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1.
Pan Afr Med J ; 33: 193, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31692677

RESUMO

Introduction: Blood cultures are the best diagnostic tool for the detection of bacteremia. However, false positive results may lead to confusion about antibiotic regimens, putting the lives of patients at risk. The main purpose of this study was to assess the prevalence of coagulase negative Staphylococci (CoNS) as well as of Corynebacterium spp and Bacillus spp in the bags of blood culture analyzed in the microbiology laboratory at the Ibn-Rochd University Hospital in Casablanca. This prevalence was evaluated according to various Hospital Departments over the year 2016. Methods: We conducted a descriptive, retrospective study by analysing the computerized database of the Laboratory of bacteriology and virology at the Ibn-Rochd University Hospital in Casablanca over a 12-month period from 1st January to 31st December 2016. Our study focused on bacteria forming part of the commensal flora (coagulase negative Staphylococcus, Corynebacteria spp and Bacillus spp). The blood culture bags were incubated in the automated blood culture system (Bactec FX). The identification of the germs from a positive culture was performed according to the standard techniques of bacteriology and susceptibility testing was performed according to EUCAST 2015. We conducted an analysis of the computerized database of KALISIL system (Netika) version (2.2.10.) of the Microbiology Laboratory at the Ibn-Rochd University Hospital in Casablanca. Results: Out of 7959 requests for blood cultures obtained from 5801 patients addressed to the laboratory of bacteriology, 2491 were positive, of which 848, reflecting a rate of 34% of positive bags or 10.6% of the whole of bags received over the year 2016, were positive for coagulase negative Staphylococcus, 56 bags of blood cultures, reflecting a rate of 2.2%, were positive for Corrynébacteruim SP, followed by 60 bags of blood cultures, reflecting a rate of 2.4%, which were positive for Bacillus sp. The frequency of isolation of coagulase negative Staphylococcus compared to other bacteria according to Clinical Departments showed a higher frequency in the Paediatric Department (47.2%) followed by the Medicine Department (44.1%). Conclusion: This study shows that coagulase negative Staphylococci are the organisms most frequently isolated from blood cultures. They are a non-negligible cause of nosocomial infections, but they are also the most common blood culture contaminants.


Assuntos
Bacteriemia/epidemiologia , Infecções Estafilocócicas/epidemiologia , Staphylococcus/isolamento & purificação , Bacteriemia/diagnóstico , Bacteriemia/microbiologia , Hemocultura , Coagulase , Infecção Hospitalar/diagnóstico , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Hospitais Universitários , Humanos , Marrocos/epidemiologia , Prevalência , Estudos Retrospectivos , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/microbiologia , Staphylococcus/enzimologia
2.
Pan Afr Med J ; 33: 252, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692814

RESUMO

Introduction: HIV and syphilis are major public health problems in Morocco. The region of Souss-Massa, south-west of the country, hold more than 24% of HIV seropositive cases registered in Morocco during 2009. The aim of this study is to evaluate the seroprevalence of syphilis among HIV seropositive patients in the region of Souss-Massa, south-west of Morocco. Methods: To evaluate the seroprevalence of syphilis and neurosyphilis among HIV seropositive patients, we retrospectively investigated the medical records of HIV-infected patients attending the regional hospital located in the city of Agadir, during the period comprised between 2011 and 2016. Results: The population studied involved 1381 males (49.18%) and 1427 females (50.82%) HIV seropositive patients. Among them, 481 patients were seropositive for syphilis and three cases were diagnosed with neurosyphilis. The sex ratio distribution was 243 male (52.71%) and 218 female (47.29%). The prevalence of syphilis among the studied population was estimated to 16.42% with a slight dominance in male (17.63%) compared to female (15.28%). By contrast, neurosyphilis was only detected in male patients, with a prevalence estimated to 0.11%. Conclusion: Even if the prevalence of HIV and syphilis is stable in the region of Souss-Massa, the prevalence of syphilis among HIV seropositive patients remained high and correlated positively with that of HIV infection. We did not find a significant difference between the genders, in relation to the prevalence of HIV and syphilis. We concluded that it was essential to continue monitoring the population, in order to improve the prevention and the access to the medical care in the south-west of Morocco.


Assuntos
Infecções por HIV/epidemiologia , Neurossífilis/epidemiologia , Sífilis/epidemiologia , Feminino , Humanos , Masculino , Marrocos/epidemiologia , Prevalência , Estudos Retrospectivos , Estudos Soroepidemiológicos , Distribuição por Sexo
3.
Bull Cancer ; 106(11): 1008-1022, 2019 Nov.
Artigo em Francês | MEDLINE | ID: mdl-31606139

