RESUMEN
Background and Purpose: Onychomycosis is a common nail infection characterized by the discoloration, thickening, and detachment of nails. This study aimed to provide valuable insights into this pathology by assessing its prevalence, clinical aspects, related comorbidities, and causative agents in patients from a Moroccan population. Materials and Methods: This retrospective study was conducted on 1,606 subjects at the Mycology-Parasitology laboratory of the National Institute of Hygiene in Rabat, Morocco, over five years (2016-2020). Nail samples were collected from both fingernails and toenails and processed through microscopic examination and culture. The incubated tubes were kept at a temperature range of 28-30°C for 4-5 weeks. Results: Onychomycosis was mycologically confirmed in 1,794 samples (93.24%). It occurred commonly in the 41-60 age group, with a higher incidence among females (74.53%). Diabetes, alongside other chronic diseases, was prevalent among patients with underlying conditions, comprising 131 cases (40.56%). Disto-lateral subungual onychomycosis emerged as the most prevalent clinical presentation, comprising 1,536 cases (79.92%). Fingernails primarily affected by yeasts, notably Candida albicans, accounted for 565 cases (29.80%), while toenails were predominantly impacted by dermatophytes, primarily Trichophyton rubrum (n=1,230, 64.87%). Mixed infections exclusively featured yeasts and dermatophytes, predominantly T. rubrum and C. albicans, which accounted for 79 (4.40%) cases. The study explored the influence of molds, yielding insights into their rarity in onychomycosis. Conclusion: These findings hold significant implications for the clinical management and diagnosis of onychomycosis, particularly in patients with underlying chronic conditions. Further epidemiological studies across Morocco are needed for meaningful comparisons.
RESUMEN
Point-of-care (POC) testing for Toxoplasma infection has the potential to revolutionize diagnosis and management of toxoplasmosis, especially in high-risk populations in areas with significant environmental contamination and poor health infrastructure precluding appropriate follow-up and preventing access to medical care. Toxoplasmosis is a significant public health challenge in Morocco, with a relatively heavy burden of infection and, to this point, minimal investment nationally to address this infection. Herein, we analyse the performance of a novel, low-cost rapid test using fingerstick-derived whole blood from 632 women (82 of whom were pregnant) from slums, educational centres, and from nomad groups across different geographical regions (i.e. oceanic, mountainous) of Morocco. The POC test was highly sensitive and specific from all settings. In the first group of 283 women, sera were tested by Platelia ELISA IgG and IgM along with fingerstick whole blood test. Then a matrix study with 349 women was performed in which fingerstick - POC test results and serum obtained by venipuncture contemporaneously were compared. These results show high POC test performance (Sensitivity: 96.4% [IC95 90.6-98.9%]; Specificity: 99.6% [IC95 97.3-99.9%]) and high prevalence of Toxoplasma infection among women living in rural and mountainous areas, and in urban areas with lower educational levels. The high performance of POC test confirms that it can reduce the need for venipuncture and clinical infrastructure in a low-resource setting. It can be used to efficiently perform seroprevalence determinations in large group settings across a range of demographics, and potentially expands healthcare access, thereby preventing human suffering.