Clinical and epidemiological study of onychomycosis among patients of the national institute of hygiene in rabat, Morocco (2016-2020).

Background and Purpose:  Onychomycosis is a common nail infection characterized by the discoloration, thickening, and detachment of nails. This study aimed to provide valuable insights into this pathology by assessing its prevalence, clinical aspects, related comorbidities, and causative agents in patients from a Moroccan population. Materials and Methods:  This retrospective study was conducted on 1,606 subjects at the Mycology-Parasitology laboratory of the National Institute of Hygiene in Rabat, Morocco, over five years (2016-2020). Nail samples were collected from both fingernails and toenails and processed through microscopic examination and culture. The incubated tubes were kept at a temperature range of 28-30°C for 4-5 weeks. Results:  Onychomycosis was mycologically confirmed in 1,794 samples (93.24%). It occurred commonly in the 41-60 age group, with a higher incidence among females (74.53%). Diabetes, alongside other chronic diseases, was prevalent among patients with underlying conditions, comprising 131 cases (40.56%). Disto-lateral subungual onychomycosis emerged as the most prevalent clinical presentation, comprising 1,536 cases (79.92%). Fingernails primarily affected by yeasts, notably Candida albicans, accounted for 565 cases (29.80%), while toenails were predominantly impacted by dermatophytes, primarily Trichophyton rubrum (n=1,230, 64.87%). Mixed infections exclusively featured yeasts and dermatophytes, predominantly T. rubrum and C. albicans, which accounted for 79 (4.40%) cases. The study explored the influence of molds, yielding insights into their rarity in onychomycosis. Conclusion:  These findings hold significant implications for the clinical management and diagnosis of onychomycosis, particularly in patients with underlying chronic conditions. Further epidemiological studies across Morocco are needed for meaningful comparisons.

Coding-Complete Genome Sequences of a Delta Subvariant (AY.33) of SARS-CoV-2 Obtained from Moroccan COVID-19 Patients.

We report here the complete genome sequences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strains obtained from Moroccan patients with COVID-19. The analysis of these sequences indicates that the identified strains belong to the AY.33 sublineage of the Delta variant.

Survey and Diagnostic Challenges after Transmission-Stop: Confirming Elimination of Schistosomiasis haematobium in Morocco.

Clinical cases of Moroccan residents have been recorded since 2004, indicating successful interruption of transmission of S. haematobium infection at national level. The first national survey initiated in 2009 for Schistosomiasis haematobium among children born after 2004, applied diagnostic test was the HAMA-EITB, based on the Western blot technology, and molecular malacological diagnostic tools clearly confirm transmission stop. In 2015, a recent, small survey utilizing an HAI, ELISA tests and an ultrasensitive antigen test, FTCUP CAA, in a group of individual with a past history of infection. However, obviously follow-up surveys to prevent reemergency and for certification of the schistosomiasis elimination require vigilant diagnosis strategies. Here we discuss diagnosis story line in the national laboratory and challenges based on the available tools in relation to their clinical parameters (sensitivity/specificity; Sn/Sp), practicability and associated costs. When transmission stop has been achieved, survey cost and speed are likely to benefit from cost effective pooling strategies and ultrasensitive assays indicating active infection in all potential risk groups. Similarly molecular pooling strategies to monitor infections in the snail vectors.

Molecular epidemiological study of cutaneous leishmaniasis in Beni Mellal and Fquih Ben Saleh provinces in Morocco.

Leishmaniases are parasitic diseases frequent in the Mediterranean Basin. Cutaneous leishmaniasis (CL) has been recently emerged in several new foci, causing a public health problem in Morocco. This study was performed to evaluate the epidemiological status of cutaneous leishmaniasis (CL) in Beni Mellal and Fquih Ben Saleh Provinces and to identify the causative agent. A total of 584 (56% female, 44% male) confirmed cases of CL were enrolled during the study period 2000-2012. Majority of cases (56%) were recorded in three sectors: Zaouiat Cheikh, Beni Mellal and Oulad Ayad. Fisher statistical test showed that there is a significant effect of the total cases of CL affected in the 185 localities. The age distribution of CL cases was relatively stable, with the majority of patients (62.34%) aged less than 9 years old with significant differences (p-value<2.2e-16). CL lesions were mostly located on the face (89%). The average number of lesions per patient was 1.38. Leishmania tropica was identified as the causative agent based on species-specific ITS1-PCR-RFLP assay.

Epidemiological characteristics of a new focus of cutaneous leishmaniasis caused by Leishmania tropica in Settat, Morocco.

A new emerging focus of human cutaneous leishmaniasis (HCL) caused by Leishmania tropica was identified within the province of Settat. This study was performed in order to analyze the reasons of the extension of CL in this area, and to describe the clinico-epidemiological characteristic of this emerging focus during 2007-2012. A total of 553 suspected cases of CL were diagnosed in laboratory of Settat, controlled and confirmed in reference national laboratory of leishmaniasis in Rabat. Leishmania parasite is found in 356 cases. Most of them (33.89%) were recorded in localities of Ouled Ghalem (110 cases) and Laamarcha (102 cases) of El Borouj sector. The lesions were typically small, dry and mostly located on the face and extremities. Majority of infection (25%) was recorded among children under 11 years old, and female (72%). Strains of L. tropica were identified by PCR ITS1 from positive slides and zymodeme MON-102 was typed using isoenzyme technique on starch gel electrophoresis.

Coexistence of Leishmania tropica and Leishmania infantum in Sefrou province, Morocco.

Cutaneous leishmaniasis (CL) has been recently emerged in new foci, posing a public health problem. Increasing cases of CL have been reported during recent years in Sefrou province, a previously non-endemic area. The present study was designed for epidemiological and parasitological characterization of the disease for the first time in this area. The results of a retrospective analysis of CL cases reports, between 2000 and 2011 showed that the incidence was estimated to 463/100,000 inhabitants/year, with a total of 1242 cases were notified from 1997 to 2011. Most patients were infected in the sector El Menzel (22.81%) and Sefrou (20.51%). Other cases have been reported in the 15 other sectors, reflecting the geographical spread of the disease. The highest rate lesions were found in the age group of 9 years or less with significant differences (p-value<2.2e-16) comparing to the older age groups. The most affected lesion was localized in the face (64%). The average number of lesions per patient was 2.35 with a maximum of 5 lesions. The clinical aspects of lesions were mostly crusted. The causative agents of CL in this province were identified as the coexistence of L. tropica and L. infantum by species-specific ITS1-PCR-RFLP assay. CL remains an emergent disease in Sefrou with an incidence and a continuously geographical spread. Recent environmental changes, auspicious to vectors had probably contributed to that situation.