RESUMO

With more than 3300 new cases and almost 2500 deaths each year, cervical cancer (CC) ranks second among female cancers in Moroccan women. The majority of cases occurs in women aged 50 and over. In absence of a national cancer registry, data published in Morocco are limited to the number of cases recorded in some oncology centers, so the incidence of this cancer is likely much higher than estimated. A Moroccan national program against CC based on the practice of visual inspection after application of acetic acid was set up in 2010, allowing both screening and possibly immediate treatment of (pre)cancerous lesions. However, this program has not been implemented in all regions of the country. The CC develops slowly and most often without any symptoms, and so it is diagnosed at an advanced stage of the disease. Virtually, all CC are associated with persistent infection of high risk human papillomavirus (HPV), particularly HPV16 and 18. For more than ten years, two prophylactic vaccines targeting these two HPV genotypes have been marketed. They have proved their excellent immunogenicity and efficacy and they are well tolerated. However, HPV vaccine is not yet recommended by health authorities in Morocco. In this literature review, we focused on the current situation of CC, the prevalence of HPV infection and the prevention strategies against CC in Morocco.


Assuntos
Infecções por Papillomavirus/prevenção & controle , Lesões Pré-Cancerosas/prevenção & controle , Neoplasias do Colo do Útero/prevenção & controle , Ácido Acético/administração & dosagem , Adulto , Algoritmos , Coinfecção/epidemiologia , Detecção Precoce de Câncer/métodos , Feminino , Infecções por HIV/epidemiologia , Papillomavirus Humano 16/imunologia , Papillomavirus Humano 18/imunologia , Humanos , Incidência , Indicadores e Reagentes/administração & dosagem , Pessoa de Meia-Idade , Marrocos/epidemiologia , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/epidemiologia , Vacinas contra Papillomavirus/administração & dosagem , Lesões Pré-Cancerosas/diagnóstico , Lesões Pré-Cancerosas/epidemiologia , Lesões Pré-Cancerosas/virologia , Prevenção Primária , Sistema de Registros/estatística & dados numéricos , Gestão de Riscos , Prevenção Secundária , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/virologia
4.
Pan Afr Med J ; 33: 163, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31565125

RESUMO

Viral hepatitis is a serious public health problem. Its epidemiology is not precisely known in Morocco. Our objective was to assess the prevalence of HBV and HCV in a particular population of "blood donors" at the Regional Blood Transfusion Centre in Oujda. A retrospective study was conducted from May 1, 2013 to May 31, 2015. Thirty-one thousand nine hundred and fifty-two blood donors were tested. Antigen detection was made according to ELISA technique (MonolisaTMHBs Ag ULTRA). HCV research was performed by ELISA using the kit « Monolisa HCV Ag-Ab ULTRA ¼. 177 blood donors included, they are divided into 155 male (87.6%) and 22 female (12.4%) subjects with a ratio of 7. The average age was 37.64 ± 12 years. Six cases were positive for HCV with an overall prevalence of 0.02%. The population study by sex shows a prevalence of 0.004% for 23177 male sera and 0.057% for 8775 female sera. Six donors were HCV positive, of which 05 were female (83.33%) and one was male (16.66%). The average age was 43 ± 14 years. Co-infection with HCV HBV-HCV and HCV-Syphilis and HCV-HIV are absent. Co-infection with HBV and HIV was found in one case. HBV-syphilis co-infection was found in 04 cases. Chronic viral hepatitis is a real global health problem. Its prevalence is currently estimated at 0.55% for HBV and 0.02% for HCV, reclassifying Morocco as a low endemic area. The prevention remains the most effective method to successfully control HBV and HCV infection.


Assuntos
Doadores de Sangue/estatística & dados numéricos , Infecções por HIV/epidemiologia , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Adolescente , Adulto , Coinfecção , Ensaio de Imunoadsorção Enzimática , Feminino , Antígenos de Superfície da Hepatite B/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Prevalência , Estudos Retrospectivos , Sífilis/epidemiologia , Adulto Jovem
5.
Pan Afr Med J ; 33: 74, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31448036

RESUMO

Myocardial infarction (MI) is a major cause of cardiovascular mortality. Inferior MI accounts for 30-50% of infarctions but it is associated with a favorable prognosis compared to anterior infarct. This study aimed to study the epidemiological, clinical, electrical, echocardiographic, angiographic features of inferior MI, as well as its complications and its therapeutic approaches. Over a period of 3 years, we admitted 720 patients with STEMI, of whom 103 with inferior STEMI, reflecting a rate of 14.3%. There was a clear male predominance, with an average age of 58 years (men) and 62 years (women). Smoking was the main risk factor for cardiovascular disease (57.28% of patients were smokers). Right ventricular infarction was found in 11.65% of cases. Half of these patients had hemodynamic instability. Third-degree atrioventricular block was diagnosed in 12.6% of patients. Therapeutic approach was based on thrombolysis (7 patients) and coronary angiogram (42 patients). Inferior MI was caused by right coronary lesion in 53% of cases and circumflex artery occlusion in 47% of cases. Right coronary is responsible for right ventricular infarction in 100% of cases. Coronary angioplasty was performed in 18 patients after coronary angiogram. Eleven patients underwent transluminal coronary angioplasty in the right coronary while 2 patients underwent transluminal coronary angioplasty in the circumflex artery. Early mortality at 30 days was 1.94%. In the right ventricular infarction group mortality rate was about 17%.


