[Epidemiology profil of fever typhoid in Meknes (Morocco) 2013-2016]. / Profil épidémiologique de la fièvre typhoïde, Meknès, 2013­2016.

INTRODUCTION: Twenty million cases of typhoid and paratyphoid fever (TF) are observed annually worldwide with more than 200,000deaths. These fevers occur in areas where hygiene is precarious, mainly in developing countries. The objective of this study was to describe epidemiological patterns of TF in Meknes, Morocco in order to improve preventive measures. METHODS: We conducted a case series study based on data from 2013 to 2016 in the Meknes TF surveillance system. Data collected included socio-demographic variables, place of residence, season, mode of water supply, and food consumed. Diagnosis of TF was confirmed with the Widal test. Data were analyzed with Epi-info version 7 and mapping was done with Qgis version 2.18.1. RESULTS: Three hundred and twenty-two cases were reported with a male/female sex ratio of 0.9. Average age was 26±20years. Incidence increased from 13 per 100.000inhabitants in 2013 to 8 per 100.000 inhabitants in 2016. Two hundred and seventy-nine (87%) cases occurred in urban areas and 174 (54%) cases developed in summer. One death was recorded. CONCLUSION: Public awareness campaigns on health education for hygiene are needed. Focus should be placed on transmission by food handlers.

Epidemiologic profile of Hepatitis A in Meknès, Morocco, 2013-2016.

Hepatitis A virus (HAV) is responsible for 1.5 million cases of infection annually worldwide. This disease occurs in areas where hygiene is precarious and affects mainly developing countries. In Morocco, 222 cases were reported in 2015, 34 of them from the city of Meknes. The objective of this study is to describe the trends in HAV incidence in Meknes to improve preventive measures. For this cross-sectional descriptive study, we investigated each case reported to the HAV surveillance system between 2013 and 2016. The following data were collected: socio-demographic information, season of infection, mode of water supply, food consumed, food purchasing environment, and laboratory confirmation of cases (by an ELISA test to detect anti-HAV IgG). Data were analyzed by Epi info version 7.2.0.1, with mapping by QGIS version 2.18.1. In all, 192 cases were reported with a sex ratio (m/f) of 1.3 and an average age of 13 ± 10 years. Incidence fell from 10 per 100 000 inhabitants in 2013 to 1.6 per 100 000 in 2016. Most cases (n = 160, 83%) came from the urban environment, and 63 (32%) occurred in springtime. Two people died. The incidence of HAV in the Meknes area has fallen, but public awareness campaigns by health education in the field of personal hygiene remain necessary. It is also essential to improve implementation of regulations banning food handling by virus carriers. Sanitary control of informal markets must be improved.

[Epidemiology of burn wound infection in Rabat, Morocco: Three-year review]. / Épidémiologie de l'infection des plaies des brûlés de Rabat, Maroc : expérience de trois ans.

OBJECTIVE: To determine the bacteriological profile of burn wounds in patients hospitalized in the burn unit of the Military Hospital in Rabat and describe their sensitivity to antibiotics. MATERIAL AND METHODS: This prospective study was conducted from July, 2009, through March, 2011, in the hospital bacteriology laboratory, in collaboration with the burn unit. At each admission, a questionnaire was completed to collect the patient's data. Bacteriological samples were collected from burn wounds at admission and every time the bandage was changed. Identification of bacteria was based on their culture, morphological, and biochemical characteristics. Antibiotic susceptibility was determined with the agar diffusion method, in accordance with the recommendations of the French Society of Microbiology. Statistical analysis was performed with SPSS Version 13 (Statistical Package for the Social Sciences) software. RESULTS: The study included 58 burn patients. Their mean age was 38.2 ± 15.5 years; the mortality rate was 13.8%, and the prevalence of infection 43.1%. We identified 126 non-redundant bacterial strains from the 112 samples collected, most often Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterobacter cloacae, and Staphylococcus spp. CONCLUSION: Heightened vigilance and rigorous application of hygiene rules, together with continuous epidemiological surveillance of burn wound bacteria, are essential to optimize empiric antibiotic therapy.

[Coronarography in the study of myxoma. Apropos of a case diagnosed by this technic]. / Apport de la coronarographie dans l'étude des myxomes. A propos d'un cas diagnostiqué par cette technique.

In a 59 years old woman presenting a rudimentary picture of myocardial infarction, ventriculograms confirm a limited necrosis and coronarography shows an abnormal vascular image, evoking an intracardiac tumor, while the arteries are free of atherosclerosis or thrombosis on angiography. Although auscultation and echography are normal, the diagnosis of myxoma will be confirmed by angiocardiography, then by surgery and pathology. The advantage of selective coronary angiography in myxomas is considered with 24 cases from the literature having undergone this examination, including 20 cases, among which ours, which present an aspect of "tumoral vascularisation". The particularities of coronarography (aneurysms, embolic obstruction, origin and aspect of hypervascularisation) are analyzed. This technique appears very useful, not only to detect a complication of the tumor or an associated coronaritis, but also to help in the diagnosis of myxomas in cases where angiocardiography or mostly echocardiography are deficient.