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.

Serotype distribution and antimicrobial susceptibility of invasive Streptococcus pneumoniae isolates among adult and elderly population before and after introduction of pneumococcal conjugate vaccine in Casablanca, Morocco.

BACKGROUND: Streptococcus pneumoniae (S. pneumoniae), remains a major cause of mortality and morbidity worldwide. The objective of this study was to determine the trends of invasive pneumococcal diseases (IPD) in adult and elderly population in Casablanca (Morocco) before and after introduction of pneumococcal conjugate vaccine (PCV) by determining the distribution of pneumococcal serotypes and antibiotic resistance profile of isolated strains. METHOD: The proposed study is a retrospective laboratory-based surveillance of IPD in hospitalized adult (15-59 years old) and elderly (≥ 60 years old) patients in Ibn Rochd University Hospital Centre from 2007 to 2019 (13 years). All the 250 non-duplicate clinical invasive isolates from adult and elderly patients, confirmed as S. pneumoniae according to the laboratory standard identification procedures, are included in this study. RESULTS: A significant decrease of the overall incidence in IPD was observed only in adults from 0.71 to 0.54/100000 populations (P = 0.02) and to 0.47/100000 populations (P = 0.0137) in the early and mature post-vaccine period respectively compared to the pre-vaccine period. Our results also showed a significant reduction in the overall prevalence of vaccine serotypes from 28.17 to 6.90% (P = 0.0021) for the PCV-10 serotypes, and from 46.48 to 25.86% (P = 0.0164) for the PCV-13 serotypes only in the mature post-vaccine period (2015-2019). In parallel, the rate of non-vaccine serotypes did not significantly change in the early post-vaccine period (2011-2014) while it increased considerably from 54 to 74.14% (P = 0.0189) during the mature post-vaccine period. The rate of penicillin non-susceptible pneumococcal isolates decreased significantly from 23.94 to 8.77% (P = 0.02) in adult patients, and the rate of cotrimoxazole non-susceptible pneumococcal isolates significantly decreased from 29.58 to 8.77% in the early post-vaccine period (P = 0.003) and to 7.24% in the mature post-vaccine period (P = 0.0007). CONCLUSION: Although childhood vaccination has considerably reduced the incidence of IPD in adult population through the herd effect, IPD remain a real public health problem due to the alarming increase in non-vaccine serotypes (NVS) and the lack of herd effect among elderly population. The rate of antibiotic resistance was relatively low. Nevertheless, resistance constitutes a serious problem to the therapeutic arsenal due to the known capacity for genetic dissemination in the pneumococcus.

Anxiety, Stress, and Depression Among Healthcare Professionals During the COVID-19 Pandemic: A Cross-Sectional Study in Morocco.

The COVID-19 pandemic has caused an enormous psychological impact worldwide. This study aimed to assess anxiety, depression, stress, and compensatory behaviors among Moroccan healthcare workers (HCWs) during COVID-19. This descriptive cross-sectional study was conducted using a snowball sampling strategy. This descriptive cross-sectional study was conducted using a snowball sampling strategy. Online surveys were sent to groups of HCWs working in Casablanca and Fez cities. Post-traumatic stress disorder (PTSD) was measured using the Impact of Event Scale revised (IES-R) scale, and the DASS-21 was used to measure anxiety, depression, and stress among participants. Compensatory behaviors used by HCWs to manage these symptoms were also investigated. The majority of participants (72.5%) experienced moderate to severe distress during the COVID-19 pandemic. The majority of participants (53.1%) reported symptoms of mild to extremely severe depression. Overall, nurses, female, and frontline HCWs experienced more stress, anxiety, and depression (P < .001). Leisure activities (29%), sport (19%), and drinking tea/coffee (19%) were the most common compensatory behaviors. Our findings suggest that psychological support and interventions targeting high-risk HCWs with heavy psychological distress are needed. It is of paramount importance to improve the psychological endurance and safeguard the mental and physical well-being of HCWs, who find themselves on the frontline of health and humanitarian crises, when they are needed the most.

Epidemiological, toxicological and physiopathological characteristics of scorpion stings and their management in Morocco: A literature review.