Assuntos
Angioplastia Coronária com Balão/métodos , Angiografia Coronária/métodos , Infarto Miocárdico de Parede Inferior/epidemiologia , Idoso , Bloqueio Atrioventricular/epidemiologia , Doenças Cardiovasculares/epidemiologia , Feminino , Humanos , Infarto Miocárdico de Parede Inferior/fisiopatologia , Infarto Miocárdico de Parede Inferior/terapia , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Fumar/efeitos adversos , Fumar/epidemiologia
6.
Pan Afr Med J ; 32: 56, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31223348

RESUMO

Introduction: colorectal cancer is a major public health problem. This study aims to analyze the epidemiological, nutritional, clinical and anatomopathological features of patients with colorectal cancer at the University Hospital in Casablanca. Methods: our case-control study focused on patients assigned to treatment for colorectal cancer in 2015 compared with a control group that didn't have cancer. Results: the average age of our patients was 56.65 years, with a standard deviation of 14.64. The most common histological type of cancer in study patients was Lieberkhünien adenocarcinoma with a proportion of 82%. The analysis of the body mass index showed that 50% of study patients were obese vs 20% of patients in the control group and that 19% of study patients had diabetes vs 8% patients in the control group (p< 0.019). Moreover, the analysis of dietary habits in study patients compared to those of patients in the control group showed that the average frequency of weekly consumption of red meat was higher in study patients than in the control group (4.24 vs 3.26; p = 0.009) and , conversely, for the consumption of fish (0.97 vs 1.76; p = 0.0001). On the other hand, the average consumption of vegetables and fruits was lower in study patients than in the control group (5.00 vs 9.50; p = 0.0001). Concerning the toxic habits of our patients, 32% of study patients were smokers vs. 13% of patients in the control group. Conclusion: our results show that awareness about our dietary habits and changes in our living habits could reduce the incidence of colorectal cancer and therefore mortality and morbidity.


Assuntos
Adenocarcinoma/epidemiologia , Neoplasias Colorretais/epidemiologia , Dieta/estatística & dados numéricos , Comportamento Alimentar , Adenocarcinoma/patologia , Adulto , Idoso , Índice de Massa Corporal , Estudos de Casos e Controles , Neoplasias Colorretais/patologia , Feminino , Hospitais Universitários , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Estado Nutricional , Obesidade/epidemiologia , Fatores de Risco , Fumar/epidemiologia
7.
Pan Afr Med J ; 32: 108, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31223398

RESUMO

Neurological disorders secondary to vitamin B12 deficiency are polymorphic and diverse. There have been very few studies conducted in the Moroccan as well as in the African population. This study aims to describe the clinical, paraclinical, evolutionary features of neurological manifestations in patients with vitamin B12 deficiency within the Department of Neurology at the Moulay Ismail Military Hospital, Meknes over a period of 18 years (1999-2017). The study involved 06 women and 23 men, with an average age of 57 years. The mean time between symptom onset and diagnosis was 3 months. Neurological manifestation was indicative of vitamin B12 deficiency in 100% of cases. The average hemoglobin level was 10 g/dl, the mean corpuscular volume was 115 fl. Medullary megaloblastosis and atrophic gastritis were found in 95% and 90% of cases respectively. Regular electromyography (EMG), electroencephalography (EEG) and visual evoked potentials (VEP) showed subclinical peripheral and optic neuropathies. In 20 cases they were caused by Biermer's anemia. All the patients received parenteral Vitamin B12 with good outcome. These results demonstrate the importance of early diagnosis in patients with a potentially serious neuropsychiatric condition as well as of rapid substitution treatment which is the only therapeutic option to secure a good outcome.


Assuntos
Anemia Perniciosa/epidemiologia , Doenças do Sistema Nervoso/epidemiologia , Deficiência de Vitamina B 12/complicações , Vitamina B 12/administração & dosagem , Idoso , Anemia Perniciosa/diagnóstico , Anemia Perniciosa/etiologia , Eletroencefalografia/métodos , Eletromiografia/métodos , Potenciais Evocados Visuais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/etiologia , Doenças do Nervo Óptico/diagnóstico , Doenças do Nervo Óptico/epidemiologia , Doenças do Nervo Óptico/etiologia , Estudos Retrospectivos , Fatores de Tempo , Deficiência de Vitamina B 12/diagnóstico
8.
Breast Dis ; 38(2): 39-45, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31104003

RESUMO

BACKGROUND: Inflammatory breast cancer (IBC) is a rare and aggressive type of breast cancer (BC). Physicians have difficulty diagnosing it correctly given its clinical nature. Previous studies have shown that North Africa compared to the United States has a higher proportion of IBC relative to all BC. PURPOSE: The purpose of this study was to calculate a corrected IBC incidence rate using the population-based registry of Casablanca and other, local hospital-based data sources and to characterize the clinical presentation and basis of diagnosis of IBC. METHODS: We retrieved the Casablanca registry data from 2009-2012, and matched its data with demographic and clinical data from the medical records, logbooks and a local epidemiologic IBC case-control study. A corrected incidence was calculated after accounting for missed cases in the registry. RESULTS: The data showed that the incidence of IBC in the registry was significantly underestimated when the population-based and hospital data were combined. CONCLUSIONS: Population-based registries should focus on specific measures for verifying the diagnosis of IBC since physicians may miss documenting the disease in medical records. This study may have implications for better reporting and documentation of IBC in hospital- and population-based cancer registries in Morocco and other similar countries.


