Enhancing pollutant removal efficiency in urban domestic wastewater treatment through the hybrid multi-soil-layering (MSL) system: A case study in Morocco.

This paper evaluates the performance and potential of a full-scale hybrid multi-soil-layering (MSL) system for the treatment of domestic wastewater for landscape irrigation reuse. The system integrates a solar septic tank and sequential vertical flow MSL and horizontal flow MSL components with alternating layers of gravel and soil-based material. It operates at a hydraulic loading rate of 250 L/m2/day. Results show significant removal of pollutants and pathogens, including total suspended solids (TSS) (97%), chemical oxygen demand (COD) (88.57%), total phosphorus (TP) (79.93%), and total nitrogen (TN) (88.49%), along with significant reductions in fecal bacteria indicators (4.21 log for fecal coliforms and 3.90 log for fecal streptococci) and the pathogen Staphylococcus sp. (2.43 log). The principal component analysis confirms the effectiveness of the system in reducing the concentrations of NH4, COD, TP, PO4, fecal coliforms, fecal streptococci, and fecal staphylococci, thus supporting the reliability of the study. This work highlights the promising potential of the hybrid MSL technology for the treatment of domestic wastewater, especially in arid regions such as North Africa and the Middle East, to support efforts to protect the environment and facilitate the reuse of wastewater for landscape irrigation and agriculture.

Epidemiological, clinical and therapeutic profiles of mantle cell lymphoma cared for in a Moroccan center: a review of 14 cases.

Mantle cell lymphoma (MCL) accounts for 3-10% of non-Hodgkin's lymphomas (NHL). We identified 14 patients with mantle cell lymphoma, with an average number of 3.5 new cases/year. A male predominance was observed with a sex ratio equal to 6. The average age of our patients was 64.4±14.1 years, with an average diagnostic delay of 6.57 months. Regarding the clinical presentation, adenopathy was the most reported physical sign (78.6%) followed by B symptoms (57.1%). Disseminated stages were the most frequent in our series: stages IV (78.5%) and III (7.1%) versus stages I (0%) and II (7.1%). The extra-ganglionic localizations observed were hepatic 5 cases (31.1%), pulmonary 04 cases (25%), medullary 4 cases (25%), pleural 2 cases (12.5%) and prostate 1 case (6.2%). All diagnosed cases are mantle cell lymphomas, of which 12 cases (85.7%) are classical and 2 cases (14.3%) indolent. The high-risk group is, according to international prognostic index (MIPI) MCL prognostic score, the most represented in our series: 0-3 = 6 cases (42.9%), 6-11 = 8 cases (57.1%). The therapeutic protocol chosen 1st line: 9 patients treated with R-DHAP, three with R-CHOP, one with DHAOX and one with R-CVP. Second line: two patients treated with R-DHAP, one after R-CHOP and the other after R-CVP. Two patients received autologous hematopoietic stem cell transplant at the end of the treatment. The evolution was marked by the death of 7 patients, 3 lost to follow-up and 4 still followed. Additionally, the study highlights characteristics and treatment patterns of mantle cell lymphoma, emphasizing its predominance in males, delayed diagnosis, frequent dissemination, and high-risk classification, with chemotherapy as the primary treatment modality and a challenging prognosis contributing to a comprehensive understanding of mantle cell lymphoma presentation and management.

Molecular analysis of genetic mutations in non-small cell lung cancer in Morocco.

