Human activities and densities shape insecticide resistance distribution and dynamics in the virus-vector Culex pipiens mosquitoes from Morocco.

BACKGROUND: Mosquitoes of the Culex pipiens complex are widely distributed vectors for several arboviruses affecting humans. Consequently, their populations have long been controlled using insecticides, in response to which different resistance mechanisms have been selected. Moreover, their ecological preferences and broad adaptability allow C. pipiens mosquitoes to breed in highly polluted water bodies where they are exposed to many residuals from anthropogenic activities. It has been observed for several mosquito species that anthropization (in particular urbanization and agricultural lands) can lead to increased exposure to insecticides and thus to increased resistance. The main objective of the present study was to investigate whether and how urbanization and/or agricultural lands had a similar impact on C. pipiens resistance to insecticides in Morocco. METHODS: Breeding sites were sampled along several transects in four regions around major Moroccan cities, following gradients of decreasing anthropization. The imprint of anthropogenic activities was evaluated around each site as the percentage of areas classified in three categories: urban, agricultural and natural. We then assessed the frequencies of four known resistance alleles in these samples and followed their dynamics in five urban breeding sites over 4 years. RESULTS: The distribution of resistance alleles revealed a strong impact of anthropization, in both agricultural and urbanized lands, although different between resistance mutations and between Moroccan regions; we did not find any clear trend in the dynamics of these resistance alleles during the survey. CONCLUSIONS: Our study provides further evidence for the role of anthropic activities in the selection and maintenance of mutations selected for resistance to insecticides in mosquitoes. The consequences are worrying as this could decrease vector control capacities and thus result in epizootic and epidemic outbreaks. Consequently, concerted and integrated disease control strategies must be designed that include better management regarding the consequences of our activities.

Association between nutritional status, body composition, and fitness level of adolescents in physical education in Casablanca, Morocco.

Aim: This study aims to analyze and compare dietary intake, as well as to examine the associations between energy intake in terms of macronutrients, body composition, and physical fitness (PF) specifically cardiorespiratory endurance (CE) among a sample of young adolescents aged 15 to 18 years, who participate in physical education and sports sessions in public schools in Casablanca, Morocco. Materials and methods: A total of 311 participants, including 156 girls and 154 boys, were included in the study. Each participant maintained a food diary for 3 days during the same study week. Additionally, body composition measurements were taken using bioelectrical impedance analysis (BIA). The PF was assessed using the validated mini-Cooper test (6 min). Results: The results show that the participants had an average total energy intake of 2386.7 ± 492.7 kcal. A significant difference was observed between boys and girls, with average energy intakes of 2468.8 ± 531.1 kcal and 2304.0 ± 437.0 kcal, respectively. These dietary intakes were significantly lower than their needs and nutritional recommendations. The associations of nutritional status, sex, body mass index (BMI) and physical fitness (PF) were tested and a positive correlation was observed following an adequate intake of carbohydrates (CHO) and proteins on Vo2max, while a negative association was observed with regard to Body fat for both sexes. Boys exhibit significantly better PF than girls (p < 0.01). Obese participants had the lowest PF and an unbalanced nutritional status, the adolescents with a normal weight p < 0.01 displayed a high level of PF compared to individuals in other weight categories. Conclusion: The PF is significantly associated with macronutrient intake status and body composition, especially BMI and BF. The Underweight, overweight, and obese students demonstrated poorer performance in physical fitness indices compared to normal-weight. Adolescents adhering to recommended CHO and protein intake levels tend to exhibit enhanced physical fitness. Implementing strategies to encourage students to maintain a balanced diet and engage in regular physical exercise is essential.

Data insights from a Moroccan phytochemical database (MPDB) derived from aromatic & medicinal plants.

The geographical location of Morocco and the diversity of its topography ensure a high variability of climate conditions, ranging from humid to Saharan, and extending through subhumid, arid, and semi-arid stages. This variability offers a high floristic diversity, while the medical use of these phytochemicals has not been fully explored. Advanced computer-aided drug discovery utilizes chemical biology to accelerate the study of phytochemicals at the molecular level and discover novel therapeutic pathways. Currently, there is no online resource for phytochemicals in Morocco. Therefore, it is of interest to describe the Moroccan Phytochemicals Database (MPDB), accessible, featuring over 600 phytochemicals derived from journal articles and other reports. The web interface of the database, which is simple and easy to use, provides each phytochemical's reference, plant sources, 3D structures, and all related information. Furthermore, we provide direct links to commercially available analogs from Mcule. In addition, we provide the results of the first virtual screening against cardiovascular targets. We present these data to facilitate further exploration and exploitation of Morocco's rich phytochemical resources, and to contribute to the global understanding and application of these compounds in the medical and scientific communities.

