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Introduction: the objective of this study is to examine dietary habits and certain cooking practices, evaluating their influence on the prevalence of anemia in pregnant women and exploring other factors associated with anemia in Morocco, specifically in the province of Sidi Kacem., Methods: the research utilized a survey conducted over a one-year duration, spanning from August 01, 2018, to August 01, 2019, employing a cross-sectional, and analytical methodology. The prevalence of anemia in pregnant women was determined based on complete blood count tests, using hemoglobin (Hb) levels and World Health Organization (WHO) thresholds. An anonymous structured questionnaire was used to assess the dietary practices of the participants. The impact of these practices on anemia was analyzed using multivariate logistic regression models. Data analysis was conducted using Statistical Package for the Social Sciences (SPSS) software version 26., Results: the anemia rate among pregnant women in the province of Sidi Kacem was 43.03%. The findings of the binary logistic regression analysis revealed a statistical association between anemia, the main sources of iron in the diet, the frequency of consumption of caffeine-containing beverages (tea, coffee) with meals, the use of specific cooking techniques that could influence the iron content of foods, and the daily diet., Conclusion: the prevalence of nutritional challenges in Morocco poses a barrier to human development and enhanced health outcomes. A comprehensive understanding of the severity of these deficiencies is imperative for tailoring interventions that are contextually relevant to each region within the country., Competing Interests: The authors declare no competing interests., (Copyright: Najoua El Aski et al.)

Introduction: visceral leishmaniasis (VL) represents the most serious and severe form of leishmaniasis in Northern Morocco. In this context, the objective of this study was to describe the epidemiological profile of VL in the Tangier Tetouan Al-Hoceima region from 2009 to 2018., Methods: the epidemiologic data was collected from April 28 th , 2019 to February 2 nd , 2020 from files and investigation reports of cases. Additionally, annual reports for VL from the health services and provincial laboratories of parasitology were consulted. The analysis was conducted using statistical package for the social sciences (SPSS) v26 software., Results: the study included 304 cases. Chefchaouen province was the highest endemic area (54.5%). The cases in the spring reached 36.5% and were characterized by age ≤5 years old (78.8%), male gender (M/F=1.3) and rural residents (91.4%). The number of inhabitants per household of cases was >5 persons (68.5%). A total of 94.3% and 98% had no suspect cases around or in their homes, respectively. Farmers accounted for 74.5% of cases. Signs of fever were present in 17.4% of cases, with 67.3% of these cases presenting these signs for a duration of more than 30 days. A total of 64.2% cases were diagnosed within a month. The serological test was used for diagnosis in 67.1% of cases and for the treatment, glunantime® was used in all cases (100%)., Conclusion: to eliminate the VL infection, it's necessary to monitor the entomological, mammalogical investigation. Also, to activate the Integrated Vector Control Management Committee at the most endemic province and to inform the community as well as the professionals of health about the VL control measures. A correlational study of the VL socio-economic and climate factors is recommended., Competing Interests: The authors declare no competing interests., (Copyright: Kaoutar Nabah et al.)

Introduction: the prevalence of Helicobacter pylori (H. pylori) infection in children is very high in Morocco. Eradication rates of H. pylori infection decrease due to the emergence of resistance to antibiotics. Data on the antimicrobial susceptibility of H. pylori in Moroccan children are not available. This study aims to assess the prevalence of H. pylori infection and the metronidazole resistance rate of H. pylori in Moroccan pediatric patients, and their association with epidemiologic factors., Methods: a cross-sectional study was conducted on 132 pediatric patients who had an indication for upper gastrointestinal endoscopy and attended pediatric hospital Abderrahim Harouchi of the University Hospital Ibn Rochd, Casablanca, Morocco. Detection of H. pylori infection and the susceptibility to metronidazole was performed by classic PCR. Statistical analysis was performed using R Studio software., Results: the overall prevalence of H. pylori infection was 80.3%. vomiting was significantly associated with H. pylori infection (p-value=0.01). Regarding the resistance rate of metronidazole, we found that the prevalence of H. pylori resistance to metronidazole was high (70.8%) and it significantly increased, especially in pediatric patients living in urban areas (p-value=0.01)., Conclusion: the prevalence of H. pylori infection and resistance rate of metronidazole were very high in Moroccan children. Therefore, triple therapy with metronidazole must be preceded by a study of the bacterium's susceptibility to the prescribed antibiotics, in particular to metronidazole., Competing Interests: The authors declare no competing interests., (Copyright: Fatima Zahra Kheir et al.)

