Quality of life predictors among Moroccan adults with epilepsy.

PURPOSE: This study aimed to determine the factors associated with quality of life (QOL) in adult patients living with epilepsy in Morocco. METHODS: 110 patients with epilepsy aging 18 years old were interviewed using the standard and validated Moroccan version of the Quality of Life in Epilepsy inventory with 31 items (QOLIE-31). Descriptive statistics, one-way ANOVA, and multivariate regression were used for data analysis. RESULTS: The mean age of the patients was 35.70 years old (standard deviation (SD)12.2). The mean total score of QOLIE-31 was 43.6±10.2. The highest mean±SD score was the medication effects subscale 52.3±12.1, and the lowest was the overall quality of life subscale 39.2±13.2. Patients with no seizure episode during the last month had a better mean total score of QOLIE-31 (47.6±10.5) than the study participants having a seizure in the last month (40.6±8.9, p≤0.001). These data supported that presence of seizure in the past 4 weeks (ß=4.626, CI95 % 1.123; 8.130), memory disorders (ß=10.025, IC 95 % 2.811; 17.239), seizure trigger factors such as forgetting to take antiepileptic drugs (AEDs) (ß=5.205, IC 95 % 1.769; 8.641), personal problems (ß=4.957, IC 95 % 0.604; 9.310), low monthly income (<2000MAD, 194.94$: ß= -9.937, IC 95 % -18.536; -1.338), (2000-5000MAD, 194.94$- 487.35$: ß= -24.804, IC 95 % -43.171; -6.437), and employment (ß= -4.291, IC 95 % -7.976; -0.605) were the factors associated with QOL. SIGNIFICANCE: The overall QOL of patients with epilepsy was low. This study showed that the presence of seizures, memory disorders, monthly income, trigger factors, and employment status were QOL predictors for epileptic patients.

Direct Healthcare Cost of Ischemic Stroke Management in Morocco.

BACKGROUND: Strokes are a group of heterogeneous conditions that can cause lasting brain damage, long-term disability, or even death. In Morocco, the management of this disease generates important expenses and increases the financial burden on health care. In order to rationalize the expenses and to direct the budgetary policy in healthcare, we aimed to estimate the cost of ischemic stroke (IS) management in Morocco through this study. METHODS: A cost-of-illness study was conducted between March 2018 and March 2019 at the neurology department of the Hassan II University Hospital, Fez. We included all patients who were admitted, during this period, to the department for IS. The collected data included sociodemographic information, and all details regarding the patient's medical management (diagnosis, treatment, etc.). The cost was estimated using a "bottom-up micro-costing" approach with a societal perspective. RESULTS: A total of 267 individuals were included in this study with a female predominance (56.6%); the mean age was 66.93 ± 14.83 years. The total cost of ischemic stroke management per patient per year was estimated at $3674.32 ± 1340.81, with a high share related to hospitalization at $1415.06 ± 1015.53. A statistically significant association was found between total cost and age (p=0.014), National Institutes of Health Stroke Scale (NIHSS) score (p≤0.001), and length of hospitalization (p≤0.001); however, no association was found with other factors (sex, complication, Rankin score, etc.). CONCLUSION: Ischemic strokes are relatively frequent in Morocco. Their management generates an important cost, which is influenced by several factors such as severity of the disease and the duration of hospitalization. This cost can be decreased by rationalizing the expenses and acting on various risk factors of ischemic strokes.

The prevalence and associated factors of depression, anxiety, and PTSD among Moroccan medical doctors in the COVID-19 pandemic: a national study.

COVID-19 pandemic is facing healthcare professionals with unprecedented challenges, which might alter their mental health. We targeted assessing depression, generalized anxiety, and post-traumatic stress disorder (PTSD) of Moroccan medical doctors during the COVID-19 pandemic; this would allow identifying the associated factors. A cross-sectional national study was carried out on 1267 exposed and unexposed public health medical doctors to COVID-19 patients. The study was conducted between May 15 and 15 June 2020. An anonymous self-administered questionnaire was completed online voluntarily and randomly. We used the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder (GAD-7), and the PTSD Checklist for DSM­5 (PCL-5) to assess depression, generalized anxiety, and PTSD, respectively. The respondents' rate was 63.3%. The mean age was 30.97 ± 6.65 years old, and 59.3% (N = 751) were females with a sex ratio M/F of 0.68. The sample included 43.0% (N = 545) of COVID-19 frontline doctors. Among all participants, 31.5% (N = 400) had depression, 29.2% (N = 370) had generalized anxiety, and 21.7% (N = 276) had PTSD. The average scores of the PHQ-9, the GAD-7, and the PCL-5 were 7.79 (± 5.54), 6.12 (±5.72), and 18.58 (±17.62), respectively. The multivariate logistic regression showed that working in primary and secondary hospitals, moderate and high-stress perceptions, a chronic physical illness, and a family history of psychiatric disorder were independently associated factors of depression, generalized anxiety, and PTSD. The females expressed significantly more anxiety. Doctors living in a family consisting of member with chronic disease showed a significantly higher risk of PTSD. The security sense of contamination risk and low threat perception of COVID-19 were significantly protective factors of depression, anxiety, and PTSD. Moroccan medical doctors are in psychological distress. It is essential to preserve medical doctors' mental well-being health for a better fight against the COVID-19 pandemic through effective and targeted health policies.