No association between habitat, autogeny and genetics in Moroccan Culex pipiens populations.

BACKGROUND: Mosquitoes of the Culex pipiens complex are found across the globe and are the focus of many research studies. Among the temperate species C. pipiens sensu stricto (s.s.), two forms are usually described: molestus and pipiens. These two forms are indistinguishable in terms of morphology but show behavioral and physiological differences that may have consequences for their associated epidemiology. The two forms are well defined in the northern part of the species distribution, where autogeny is strictly associated with the molestus form. However, whether the two remain distinct and show the characteristic differences in behavior is less clear in North Africa, at the southern edge of their range. METHODS: The association between autogeny, as determined by ovarian dissection, and molecular forms, based on the CQ11 microsatellite marker, was studied in six Moroccan populations of C. pipiens. RESULTS: An overall low prevalence of autogeny was found at three of the Moroccan regions studied, although it reached 17.5% in the Agadir population. The prevalence of form-specific CQ11 alleles was quite similar across all populations, with the molestus allele being rarer (approx. 15%), except in the Agadir population where it reached 43.3%. We found significant deficits in heterozygotes at the diagnostic CQ11 locus in three populations, but the three other populations showed no significant departure from panmixia, which is in line with the results of a retrospective analysis of the published data. More importantly, we found no association between the autogeny status and CQ11 genotypes, despite the many females analyzed. CONCLUSIONS: There was limited evidence for two discrete forms in Morocco, where individuals carrying pipiens and molestus alleles breed and mate in the same sites and are equally likely to be capable of autogeny. These observations are discussed in the epidemiological context of Morocco, where C. pipiens is the main vector of several arboviruses.

Distribution of insecticide resistance and molecular mechanisms involved in the West Nile vector Culex pipiens in Morocco.

BACKGROUND: Mosquitoes of the Culex pipiens complex are the vectors of several arboviruses and are thus subjected to insecticide control worldwide. However, overuse of insecticides selects for resistance. While assessing the resistance status of the vectors is required for effective and sustainable disease control, resistance has so far only been sparsely studied in Morocco. In this study, we establish a first countrywide assessment of the levels of resistance to various insecticides and the potential responsible mechanisms involved. Cx. pipiens larvae were collected from natural populations of five regions of Morocco, and their taxonomic status was determined (molecular forms). The level of their susceptibility to insecticides was assessed by single-diagnostic-dose bioassays. Molecular identification of known resistance alleles was investigated to determine the frequency of target-site mutations. RESULTS: This study confirms that Moroccan populations are an interbreeding mix of pipiens and molestus forms, with large gene flow for the resistance alleles. We also found that Cx. pipiens mosquitoes are resistant to all insecticide families, all over Morocco: resistance is high for insecticides used in mosquito control, but also present for other pesticides. Resistance alleles are similarly more frequent for mosquito control insecticides. However, their distribution is heterogeneous in the five regions, with significant genetic differentiation between populations, revealing the crucial role of local insecticide treatment practices. CONCLUSION: This study provides reference countrywide data that highlight the need for further research to refine the distribution of resistance in Morocco and to understand the role of agriculture/urban residuals in its spread. © 2020 Society of Chemical Industry.

Sociodemographic and Lifestyle Factors Associated with Adherence to Mediterranean Diet in Representative Adult Population in Casablanca City, Morocco: A Cross-Sectional Study.

Several studies had revealed that following the Mediterranean diet (MD) contributes to beneficial health status and a decreased risk of many chronic diseases. The aim of our study was to assess adherence to MD in Casablanca City and to identify the relationship between MD adherence and sociodemographic and lifestyle parameters. This cross-sectional study concerned 719 subjects with complete dietary data. Data collection was performed using a questionnaire including sociodemographic and lifestyle factors. The dietary intake was assessed with the use of a food-frequency questionnaire. The compliance with MD was evaluated with a simplified MD score. Our study showed that high adherence to the MD was characterized by high intakes of vegetables, fruits, pulses, fish, cereals, olive oil, and low meat and dairy consumption according to the Simplified MD score. As regard to the multivariate logistic, being a man, being married, persons with a level of education >6 years, luxurious housing, and consumption of alcohol were associated with a higher adherence to MD, while, the overweight was negatively associated with a higher adherence to MD. Maintaining the traditional MD pattern is crucial for public health; in this way, more research is needed in this area in order to precisely measure these associations.