Non-small cell lung cancer (NSCLC) is a significant global health issue with diverse molecular profiles affecting treatment responses. Yet, NSCLC's molecular epidemiology in Morocco is largely unexplored. This study focuses on NSCLC genetic mutations, specifically in adenocarcinoma, among Moroccan patients to contribute to understanding NSCLC in this population. Ninety-four patients diagnosed with lung adenocarcinoma were analyzed. Formalin-fixed paraffin-embedded tissue samples were processed, and deoxyribonucleic acid (DNA)/ribonucleic acid (RNA) was extracted using standardized protocols. Mutations were detected using the AmoyDx Pan Lung Cancer Polymerase Chain Reaction (PCR) Panel kit, and their frequencies were assessed through statistical analysis. Epidermal Growth Factor Receptor (EGFR) mutations were detected in 22.34% of patients, predominantly exon 19 deletions (66.66%) and exon 21 L858R mutations (23.80%). Anaplastic lymphoma kinase (ALK) gene fusion was observed in 3.19% of patients, and KRAS mutations in 1.06%. No mutations were found in other tested genes. A slightly higher mutation rate was noted in females (54.16%) compared to males (45.84%). The study reveals a distinct mutation profile in Moroccan NSCLC patients, with a notable prevalence of EGFR mutations, albeit lower than in some Asian populations. The significance of EGFR mutations in treatment response aligns with global findings, highlighting the importance of understanding regional molecular variations for personalized therapy. Despite limitations in sample size and clinical data, this study sheds light on the genetic landscape of NSCLC in Morocco. The observed mutation rates, particularly in EGFR, underscore the potential for targeted therapies in Moroccan NSCLC patients, emphasizing the need for further research to refine treatment strategies tailored to this population.

Cluster analysis of cancer knowledge, attitudes and behaviors in the Moroccan population.

BACKGROUND: Cancer has become a major health concern due to the increasing morbidity and mortality rates, and its negative social, economic consequences and the heavy financial burden incurred by cancer patients. About 40% of cancers are preventable. The aim of this study was to assess the knowledge, attitudes, and practices regarding cancer prevention, and associated characteristics to inform the development of targeted cancer prevention campaigns and policies. METHODS: We conducted a cross-sectional survey of adult patients at Mohamed Sekkat and Sidi Othmane Hospitals in Casablanca, Morocco. Data collection was conducted by two trained interviewers who administered the questionnaire in-person in the local language. An unsupervised clustering approach included 17 candidate variables for the cluster analysis. The variables covered a wide range of characteristics, including demographics, health perceptions and attitudes. Survey answers were calculated to compose qualitative ordinal categories, including a cancer attitude score and knowledge score. RESULTS: The cluster-based analysis showed that participants in cluster 1 had the highest mean attitude score (13.9 ± 2.15) and percentage of individuals with a high level of knowledge (50.8%) whereas the lowest mean attitude score (9.48 ± 2.02) and knowledge level (7.5%.) were found in cluster 3. The participants with the lowest cancer attitude scores and knowledge levels were aged 34 to 47 years old (middle age group), predominantly females, living in rural settings, and were least likely to report health professionals as a source of health information. CONCLUSIONS: The findings showed that female individuals living in rural settings, belonging to an older age group, who were least likely to use health professionals as an information source had the lowest levels of knowledge and attitudes. These groups are amenable to targeted and tailored interventions aiming to modify their understanding of cancer in order to enhance the outcomes of Morocco's on-going efforts in cancer prevention and control strategies.

Physico-chemical characterisation of irrigation basin waters and inventory study of their algal communities.

To cope with the water shortage in Sous Massa region of Morocco, agricultural producers in the region have resorted to different types of water supply basins, known as "irrigation basins" but the phenomenon of eutrophication has hindered the continuity of agricultural productivity by altering the quality of the water used for irrigation on the one hand, and causing economic damage to agricultural producers due to the clogging of the water pumping network on the other. We began by characterising the physico-chemical quality of the water to determine the causes of its high nutrient content, then we determined the taxonomy of the algal species in the irrigation basins to which we had access. A qualitative study of the water in the irrigation basins in order to better explain the inventory obtained from the taxonomic identification of the algal biomass collected, which proved the existence of new species, not previously identified, characterising the freshwaters of the Moroccan region, is under the scope of this work. The species studied belong mainly to the following groups: green algae (11 genera of Chlorophyta and 7 genera of Charophyta), blue algae (7 genera of Cyanobacteria), brown algae (7 genera of Diatoms), and one genus of Euglenophyta.

