associated with lower costs versus HBRV from both the country payer (-$1.8 M) and societal (-$4.1 M) perspectives, and versus BRV-PV 1-dose vial from the societal perspective (-$187,000), dominating those options in the cost-effectiveness analysis. However, costs of BRV-PV 1-dose vial were lower than HRV from the payer perspective, resulting in an ICER of approximately $328,376 per QALY, above the assumed cost effectiveness threshold of $3,500. Vaccination with a 2-dose schedule of HRV may be a cost-saving option and could lead to better health outcomes for children in Morocco versus 3-dose schedule rotavirus vaccines.
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Análise Custo-Benefício , Infecções por Rotavirus , Vacinas contra Rotavirus , Humanos , Vacinas contra Rotavirus/economia , Vacinas contra Rotavirus/administração & dosagem , Vacinas contra Rotavirus/imunologia , Pré-Escolar , Infecções por Rotavirus/prevenção & controle , Infecções por Rotavirus/economia , Lactente , Marrocos , Feminino , Masculino , Recém-Nascido , Vacinação/economia , Gastroenterite/prevenção & controle , Gastroenterite/economia , Gastroenterite/virologiaRESUMO
BACKGROUND: Between 2000 and 2017/2018, Morocco reduced its maternal mortality ratio by 68% and its neonatal mortality rate by 52%-a higher improvement than other North African countries. We conducted the Exemplars in Maternal and Neonatal Health study to systematically and comprehensively research factors associated with this rapid reduction in mortality over the past two decades. METHODS: The study was conducted from September 2020 to December 2021 using mixed methods, including: literature, database and document reviews, quantitative analyses of national data sets and qualitative key-informant interviews at national and district levels. Analyses were based on a conceptual framework of drivers of health and survival of mothers and neonates. RESULTS: A favourable political and economic environment, and a high political commitment encouraged prioritisation of maternal and neonatal health (MNH) by aligning evidence-based policy and technical approaches. Five main factors accounted for Morocco's success: (1) continuous increases in antenatal care and institutional delivery and reductions socioeconomically-based inequalities in MNH service usage; (2) health-system strengthening by expanding the network of health facilities, with increased uptake of facility birthing, scale-up of the production of midwives, reductions in financial barriers and, later in the process, attention to improving the quality of care; (3) improved underlying health status of women and changes in reproductive patterns; (4) a supportive policy and infrastructure environment; and 5) increased education and autonomy of women. CONCLUSION: Our study provides evidence that supportive changes in Morocco's policy environment for maternal health, backed by greater political will and increased resources, significantly contributed to the dramatic progress in reducing maternal and neonatal mortality. While these efforts were successful in improving MNH in Morocco, several implementation challenges still require special attention and renewed political attention is needed.
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Mortalidade Infantil , Mortalidade Materna , Política , Humanos , Marrocos , Mortalidade Infantil/tendências , Recém-Nascido , Feminino , Mortalidade Materna/tendências , Gravidez , Lactente , Desenvolvimento Sustentável , Serviços de Saúde Materna , Política de SaúdeRESUMO
A multibiomarker approach helps assess environmental health as it provides a complete tool to understand the effects of environmental stressors on ecosystems and human health. We applied this approach in the central Atlantic Ocean of Morocco, an area subjected to the impact of many types of pollutants, threatening the durability of its resources. In this study, four biomarkers acetylcholinesterase (AChE), glutathione-s-transferase (GST), metallothioneins (MTs), and catalase (CAT) were measured in the digestive gland of the mussel Mytilus galloprovincialis collected from four sites: Imsouane (S1), Cap Ghir (S2), Imi Ouaddar (S3), and Douira (S4). These sites were chosen due to the diversity of impacts ranging from industrial to agricultural and touristic. We also assembled all the enzymatic responses (AChE, GST, CAT, and MTs), using the integrated biomarker response (IBR), to estimate the degree of impact of pollutants at the prospected sites to reveal all the complex interactions between biomarkers and to classify sites via the integrated approach. Results show a seasonal change in biomarker responses with variability between sites. We also recorded the highest levels of AChE inhibition and GST induction in S1, higher levels of catalase activity in S4, and a significant impact on metallothionein concentration in S1 and S3. This project highlights the interest in using a multibiomarker approach to ensure accurate interpretation of biomarker variation to protect the Moroccan coast and its resources.