Assuntos
Neoplasias Inflamatórias Mamárias/diagnóstico , Neoplasias Inflamatórias Mamárias/epidemiologia , Sistema de Registros , Adolescente , Adulto , Idoso , Criança , Feminino , Hospitais , Humanos , Incidência , Registros Médicos , Pessoa de Meia-Idade , Marrocos/epidemiologia , Adulto Jovem
9.
Biomed Res Int ; 2019: 2080352, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31001551

RESUMO

Unlike the other hemoglobinopathies, few researches have been published concerning α-thalassemia in Morocco. The epidemiological features and the mutation spectrum of this disease are still unknown. This regional newborn screening is the first to study α-thalassemia in the north of Morocco. During the period from January 2015 to December 2016, 1658 newborns umbilical blood samples were investigated. Suspected newborns were screened for α-globin defects using Gap-PCR and Multiplex Ligation-dependent Probe Amplification technique. The prevalence of α-thalassemia, its mutation spectrum, and its allelic frequencies were described for the first time in Morocco. Six different α-globin genetic disorders were detected in 16 neonates. This screening valued the prevalence of α-thalassemia in the studied population at 0.96% and showed the wide mutation spectrum and the heterogeneous geographical distribution of the disease. A high rate of carriers was observed in Laouamra, a rural commune in Larache province. Heterogeneity of α-globin alleles in Morocco explains the high variability of α-thalassemia severity. This diversity reflects the anthropological history of the country. These results would contribute to the prevention of thalassemia in Morocco directing the design of a nationwide screening strategy and awareness campaign.


Assuntos
Alelos , Frequência do Gene , Mutação , alfa-Globinas/genética , Talassemia alfa/epidemiologia , Talassemia alfa/genética , Feminino , Humanos , Recém-Nascido , Masculino , Marrocos/epidemiologia , Prevalência
10.
Ann Biol Clin (Paris) ; 77(2): 169-173, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30998197

RESUMO

OBJECTIVE: Thalassemias is the consequence of a synthesis imbalance between the α and ß chains of hemoglobin. It's a hereditary haemolytic anemias, which presents a problem of public health because of their frequency and the difficulties of their care. The objective of this work is to study the epidemiological, clinico-biological, therapeutic and evolutionary profile of thalassemic patients in Morocco. METHODS: We're reporting the results of a retrospective multicenter study on all cases of thalassemia taken at the hospitals: Avicenne military hospital in Marrakech, Mohammed VI hospital in Marrakech and the regional center for blood transfusion in Agadir. RESULTS: During this period we collected 81 cases of thalassemias. The average age was 13 years (from 1 month to 60 years) with a sex ratio (M/F) of 0.8. The reason for consultation was anemia in 43% of cases. The electrophoresis of hemoglobin has shown a predominance of the ß-thalassemia minor form. On the evolutionary level, iron overload and endocrine complications were the most frequent. CONCLUSION: The development of a prevention program based mainly on health education, the reduction of consanguineous marriages and genetic counseling, are probably the main ways of combating the emergence of new thalassemic cases.


Assuntos
Talassemia beta/diagnóstico , Talassemia beta/epidemiologia , Talassemia beta/terapia , Adolescente , Adulto , Transfusão de Sangue/métodos , Transfusão de Sangue/estatística & dados numéricos , Criança , Pré-Escolar , Progressão da Doença , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Estudos Retrospectivos , Adulto Jovem , Talassemia beta/patologia
11.
PLoS Negl Trop Dis ; 13(4): e0007321, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30964864