A psychological insight of Moroccan adults' immunisation behaviour towards emergency vaccines.

BACKGROUND: The psychology of vaccination behaviour explains how thoughts and feelings influence people's willingness to receive vaccines. Understanding vaccination behaviour is crucial to successfully managing vaccination campaigns. AIM: Investigating factors associated with immunisation stress among students at Mohammed First University. SETTING: This study was conducted on students at Mohammed First University institutions. METHODS: This study is a descriptive and analytical cross-sectional study. It was conducted on 305 students at Mohammed First University institutions using a 90-item questionnaire. RESULTS: Three hundred and five participants have been included in this survey. Overall, 65.5% of the students in our sample had a positive perception towards COVID-19 vaccines. Nevertheless, 34.5% had a negative opinion regarding immunisation. According to the analysis of perceived stress scale, 40% (n = 122) of students expressed moderate to high stress regarding vaccination. Students with a negative perception of vaccine showed a higher level of stress than those with a positive one. Stressed students tended to be older than others, coming from other institutions, other than the medical faculty, and were renting alone. Vaccine accessibility was the less significant reason associated with stress regarding vaccination. Moreover, participants with high levels of confidence in social media, exhibited higher stress. Nevertheless, those who believed in scientific journals were significantly less stressed. CONCLUSION: These results reflect a positive perception and acceptance of vaccines, with a considerable level of stress regarding vaccination.Contribution: This study suggests emphasising the mental health of Moroccan young adults, to better sensitise and inform them about immunisation.

Epidemiology and risk factors for staphylococcal urinary tract infections in the Moroccan Casablanca area.

PURPOSE: This study aimed to ascertain the prevalence and risk factors for developing staphylococcal urinary tract infections (UTIs) in the Casablanca area of Morocco. METHODS: In Casablanca, Morocco, a retrospective evaluation of 772 UTIs patients was conducted between January 2020 and December 2022. The research included two groups of patients: those with staphylococcal UTIs and those without. Sex, age, chronic illnesses, antibiotic exposure, urinary catheterization, urological surgery, and UTIs history were the risk variables assessed. We employed a logistic regression model to identify the characteristics that were predictive of staphylococcal UTIs. RESULTS: Eight staphylococcal species were responsible for 16.84% of UTIs in 772 non-repeating individuals. Patients infected with S. saprophyticus (35.38%) were the most common, followed by those infected with S. epidermidis (24.61%), S. aureus (13.85%), and S. hemolyticus (10.78%). Multivariate logistic regression analysis revealed that male sex (95% CI: 0.261-0.563), immunosuppression and immunosuppressive treatments (95% CI: 0.0068-0.64), chronic diseases (95% CI: 0.407-0.965), previous UTIs (95% CI: 0.031-0.228), frequency of urination more than 8 times a day (95% CI:1.04-3.29), frequency of urination once or twice a day (95% CI: 1.05-2.39), and urinary catheterization (95% CI: 0.02-0.22) were the most likely predictors of staphylococcal UTIs. In addition, a larger proportion of patients with staphylococcal UTIs were made aware of the risk factors associated with staphylococcal UTIs (52.31%, χ2 = 4.82, = 0.014). CONCLUSIONS: This is the first global study to evaluate the predictive factors for acquiring UTIs caused by staphylococci. Monitoring these factors will enable medical authorities to devise effective strategies for managing UTIs and combating antibiotic resistance.

Integrating fuzzy-AHP and GIS for solid waste disposal site selection in Kenitra province, NW Morocco.

