[Epidemiology of imported malaria and entomological study of breeding sites of potential risk areas in the province of Khemisset (Morocco)]. / Situation épidémiologique du paludisme importé et étude entomologique des gîtes larvaires de localités à risque potentiel dans la province de Khémisset (Maroc).

No case of autochthonous malaria has been detected in Morocco since 2004. This achievement is due to a national strategy to combat the disease by appropriate and well-organized disease detection and treatment, as well as control of the mosquito vector of the disease, the female Anopheles mosquito. Nonetheless, imported malaria cases have been increasing (75 in 2007), due to the rise in international travel and migration from countries where the disease is endemic. This work is divided into two parts: the first part is a retrospective study of the cases of imported malaria identified by optical microscopy in the Laboratory of Medical Entomology of the Khemisset Provincial Delegation of Health from 2000 to 2010. The second part is an entomological study conducted in 2010 of the Culicidae insect family, especially the Anopheles genus. The results show that of 176,457 requests for parasite testing, 14 were positive. All positive samples came from men older than 23 years. The cases identified are imported from two African countries: the Democratic Republic of Congo (86%) and Ivory Coast (14%). The years of high incidence were 2003 with four cases and 2000, 2004 and 2006 with two cases. The species found are Plasmodium falciparum in 13 cases (93%) and Plasmodium ovale in one case (7%). The vector of autochthonous malaria, which was eliminated in 2004, is Anopheles (Anopheles) labranchiae Fallerouni 1926, and it was the dominant species found in our entomological study (424 larvae). The other species were found in breeding sites in potential at-risk locations in the study area.

Molecular characterisation of rifampicin-resistant Mycobacterium tuberculosis strains from Morocco.

Mutations in the rpoB gene associated with rifampicin (RMP) resistance were studied in 47 RMP-resistant and 147 RMP-susceptible clinical strains of Mycobacterium tuberculosis from Morocco using probe-based assay and DNA sequencing. RMP-resistant mutations were identified in 85% of RMP-resistant isolates. No mutations were observed among the 147 RMP-susceptible strains. Sequence analysis identified 10 alleles, including two deletions not previously reported. Nucleotide changes at codons 531, 526 and 516 were the most prominent, accounting for 74.4% of our RMP-resistant strains. These results demonstrate that resistance genotyping at these codons would be a good marker for the rapid detection of RMP resistance.

Systemic and splanchnic hemodynamic effects of molsidomine in rats with carbon tetrachloride-induced cirrhosis.

Molsidomine, a long-acting vasodilator mainly used as an antianginal agent, was reported to decrease the portohepatic venous pressure gradient in patients with alcoholic cirrhosis. This study investigated the effects of linsidomine, the active metabolite of molsidomine, on systemic and splanchnic hemodynamics in rats with CCl4-induced cirrhosis using the microsphere technique. Compared with placebo-treated rats, linsidomine-treated animals were found to have a significant decrease in portal venous pressure (-18%, p less than 0.01) and in mean arterial pressure (-16%, p less than 0.01), smaller peripheral resistances (p less than 0.01), greater portal venous inflow (p less than 0.05), smaller splanchnic arteriolar resistances (p less than 0.01) and smaller protocol-lateral resistances (p less than 0.05). Cardiac output, hepatic arterial blood flow, portal blood flow and estimated hepatic blood flow were not significantly different between the two groups of animals. Linsidomine-treated rats exhibited a trend toward greater collateral blood flow compared with controls, but this difference was not significant. We conclude that linsidomine decreases portal venous pressure by reducing portocollateral resistances without affecting liver blood flow. These effects should be beneficial for patients with cirrhosis and portal hypertension.