RESUMO

BACKGROUND: Leishmania major is an endemic vector-borne disease in Morocco that causes zoonotic cutaneous leishmaniasis (ZCL), especially in arid pre-Saharan regions where its unique vector and reservoir are Phlebotomus papatasi and Meriones shawi, respectively, and may cause epidemics. In late 2017, the Zagora province, an endemic focus for ZCL in southern Morocco, had CL outbreak. The main objective of our investigation was to analyze the epidemiological features of this latest ZCL outbreak. METHODOLOGY/PRINCIPAL FINDINGS: We analyzed epidemiological features of this latest ZCL outbreak. The Regional Delegation of Health, Zagora, recorded 4,402 CL patients between October 2017 and end of March 2018. Our findings showed that 24 municipalities were affected and majority (55.1%) of infected cases belonged to the Tinzouline rural municipality. Majority of patients were females (57.2%). While all age group patients were affected, those aged <10 years were the most affected (42.1%). During this outbreak over 5 days in December 2017, we conducted a survey in Tinzouline and recruited and sampled 114 CL patients to confirm CL diagnosis by parasitological (direct examination and culture) and molecular (ITS1-PCR) methods and identify the etiological agent of infection using ITS1-PCR-RFLP and sequencing. We completed a detailed questionnaire including clinical and epidemiological data for each patient and found 72.8% of patients presenting multiple lesions (≥2), with an average number of lesions of 5.16 ± 0.5. Lesions were more prevalent in the upper limbs, with the most common type being the ulcerocrusted lesion (60.5%). We detected no associations between lesion type and patients' sex or age. CONCLUSIONS/SIGNIFICANCE: Among 114 clinically diagnosed CL patients, we confirmed 90.35% and identified L. major as the species responsible for this outbreak. Self-medication using various products caused superinfection and inflammation of lesions and complicated the diagnosis and treatment. Thus, ZCL remains a major public health problem in the Zagora province, and commitment of all stakeholders is urgently required to implement a sustainable regional control program.


Assuntos
Surtos de Doenças , Reservatórios de Doenças/parasitologia , Leishmaniose Cutânea/epidemiologia , Zoonoses/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Leishmania major/genética , Leishmania major/isolamento & purificação , Leishmaniose Cutânea/diagnóstico , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Phlebotomus/parasitologia , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , Prevalência , Pele/parasitologia , Pele/patologia , Inquéritos e Questionários , Adulto Jovem , Zoonoses/parasitologia
12.
Prog Urol ; 29(3): 173-182, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30819635

RESUMO

PURPOSE: Incidence of pediatric urolithiasis is decreasing in most developing countries where endemic bladder stones are less prevalent than in the past years. In parallel, stone composition has changed. Only few data are available in North Africa, except for Tunisia. We report stone composition in the Moroccan pediatric population. MATERIAL AND METHODS: Composition of 432 stones from children (302 boys, 130 girls) was determined by infrared spectroscopy. The samples were collected during the period 1999-2016. Stone morphology, which is an important aspect for etiology was determined by examination of each stone under a stereomicroscope. Stone composition was compared to patients' age and gender. RESULTS: The global male-to-female ratio was 2.32. Regarding stone composition, calcium oxalate was the main component in 51.6% of the stones, followed by struvite (18.1%), ammonium urate (9.5%) and carbapatite (9%). Significant differences were found between males and females: calcium oxalate accounted for 72.3% of stones in girls and 42.7% in boys (P<10-6); conversely, struvite was more frequent in boys than in girls (22.2 vs 8.5%, P<10-4). The same was found for calcium phosphate stones (11.9% in boys; 4.6% in girls, P<0.05). Stone morphology helped us for detecting several pathological conditions: type Ic whewellite stones, as a marker for primary hyperoxaluria, was found in 17.6% of stones and type IIId ammonium urate stones, suggestive for infectious diarrhea, was identified in 20.1% of all stones. CONCLUSION: This is the largest series of pediatric stones in Morocco studied by infrared analysis and morphological examination. LEVEL OF EVIDENCE: 3.


Assuntos
Oxalato de Cálcio/química , Espectrofotometria Infravermelho/métodos , Cálculos Urinários/química , Urolitíase/epidemiologia , Adolescente , Fatores Etários , Apatitas/química , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Masculino , Marrocos/epidemiologia , Fatores Sexuais , Estruvita/química , Cálculos Urinários/epidemiologia
13.
Mult Scler Relat Disord ; 30: 141-148, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30772672

RESUMO

BACKGROUND: Neuromyelitis optica spectrum disorder (NMOSD) was suggested to be more frequent and have specific features among populations from Africa or North Africa. However, we could not find any large study about NMOSD in an African population in the medical literature. OBJECTIVES: To describe the characteristics of NMOSD in a Moroccan monocenter population. PATIENTS AND METHODS: A retrospective study was conducted. Patients fromJanuary 1999 to December 2015 fulfilling the 2015 International Consensus Criteria for NMOSD were included. RESULTS: Sixty four patients fulfilled the criteria. Mean age at onset was 35.7 ±â€¯10.7 years, and the sex ratio was 1/3.57. First clinical event was represented by optic neuritis (38.1%), followed by myelitis (27.0%) and a Devic's syndrome (17.2%). Mean annualized relapse rate was 1.07 ± 1.23 and mean EDSS at last visit was 5.1 ±â€¯2.8. Aquaporine 4 antibodies were positive in 47.1%. Brain lesions were found in 71.2%. Most patients (76.6%) received disease-modifying therapy, mainly cyclophosphamide (86.0%) and 49% remained relapse-free after treatment initiation CONCLUSION: Data from our study suggest more similarities between North African NMOSD patients and non-Caucasian populations. More studies are needed to assess other pathological patterns and compare disease course to other populations.


