Economic burden of lung cancer in Morocco: A cost of illness study.

INTRODUCTION: Lung cancer is the most common cancer in men and the second most common cancer in women. It is associated with substantial economic impact in terms of direct and indirect costs. The main objective of this study is to estimate the direct medical cost of lung cancer management in Morocco MATERIALS AND METHODS: A cost-of-illness study was conducted among patients treated at the Mohammed VI Center of Cancer (Casablanca) in 2019. The costs were estimated from the societal perspective using a bottom-up approach. The materials and procedures used were identified and quantified retrospectively from the information system and files. Their monetary value was calculated according to official prices published by the national health insurance agency. The horizon time adopted was 12 months. RESULTS: The study included 271 patients, with an average age of 62.5 ± 9.5 years. Of these, 93.4 % were men and 92.1 % were former smokers. In terms of cancer staging, 68.3 % of patients were in stage IV while 28.8 % were in stage III. Adenocarcinoma was present in 43.5 % of cases. Patients underwent an average of 10.6 ± 5.1 radiological investigations, 56.1 ± 30.9 biological tests, and 24.1 ± 11.7 consultations. The average direct medical cost was 4455.3 USD (95 % CI: 4037.4-4873.2). Chemotherapy accounted for 19.9 % of the total cost, while radiological investigations and drugs accounted for 18.7 % and 17.6 %, respectively. Diagnostic tests and radiotherapy each accounted for 7.6 % of the total cost, while biological tests accounted for 7.5 % and hospitalizations accounted for 7.1 %. The cost was statistically higher in young patients (p = 0.017), in patients with adenocarcinoma (p < 0.0001), in patients with stage II tumor (< 0.00001), in patients who have undergone surgery (p = 0.002), chemotherapy (p < 0.0001), radiotherapy (p < 0.001) and in those without metastases (p < 0.0001). CONCLUSION: These results provide evidence to support the ratification of the Framework Convention on Tobacco Control and the full adherence of the Kingdom of Morocco to the MPOWER measures.

Cross-cultural adaptation and validation of the Moroccan version of the Glaucoma Quality of Life-15 (GQL-15) questionnaire in patients with glaucoma.

BACKGROUND: Glaucoma is the second leading cause of blindness in the world. In addition, visual impairment and psychological strain have been shown to have a significant impact on quality of life (QoL) in glaucoma patients. Maintaining the quality of life of glaucoma patients has become an important component of treatment. The goal of this study is to develop a Moroccan Arabic dialect version of the Glaucoma Quality of Life-15 questionnaire and to examine its psychometric properties. METHODS: The Glaucoma Quality of Life-15 questionnaire was translated and cross-culturally adapted into Moroccan Arabic dialect and administered to glaucoma patients recruited from the ophthalmology department of the Omar Drissi Hospital, Hassan II University Hospital, Fez. Sociodemographic and other clinical data were collected. Psychometric properties were performed, including internal consistency, which was tested using Cronbach's alpha (α), test-retest reliability using intraclass correlation coefficients (ICC). Construct validity was assessed by examining the convergent and divergent validity of items. RESULTS: The questionnaire was administered to 148 patients with a mean age of 60.91 ± 15.10 years. Over half of the patients were female (58.1%), patients were married (77.7%), illiterate (62.2%) and unemployed (82.3%). The majority of patients had primary open angle glaucoma (68.9%). The mean time to complete the GQL-15 was 3.26±0.51min. The mean summary score for the GQL-15 was 39.50±16.76. Cronbach's alpha for the entire scale was 0.95 (central and near vision 0.58; peripheral vision 0.94; glare and dark adaptation 0.87). CONCLUSION: The Moroccan Arabic dialect version of the GQL-15 demonstrates adequate reliability and validity. Therefore, this version could be used as a reliable and valid tool for quality-of-life assessment in Moroccan glaucoma patients.

Depression and anxiety in patients with diabetes in a Moroccan region.

AIMS: To estimate prevalence of anxiety and depression in patients with diabetes mellitus and identify their determinants. METHODS: A cross-sectional study was conducted at Hassan II University-Hospital of Fes in 2019-2020. Anxiety and depression were measured by using the Hospital Anxiety and Depression Scale (HADS). Multivariate analysis by logistic regression was used to determine factors associated with depression and anxiety, adjusting for confounding factors. All statistical analyses were conducted using EPIINFO7. RESULTS: A total of 243 diabetics were included in the study. The average age of the participants was 48.07±14.25 years, 58% were females and 72% were diagnosed with diabetes type II. The prevalence of depressive symptoms and anxiety symptoms was (18, 1%, CI95%=(13-23)) and (29.6%, CI95%=(24-35)), respectively. The prevalence of depression and anxiety was higher among women than man and increases with increasing duration of the disease. In multivariate analysis, illiterates (OR=3.19, CI95%=(1.46-6.98)), those with depression (OR=3.61, CI95%=(1.78-7.32)), and type 1 diabetics (OR=3.22, CI95%=(1.44-7.21)) are a higher risk of developing anxiety. Depression was associated with older age (OR=2, 65, CI95%=(1, 14-6, 14)), use of insulin (OR=3.77 CI95%=(1.50-9.44)) and anxiety symptoms (OR=4, 27, CI95%=(2, 05-8, 91)). CONCLUSION: High prevalence of depressive and anxiety symptoms in diabetics suggests consideration of psychological aspect in implementation of diabetes managing program.