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Acetilcolinesterase , Biomarcadores , Catalase , Monitoramento Ambiental , Glutationa Transferase , Metalotioneína , Mytilus , Animais , Marrocos , Biomarcadores/metabolismo , Monitoramento Ambiental/métodos , Acetilcolinesterase/metabolismo , Glutationa Transferase/metabolismo , Metalotioneína/metabolismo , Catalase/metabolismo , Oceano Atlântico , Poluentes Químicos da Água/análiseRESUMO
INTRODUCTION: Morocco is carrying out several actions to generalize basic compulsory health insurance (CHI). Managing this project requires coordination, information sharing, and the commitment of all actors to the goal of covering an additional 22 million people. One of the key factors for achieving this objective is the implementation of a unified registration system. PURPOSE OF THE RESEARCH: The aim is to analyze the existing situation and the feasibility of implementing a unified registration system, and to describe the potential positive impact of the latter on the extension of CHI. RESULTS: This work is based on a diagnosis of the current situation. It draws on the legal framework, all available documents and figures, and on an analytical reading supported by existing literature. It reveals that due to the inadequacy or even the absence of an appropriate legal basis, each managing body has its own registration system. The lack of a unified system has given rise to a number of constraints. These concern, among other things: (i) mobility between or within schemes, which does not operate smoothly because it leads to re-registration (ii) inadequate monitoring of double benefit claims, which is the case for more than one scheme, due to insufficient and hesitant anti-fraud action (iii) the sharing and use of reliable data, which hinders decision making, evaluation, and monitoring. CONCLUSIONS: It is essential to adopt legal texts that will provide the basis for a unified system with regulations enabling the participation of all stakeholders, with the aim of steering the roll-out of CHI effectively and efficiently.
Introduction: Le Maroc mène, depuis quelques années, plusieurs actions permettant de généraliser l'assurance maladie obligatoire (AMO). Le pilotage de ce chantier nécessite la coordination, le partage d'informations et l'engagement de tous les acteurs afin de couvrir 22 millions de personnes supplémentaires. L'un des éléments clés pour optimiser la réalisation de cet objectif consiste à mettre en place un système unifié d'immatriculation. But de l'étude: Analyser l'existant et la faisabilité de la mise en place d'un système unifié d'immatriculation, tout en précisant ses retombées positives sur l'extension de l'AMO. Résultats: Ce travail, fondé sur un diagnostic, appuyé par l'arsenal juridique, des documents et des chiffres disponibles ainsi qu'une lecture analytique renforcée par la littérature existante, a permis de constater que, du fait de l'insuffisance voire l'absence d'un soubassement juridique adapté, chaque organisme gestionnaire a son propre système d'immatriculation. L'absence d'un système unifié gêne notamment : 1) la mobilité entre régimes ou intra-régimes, étant donné qu'elle ne se fait pas de manière fluide car elle génère la ré-immatriculation ; 2) le contrôle du double bénéfice d'un régime insuffisamment organisé et incapable de lutter contre la fraude ; 3) le partage et l'exploitation de données fiables empêchant d'assurer de manière appropriée le suivi, l'évaluation et la prise de décision. Conclusion: Il est indispensable d'adopter des textes juridiques pour fonder un système unifié qui permettra l'encadrement et l'engagement de toutes les parties prenantes dans l'objectif de piloter la généralisation de l'AMO avec efficacité et efficience.