Assuntos
Neuromielite Óptica/epidemiologia , Neuromielite Óptica/terapia , Adolescente , Adulto , Fatores Etários , Idade de Início , Aquaporina 4/imunologia , Autoanticorpos/metabolismo , Estudos de Coortes , Grupos Étnicos , Feminino , Humanos , Estimativa de Kaplan-Meier , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Neuromielite Óptica/diagnóstico por imagem , Neuromielite Óptica/etnologia , Fatores Sexuais , Adulto Jovem
14.
Parasite ; 26: 6, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30767889

RESUMO

Toxoplasmosis is an important zoonosis caused by an obligate intracellular parasitic protozoan, Toxoplasma gondii. The disease is distributed worldwide and can affect all warm-blooded vertebrates, including humans. The present review aimed to collect, compile and summarize the data on the prevalence of T. gondii infection in humans and animals in the five North African countries (Morocco, Algeria, Tunisia, Libya and Egypt). Published data from national and international databases were used. Distribution patterns and risk factors for T. gondii infection are discussed, focusing on biotic and abiotic factors. This review is a comprehensive epidemiological analysis of T. gondii infection in North Africa and will therefore be a useful tool for researchers. It can also be used to propose or enhance appropriate national toxoplasmosis control programs.


Assuntos
Toxoplasmose Animal/epidemiologia , Toxoplasmose/epidemiologia , Zoonoses/epidemiologia , África do Norte/epidemiologia , Argélia/epidemiologia , Animais , Animais Selvagens/parasitologia , Anticorpos Antiprotozoários/sangue , Egito/epidemiologia , Feminino , Humanos , Líbia/epidemiologia , Gado/parasitologia , Marrocos/epidemiologia , Gravidez , Prevalência , Fatores de Risco , Toxoplasma/fisiologia , Toxoplasmose/transmissão , Tunísia/epidemiologia , Zoonoses/parasitologia
15.
Ann Biol Clin (Paris) ; 77(1): 87-94, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30799303

RESUMO

Risk analysis consists in identification, scoring and ranking of risks in order to manage the major risks. The aim of the study is to determine the risk analysis of the pre-analytical step of routine hemostasis in Hematological laboratory of CHU Ibn Rochd-Casablanca, Morocco. MATERIAL AND METHODS: The identification of pre-analytical activities of routine hemostasis was extensively realized according to a "by-proccess" methodology. According to "5M" analysis, we identified the risks associated with these activities. Therefore, the scoring of each risk was realized according to «AMDEC¼ methodology, by the staff of hematological laboratory. Risks were classified according to their severity and the major were identified using "Pareto diagram". RESULTS: Forty eight risks were identified in 15 activities. Identity monitoring (13.7%), pre-analytical storage of samples (13.4%), pre-analytical treatment, including centrifugation (12.9%) and transport to the laboratory (11.3%) represented the activities that exhibited the highest level of risk. Using "Pareto diagram", we retained 19 major risks, related to medical prescription, identity monitoring, transport to the laboratory, pre-analytical treatment of samples and IT processing. DISCUSSION AND CONCLUSION: Risk analysis allowed the identification of 19 major risks out of 48 identified risks, related to the pre-analytical step of routine hemostasis. These 19 major risks needed a plan to reduce their criticity.


Assuntos
Testes Diagnósticos de Rotina , Testes Hematológicos , Hemostasia/fisiologia , Fase Pré-Analítica , Gestão de Riscos , Estudos Transversais , Erros de Diagnóstico/estatística & dados numéricos , Testes Diagnósticos de Rotina/métodos , Testes Diagnósticos de Rotina/normas , Testes Diagnósticos de Rotina/estatística & dados numéricos , Testes Hematológicos/métodos , Testes Hematológicos/normas , Testes Hematológicos/estatística & dados numéricos , Humanos , Laboratórios/normas , Marrocos/epidemiologia , Fase Pré-Analítica/métodos , Fase Pré-Analítica/normas , Fase Pré-Analítica/estatística & dados numéricos , Fatores de Risco , Gestão de Riscos/métodos , Gestão de Riscos/normas , Gestão de Riscos/estatística & dados numéricos
16.
BMC Public Health ; 19(1): 118, 2019 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-30691432

RESUMO

BACKGROUND: Cystic echinococcosis (CE), a neglected zoonosis caused by the larval stage of the tapeworm Echinococcus granulosus, remains a public health issue in many developing countries that practice extensive sheep breeding. Control of CE is difficult and requires a community-based integrated approach. We assessed the communities' knowledge and perception of CE, its animal hosts, and its control in a CE endemic area of the High Atlas Mountains, Morocco. METHODS: We conducted twenty focus group discussions (FGDs) stratified by gender with villagers, butchers and students in ten Berber villages that were purposefully selected for their CE prevalence. RESULTS: This community considers CE to be a severe and relatively common disease in humans and animals but has a poor understanding of the parasite's life cycle. Risk behaviour and disabling factors for disease control are mainly related to cultural practices in sheep breeding and home slaughtering, dog keeping, and offal disposal at home, as well as in slaughterhouses. Participants in our focus group discussions were supportive of control measures as management of canine populations, waste disposal, and monitoring of slaughterhouses. CONCLUSIONS: The uncontrolled stray dog population and dogs having access to offal (both at village dumps and slaughterhouses) suggest that authorities should be more closely involved in CE control. This study also highlights the need for improved knowledge about the transmission cycle of the parasite among communities and health professionals. Inter-sectoral collaboration between health staff, veterinarians, and social scientists appears to be crucial for sustainable control of this parasitic zoonosis.


