Determinants associated with low dietary diversity among migrants to Morocco: a cross sectional study.

Low dietary diversity (LDD) is prevalent among vulnerable populations, posing a morbidity risk. Few studies have been conducted on the dietary diversity of migrants. The objectives of this study are to determine the prevalence of LDD among migrants in Morocco and the risk factors associated with it. In the Oriental region, we conducted a cross-sectional study with migrants between November and December 2021. The sampling method used was convenience sampling. A face-to-face, structured questionnaire was used to collect sociodemographic, behavioral, and clinical data. We calculated a dietary diversity score based on a 24-h food recall and assessed food intake. The risk factors associated with LDD were identified using multivariate logistic regression. A total of 445 migrants was enrolled. The prevalence of LDD was 31.7%. Risk factors associated with LDD were: being homeless (adjusted Odds Ratio (AOR) of 6.32; CI% [3.55-11.25]), a lack of social support (AOR of 2.30; CI% [1.33-03.98]), and low monthly income (AOR of 8.21; CI% [3.39-19.85]). Public policies must focus on social and environmental determinants. Nutrition training programs should be set up for the migrant population.

Uncontrolled blood pressure and its risk factors among hypertensive patients, Marrakech, Morocco.

Hypertension is a public health problem. Failure to control blood pressure figures is responsible for morbidity and premature mortality. This study aims to describe the characteristics of hypertensive patients followed at primary health care centers in Marrakech. Between May 2021 and December 2022, a cross-sectional study of 922 hypertension patients attending primary health care centers in Marrakech was done. To gather socio-demographic, behavioral, and clinical data, as well as hypertension treatment features and the care-patient-physician triad, a face-to-face questionnaire was employed. To identify risk factors associated with uncontrolled blood pressure, multivariate logistic regression was used. Uncontrolled blood pressure was found in 73.5% of people. The patients' average age was 63.4 ± 9.4 years (mean ± standard deviation), and 524 (77.3%) were women. Tobacco consumption (Adjusted Odd Ratio of 4.34; 95% CI [1.58-11.9]); lack of self-monitoring of hypertension (AOR of 1.69; 95% CI [1.14-2.52]); a family history of hypertension (AOR of 1.58; 95% CI [1.12-2.22]); overweight or obesity (AOR of 1.73; 95% CI [1.15-2.58]); and nonadherence to antihypertensive medication (AOR of 1.58; 95% CI [1.05-2.38]) were identified as risk factors for uncontrolled blood pressure. In hypertensive individuals, the percentage of uncontrolled blood pressure is considerable. It is essential to provide therapeutic education classes for hypertension patients in order to strengthen their power and autonomy in managing their hypertension.

The prevalence and risk factors for anxiety and depression symptoms among migrants in Morocco.

Humanitarian migration can result in mental health issues among migrants. The objective of our study is to determine the prevalence of anxiety and depression symptoms among migrants and their risk factors. A total of 445 humanitarian migrants in the Orientale region were interviewed. A structured questionnaire was used in face-to-face interviews to collect socio-demographic, migratory, behavioral, clinical, and paraclinical data. The Hospital Anxiety and Depression Scale was used to assess anxiety and depression symptoms. Risk factors for anxiety and depression symptoms were identified using multivariable logistic regression. The prevalence of anxiety symptoms was 39.1%, and the prevalence of depression symptoms was 40.0%. Diabetes, refugee status, overcrowding in the home, stress, age between 18 and 20 years, and low monthly income were associated with anxiety symptom. The associated risk factors for depression symptoms were a lack of social support and a low monthly income. Humanitarian migrants have a high prevalence of anxiety and depression symptoms. Public policies should address socio-ecological determinants by providing migrants with social support and adequate living conditions.

Disease burden among migrants in Morocco in 2021: A cross­sectional study.