Selecting an optimal solid waste disposal site is one of the decisive waste management issues because unsuitable sites cause serious environmental and public health problems. In Kenitra province, northwest Morocco, sustainable disposal sites have become a major challenge due to rapid urbanization and population growth. In addition, the existing disposal sites are traditional and inappropriate. The objective of this study is to suggest potential suitable disposal sites using fuzzy logic and analytical hierarchy process (fuzzy-AHP) method integrated with geographic information system (GIS) techniques. For this purpose, thirteen factors affecting the selection process were involved. The results showed that 5% of the studied area is considered extremely suitable and scattered in the central-eastern parts, while 9% is considered almost unsuitable and distributed in the northern and southern parts. Thereafter, these results were validated using the area under the curve (AUC) of the receiver operating characteristics (ROC). The AUC found was 57.1%, which is a moderate prediction's accuracy because the existing sites used in the validation's process were randomly selected. These results can assist relevant authorities and stakeholders for setting new solid waste disposal sites in Kenitra province.

Lower Ordovician synziphosurine reveals early euchelicerate diversity and evolution.

Euchelicerata is a clade of arthropods comprising horseshoe crabs, scorpions, spiders, mites and ticks, as well as the extinct eurypterids (sea scorpions) and chasmataspidids. The understanding of the ground plans and relationships between these crown-group euchelicerates has benefited from the discovery of numerous fossils. However, little is known regarding the origin and early evolution of the euchelicerate body plan because the relationships between their Cambrian sister taxa and synziphosurines, a group of Silurian to Carboniferous stem euchelicerates with chelicerae and an unfused opisthosoma, remain poorly understood owing to the scarce fossil record of appendages. Here we describe a synziphosurine from the Lower Ordovician (ca. 478 Ma) Fezouata Shale of Morocco. This species possesses five biramous appendages with stenopodous exopods bearing setae in the prosoma and a fully expressed first tergite in the opisthosoma illuminating the ancestral anatomy of the group. Phylogenetic analyses recover this fossil as a member of the stem euchelicerate family Offacolidae, which is characterized by biramous prosomal appendages. Moreover, it also shares anatomical features with the Cambrian euarthropod Habelia optata, filling the anatomical gap between euchelicerates and Cambrian stem taxa, while also contributing to our understanding of the evolution of euchelicerate uniramous prosomal appendages and tagmosis.

[Evaluation of training in transfusion safety offered to medical students in Morocco]. / Evaluation d´une formation en sécurité transfusionnelle auprès des étudiants en médecine au Maroc.

Introduction: students worldwide receive little training on blood transfusion therapies during their time at medical schools and hospitals, then reformulation of academic programs is mandatory. Indications for blood transfusions are more frequent than recommended, which helps to increase the risks associated with this procedure. To overcome this, structured objective training on nursing care and procedures was organised with the topic of transfusion safety. The purpose of our study was to assess medical students´ appreciation of this training and the degree to which this population had mastered it. Methods: we conducted a cross-sectional, descriptive, single-centre study. We conducted a survey among the 3rd-year medical students. A self-administered assessment questionnaire, as well as an evaluation grid for acquired skills, filled in by the training doctors during the session, were used. Data analysis was based on descriptive statistics using Excel software. Results: three hundred and eighty-four (n=384) students were invited to attend this training course, 275 (71.6%) of whom were enrolled in the study. The overall satisfaction rate was 93.8%. The objectives and organisation were 95.6% successful. The quality of the training was 90.3% satisfactory. The choice of topic for the station was satisfactory for 80% of participants, the flow of the session for 86.3%, the quality of the organisation and debriefing for 89%, the interaction between trainers and learners for 90.2%, the motivation of trainers and the reflection stimulated in the learners for 92%. We noted that 93% of students had never participated in training in transfusion safety. Mastery of global skills was total for 67%, partial for 26% and absent for 7%. The students mastered the procedures for checking the identity and grouping of the product to be transfused at 97%, the principle of interpreting the ultimate pre-transfusion test (96%), the purpose of ultimate test at the patient´s bedside 93% with mastery of its technical implementation 83%. Conclusion: training in transfusion safety was well received, with a satisfactory level of proficiency. This experience can easily be extended to other topics.