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Seguro Saúde , Cobertura Universal do Seguro de Saúde , Humanos , MarrocosRESUMO
Introduction: the risk management system is useful to identify, analyze, and reduce the risk occurrence of adverse events (AEs) in health services. This system suggests useful improvements to patients and to the whole institution and also contributes to the acquisition of a collective and organizational safety culture. This study presented a state of the art of the management of AEs identified in different services of a regional hospital in the north of Morocco. Methods: this is a retrospective cross-sectional exploratory study carried out from 2017 to 2019 using observations and semi-structured interviews, which were recorded, re-transcribed, and analyzed. Data was also collected from audit reports, results of investigations of the nosocomial infection control committee and the risk management commission, AEs declaration sheets, and meetings reports. Results: a number of 83 AEs were recorded, 10 of which were urgent. The reported events were related to care, infection risk, the drugs circuit, and medico-technical events. Two hundred cases of nosocomial infections were also recorded, of which 75 occurred in the intensive care unit and 35 in the maternity service. Surgical site infections were the most frequently reported complication. Adverse events were related to organizational failure, equipment problems, and errors related to professional practices. Conclusion: our findings may guide the improvement of the event management system in order to reduce the occurrence of future incidents. Thus, improving the risk management system requires setting up training strategies for staff on the importance of this system and its mode of operation.
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Infecção Hospitalar , Erros Médicos , Gestão de Riscos , Humanos , Marrocos , Estudos Transversais , Estudos Retrospectivos , Gestão de Riscos/organização & administração , Infecção Hospitalar/prevenção & controle , Infecção Hospitalar/epidemiologia , Erros Médicos/prevenção & controle , Erros Médicos/estatística & dados numéricos , Hospitais , Feminino , Infecção da Ferida Cirúrgica/prevenção & controle , Infecção da Ferida Cirúrgica/epidemiologia , MasculinoRESUMO
The bioaccumulation of trace metals Cd, Cr, Cu, Fe, and Zn in soft tissues of the barnacle Pollicipes pollicipes was investigated seasonally along the Atlantic coast of northwestern Morocco. Average concentrations (µg g-1 dry weight) exhibited a decreasing order: Fe (548.15 ± 132.43) > Zn (430.80 ± 181.68) > Cd (17.46 ± 9.99) > Cu (7.72 ± 1.26) > Cr (3.12 ± 0.80), with the highest levels during wet seasons. The "Metal Pollution Index" and "Individual Multimetal Bioaccumulation Index" revealed a substantial barnacle contamination in industrialized areas. Additionally, Cd and Zn concentrations surpassed permissible guideline limits. While the "Target Hazard Quotient" and "Hazard Index" unveiled no significant health risks associated with barnacle consumption for humans, Cd posed potential risks, particularly for children consuming barnacles from polluted locations. Regarding the "Maximum Safe Consumption", Cd demonstrated potential harm across all sex and age groups. These findings contribute valuable data on the safety of barnacle consumption, marking the initial assessment of such risks in Morocco. The study offers evidence of metal pollution occurrence and proposes the barnacle species as a reliable biomonitor of trace metal bioavailabilities in marine coastal areas. To our knowledge, this investigation is the first comprehensive report of metal contamination biomonitoring using barnacles from Moroccan Atlantic waters.
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Monitoramento Biológico , Thoracica , Poluentes Químicos da Água , Marrocos , Animais , Medição de Risco , Humanos , Poluentes Químicos da Água/análise , Monitoramento Biológico/métodos , Monitoramento Ambiental/métodos , Metais Pesados/análise , Contaminação de Alimentos/análiseRESUMO