Assuntos
Equinococose/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Doenças Negligenciadas/prevenção & controle , Zoonoses/prevenção & controle , Animais , Cães , Equinococose/epidemiologia , Feminino , Grupos Focais , Humanos , Masculino , Marrocos/epidemiologia , Doenças Negligenciadas/epidemiologia , Prevalência , Ovinos , Zoonoses/epidemiologia
17.
PLoS One ; 14(1): e0209425, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30629614

RESUMO

This study was conducted in order to assess the acquisition rate of Acinetobacter baumannii by newborn screening, on admission and during the discharge process of neonatal intensive care unit. (NICU). Furthermore, we investigated risk factors for potential colonization and molecular epidemiology of isolated resistant bacteria. This prospective study was conducted in the neonatal unit of Hassan II University Hospital of Fez from February 2013 to July 2015. During this period, all consecutive admitted neonates were screened for A. baumannii intestinal carriage, on admission and during the discharge process. Bacteriological and molecular tests were evaluated according to the international standards. This study examines the screening on admission of 455 newborns, 59% of whom were male. The average gestational age and birth weight were 35.2 weeks and 2612.1 g respectively. In total, 277 patients were included in the acquisition study on admission. The prevalence of multi-drug resistant (MDR) A. baumannii strain carriage was 6.5%, while the acquisition rate during the hospital recovery was 13.7%. In this study, 68 MDR A. baumannii isolates were collected. The resistance rates to different antibiotic classes including, Ceftazidime, Gentamycin and Ciprofloxacin varied between 92 and 100%. Moreover, 13% of MDR A. baumannii isolates were carbapenemase producers and 88% harbored blaOXA-23 gene. On admission, three risk factors were significantly associated with A. baumannii colonization: age (OR, 2.803; IC95%, 1.191-6.596; P = 0.01), gender (OR, 0.382; IC95%, 0.158-0.921; P = 0.03) and the delivery birth at the Maternity of University Hospital (MUH), (OR, 0.196; IC95%, 0.071-0.540; P = 0.002). However during hospitalization, the only risk factor associated with acquisition of A. baumannii was the respiratory distress (OR, 2.270; IC95%, 1.055-4.881; P = 0.03). A high intestinal carriage rate of A. baumannii and multiple antibiotic resistance were found in our NICU. Thus, the spread of MDR A. baumannii should be monitored by an active surveillance strategy.


Assuntos
Infecções por Acinetobacter/epidemiologia , Acinetobacter baumannii , Portador Sadio/epidemiologia , Infecção Hospitalar/epidemiologia , Infecções por Acinetobacter/tratamento farmacológico , Infecções por Acinetobacter/microbiologia , Acinetobacter baumannii/efeitos dos fármacos , Acinetobacter baumannii/genética , Acinetobacter baumannii/isolamento & purificação , Portador Sadio/tratamento farmacológico , Portador Sadio/microbiologia , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/microbiologia , Farmacorresistência Bacteriana Múltipla/genética , Feminino , Genes Bacterianos , Hospitais Universitários , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Intestinos/microbiologia , Masculino , Epidemiologia Molecular , Marrocos/epidemiologia , Estudos Prospectivos , Fatores de Risco
18.
Pan Afr Med J ; 30: 204, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30574223

RESUMO

The causes of infertility vary widely and differ between regions and within countries. There is no report on this subject in Morocco. Therefore, the aim of this study was to determine the causes of infertility in Moroccan infertile couples and to compare the findings with data from the various published studies. This retrospective study included 1265 infertile couples who attended the Assisted Reproductive Technology Unit of the Reproductive Health Centre of the University Hospital Ibn Sina in Rabat. All couples had been infertile for at least 1 year and both partners were fully investigated. The median duration of infertility was 5 ± 4 years. Couples had primary and secondary infertility in 77.2% and 22.8% of cases, respectively. Among the 1265 couples, 39.6% had a female factor, 28.2% had a male factor, 17% had both male and female factors and in 15.2% of couples, the cause of infertility was undetermined. The most common causes of male infertility were varicocele (14.3%), obstructive azoospermia (7%), Congenital anomalies (5.5%) and male accessory gland infection (4%). Results showed that 54.8% of men had a normal semen analysis. Among women, infertility factors were ovulatory disorders (27.5%), tubal factor (26.6%), uterine factor (12.6%), endometriosis (4.1%), and 43.4% of women were normal. The causes of infertility in this study are comparable with those reported by the World Health Organization and other studies. However, the substantial delay before attending an infertility clinic highlighted by the study needs additional consideration.