Predictors of mortality in hemodialysis patients.

INTRODUCTION: Mortality in patients with chronic renal failure is high compared to the general population. The objective of our study is to evaluate the predictive factors related to mortality in hemodialysis. METHODS: This is a retrospective study involving 126 hemodialysis patients in the Nephrology Department of Ibn Rochd Hospital, Casablanca. Data were collected between January 2012 and January 2016. For each of our patients, we analyzed demographic, clinical, biological and anthropometric data. The Kaplan-Meier method and the log-rank test were used to evaluate and compare survival curves. To evaluate the effect of predictors of mortality, we used the proportional Cox hazard model. RESULTS: The analysis of the results showed that the surviving patients were younger than the deceased patients (43.07±13.52 years versus 53.09±13.56 years, p=0.001). Also, the latter has a significantly lower albumin and prealbumin levels (p=0.01 and p=0.04 respectively). Overall survival was 80.2%. Cox regression analysis at age (HR=1.26, p<0.0002), inflammation (HR=1.15, p<0.03), AIP> 0.24 (HR=2.1, p<0.002) and cardiovascular disease (RR=2.91, p<0.001) were associated with global and cardiovascular mortality. CONCLUSION: Our study showed that the mortality rate is high in our cohort. In addition, cardiovascular diseases, under nutrition and inflammation are predictive factors for mortality. Treatment and early management of these factors are essential for reducing morbidity and mortality.

Assessing the prevalence of protein-energy wasting in haemodialysis patients: A cross-sectional monocentric study.

INTRODUCTION: Protein-energy wasting (PEW) is a strong predictive factor for morbidity and mortality in haemodialysis (HD) patients. However, there is no consensus for its assessment. The present study aimed to assess the nutritional status of patients on chronic HD by use of different nutritional assessment parameters, and at verifying which can identify the greatest number of HD patients with PEW. Also, to investigate predictors of nutritional status in a haemodialysis center in Morocco. PATIENTS AND METHODS: This is a cross-sectional analysis performed on 126 patients aged 44.82±14.01 years, undergoing maintenance HD in the Department of nephrology of the university hospital centre of Casablanca, Morocco. Energy and nutrients intake assessment was obtained by a three-day period food recall. Biochemical parameters, bioelectric impedance analysis, and subjective global assessment (SGA), have been performed to assess nutritional status. RESULTS: According to SGA the prevalence of PEW was 74.62%. However, when using the ISRMN malnutrition criteria only 36.50% of the patients were diagnosed with PEW. Pearson correlation showed a negative association between the degree of malnutrition evaluated by SGA and serum prealbumin (r=-0.54; P=0.0001), serum albumin (r=-0.50; P=0.001), energy (r=-0.34; P=0.002), protein intake (r=-0.41; P=0.0001), and a significant positive correlation with CRP (r=0.65; P=0.0001) was determined, but not with anthropometric measurements nor lipids profile. The areas under the receiver operating characteristic curve were 0.841 (95% CI: 0.751-0.932) for serum prealbumin, and 0.737 (95% CI: 0.634-0.840) for serum albumin. CONCLUSION: Our results showed a high prevalence of PEW among Haemodialysis patients. Also, our findings suggest that SGA, serum albumin and prealbumin may be relative appropriate and practical markers for assessing nutritional status in HD patients.

Inflammation and cardiovascular risk assessment in Moroccan obese patients with and without metabolic syndrome: importance of lipoproteins ratios.

BACKGROUND: Obesity predisposes an individual to numerous risk factors for cardiovascular diseases. Inflammation, reported as a link between obesity and cardiovascular disease, contributes to the development of atherosclerosis. OBJECTIVES: The aim of our study was to assess the relationship between lipid parameters, low grade inflammation and metabolic syndrome in a sample of obese Moroccan adults with or without metabolic syndrome (MetS). PATIENTS & METHODS: Our study included 235 obese patients, mean aged 53.30 ± 9.73 years, with or without MetS. Our data included anthropometric measurements, lipoprotein and apolipoproteins profiles and several lipid ratios. RESULTS: In patients with MetS, lipoprotein profile alterations and low-grade inflammation were observed. Lipid ratios were better predictors of cardiovascular risk than lipids alone because of their relative associations with lipoproteins and apolipoproteins. CONCLUSION: Our study shows that Moroccan obese adults with MetS have altered lipoproteins profiles and suffer from low-grade inflammation. Indeed, we have detected a high level of small dense LDL particles and HDL particles defectiveness. Hence, we propose that risk management of cardiovascular events should be based on lipoprotein ratios rather than lipids alone. Treatments should also take into account inflammatory markers and LDL heterogeneity.