The rhizosphere of a drought-tolerant plant species in Morocco: A refuge of high microbial diversity with no taxon preference.

Arid and semi-arid areas are facing increasingly severe water deficits that are being intensified by global climate changes. Microbes associated with plants native to arid regions provide valuable benefits to plants, especially in water-stressed environments. In this study, we used 16S rDNA metabarcoding analysis to examine the bacterial communities in the bulk soil, rhizosphere and root endosphere of the plant Malva sylvestris L. in Morocco, along a gradient of precipitation. We found that the rhizosphere of M. sylvestris did not show significant differences in beta-diversity compared to bulk soil, although, it did display an increased degree of alpha-diversity. The endosphere was largely dominated by the genus Rhizobium and displayed remarkable variation between plants, which could not be attributed to any of the variables observed in this study. Overall, the effects of precipitation level were relatively weak, which may be related to the intense drought in Morocco at the time of sampling. The dominance of Rhizobium in a non-leguminous plant is particularly noteworthy and may permit the utilization of this bacterial taxon to augment drought tolerance; additionally, the absence of any notable selection of the rhizosphere of M. sylvestris suggests that it is not significatively affecting its soil environment.

Self-reported depression and its risk factors among hypertensive patients, Morocco: a cross-sectional study.

Hypertensive patients are at an elevated risk of developing mental diseases such as depression, which can impair their quality of life. The purpose of this study is to measure the prevalence of self-reported depression among hypertensive patients treated at primary health care facilities in Marrakech. Between May 2021 and December 2022, a cross-sectional study of 1053 hypertensive patients attending primary health care facilities in Marrakech was conducted. A face-to-face questionnaire was used to collect socio-demographic, behavioral, and clinical data, as well as hypertension treatment characteristics and the care-patient-physician triad. The Patient Health Questionnaire-9 was used to assess self-reported depression. To identify self-reported depression risk factors, multivariate logistic regression was used. Depressive symptoms were reported by 56.1% of hypertensive patients. The patients' average age was 63.2 ± 9.5 years, and 508 (85.9%) were female. Female sex, stress, a low-salt diet, pain and physical discomfort, an urban living environment, a lack of self-monitoring of hypertension, an unsatisfactory relationship with the healthcare system, a family history of hypertension, and the perception of adverse effects of the antihypertensive drug were all associated with self-reported depression. Self-reported depression is prevalent among hypertensive patients in Marrakech. The mental health component should be emphasized while addressing hypertensive patients in primary health care facilities.

Epidemiological, Diagnostic and Therapeutic Aspects of Hepatocellular Carcinoma in Morocco: A Case Series and Review of Literature.