BACKGROUND: Morocco, traditionally an emigration country, has evolved into not only a transit country to Europe but also a country of residence for an increasing number of migrants, with 102,400 migrants in 2019. This is due to its geographic location, the induced effects of its "African policy," and the various laws adopted by Moroccan legislators in recent years. The purpose of this study is to determine the prevalence of communicable and noncommunicable diseases among migrants such as Hepatitis C virus (HCV), human immunodeficiency virus (HIV), diabetes, and hypertension. METHODS: We conducted a cross-sectional study in Oujda, Morocco, between November and December 2021. Face-to-face interviews with enrolled migrants aged 18 years and over, present in Oujda and attending an association, were carried out to collect socio-demographic data, lifestyle behaviors, and clinical parameters. Diabetes and hypertension were the primary outcomes. The Pearson's chi-squared test and the student's t-test were used to assess the bivariate associations between primary outcomes and categorical and continuous variables. In a multivariate model, we adjusted for predictors that were significant (p-value ≤0.05) in bivariate analysis to estimate Adjusted Odd Ratios (AOR) and 95% confidence intervals (CI). RESULTS: There were 495 migrants enrolled, with a male/female ratio of two and an average age of 27.3±11.5 years (mean±standard deviation), ranging from 18 to 76 years. Hepatitis C virus, human immunodeficiency virus, diabetes, and hypertension were found in 1%, 0.2%, 3.8%, and 27.7% of the population, respectively. Family history of diabetes was a risk factor for diabetes in the Oujda migrant population, with an Adjusted Odds Ratio (AOR) of 5.36; CI% [1.23-23.28]. Age (AOR of 1.1; CI% [1.06-1.13]) and African origin (AOR of 3.07; CI% [1.06-8.92]) were identified as risk factors for hypertension. CONCLUSION: Migrants in Oujda are healthy. The high prevalence of hypertension, as well as the presence of HCV and HIV positive cases, emphasizes the importance of routine screening for hypertension, HCV, and HIV in order to detect and treat these diseases as early as possible.

Prevalence and determinants of intercourse without condoms among migrants and refugees in Morocco, 2021: a cross-sectional study.

With the world's migratory flow, the risk of infection by the human immunodeficiency virus (HIV) among migrants is increasing. The prevalence of intercourse without condoms with a casual or commercial sex partner, a high-risk sexual behavior for HIV infection, is unknown among migrants. The purpose of this study was to determine the prevalence of intercourse without condoms among migrants and the risk factors associated with not using condoms. In Oujda, we conducted a cross-sectional survey of 416 sexually active migrants. We used a multistage sampling method. Face-to-face interviews were conducted with participants to collect socio-demographic information, disease perception, behavioral habits, sexual behavioral habits, and para-clinical parameters. A multivariate logistical regression analysis identified the risk factors associated with high-risk HIV sexual behaviors. The prevalence of intercourse without condoms with a casual or commercial sex partner was 72.8%, with a median age of 25.0 years, and 212 (69.9%) were males. The prevalence of HIV was 0.2%. Being homeless, having difficulty obtaining condoms, and only having a basic education were all risk factors for these sexual behaviors. Migrants with precarious living conditions are at increased risk of having intercourse without condoms. This group must be prioritized by strengthening public health programs targeting the health of migrants as well as the intervention of thematic non-governmental organizations. Vigilant monitoring of the HIV epidemic, with a focus on vulnerable populations, should be a high priority in Morocco.

Drug non-adherence in hypertensive patients in Morocco, and its associated risk factors.

AIMS: Hypertension is a widespread public health problem; unfortunately, non-adherence to the treatment hinders the control of high blood pressure. Drug non-adherence is the degree to which a patient does not follow the prescription. We aimed to assess the extent of drug non-adherence among hypertensive patients treated in Meknes and identify risk factors associated with inobservance. METHODS AND RESULTS: Between November and December 2017, we conducted a cross-sectional study enrolling 922 hypertensive patients managed at Meknes's primary healthcare facilities (PHCF) using the multistage sampling method. We interviewed patients face to face to collect their socio-demographic characteristics, lifestyle behaviours, clinical parameters, and the relationship between the care system, the patient, and the physician. A multivariate logistic regression analysis highlighted the risk factors associated with drug non-adherence. The prevalence of drug non-adherence was 91% with a mean age of 61 ± 11 years (mean ± standard deviation) and a male/female ratio of 1/3. Risk factors associated with drug non-adherence were: (i) male sex [adjusted odds ratio (AOR) = 2.5, 95% confidence interval (CI) (1.26-5.10)]; (ii) monthly income per household <150$ [AOR = 4.47, 95% CI (1.22-16.34)]; (iii) monthly income per household 150-200$ [AOR = 4.44, 95% CI (1.04-18.93)]; (iv) bad relationship with the healthcare system [AOR = 2.17, 95% CI (1.29-3.67)]; and (v) uncontrolled blood pressure [AOR = 1.87, 95% CI (1.15-3.02)]. CONCLUSION: The prevalence of drug non-adherence is general among hypertensive patients in Meknes. Prevention should: (i) ensure the availability of adequate stocks of the anti-hypertensive drug at the PHCF; (ii) secure sufficient drug stocks to treat the poorest patients first; and (iii) improve blood pressure control in patients.