All around the world, scorpion envenomation represents a public health issue. In Morocco, it represents the first cause of poisoning. The aim of this review is to highlight the epidemiological, toxicological and physiopathological characteristics of scorpion stings and envenomation in Morocco as well as their management. According to the bibliography, the most areas affected by scorpion stings and envenomation are those in the center and south of Morocco. Lethality rate is more important in children than adult. Age, admission class, season, serum venom concentration, and the time elapsed between the scorpion sting and medical intervention are risk factors for a poor prognosis. Until now, we have only known the LD50 of 14 scorpion species from three genera: Androctonus, Buthus and Hottentota, and only 6 species, out of 61 moroccan scorpions, have been assessed for their venom toxicity on mice organs. The venom of harmful moroccan scorpions induces several histopathological changes in the myocardium, brain, liver, pulmonary alveoli, and kidneys in rats, as well as severe consequences in the lungs with intra-alveolar hemorrhage. There was also a significant increase in serum enzyme levels of aspartate transaminase (AST), alanine transaminase (ALT), creatine phosphokinase (CPK), and lactate dehydrogenase (LDH), as well as high levels of plasma albumin, creatine and glucose. In the absence of a specific treatment, the management of scorpion envenomation is based only on symptomatic therapy. We noted a widely use of traditional remedies. Despite the magnitude of the scorpion problem in Morocco, it remains understudied and continues to claim lives, particularly given the lack of an efficient etiological cure.

The association of Chlamydia trachomatis and human papillomavirus co-infection with abnormal cervical cytology among women in south of Morocco.

PURPOSE: Evidence indicates that human papillomavirus (HPV) and Chlamydia trachomatis (CT) co-infection increases the risk of developing cervical pathogenesis. This study aims to assess the prevalence and possible risk factors of CT and HPV/CT co-infection in women from South of Morocco with normal and abnormal cytology. METHODS: Participants were recruited after signing an informed consent. Cervical samples were collected and analysed for the presence of HPV or CT. Detection of genomic DNA of both pathogens was performed by nested polymerase chain reaction. HPV genotypes defined by Sanger sequencing method. The association between demographic features and co-infection status was determined using a logistic regression model. A possible association between the presence of HPV and CT and cytological abnormality patterns was also investigated. RESULTS: We recruited n = 438 women, aged between 18 and 86 years. Around 59% of participants underwent a pap smear test for the first-time. Genomic DNA of HPV, CT and HPV/CT co-infection was detected in 32.3%, 17.7%, and 13.4% of the total samples, respectively. The identified risk factors associated with CT infection were history of sexually transmitted infections and marital status. By contrast, only smoking was found to be associated with HPV/CT co-infection. Evidence showed that co-infection was associated with an increased risk of developing cervical abnormalities (OR 3.18, 95% CI 0.96-9.21; p = 0.040). CONCLUSION: HPV and CT rates were high among the studied population. Evidence suggests that HPV/CT co-infected women were more susceptible to developing abnormal cytology.

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.

Population Genetic Structure of Phlebotomus sergenti (Diptera: Psychodidae) Collected in Four Regions of Morocco Based on the Analysis of Cyt b and EF-1α Genes.

Phlebotomus (Ph.) sergenti is the main vector of Leishmania (L.) tropica (Trypanosomatida: Trypanosomatidae), the causative agent of anthroponotic cutaneous leishmaniasis in Morocco. This species has an extended geographical distribution, wider than that of the parasite. The main objective of our study was to analyze the genetic diversity of Ph. sergenti collected in four foci in Morocco: Taza, Foum Jemâa, El Hanchane, and Ouarzazate. We studied a set of diversity and population structure indices by sequencing two markers; nuclear EF-1α and mitochondrial Cyt b from 175 individual sand flies. Our results showed a considerable degree of intraspecific polymorphism with a high number of haplotypes identified in both genes. Many polymorphic sites detected in the Cyt b sequences (SCyt b = 45) indicate that it is the most polymorphic marker showing a distinct distribution of haplotypes according to their geographical origin, whereas the EF-1α marker showed no geographical isolation. Analysis by Tajima's D and Fu's Fs tests revealed a possible recent expansion of the populations, especially with the EF-1α marker, showing significant values in Taza and Ouarzazate sequences. The present study revealed significant genetic diversity within Ph. sergenti populations in Morocco. The results warrant further research using a combination of more than two markers including mitochondrial and non-mitochondrial markers, which may provide more information to clarify the genetic status of Ph. sergenti.