Assessing the prevalence of SARS-CoV-2 IgG positivity through population-based serological surveys is crucial for monitoring COVID-19 vaccination efforts. In this study, we evaluated SARS-CoV-2 IgG positivity within a provincial cohort to understand the magnitude of the humoral response against the SARS-CoV-2 vaccine and to inform evidence-based public health decisions. A community-based cross-sectional seroprevalence study was conducted, involving 10,669 participants who received various vaccines (two doses for BBIBP-CorV/Sinopharm, Covishield vaccine, and Pfizer/BioNTech, and one dose for Johnson & Johnson's Janssen COVID-19 vaccine). The study spanned 16 provinces in the Casablanca-Settat region from February to June 2022, during which comprehensive demographic and comorbidity data were collected. We screened samples for the presence of IgG antibodies using the SARS-CoV-2 IgG II Quant assay, which quantifies antibodies against the receptor-binding domain (RBD) of the spike (S) protein, measured on the Abbott Architect i2000SR. The overall crude seroprevalence was 96% (95% CI: 95.6-96.3%), and after adjustment for assay performance, it was estimated as 96.2% (95% CI: 95.7-96.6). The adjusted overall seroprevalences according to vaccine brands showed no significant difference (96% for BBIBP-CorV/Sinopharm, 97% for ChAdOx1 nCoV-19/Oxford/AstraZeneca, 98.5% for BNT162b2/Pfizer-BioNTech, and 98% for Janssen) (p = 0.099). Participants of older age, female sex, those with a history of previous COVID-19 infection, and those with certain chronic diseases were more likely to be seropositive among ChAdOx1 nCoV-19/Oxford/AstraZeneca and BBIBP-CorV/Sinopharm vaccinee groups. Median RBD antibody concentrations were 2355 AU/mL, 3714 AU/mL, 5838 AU/mL, and 2495 AU/mL, respectively, after two doses of BBIBP-CorV/Sinopharm, ChAdOx1 nCoV-19/Oxford/AstraZeneca, BNT162b2/Pfizer-BioNTech, and after one dose of Janssen (p < 0.0001). Furthermore, we observed that participants vaccinated with ChAdOx1 nCoV-19/Oxford/AstraZeneca and BBIBP-CorV/Sinopharm with comorbid chronic diseases exhibited a more pronounced response to vaccination compared to those without comorbidities. In contrast, no significant differences were observed among Pfizer-vaccinated participants (p > 0.05). In conclusion, our serosurvey findings indicate that all four investigated vaccines provide a robust humoral immune response in the majority of participants (more than 96% of participants had antibodies against SARS-CoV-2). The BNT162b2 vaccine was found to be effective in eliciting a strong humoral response compared to the other three vaccines. However, challenges still remain in examining the dynamics and durability of immunoprotection in the Moroccan context.
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Vacinas contra COVID-19 , COVID-19 , Feminino , Humanos , ChAdOx1 nCoV-19 , Vacina BNT162 , Marrocos/epidemiologia , Estudos Transversais , Estudos Soroepidemiológicos , COVID-19/epidemiologia , COVID-19/prevenção & controle , SARS-CoV-2 , Anticorpos Antivirais , Imunoglobulina G , Doença CrônicaRESUMO
In Africa, Morocco is the 10th largest producer of plastic. The severity of this plastic has attracted increasing amounts of attention in the Moroccan Atlantic and Mediterranean in recent years. However, at the national level, there is limited knowledge of plastic pollution. To obtain an exhaustive and comprehensive evaluation of plastic pollution levels in Morocco, large-scale monitoring is needed on all the coasts of the country. In this context, this paper examined the composition, abundance, distribution, source and quality of beaches on two Moroccan coasts using four beach quality indices along 29 beaches. During two seasons, a total of 72,105 items were counted. The mean litter abundance was 0.31 items/m2, and the Mediterranean beaches were more dense than the Atlantic beaches. In particular, litter density was greater in spring (0.35 items/m2) than in summer (0.29 items/m2). The data indicate considerable differences in the density of marine debris according to the seasonality, beach typology and presence of rivers. Hazardous litter items were collected along both Moroccan coasts, constituting 8.41 % of the total collected items, with a mean of 0.026 items/m2. The use of environmental indices allowed us to classify Moroccan beaches as "moderate cleanliness", "moderate abundance" of plastics, "moderately safe" presence of hazardous litter and "mediocre" environmental status. The findings of the present study indicate that the sources of litter on both Moroccan coasts come mainly from recreational activities and dumping. The waste management practices recommended for Moroccan beaches include reducing sources, mitigating mitigation measures and changing littering behavior.