Epidemiological profile of methanol poisoning, El Hajeb, Morocco.

BACKGROUND: Methanol poisoning is of particular importance in low and middle-income countries. We reported on a methanol poisoning incident that occurred 22 May 2017, in El Hajeb (Morocco). AIMS: This study aimed to describe the extent of the intoxication, determine its source and implement the necessary preventative measures. METHODS: We conducted a cross-sectional survey. A standardized questionnaire including socio-economic data, clinical symptoms and time of use was administered face-to-face to cases of methanol poisoning. Biological samples were taken for toxicological analysis. Data were entered and analyzed on Epi Info version 7. RESULTS: Twenty-six cases of methanol poisoning were surveyed with a mean age of 39.7 (SD 11.1) years and a male/female sex ratio of 5.5. All intoxicated cases were of low socioeconomic status. The mean latency period between use and symptom onset was 1.5 (SD 1) days. Reported symptoms were mildly altered consciousness in 14 cases (53.8%), abdominal pain in 10 cases (38.5%), headache in 9 cases (34.6%), vomiting in 8 cases (30.8%) and coma in 7 cases (27.1%). Mortality was 65% and 4 cases developed blindness. Laboratory results confirmed the presence of methanol in the blood with values greater than 0.6 g/L. The dose of methanol in the associated bottle was 217 g/L. CONCLUSION: Public awareness of the dangers of methanol intoxication is important. Health professionals need to be aware of the clinical signs and what to do in the event of methanol poisoning.

Prevalence of uncontrolled blood pressure in Meknes, Morocco, and its associated risk factors in 2017.

BACKGROUND: Uncontrolled high blood pressure (UBP) can lead to various cardiovascular complications causing an estimated nine million deaths per year worldwide. In Meknes, epidemiologic data on UBP are scarce, depriving programs from evidence-based information that would allow a better management of hypertension. Hence, we aimed to assess UBP prevalence in hypertensive patients treated in Meknes and identify UBP-associated risk factors. METHODS: Between November and December 2017, we conducted a cross-sectional study enrolling 922 hypertensive patients managed at Meknes's primary health care facilities using the multistage sampling method. We interviewed patients face to face to collect their socio-demographic-characteristics, lifestyle behaviours, clinical parameters and the triad care system-patient-physician. Another questionnaire was self-administered by physicians to characterize therapeutic inertia. A multivariate logistic regression analysis highlighted the risk factors associated with UBP. RESULTS: UBP prevalence was 73% with a mean age of 61±11 years (mean±standard deviation) and a male/female ratio of 1/3. Risk factors associated with UBP were: therapeutic inertia (adjusted odds ratio to other variables (AOR) = 18.2, 95% CI [8.35-39.84]), drug non-adherence (AOR = 1.8, 95% CI [1.07-3.04]), obesity/overweight (AOR = 1.6, 95% CI [1.03-2.58]), unemployment (AOR = 1.9, 95% CI [1.09-3.01]), low income (AOR = 2.6, 95% CI [1.01-6.86]), family history of hypertension (AOR = 1.5, 95% CI [1.07-2.08]) and male sex (AOR = 1.6, 95% CI [1.04-2.58]). CONCLUSION: UBP prevalence is high in Meknes. Prevention should firstly focus on raised awareness of hypertensive patients' self-care management. Secondly, health professionals should better comply to the guidelines of anti-hypertensive treatments. Lastly, health professionals should frequently be reminded to reach therapeutic goals to overcome therapeutic inertia.

Burn unit: colonization of burn wounds and local environment.

BACKGROUND: We present the results of a comparative prospective study of the resistance profile of strains isolated from pathological material of patients hospitalized in the burn unit of the military hospital in Rabat and from their environment over a period of one and a half years (July 2009-February 2011). METHODS: The study concerned 125 pathological products from patients (40 men, 20 women; mean age 38±14.8 years; range 2 to 80 years) hospitalized with burns. This allowed the isolation of 86 non-redundant bacterial strains during the first period and 50 during the second. RESULTS: The dominant species were Acinetobacter baumannii (15.6%), followed by Pseudomonas aeruginosa (13.8%) and Staphylococcus aureus (11%). During the second period, we noted the abundance of A. baumannii (15.5%), followed by P. aeruginosa (11.3%) and Klebsiella pneumoniae (8.5%). Of the 104 environmental samples of burn patients, 139 microorganisms were isolated. Coagulase-negative staphylococcus was the most abundant strain in the two study periods (69.2% and 64.6%). CONCLUSION: All species showed an almost identical sensitivity to the various antibiotics tested.