What happened during COVID-19 in African ICUs? An observational study of pulmonary co-infections, superinfections, and mortality in Morocco.

BACKGROUND: There is a growing literature showing that critically ill COVID-19 patients have an increased risk of pulmonary co-infections and superinfections. However, studies in developing countries, especially African countries, are lacking. The objective was to describe the prevalence of bacterial co-infections and superinfections in critically ill adults with severe COVID-19 pneumonia in Morocco, the micro-organisms involved, and the impact of these infections on survival. METHODS: This retrospective study included severe COVID-19 patients admitted to the intensive care unit (ICU) between April 2020 and April 2021. The diagnosis of pulmonary co-infections and superinfections was based on the identification of pathogens from lower respiratory tract samples. Co-infection was defined as the identification of a respiratory pathogen, diagnosed concurrently with SARS-Cov2 pneumonia. Superinfections include hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). A multivariate regression analysis was performed to identify factors independently associated with mortality. RESULTS: Data from 155 patients were analyzed. The median age was 68 years [62-72] with 87% of patients being male. A large proportion of patients (68%) received antibiotics before ICU admission. Regarding ventilatory management, the majority of patients (88%) underwent non-invasive ventilation (NIV). Sixty-five patients (42%) were placed under invasive mechanical ventilation, mostly after failure of NIV. The prevalence of co-infections, HAP and VAP was respectively 4%, 12% and 40% (64 VAP/1000 ventilation days). The most isolated pathogens were Enterobacterales for HAP and Acinetobacter sp. for VAP. The proportion of extra-drug resistant (XDR) bacteria was 78% for Acinetobacter sp. and 24% for Enterobacterales. Overall ICU mortality in this cohort was 64.5%. Patients with superinfection showed a higher risk of death (OR = 6.4, 95% CI: 1.8-22; p = 0.004). CONCLUSIONS: In this single-ICU Moroccan COVID-19 cohort, bacterial co-infections were relatively uncommon. Conversely, high rates of superinfections were observed, with an increased frequency of antimicrobial resistance. Patients with superinfections showed a higher risk of death.

[Adenocarcinoma of the paranasal sinuses in sheep: First case description in Morocco]. / Adenokarzinom der Sinus paranasales bei Schafen: Erstbeschreibung in Marokko.

INTRODUCTION: Small ruminant sinus adenocarcinoma (ENA) is a contagious disease caused by a beta retrovirus called Enzootic Nasal Tumor Virus or ENTV. The first cases were sporadically diagnosed in Morocco in 2018. However, in the last two years, ENTV has appeared enzootic in three herds of the Sardi breed. The annual incidence varied between 5 and 20 %. Most cases involved female animals aged 15 to 42 months. The disease developed within 2 to a maximum of 6 months. Diseased animals presented with progressive weight loss and increased mortality or needed to be slaughtered. The condition associated mainly with unilateral skull deformation, serous or seromucous nasal discharge with dyspnea, and in some individuals an exophthalmos. During pathology tumor-like masses were found in the paranasal sinuses, which showed the growth of an expansive and organized epithelial neoplasm on histopathology. After an overview of the differential diagnoses that can lead to confusion with ANE, the authors investigate why the disease occurs more frequently in Morocco and particularly in the Sardi breed.

INTRODUCTION: L'adénocarcinome des sinus nasaux des petits ruminants (ANE) est une maladie contagieuse, provoquée par un betaretrovirus appelé l'Enzootic Nasal Tumor Virus ou ENTV. Les premiers cas ont sporadiquement été diagnostiqués au Maroc en 2018. Cependant, durant les deux dernières années, l'ANE a sévi de manière enzootique dans trois troupeaux, tous naisseurs, qui exploitent la race Sardi. L'incidence annuelle varie de 5 à 20 %. La majorité des cas étaient des femelles, âgées entre 15 et 42 mois. La maladie évolue en 2 à 6 mois au maximum. Les malades maigrissent progressivement et la quasi-totalité meurt si elle n'est pas abattue avant. L'affection associe principalement des lésions de la face, avec déformation du crâne souvent unilatérale, des écoulements nasaux séreux ou séro-muqueux avec difficulté respiratoire et l'exophtalmie chez certains individus. L'autopsie a permis de mettre en évidence des masses tumorales dans les sinus. A l'examen histopathologique, les masses tumorales correspondent à un néoplasme épithélial expansif et organisé. Les auteurs, après avoir passé en revue les diagnostics différentiels pouvant prêter à confusion avec l'ANE, s'interrogent sur les raisons de sa recrudescence au Maroc, particulièrement chez la race Sardi.