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Plásticos , Resíduos , Resíduos/análise , Praias , Monitoramento Ambiental , MarrocosRESUMO
Water erosion poses a significant environmental threat in the Mediterranean region, with pronounced impacts observed throughout Morocco. It impairs soil quality and disrupts both sediment transport and water availability. Contributing factors range from natural (climate, topography, and geology) to anthropogenic (land use, vegetation cover, and management). This study introduces an improved Priority Actions Program/Regional Activity Centre (PAP/RAC) model, enriched with GIS and the Caesium-137 (137Cs) technique, to investigate erosion within Morocco's Raouz basin. Enhanced with additional variables including soil types, slope length, rainfall erosion potential, slope orientation, soil moisture, and land surface temperature, the model transcends the classical approach, promoting granularity and precision in predictions. In addition to the comprehensive model, the 137Cs method, which discerns long-term soil erosion and redistribution, provides a dual-faceted validation, bolstering the robustness of this project's erosion risk evaluation. This study's outcomes underscore the gravity of the erosion hazard with significant soil depletion rates ranging from 8.1 to 20 t ha-1 yr-1, demonstrating the model's alignment with empirical data, affirming its utility. The modified PAP/RAC model concurs with the 137Cs data, demonstrating its usefulness for water erosion assessment and management in similar areas.
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Radioisótopos de Césio , Sistemas de Informação Geográfica , Marrocos , Radioisótopos de Césio/análise , Erosão do Solo , Monitoramento Ambiental/métodos , Modelos TeóricosRESUMO
The aim of our study was to assess the overall survival rates for colorectal cancer at 3 years and to identify associated strong prognostic factors among patients in Morocco through an interpretable machine learning approach. This approach is based on a fully non-parametric survival random forest (RSF), incorporating variable importance and partial dependence effects. The data was povided from a retrospective study of 343 patients diagnosed and followed at Hassan II University Hospital. Covariate selection was performed using the variable importance based on permutation and partial dependence plots were displayed to explore in depth the relationship between the estimated partial effect of a given predictor and survival rates. The predictive performance was measured by two metrics, the Concordance Index (C-index) and the Brier Score (BS). Overall survival rates at 1, 2 and 3 years were, respectively, 87% (SE = 0.02; CI-95% 0.84-0.91), 77% (SE = 0.02; CI-95% 0.73-0.82) and 60% (SE = 0.03; CI-95% 0.54-0.66). In the Cox model after adjustment for all covariates, sex, tumor differentiation had no significant effect on prognosis, but rather tumor site had a significant effect. The variable importance obtained from RSF strengthens that surgery, stage, insurance, residency, and age were the most important prognostic factors. The discriminative capacity of the Cox PH and RSF was, respectively, 0.771 and 0.798 for the C-index while the accuracy of the Cox PH and RSF was, respectively, 0.257 and 0.207 for the BS. This shows that RSF had both better discriminative capacity and predictive accuracy. Our results show that patients who are older than 70, living in rural areas, without health insurance, at a distant stage and who have not had surgery constitute a subgroup of patients with poor prognosis.
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Neoplasias Colorretais , Seguro Saúde , Humanos , Marrocos/epidemiologia , Estudos Retrospectivos , Análise de Sobrevida , Fatores de Risco , Aprendizado de Máquina , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/epidemiologiaRESUMO
The widespread application of pesticides in Morocco's agriculture renders their monitoring in food and environmental samples very necessary. Recent years have witnessed a growing interest in reporting studies related to the monitoring of pesticide residues in food, water, groundwater, and soil as well as their quantitative health risk assessment. Most published studies have been done by university researchers. However, the lack of research reproducibility remains a problem that considerably limits the possibility of exploiting data from the literature. Our study involves an extensive literature review utilizing search engines with keywords like "pesticide residues," "monitoring," "vegetables and fruits," "water and soil," "risk assessment," and "Morocco" from 2009 to 2023. Analysis of pesticide residues in foodstuffs and environmental samples highlights concerns over compliance with EU regulations, the health risks associated with pesticide exposure, and the necessity for comprehensive monitoring and risk assessment strategies. This paper could help influence policies to develop a strategy and action plan for the sound management of pesticides, including measures to reduce their use, raise awareness, and monitor compliance. Also, this paper could be useful for scientists interested in understanding the current situation and challenges regarding pesticide residues in Morocco, as well as countries with which commercial links exist.