Association of apolipoprotein E gene polymorphism with end-stage renal disease and hyperlipidemia in patients on long-term hemodialysis.

BACKGROUND: Cardiovascular diseases (CVDs) are the leading cause of death of patients with chronic renal failure. Apolipoprotein E (apoE) plays an important role in the homeostasis of cholesterol and triglycerides. OBJECTIVE: We aimed to investigate the possible link(s) between apoE gene polymorphism, inflammation and lipoproteins in hemodialysis patients. METHODS: We studied 109 end-stage renal disease (ESRD) patients and 97 controls. The serum lipids, apolipoproteins, lipoprotein particles, high-sensitivity C-reactive protein (hs-CRP) and total homocysteine (t-Hcy) levels and paraoxonase (PON) activity were determined in our patients. We also analyzed apoE gene polymorphism in the patients and controls. RESULTS: The analysis of the apoE gene demonstrated a predominance of the e3 allele in both the patients and controls, followed by the e4 and then the e2 alleles. The analysis of the apoE genotype and allele frequencies showed significantly higher e4 allele and E3E4 genotype frequencies and decreased e3 allele and E3E3 genotype frequencies in the patients compared with the controls. The e2, e4 and E3E4 carriers within the ESRD patient population presented an atherogenic lipid profile. However, there were no significant variations in the serum PON activity and the hs-CRP and t-Hcy levels between individuals with different apoE polymorphisms. CONCLUSIONS: Our findings suggest an association between the e4 allele, E3E4 genotype and ESRD. The apoE polymorphism affects the serum lipoprotein levels, and the ESRD patients who are e4 and e2 allele carriers are more likely to present an atherogenic lipoprotein profile that may be a major factor associated with increased risk of CVD.

Usefulness of lipid ratios and atherogenic index of plasma in obese Moroccan women with or without metabolic syndrome.

OBJECTIVES: Our study aimed to study the impact of obesity and metabolic syndrome (MetS) on lipoprotein profiles and cardiovascular risk through lipid ratios and atherogenic index of plasma (AIP) in Moroccan women. METHODS: Our study included 240 Moroccan women, aged 53.31 +/- 8.51 years, divided into three groups: controls (group 1, n = 80), obese without MetS (group 2, n = 80) and obese with MetS (group 3, n = 80). Anthropometric and lipid measurements were taken and specific lipid ratios assessed, as well as Non-HDL cholesterol (Non-HDL-C) and atherogenic index of plasma (ALP). RESULTS: Group 2 presented similar lipoprotein profiles compared with group 1. Group 3 had higher triglyceride (TG) levels than group 1, which, in turn, increased HDL and AIP values. Dyslipidemia in group 3 was demonstrated by higher TG levels, lipid ratios and AIP and lower HDL-C levels compared with group 2. All of these abnormalities are responsible for elevations of risks of cardiovascular diseases. Closer associations were found between cardiovascular risk and lipid ratios and AIP than lipids alone. CONCLUSION: Our study confirms that MetS affects the serum lipoprotein profile of obese women. Lipid ratios, non HDL-C and AIP remain useful tools for the diagnosis and prognosis of cardiovascular disease by their associations with lipid parameters and their high predictive values.

Paraoxonase activity in healthy, diabetic, and hemodialysis patients.

OBJECTIVES: Paraoxonase 1 (PON1) is mainly complexed to HDL and is responsible, at least in part, for their antioxidant properties. The aims of our study were to determine the phenotype distribution and enzymatic activities of PON1 and the oxidative stress status of healthy subjects and diabetic and hemodialysis patients. DESIGN AND METHODS: PON1 paraoxonase and arylesterase activities and oxidative stress markers [malondialdehyde (MDA) and vitamin E levels] were measured in 300 individuals as a function of health status. RESULTS: The prevalence of the PON1 phenotypes in the study population was 74.51%, 18.15% and 7.34% for QQ, QR and RR, respectively. The phenotype distribution did not change significantly as a function of health status (healthy, diabetes, hemodialysis). However, the hemodialysis patients had lower PON1 paraoxonase and arylesterase activities than the diabetic patients and healthy subjects, while there were no significant differences between the diabetic patients and the healthy subjects. Oxidative stress markers (MDA levels and vitamin E/cholesterol ratio) were significantly higher in the diabetic and hemodialysis patients than in the healthy subjects. CONCLUSIONS: The lower plasma PON1 enzymatic activities in the hemodialysis patients was not associated with a difference in the phenotype distribution of PON1. Oxidative stress conditions were significantly higher in these patients, which may increase the risk of atherosclerosis in this population.