Multifactorial hypovitaminosis D among women in the South-East Oases of Morocco.

This study assessed the vitamin D status among women in South-East Oases of Morocco. Two hundred thirty-three healthy volunteer women were recruited at five urban and rural health centers. Hypovitaminosis D is very common in this region and correlated to age, monthly income, skin color, daily sun exposure, BMI, and body fat percentage. PURPOSE: This study assessed the vitamin D status among women in the Draa-Tafilalet region and its relationship with clinical, anthropometric, and behavioral parameters. METHODS: The study was carried out with 233 women in consultation at five urban and rural health centers in the South-East region of Morocco. The data collected relate to age, monthly income, educational level, BMI, body fat percentage, daily sun exposure, physical activity level, veil wear, and skin color. The plasma determination of vitamin D was measured by immunofluorescence. Statistical analyses were performed using Python and Jamovi. RESULTS: The median 25(OH)D plasma concentration was 9.95 ng/mL (IQR: 8-13.18). A total of 50.64% of women had 25(OH)D levels below 10 ng/ml and 47.21% had levels between 10 and 30 ng/mL. Statistical tests showed an association between hydroxyvitamin D plasma levels and age (r = - 0.139; p = 0.034), monthly income (p = 0.001), BMI (r = - 0.200; p = 0.002), body fat percentage (r = - 0.131; p = 0.049), daily sun exposure (r = 0.165; p = 0.012), and skin color (p < 0.001). Binomial logistic regression showed that darker skin was associated with vitamin D deficiency (< 10 ng/mL). It also showed that high income and longer sun exposure could be protecting factors against vitamin D deficiency. CONCLUSION: The plasma concentrations of vitamin D in women in the Draa-Tafilalet region were low compared to expected results for a high sunshine time area.

Neuromeningeal tuberculosis in HIV-negative patients: a retrospective study in Rabat, Morocco.

Neuro-Meningeal Tuberculosis (NMT) is a severe infection of the central nervous system which causes a public health problem in Morocco and in several countries in the world. In order to describe the epidemiological, clinical, paraclinical and outcome among NMT patients without HIV, we carried out a retrospective study at the neurology department of the Military Hospital of Rabat in Morocco, over a period of 17 years (2000-2017). Forty patients were included with a mean age of 44 years (± 18) and a sex ratio of 1.66. A history evoking the possibility of tuberculous origin was found in 8 patients (20%). Febrile confusion was the most common clinical manifestation and was observed in 22 patients (55%) followed by febrile meningeal syndrome in 12 patients (30%). The main abnormalities noted in brain magnetic resonance imaging (MRI) were: hydrocephalus in 13 cases (32.5%), intra-cranial tuberculomas in 10 patients (25%) and leptomeningitis in 9 cases (22.5%). Cerebrospinal fluid study found clear aspect in 29 patients (75%), direct acid fast bacilli smear examination was positive in 4 patients (10%) and positive culture in 4 patients (10%). The Polymerase chain reaction (PCR) study returned positive in 6 patients (35%) of the 17 patients tested. The outcome was good in 18 patients (45%) while 19 patients suffered from neurological sequelae (47.5%) and 3 cases of death recorded (7.5%). Febrile confusion was the most reported manifestation in our patients. Subacute onset of symptoms was the most predominant feature in our patients as reported in the literature. Our results are consistent with the literature and confirm the severity of this infectious disease, even in HIV-negative patients.

La morbidité maternelle : situation et déterminants entre 2020 et 2021 dans la province d'Essaouira, Maroc.