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Resíduos de Praguicidas , Praguicidas , Humanos , Marrocos , Reprodutibilidade dos Testes , Monitoramento Ambiental , Frutas , Solo , ÁguaRESUMO
Objective: The aim of this study was to examine the correlation between accessibility to healthcare facilities and transportation in the Guelmim Oued Noun region of Morocco, where transportation barriers continue to pose a major challenge to accessing healthcare, despite efforts aimed at reducing access barriers. Methods: Data collection for this study involved the administration of a survey among 328 outpatients residing in the Guelmim Oued Noun region, Morocco. The utilization of canonical correlation served as the analytical method, employed to quantify and assess the relationship between transportation related barriers and the access of healthcare services in the specified region. Results: Our research reveals that transportation factors account for approximately 25% of the variation in access to healthcare services. The number of transportation modes utilized by outpatients and the affordability of transportation were found to be significant contributors to the transportation dimension. These findings confirm the significant relationship between transportation and access to healthcare facilities in the region under investigation. Conclusion: Further research is recommended to specifically address transportation barriers to healthcare access services among socially excluded populations, with a focus on promoting mobility inclusivity.
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Acessibilidade aos Serviços de Saúde , Meios de Transporte , Humanos , Marrocos , Instalações de Saúde , Inquéritos e QuestionáriosRESUMO
To understand the mechanism of health inequities and their influence on maternal health, the Commission on Social Determinants of Health (CSDH) provides a framework to identify structural and intermediate causes of health inequity. This review maps and describes the current socioeconomic determinants of maternal health in Morocco according to the CSDH framework. A scoping study was carried out from six databases (Springer, Web of Science, Pubmed, Science Direct, Jstor, and Cochrane library) based on quantitative and qualitative research done since 1990. Structural factors such as women's employment and economic status, education level, culture, and gender equity were influenced by intermediary factors such as place of residence, age at marriage, maternal age at childbirth, and parity (either alone or in conjunction with other variables). Together these factors worked to influence maternal health service usage or affected maternal health outcomes. Power dynamics were identified in a variety of social situations that impacted access to health care for women across socioeconomic categories. Studies reveal how social determinants impact maternal health in Morocco. Addressing these determinants is required for sustainably improving maternal and infant health in Morocco.
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Serviços de Saúde Materna , Saúde Materna , Gravidez , Lactente , Feminino , Humanos , Marrocos , Determinantes Sociais da Saúde , Fatores SocioeconômicosRESUMO
Morocco, a country without substantial fossil fuels, is emerging as a leader in renewable energy. This article addresses an untapped natural resource in Morocco: offshore wind. Methodologically, we use geographic information systems to assess optimal locations for offshore wind energy plants based on wind speed and power density from the Global Wind Atlas. We incorporate geological, environmental, and economic parameters and calculate capital expenses, operating expenses, development costs, and decommissioning costs to determine if the wind plant will provide a return on investment during its lifetime. The results identify three locations near the cities of Dakhla, Boujdour, and Essaouira that would recoup their investment in 14, 13, and 18 years, respectively, along with supplying 21.8% of Morocco's current energy needs for 2022. We conclude by considering the implications that the new plants would have for Morocco in the social, political, environmental, and economic dimensions. Integr Environ Assess Manag 2024;20:201-210. © 2023 SETAC.
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Energia Renovável , Vento , Marrocos , Custos e Análise de Custo , CidadesRESUMO
The Guerouaou aquifer investigation spanning 280 km2 in Ain Zohra yields promising outcomes, instilling optimism for regional water quality. These analyses were applied to 45 sampling instances from 43 wells, enabling a comprehensive water quality assessment. Groundwater conductivity ranged from medium to high, peaking at 18360 ms/cm2. The conductivity reveals insights about the groundwater's mineralization. Key physiochemical parameters fell within desirable thresholds, bolstering the positive perspective. HCO3- levels spanned 82-420 mg/L, while chloride content ranged from 38 to 5316 mg/L, benefiting water quality. NO3- ions, vital for gauging pollution, ranged from 0 to 260 mg/L, indicating favorable results. Cation concentrations exhibited encouraging variations: Ca2+- 24 to 647 mg/L, Mg2+- 12 to 440 mg/L, Na+- 18 to 2722 mg/L, K+- 1.75 to 28.65 mg/L. These collectively favor water quality. Halite breakdown dominated mineralization, as evidenced by the prevalence of Na-Cl-Na-SO4 facies. Water resource management and local communities need effective management and mitigation strategies to prevent saltwater intrusion.