Assuntos
Infertilidade Feminina/epidemiologia , Infertilidade Masculina/epidemiologia , Serviços de Saúde Reprodutiva , Adolescente , Adulto , Idoso , Feminino , Humanos , Infertilidade Feminina/etiologia , Infertilidade Masculina/etiologia , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Técnicas de Reprodução Assistida , Estudos Retrospectivos , Adulto Jovem
19.
BMC Infect Dis ; 18(1): 680, 2018 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-30567502

RESUMO

BACKGROUND: The widespread use of an effective and safe vaccine to measles has substantially decreased morbidity and mortality from this epidemic. Nevertheless, HIV-infected children vaccinated against measles may develop an impaired vaccine response and remain susceptible to this disease. In Morocco, infants are routinely vaccinated against measles, regardless of their HIV serostatus. An evaluation of the immunization of these children may be of paramount importance to implement timely measures aimed at preventing measles transmission. METHODS: In this study, we have enrolled 114 children vaccinated against measles, 50 children prenatally infected with HIV and 64 HIV-uninfected children. For all children, blood samples were taken to measure anti-measles IgG by EIA and CD4 count by flow cytometry. Additionally, HIV viral load was determined by automated real time PCR, for HIV-infected children. RESULTS: The seroprotective rate of IgG anti-measles antibodies was significantly lower among HIV-infected children (26%) compared with HIV-uninfected children (73%) (p < 0.001). Within HIV-infected children group, the comparison of variables between children without seroprotective seroconversion to measles and those with seroprotective immunity, displayed that sex and age were not statistically different, p > 0.999 and p = 0.730, respectively. However, CD4 count was lower among children with negative serostatus to measles (23% versus 32%, p < 0.001). Furthermore, viral load was higher, with 2.91 log10 ± 2.24 versus 1.7 log10 ± 1.5 (p = 0.042). Finally, 62% of children with a negative vaccine response to measles were under HAART therapy, versus 92% (p = 0.008). CONCLUSION: The majority of HIV-infected children vaccinated against measles develop a suboptimal seroprotective titer, and therefore remain at risk for this highly infectious disease. These data in combination with international recommendations, including recent WHO guidance on vaccination of HIV-infected children, suggest there is a need for national measures to prevent these children from measles.


Assuntos
Anticorpos Antivirais/sangue , Formação de Anticorpos , Infecções por HIV/epidemiologia , Transmissão Vertical de Doença Infecciosa , Vacina contra Sarampo/uso terapêutico , Sarampo/epidemiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , HIV , Infecções por HIV/sangue , Infecções por HIV/complicações , Infecções por HIV/imunologia , Humanos , Lactente , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Masculino , Sarampo/sangue , Sarampo/complicações , Vacina contra Sarampo/imunologia , Vírus do Sarampo/imunologia , Marrocos/epidemiologia , Estudos Soroepidemiológicos , Vacinação
20.
PLoS Negl Trop Dis ; 12(12): e0006910, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30571740

RESUMO

BACKGROUND: Morocco has achieved the goal of leprosy elimination as a public health problem several years ago (less than 1 case/ 10 000 habitant). The aim of this study was to analyze trends of leprosy detection during the last 17 years taking into consideration the implementation of single dose rifampicin chemoprophylaxis (SDRC) started in 2012. METHODOLOGY: Time series of leprosy cases detected at national level between 2000 and 2017. Variable collected for each year were leprosy per 100000 H, age category, gender, origin, regions, grade of disabilities and clinical forms. The detection time series was assessed by Joinpoint Regression Analysis. Annual percentage changes (APCs) were estimated to identify the years (joinpoint) when significant changes occurred in the trend. We therefore examined trends in leprosy detection according to epidemiological variables. FINDINGS: Joinpoint regression showed a reduction in the detection rate between 2000 and 2017. The APC for the period 2012-2017 (-16.83, 95% CI: -29.2 to -2.3, p <0.05) was more pronounced than that of the previous period 2000-2012 (- 4.68, 95% CI: -7.3 to -2.0, p <0.05); with a significant break in the same joinpoint year SDRC implementation. In stratified analysis, case detection decreased, but not significantly, after the joinpoint years in men, children, multi-bacillary cases, grade 0-1 disabilities, rural and urban cases and in ten regions. CONCLUSIONS: Leprosy detection was declining over years with a significant reduction by 16% per year from 2012 to 2017. SDRC may reduce leprosy detection over the years following its administration.


Assuntos
Hanseníase/prevenção & controle , Rifampina/administração & dosagem , Adulto , Quimioprevenção , Criança , Feminino , Humanos , Hanseníase/tratamento farmacológico , Hanseníase/epidemiologia , Masculino , Marrocos/epidemiologia , População Rural , População Urbana
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