Introduction : Maternal morbidity is a public health problem in developing countries.Purpose of research : The aim of this study was to determine the prevalence of maternal morbidity among women of reproductive age in the province of Essaouira (Morocco) and to describe the factors associated with it. The authors conducted a cross-sectional structured interview survey of 1300 married women aged 18 to 49. Data entry and statistical processing were performed by the SPSS-PC 18 program.Results : The prevalence of maternal morbidity was 66.8%. The main morbidities were sexually transmitted infections (48.8%) and anemia (46.6%). Multivariate analysis showed that frequency of postnatal visits, literacy of the couple and socioeconomic level were statistically associated with maternal morbidity.Conclusion : The use of postnatal care, the fight against illiteracy and the improvement of the socio-economic level of households, are factors that would reduce maternal morbidity.

Intention to vaccinate under-12 children against COVID-19 by parents in the Meknes Prefecture of Morocco.

Background: Two days before the start of the 2021 school year, more than 2 million Moroccan students (12-17 years old) had received the first dose of the anti-COVID-19 vaccine and 416 810 students had received both doses. Vaccination of young children against COVID-19 would contribute to pandemic control and "herd immunity". Aims: This study aimed to assess the extent to which Moroccan parents were likely to vaccinate their under-12 children against COVID-19. Methods: We conducted a cross-sectional study in the form of an anonymous and confidential electronic survey among parents visiting pediatric clinics in Meknes Prefecture in August and September 2021. Results: Our study shows that the majority of parents were vaccinated (67.2%), but refused to vaccinate their under-12 children (83.6%). But 72% of all parents were willing to vaccinate their children if COVID-19 mortality increased among children. Conclusion: Most parents who refused to have their children vaccinated were illiterate or had only primary education. There is therefore a need to increase awareness and information campaigns on the benefits of the COVID-19 vaccine among adults and children.

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.

Clinical and histopathological pattern of lung cancer in Morocco.

Introduction: lung cancer is the most common cancer and the leading cause of cancer death worldwide. This study aimed to provide an overview of the epidemiology of primary lung cancer in Morocco. The distribution of histological subtypes by sex and smoking status was also assessed. Methods: this was a retrospective and descriptive study using medical records of patients with primary lung cancer, diagnosed at two university hospitals in Morocco between 2014 and 2017. Results: a total of 606 patients (average age = 58.5 ± 10.64 years, men = 521) were included. Four hundred and forty-three men had a history of smoking against sex women. Most patients (85.68%) had respiratory symptoms at diagnosis. Over half of patients (53.03%) had a performance status <2 and 38.94% had at least another pulmonary disease at presentation. Chronic obstructive pulmonary disease (COPD) and tuberculosis were present in 23.43% and 18% of patients, respectively. The majority (72.27%) of men practiced an occupation associated with a significant risk of lung cancer. Adenocarcinoma was the main histological type in our series with 60.40%. Most (79.55%) patients were diagnosed at stage IV. Only 7.83% of patients benefited from surgery. The distribution of histological subtypes by sex and smoking habits showed that adenocarcinoma was more frequent in women (p=0.011), and squamous cell carcinoma in men (p=0.014). No differences between smokers and non-smokers were noted. Conclusion: our results showed a decrease in the age of diagnosis and a late stage of the disease. Adenocarcinoma was the most frequent histological type.

Ecological Survey of the Peridomestic Sand Flies of an Endemic Focus of Zoonotic Cutaneous Leishmaniasis in the South-East of Morocco.

