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BACKGROUND: Agadir city plans to reuse treated wastewater on a large scale to irrigate these green spaces. This study aims to evaluate the risk of intestinal parasites, to which human and animal populations are exposed during the reuse of treated wastewaters. METHODS: Over 21 months, wastewater samples were collected in Bensergao and Mzar wastewater treatment plants, in Agadir city, southern Morocco. The occurrences and removal of intestinal parasites were inspected using the modified Bailenger method. RESULTS: The biodiversity of helminths is higher than protozoa, while the protozoa cysts are more abundant and more prevalent. Generally, the highest parasitic loads were recorded during the hot season. For raw waters, the average concentration of protozoa cysts was 173.33 ± 70.81 cysts per L for Bensergao plant and 179.33 ± 129.22 cysts per L for Mzar plant. However, the helminths average concentration was 48.70 ± 39.91 eggs/larvae per L for Bensergao plant and 51.10 ± 31.76 eggs/larvae per L for Mzar plant. The purified water of the Mzar plant does not contain parasites, unlike the Bensergao plant where a small numbers of parasites were detected, included 2.33 ± 1.53 cysts per L for protozoa and 0.45 ± 0.58 eggs/larvae per L for helminths. CONCLUSIONS: Considering parasitological risks, the purified waters of Bensergao plant cannot be used without risks to the public health and environment. In contrast, the purified waters and the purified waters disinfected by ultraviolet radiation from the Mzar plant can be used safely to water the green spaces of Agadir city.
RESUMO
INTRODUCTION: Neuromeningeal cryptococcosis (NMC) is a severe and fatal opportunistic infection. Lethality is frequent in the absence of treatment, especially in the presence of HIV co-infection. OBJECTIVE: To determine the prevalence, epidemiological, clinical, biological and therapeutic aspects as well as the evolution of NMC for patients infected with HIV. PATIENTS AND METHODS: This is a retrospective study of 40 cases of neuromeningeal cryptococcosis diagnosed in HIV-infected patients. Data are collected for 7 years (from January 2010 to December 2016) in the registers of the parasitology laboratory and the infectious diseases department at the regional hospital center in Agadir. RESULTS: A reduction in the prevalence of neuromeningeal cryptococcosis in HIV-infected patients was noted from 2010 to 2016 (3.66% to 0.83%). The overall prevalence of NMC was 1.53%. The mean age was 37±10 years old, with 90% of patients aged less than 45 years. The main clinical symptomatology was headache (75%). The main cytochemical abnormalities of cerebrospinal fluid analysis were hyperproteinorachy (60%), hypoglycorachy (63%) and lymphocytosis (50%). The mean CD4 cell count was 47/mm3. Patients were initially treated with amphotericin B, relayed with fluconazole. The overall lethality was 35%. CONCLUSION: Neuromeningeal cryptococcosis is a serious opportunistic infection in patients HIV-infected, and the lethality rate remains unacceptable. Fighting NMC in HIV+ patients requires early diagnosis, increased access to antiretrovirals, rapid introduction of appropriate treatment and the prescription of effective systemic antifungals.