INTRODUCTION: Hepatocellular carcinoma (HCC) is the most common primary liver tumor. It is considered a global public health problem given its incidence and high mortality rate. Epidemiological studies on hepatocellular carcinoma in our Moroccan and North African contexts are rare. Hence, our study aims to determine the epidemiological, clinical, paraclinical, etiological and therapeutic aspects of this pathology in our context. MATERIALS AND METHODS: We conducted a descriptive retrospective study on patients with HCC treated by the Hepato-gastroenterology department of the university hospital of Mohammed VI in Marrakech over a period of 7 years spread between 01/01/2015 and 31/12/2021. The epidemiological characteristics, diagnostic methods and therapeutic management of HCC in these patients have been described and analyzed. RESULTS: 100 patients with HCC were identified and included in our study. The average age was 63.3 ± 12.63 years with a male predominance. The predominant etiology was cirrhosis (87% of cases) then viral hepatitis C (35%) and B (27%) and of unknown origin in 29% of cases. HCC revealed cirrhosis in 41% and was diagnosed during cirrhosis surveillance in 36% of cases. The functional signs were dominated by abdominal pain (68%), deterioration of general condition (58%) and abdominal distension (43%). Alfa-fetoprotein was elevated in 73% of cases and was above 400ng/ml in 41% of cases. The diagnosis was mainly radiological in 92% and histological in 8% of cases. The radiological aspects of HCC were dominated by mononodular form (58%), a right lobar location (80%), a diameter greater than 5 cm (58%), a typical vascular aspect (86%) with portal thrombosis in 24% and metastases in 36% of cases, especially in lymph nodes. The majority of cirrhosis in our series was classified as Child-Pugh stage B (46%) at the time of diagnosis and most patients had an advanced stage of HCC with 31% at BCLC C and 28% at BCLC D. 72% of patients received palliative treatment, and only 6% received curative treatment. At the end of the study, 48% of patients had died with an overall survival of 6.5 months. CONCLUSION: Our study achieved its main objective by providing a snapshot of HCC in our context and confirmed that HCC remains with poor prognosis since its diagnosis is often late, limiting the therapeutic choices with a very short median survival. It also noted that the viral etiology remains the main cause of HCC in our population. Therefore, prevention remains the best therapeutic approach against HCC and the need for a national or at least a regional HCC registry in our country is essential in order to develop targeted preventive measures adapted to our context and to improve the diagnostic and therapeutic approaches for our patients.

Bioassay-guided isolation of anti-inflammatory and antinociceptive metabolites among three Moroccan Juniperus leaves extract supported with in vitro enzyme inhibitory assays.

ETHNOPHARMACOLOGICAL RELEVANCE: Herbs of the genus Juniperus (family Cupressaceae) have been commonly used in ancestral folk medicine known as "Al'Araar" for treatment of rheumatism, diabetes, inflammation, pain, and fever. Bioassay-guided isolation of bioactives from medicinal plants is recognized as a potential approach for the discovery of novel drug candidates. In particular, non-addictive painkillers are of special interest among herbal phytochemicals. AIM OF THE STUDY: The current study aimed to assess the safety of J. thurifera, J. phoenicea, and J. oxycedrus aqueous extracts in oral treatments; validating the traditionally reported anti-inflammatory and analgesic effects. Further phytochemical investigations, especially for the most bioactive species, may lead to isolation of bioactive metabolites responsible for such bioactivities supported with in vitro enzyme inhibition assays. MATERIALS AND METHODS: Firstly, the acute toxicity study was investigated following the OECD Guidelines. Then, the antinociceptive, and anti-inflammatory bioactivities were evaluated based on chemical and mechanical trauma assays and investigated their underlying mechanisms. The most active J. thurifera n-butanol fraction was subjected to chromatographic studies for isolating the major anti-inflammatory metabolites. Moreover, several enzymatic inhibition assays (e.g., 5-lipoxygenase, protease, elastase, collagenase, and tyrosinase) were assessed for the crude extracts and isolated compounds. RESULTS: The results showed that acute oral administration of the extracts (300-500 mg/kg, p. o.) inhibited both mechanically and chemically triggered inflammatory edema in mice (up to 70% in case of J. thurifera) with a dose-dependent antinociceptive (tail flick) and anti-inflammatory pain (formalin assay) activities. This effect was partially mediated by naloxone inhibition of the opioid receptor (2 mg/kg, i. p.). In addition, 3-methoxy gallic acid (1), quercetin (2), kaempferol (3), and ellagic acid (4) were successfully identified being involved most likely in J. thurifera extract bioactivities. Nevertheless, quercetin was found to be the most potent against 5-LOX, tyrosinase, and protease with IC50 of 1.52 ± 0.01, 192.90 ± 6.20, and 399 ± 9.05 µM, respectively. CONCLUSION: J. thurifera extract with its major metabolites are prospective drug candidates for inflammatory pain supported with inhibition of inflammatory enzymes. Interestingly, antagonism of opioid and non-opioid receptors is potentially involved.