Leishmaniasis is a parasitosis caused by parasites of the genus Leishmania and is transmitted by Phlebotominae sand flies. An entomological survey was carried out in different localities of Zagora Province. Our work allowed us to establish an inventory of sand flies to study potential vectors of leishmaniasis and to compare the composition and the specific abundance of different endemic stations. The sand flies were collected using CDC miniature light traps during the month of July 2019 in the ten studied villages. The results indicate the presence of thirteen species, belonging to the genera Phlebotomus and Sergentomyia. Phlebotomus papatasi was the predominant species (46.65%) followed by Ph. alexandri (17%), Ph. longicuspis (11.55%), Ph. bergeroti (1.53%) and Ph. sergenti (1.27%). Phlebotomus kazeruni (0.03%) was rare, and only one female was captured in Ifred. Sergentomyia schwetzi (8.69%) was the most prevalent species in the Sergentomyia genus followed closely by Se. fallax (6.84%). Sergentomyia africana was present with a proportion of (3.86%) followed by Se. clydei (1.96%). Sergentomyia dreifussi (0.46%), Se. antennata (0.08%), and Se. minuta (0.08%) were very limited. Phlebotomus papatasi, Ph. alexandri, Ph. bergeroti, Ph. longicuspis, Ph. sergenti, Se. schwetzi, Se. clydei, and Se. fallax are constant species, being present at least in 50% of the stations (occurrence> 50%). Common species (25%-49%) were Se. minuta and Se. africana and rare species were Ph. kazeruni and Se. antennata with a very limited distribution (occurrence <12%). The greatest species richness was found in Ksar Mougni and Ifred with the occurrence of 11 species, but overall, it was high (>9 species) in most of the villages. The Shannon-Wiener index was high (H' > 1) in eight localities (Ksar Mougni, Tassaouante, Bleida, ZaouiteLeftah, Ifred, Timarighine, Ait Oulahyane, and Ait Ali Ouhassou). The high value of this index is in favor of the ZaouiteLeftah locality (Shannon-Wiener index = 1.679) which is explained by the presence of a stand dominated by Ph. papatasi. In order to avoid exposure to infections, a good epidemiological surveillance and vector with rodent control measures must be well maintained. Awareness campaigns are also required and must be conducted for better knowledge of the disease.

Medico-demographic characteristics and outcomes of COVID-19 patients admitted to a provincial hospital in Center-West of Morocco.

The current Coronavirus Disease 2019 (COVID-19) pandemic that emerged in December 2019 in China continues to claim a thousand lives worldwide. This study aimed to report characteristics and in-hospital outcomes of a Moroccan COVID-19 cohort, and identify factors which predispose patients to hospitalization and mortality from COVID-19. We conducted a cross-sectional study of symptomatic COVID-19 patients referred to COVID-19 ward of the Settat Provincial Hospital, during October 2020. A confirmed COVID-19 case was defined by a positive detection of SARS-CoV-2 genome using real-time RT-PCR assay performed on nasopharyngeal swabs. Patients´ demographic and clinical characteristics were collected and analyzed using SPSS V22.0. Univariate followed by multivariate logistic regression analysis was performed to identify factors associated with mortality due to COVID-19. In total, 269 patients were reported. The median age was 64 years [IQR 54-73], 48.7% were elderly (≥ 65 years), 51.7% were men, and the case-fatality rate (CFR) was 5.58%. Males had a higher CFR (6.5%) than females (4.6%). In deceased people: 60% males, 73.3% were elderly, and oxygen saturation values of 90% or less on admission were more frequent (86.7%) than in recovered ones (10.9%). Most patients (80.3%) had at least one comorbidity: 100% of deaths, 59% older than 60 years, CFR was 6.94% and the most prevalent diseases were diabetes (54.6%), hypertension (41.7%), and cardiac disease (40.7%). The most common symptoms on presentation were dyspnea (67.7%), fever (65.4%) and cough (58.4%). Multivariable logistic regression analysis showed that only older age (AOR: 10.860, 95% CI: 3.382-34.86; p<0.001) and cardiac disease (AOR: 0.244, 95% CI: 0.074-0.799; p=0.02) were associated with higher mortality rates. Categorizing patients at admission according to risk factors identified by multivariate and also univariate analyses (mainly dyspnea) is essential to help in deciding the hospitalization priority and the strategy that will eventually reduce death risk.

Budd-Chiari syndrome associated to Behcet disease: An observational retrospective multicenter study in Morocco.