[Carbapenemases among Klebsiella pneumoniae: sensitivity, E-test and Hodge test]. / Carbapénémases chez Klebsiella pneumoniae : antibiogramme, E-test et test de Hodge.

Carbapenems are the major weapons in the treatment of nosocomial infections. Since 1996, there have been an emergence and dissemination of carbapenem resistance in the world, especially among Enterobacteriaceae. Resistance is due to one or several mechanisms including production of carbapenemases. A prospective study was carried out from April to September 2011 at the Laboratory of Microbiology of Military Teaching Hospital in Rabat. The aim of this study was to search by phenotypic methods carbapenemases production in Klebsiella pneumoniae at Laboratory of Microbiology of the HMIMV of Rabat by disc diffusion for susceptibility to imipenem (IMP) and ertapenem (ETP), E-test and Hodge test; 211 strains of K. pneumoniae were analyzed. The samples were most frequently obtained from the urinary tract (63.8%); pus (16.5%) and blood cultures (11.8%); 27% of the strains produced extended spectrum of beta-lactamase (ESBL); 3 strains were resistant to ertapenem by disc diffusion. Investigations of these 3 strains in E-test shown that they were resistant to ertapenem but susceptible to imipenem. Tested by Hodge method, 3 strains gave repeatedly positive results. Thus, rate of K. pneumoniae producing KPC type in our study is 1.42%. Our study shows the evidence of K. pneumoniae type carbapenemase (KPC) in Military Teaching Hospital of Rabat. However, the gene encoding the type of resistance must be determined by molecular methods.

[Bacterial epidemiology in the burns unit at military teaching hospital Mohamed V of Rabat]. / Épidémiologie bactérienne à l'unité des brûlés de l'Hôpital militaire d'instruction de Rabat.

We aimed to establish the ecology of the Burns Unit of the Military Teaching Hospital Mohammed V of Rabat. We present results of a retrospective study of four years (March 2006-June 2010) on all micro-organisms isolated from patient samples. During the study period, we analyzed 307 samples corresponding to isolate bacterial strains from 288 non-redundant and 5 yeasts among which 4 corresponded to Candida albicans. The bacteriological profile of the isolated stumps showed a change between 2006 and 2010. Staphylococcus aureus in 2007 and 2008 (52.3%, 33.9%) was in 3rd position in 2010 (10.5%). Acinetobacter baumannii found in 3rd position or below (3.7%, 11.6%, 15.3%), between 2006 and 2008, reached the summit in 2009 and 2010 (22.6% and 23.7%). Pseudomonas aeruginosa, strain dominant in 2006 (33.3%) maintained its second position in 2007, 2008 and 2010 (19.8%, 18.6%, 18.4%) while it was third in 2009 (14.3%). Study of the resistance in antibiotics of the main isolated bacteria showed a stability of the profile of resistance. In conclusion, an epidemiological surveillance of bacteria is necessary, in the burns unit and in the hospital, to guide better the probability antibiotic treatment.

[Antibacterial activity of antiseptics used at Military Teaching Hospital Mohamed V of Rabat]. / Activité antibactérienne des antiseptiques utilisés à l'Hôpital militaire d'instruction Mohamed V de Rabat.

Antiseptics have a major role against the infections and their prevention. The good management of antiseptics allows the reduction of antibiotics use and thus the emergence of resistant bacterial strains. The evaluation of the antibacterial activity of three antiseptics (povidone iodine [PVPI], iodized alcohol and alcohol 70 degrees) used at HMIMV and taken from pharmacy was based on AFNOR method NF T 72-150. The analysis of their chemical properties were done by standardized methods (manganimetry, Bunsen's method, test to determine sodium thiosulfate levels [or sodium thiosulfate test] and Guy Lussac alcoholmeter). Our results were compared with those obtained in another two university hospitals of Rabat: Hospital of Speciality and Ibn Sina. The frequencies of resistant bacterial strains were respectively 4.6%, 30.7% and 15.4% to PVPI, alcohol iodized and alcohol 70 degrees . Our results have shown that the PVPI is the best antiseptic in our hospital.