Assessment, Prevalence, and Correlates of Frailty among Moroccan People Aged 50 and above Living with HIV.

BACKGROUND: Persons living with HIV experience many challenges, such as premature aging and geriatric syndromes. Frailty has become an important determinant of a series of adverse health outcomes. This research aimed to evaluate the prevalence and risk factors for frailty in this population. METHODS: A cross-sectional outpatient investigation was conducted in an urban HIV clinic. Patients aged 50 and older living with HIV were included. Frailty phenotype was evaluated using the original Fried criteria, and we calculated the Veterans Aging Cohort Study (VACS) index, Charlson Comorbidity Index, Fracture Risk Assessment Tool scores, and Mini-mental State Exam scores. RESULTS: One hundred and nine individuals were studied. Ninety-two (84.4%) were men, with a mean age of 57.65.2 years. Fourteen (12.8%) participants were frail. Frail participants were older (P = 0.001) and less likely to be virally suppressed (P = 0.01). Having ≥3 comorbidities, VACS index, polypharmacy, and 5-year mortality risk was significantly greater in the frail group. Frailty was significantly associated with poorer quality of life (P = 0.02). The cognitive impairment, falls, and malnutrition risk were significantly associated with a risk to manifest a frail phenotype. CONCLUSION: Frailty is common among Moroccans with HIV, and it is associated with greater morbidity and mortality rates. Our findings should serve as a warning sign to standardize frailty and geriatric syndrome screening in this population.

Phytochemical composition of cedar tar of the atlas and it's in vitro antifungal activity against Trichophyton rubrum, Trichophyton mentagrophytes and Microsporum canis.

The objective of this study was to identify the major compounds present in Cedar tar obtained by distillation of Cedrus atlantica wood from the Taza forest (Morocco) and to evaluate its antidermatophytic activity in vitro against the three strains of dermatophytes most widespread in Morocco, considered the main prevailing causes of fungal infections of the skin, hair and nails. GC/MS analysis revealed that cedar tar is composed mainly of hydrocarbon sesquiterpenes and oxygenated sesquiterpenes, with nine major compounds identified, including α-Cedrene, ß-Cadinene, γ-Cadinene, ß-Himachelene, α-Turmerone, ß-Turmerone, Ar-tumerone, α-Atlantone and Himachalol. The evaluation of antifungal activity was carried out by the micro dilution technique. The MIC values found were 100µg/mL, 2µg/mL and 0.1µg/mL on Trichophyton rubrum, Trichophyton mentagrophytes and Microsporum canis strains respectively. The observed strong antifungal activity of cedar tar is attributed to the prevalence of oxygenated and hydrocarbon sesquiterpenes, known for their established antidermatophytic properties. This study highlights the potential of the Atlas Cedar tar as an effective antifungal agent for the treatment of superficial mycoses, particularly dermatophytoses.

TYK2, IFITM3, IFNAR2 and OAS3 single-nucleotide polymorphisms among severe COVID-19 ICU patients in Morocco.