Budd-Chiari syndrome (BCS) is considered a rare but serious complication of Behçet's disease (BD). This study was performed to define the prevalence, clinical and biological features, treatment, and clinical course of BSC associated with BD in a Moroccan population. We retrospectively analyzed the medical records of 1578 patients fulfilling the international diagnostic criteria for BD, including those with BSC. Eighteen male and 3 female patients, with a mean age of 36 ± 8.6 years. The inferior vena cava was involved in 81% (n = 17) of cases. All forms of BCS were noted: the chronic form in 52.4% (n = 11), the subacute form in 38% (n = 8), and the fulminant form (2 cases). Ascites was the main clinical sign and was present in 62% of patients (n = 13). Other venous thromboses (superior vena cava and lower limbs) were associated with BSC in 52.4% of patients (n = 11). Arterial involvement was noted in 28.6% (n = 6). Cardiac manifestations were present in 19% (n = 4) of the patients. All the patients received anticoagulants associated with corticosteroids. Immunosuppressants were used in 95% (n = 20). One patient received infliximab. Severe complications were noted in 38% (n = 8) of patients (digestive bleeding, confusion, infections and liver failure). Four patients have died during the study period. BCS in patients with BD is not uncommon and can be life threatening. It is frequently associated with other vascular manifestations that can be difficult to treat, particularly in the presence of pulmonary artery aneurysms. Prognosis improved with the use of immunosuppressants. Biologics can be promising in the early stages.

Serological and molecular prevalence study of bluetongue virus in small domestic ruminants in Morocco.

Bluetongue is an arthropod-borne viral disease transmitted by Culicoides biting midges, affecting domestic and wild ruminants. The current study aims to assess the seroprevalence of the bluetongue virus (BTV) and confirm its active circulation among sheep and goats populations in Morocco, as well as study the risk factors associated with BTV infection. To this end, a total of 1651 samples were randomly collected from 1376 sheep and 275 goats in eight (out of 12) regions of the country between March 2018 and July 2021.These samples were primarily tested using competitive ELISA (c-ELISA). Subsequently, 65% of c-ELISA positives (n = 452) were analyzed by real-time reverse transcription-polymerase chain reaction (RT-qPCR). The results revealed an overall BTV seroprevalence in small ruminants in Morocco of 41.7%, including 42.6% in sheep and 37.5% in goats. The RT-qPCR results showed that the overall BTV viropositivity rate was 46.7%, including 48.1% in sheep and 41.8% in goats. These viro-serological rates varied significantly by age, sex, and breed of the tested animals, husbandry method, season, and geographic origin. This indicates that these parameters constitute risk factors for BTV transmission routes in Morocco. The findings also indicate that goats play a role as reservoirs in maintaining the BTV in Morocco. It appears from this study that bluetongue is endemic in Morocco. The environmental and climate conditions as well as the husbandry methods adopted in the country are particularly favorable for the virus transmission throughout the country.

[Epidemiological profile and diagnostic and evolutionary features of TB patients at the Diagnostic Centre for Tuberculosis and Respiratory Diseases in Settat, Morocco]. / Profil épidémiologique, aspects diagnostiques et évolutifs des patients tuberculeux au centre de diagnostic de la tuberculose et des maladies respiratoires de Settat, Maroc.

Introduction: tuberculosis is a public health problem in Morocco. This study aims to examine the epidemiological profile as well as the evolutionary and diagnostic features of tuberculosis in Settat, Morocco. Methods: we conducted a retrospective descriptive and analytical study of data from the medical records of TB patients managed at the Diagnostic Centre for Tuberculosis and Respiratory Diseases in Settat, Morocco from 1st January 2015 to 31 December 2019. Results: we identified 1270 cases of tuberculosis. Lung involvement was more common than extrapulmonary involvement. Ganglionic tuberculosis mainly occurred in patients with extrapulmonary tuberculosis. Severe forms included tuberculous meningitis (10 cases) and miliary tuberculosis (10 cases). Diagnosis was bacteriologically confirmed in the majority of patients (84.09%). Extreme ages and female sex were mainly affected by extrapulmonary tuberculosis. Recovery was reported in 35.12% of patients and its rate was higher in pulmonary TB patients than in extrapulmonary TB patients (62.18% vs 0.37%; P<0.001). Patients with pulmonary tuberculosis (19.33% vs 10.81%; P<0.001) were mainly lost to follow-up. Death occurred to almost the same extent in patients with pulmonary and extrapulmonary tuberculosis (2.52% vs. 2.56%). Conclusion: efforts on all fronts are still needed if the country is to achieve the goal of eliminating TB by 2030.