Baseline characteristics of patients enrolled in EXCELS: a cohort study.

BACKGROUND: The Epidemiologic Study of Xolair (omalizumab): Evaluating Clinical Effectiveness and Long-term Safety in Patients with Moderate-to-Severe Asthma (EXCELS) is a unique opportunity to evaluate the prospective, long-term clinical safety and effectiveness of the anti-IgE antibody omalizumab (Xolair) in real-world clinical practice. OBJECTIVES: To describe the study design and study cohorts of EXCELS at baseline and to compare the characteristics of this population with other large asthma cohorts. METHODS: Patients with moderate-to-severe persistent asthma and a positive skin test result or in vitro reactivity to a perennial aeroallergen were eligible for EXCELS. Two cohorts of patients with asthma were enrolled: those treated with omalizumab and those not treated with omalizumab. We analyzed baseline demographic and clinical characteristics, including asthma history and control and allergy history. RESULTS: Large proportions of patients enrolled in EXCELS had historically severe and poorly or not well-controlled asthma at the time of enrollment, objective evidence of airway obstruction, a history of long-term oral corticosteroid use, and/or other allergic disorders. Minor differences were observed between the omalizumab and nonomalizumab cohorts. Our total patient cohort was generally similar to other large cohorts. In a subgroup analysis, patients who had received omalizumab within 7 days before enrollment had more severe asthma and greater degrees of impairment at baseline than nonomalizumab patients. CONCLUSIONS: This study of baseline characteristics in EXCELS offers a unique opportunity to better understand the history of allergic patients with moderate-to-severe asthma in a real-world treatment setting. This analysis of EXCELS baseline data sets the foundation for long-term assessment of the safety and effectiveness of omalizumab.

Serum paraoxonase activity, high-sensitivity C-reactive protein, and lipoprotein disturbances in end-stage renal disease patients on long-term hemodialysis.

BACKGROUND: Hemodialysis patients are at high risk for atherosclerotic events. Enhanced oxidant stress, dyslipidemia, and inflammation may have a major role in this risk. In this work, we assessed lipoprotein status, total homocysteine, high-sensitivity C-reactive protein (hs-CRP), and paraoxonase activity in hemodialysis patients to determine the correlations among these parameters and to compare these values with those measured in normal control subjects. METHODS: We enrolled 109 end-stage renal disease patients on long-term hemodialysis and 100 age- and gender-matched healthy subjects. Total cholesterol, triglycerides, and high-density lipoprotein cholesterol levels were evaluated using colorimetric methods. Low-density lipoprotein (LDL) cholesterol was calculated according to the Friedewald formula. Serum levels of hs-CRP, apolipoproteins (Apo) AI, B, E, and lipoprotein(a) were measured by nephelometry. Lipoprotein particle (Lp) A-I and LpA-I:A-II were determined by immunoelectrophoresis. Total homocysteine levels were evaluated by the fluorescence polarization immunoassay method. Paraoxonase activity was determined using the paraoxon-like substrate. RESULTS: Compared with controls, hemodialysis patients had more frequent atherogenic dyslipidemia, hyperhomocysteinemia, and elevated hs-CRP levels. These latter findings inversely correlate with ApoA-I and LpA-I:A-II and positively with ApoB, lipoprotein(a), and ApoB/ApoA-I ratio. Homocysteine levels correlated positively with age. Paraoxonase activity was decreased in hemodialysis patients, especially in elderly patients. This enzyme activity positively correlated with LpA-I:A-II, and inversely with hs-CRP, LDL-cholesterol, and ApoE levels. CONCLUSION: The present study demonstrated an abnormal lipoprotein profile associated with increased hs-CRP and decreased paraoxonase activity in hemodialysis patients. Hence, inflammation, dyslipidemia, and increased oxidant stress linked to uremia may be contributors to increased cardiovascular risk in this population.