OBJECTIVES: This study aimed to explore the potential correlation between specific single nucleotide polymorphisms (TYK2, IFITM3, IFNAR2, and OAS3 variants) and the severity of COVID-19 in Moroccan patients. METHODS: A genetic analysis was conducted on 109 patients with PCR-confirmed SARS-CoV-2 infection in Morocco. Among these patients, 46% were hospitalized in the intensive care unit, while 59% were not hospitalized. Importantly, all patients lacked known risk factors associated with COVID-19 severity. Genotyping was performed to identify variations in TYK2 rs74956615, IFITM3 rs12252, IFNAR2 rs2236757, and OAS3 rs10735079. Statistical analysis was applied using codominant, dominant and recessive logistic regression models to assess correlations with COVID-19 severity. RESULTS: Our findings revealed no significant correlation between TYK2 rs74956615, IFITM3 rs12252, IFNAR2 rs2236757, and OAS3 rs10735079 with COVID-19 severity in Moroccan patients, as indicated in logistic regression models (p > .05). Interestingly, these results may offer insights into the mitigated impact of the COVID-19 pandemic and the reduced severity observed in SARS-CoV-2 infected patients in Morocco. Age, however, exhibited a significant correlation with severity (p < .001), with a trend towards increased likelihood of ICU admission with advancing age. Additionally, In the severe group, a higher proportion of patients were females (54%), indicating a statistically significant correlation with disease severity (p = .04). Nevertheless, female ICU patients aged above 60 years accounted for 37%, compared to 17% for males. CONCLUSION: This study underscores the absence of a genetic association between the selected polymorphisms and COVID-19 severity in Moroccan patients. Advanced age emerges as the primary factor influencing the severity of COVID-19 patients without comorbidities. We recommend setting the threshold for advanced age at 60 years as a risk factor for severe forms of COVID-19.

Health economic evaluation of 2-dose and 3-dose rotavirus vaccines in children below 5 years of age in Morocco.

Following the introduction of rotavirus vaccination into the Moroccan National Immunization Program, the prevalence of the disease has decreased by nearly 50%. However, evidence on the economic value of rotavirus vaccinations in Morocco is limited. This health economic analysis evaluated, from both country payer and societal perspectives, the costs and the cost-effectiveness of three rotavirus vaccines using a static, deterministic, population model in children aged < 5 years in Morocco. Included vaccines were HRV (2-dose schedule), HBRV (3-dose schedule) and BRV-PV 1-dose vial (3-dose schedule). One-way and probabilistic sensitivity analyses were conducted to assess the impact of uncertainty in model inputs. The model predicted that vaccination with HRV was estimated to result in fewer rotavirus gastroenteritis events (-194 homecare events, -57 medical visits, -8 hospitalizations) versus the 3-dose vaccines, translating into 7 discounted quality-adjusted life years gained over the model time horizon. HRV was associated with lower costs versus HBRV from both the country payer (-$1.8 M) and societal (-$4.1 M) perspectives, and versus BRV-PV 1-dose vial from the societal perspective (-$187,000), dominating those options in the cost-effectiveness analysis. However, costs of BRV-PV 1-dose vial were lower than HRV from the payer perspective, resulting in an ICER of approximately $328,376 per QALY, above the assumed cost effectiveness threshold of $3,500. Vaccination with a 2-dose schedule of HRV may be a cost-saving option and could lead to better health outcomes for children in Morocco versus 3-dose schedule rotavirus vaccines.

Challenges faced by human resources for health in Morocco: A scoping review.

BACKGROUND: Human resources for health (HRH) play a pivotal role in effective health system operation, yet various impediments challenge sustainable development. This scoping review aimed to explore these challenges and potential solutions in aligning the health workforce to meet the evolving healthcare needs of the Moroccan population. METHODS: We conducted a scoping review searching PubMed, Science Direct, Cairn and Google Scholar for relevant articles published between 2014 and 2023. Additionally, non-peer-reviewed literature sourced from Ministry of Health consultations and allied websites was included. RESULTS: Among the nineteen studies meeting our inclusion criteria, the majority were cross-sectional and predominantly focused on challenges faced by nurses. While some papers delineated multiple HRH challenges (5/19), the rest addressed specific challenges. The identified challenges span organizational and personal levels. Organizationally, the focus was on training, lifelong learning, continuing education, health coverage and shortages, and job satisfaction. At a personal level, HRH in the public health sector encountered challenges such as burnout, stress, and broader occupational health concerns. CONCLUSIONS: The reviewed publications underscored a spectrum of challenges necessitating robust policy interventions. Despite promising developments in the Moroccan healthcare system, addressing the unequal urban-rural HRH distribution, augmenting funding, and enhancing HRH quality of life stand as pivotal imperatives.