Musculoskeletal disorders of fishermen in the artisanal and coastal sector.

BACKGROUND: The aim of this study was to screen for musculoskeletal disorders (MSD) complaints, to analyse the activity and to identify their risk factors. MATERIALS AND METHODS: This cross-sectional epidemiological study involved 903 men aged > 20 years and with a seniority > 2 years. It included a questionnaire and an ergonomic analysis of the activity. The questionnaire included: socio-demographic and occupational characteristics, health status and life habits, stress and items from the Nordic questionnaire. The observation of work situations required video recordings and the use of three methods: Occupational Safety and Health Administration (OSHA), Rapid Upper Limb Assessment (RULA) and the Gesture Tracking and Assessment Tool (Outil de Repérage et d'Évaluation des Gestes: OREGE). RESULTS: The prevalence of MSDs was 61.9%. It was significantly higher among deckhands than among other professionals (65.6% vs 27.4%; p < 0.001) and in seasonal workers than in permanent workers (67.8% vs 43.1%; p < 0.001). A positive correlation was noted between MSDs and daily work duration. Stress was an aggravating factor, whereas leisure activities were protective. The prevalence of MSDs was 40.5% (lower back), 40.4% (wrist/hand joints), 34.6% (neck) and 31.7% (shoulders). The ergonomic analysis of the workstation was performed on a deckhand who unloaded the fish crates out of the hold of a trawler. OSHA score = 12 (normal < 5); significant risk of upper limb MSD. RULA total score = 7 (acceptable between 1 and 2); immediate modification. OREGE scores evaluating effort, repetitiveness and joint positions indicate that the actions were not recommended or to be avoided. CONCLUSIONS: The analysis made it possible to evaluate the difficulty of the job and to note a high risk of MSDs requiring ergonomic and organizational improvements.

Burnout syndrome chez les internes en médecine marocains.

INTRODUCTION: Medical interns are subject to chronic stress due to long working hours, sleep deprivation and leisure time that can lead to burnout. The aim of this study was to estimate the prevalence of burnout among medical interns of Casablanca University Hospital and to investigate potential its risk factors. METHODS: We conducted a cross-sectional study during March 2017 among medical interns of Casablanca University Hospital. The exploration of burnout was performed using the Maslash Burnout Inventory. Data were collected using a self-questionnaire. Data entry and analysis were performed using SPSS version 16.0 software. RESULTS: The prevalence of burnout was 90%. Variables statistically associated with it were female gender (p=0.024) and excessive daytime sleepiness (p=0.025) for the “Emotional exhaustion” component, and worked hours for the “Personal fulfilment” component (p=0.05). CONCLUSIONS: This survey revealed a worrying rate of burnout among medical interns. Prevention actions should be undertaken to preserve the mental health of this population at high risk of burnout.

Possible introduction of Leishmania tropica to urban areas determined by epidemiological and clinical profiles of patients with cutaneous leishmaniasis in Casablanca (Morocco).

Leishmaniases are a group of infectious diseases caused by protozoan Leishmania parasites and are transmitted by the bites of infected phlebotomine sandflies. The heterogeneity of these diseases is influenced by both parasitic properties and host factors. Cutaneous leishmaniasis (CL) is a major public health problem in Morocco, where the geographical expansion of CL (particularly CL caused by Leishmania tropica), the heterogeneous appearance of lesions and the difficulty in diagnosing CL contribute to late diagnosis of CL and delayed treatment of patients. Therefore, the main objective of this study was to describe the epidemiological and clinical profiles of patients with CL diagnosed in Casablanca (Morocco), which is a non-endemic area for CL. A cross-sectional study was conducted between 2010 and 2016, during which epidemiological and clinical data were collected from patients that met the inclusion criteria through an information sheet. Then, samples were obtained from each patient for parasitological and molecular diagnosis, and only patients with positive polymerase chain reaction and genotyping results were included in the study. Overall, 106 cases of CL were genotyped, of which 61 (57.5%) were caused by L. tropica, 38 (35.9%) by L. major and 7 (6.6%) by L. infantum. While all age groups were affected, CL cases wherein L. tropica was the causative agent were most frequently diagnosed in children aged 0-9 years (p = 0.005), whereas those caused by L. major were more frequently diagnosed in elderly patients (p = 0.004). Multivariate logistic regression analysis showed that two clinical variables were significantly associated with CL caused by L. tropica: lesion size (p = 0.002) and occurrence of lesion on the face (p = 0.005). Furthermore, the results of our survey highlighted the association of Leishmania infection when travelling to endemic areas. The high number of endemic foci where patients with CL were infected with L. tropica illustrated the tendency of this form to spread and generate epidemics, exposing young people to a greater degree to the disease. The epidemic status of CL caused by L. tropica in Morocco and the increased movement of the population from rural to urban areas indicate a possible introduction of this species to urban areas.