Introduction: the increasing demands and responsibilities placed upon teachers are causing overwhelming stress. As a result, many teachers struggle with managing their workload effectively, which increases their susceptibility to burnout. This study aims to investigate burnout among high school teachers in Tetouan, Morocco, and explore the various contributing factors., Methods: a cross-sectional study was conducted involving teachers who completed the Maslach Burnout Inventory and a comprehensive questionnaire covering personal attributes and professional responsibilities. We then used statistical software to analyze the collected data. Results: the study, involving 258 high school teachers, highlights a significant prevalence of burnout, with levels ranging from moderate to high. Particularly notable is the prevalence of emotional exhaustion, which affected 43% of the participants, whereas depersonalization (46%) and personal accomplishment (47%) exhibited relatively lower levels of concern. In addition, a thorough analysis revealed significant correlations between burnout rates and contributing factors, including gender, number of classes taught, class size, weekly working hours, and engagement in regular physical activity., Conclusion: this study highlights the substantial prevalence of burnout among high school teachers, emphasizing the urgency of teacher well-being. It enhances the understanding of the association between burnout and different work-related and lifestyle factors, enabling the identification of appropriate interventions. The interaction between burnout and these factors implies the need to further investigate gender-specific and workload-related preventive measures., Competing Interests: The authors declare no competing interests., (Copyright: Hicham Guider et al.)

Distal humerus fractures, defined as interruptions of bone continuity below the insertion of the anterior brachial muscle, are relatively rare, representing 1 to 2% of all fractures. These fractures display a bimodal distribution, predominantly affecting young men (12-19 years old) due to violent trauma and elderly women (>80 years old) due to low-energy trauma associated with osteoporosis. This study aims to present the clinical, radiological, and therapeutic outcomes of distal humerus fractures in subjects over 65 years. A retrospective analysis of 62 cases treated surgically with plates at CHU Hassan II in Fes, Morocco, from January 2010 to December 2023 was conducted. Patients included were over 65 years old with non-pathological distal humerus fractures. Data were collected on epidemiology, fracture characteristics, surgical treatment, complications, and functional outcomes. The average age of patients was 73 years, with equal gender distribution. Most fractures resulted from simple falls (56%) and road traffic accidents (33%). Common comorbidities included hypertension, dyslipidemia, obesity, and confirmed osteoporosis. Surgical treatment with plates, predominantly using the posterior approach, showed a high consolidation rate of 89%. Complications included infection, ulnar nerve paresthesia, stiffness, malunion, and nonunion. Functional outcomes, assessed using the Mayo Clinic Elbow Performance Score, were excellent to good in 64.5% of patients, with significant pain relief and satisfactory mobility observed in most cases. In conclusion, managing distal humerus fractures in individuals over 65 is challenging due to anatomical complexity and comorbidities. Conservative surgical treatment with dual plating, particularly parallel plating with anatomical pre-molded plates, provides superior stability and favorable functional outcomes, emphasizing the importance of stable fixation and early rehabilitation., Competing Interests: The authors declare no competing interests., (Copyright: Anass Abaydi et al.)

Introduction: Morocco is no exception to the global phenomenon of an ageing population. The number of people aged 60 and over rose from one million to 4.5 million between 1970 and 2022. In terms of health, 64.4% of Moroccan seniors are affected by at least one chronic disease, and almost a third suffer from disability. We aimed to estimate the prevalence and identify the factors associated with frailty among the elderly in the Essaouira province of Morocco., Methods: a descriptive and analytical cross-sectional survey of 384 people aged 65 and over attending health centres in Essaouira province was conducted between March 2022 and January 2023. Data were collected using a self-administered questionnaire. The Fried phenotype was used to assess frailty in the participants., Results: according to Fried's phenotype, 46.4% of the elderly were frail. Multivariate analyses showed that frailty was associated with family type [OR=1.9; 95% CI 1.4-2.6], professional activity [OR=2.2; 95% CI 1.2-3.9], financial difficulties [OR=1.7; 95% CI 1.1-2.8] and undernutrition [OR=2.9; 95% CI 1.7-4.8]., Conclusion: implementing a screening strategy and speeding up the process of generalising social protection are actions that will make it possible to reduce the prevalence of frailty among the elderly, prevent its complications and act on its main determinants in Morocco., Competing Interests: The authors declare no competing interests., (Copyright: Hicham Mejdouli et al.)

Introduction: the present study aimed to establish an epidemiological profile of patients consulting the unit of maxillofacial prosthodontics in Rabat. Results deriving from this study will help enhance the quality of patient care in our center and can also serve as a comparison tool with other maxillofacial teams around the world., Methods: during 11 months all patients consulting the unit of maxillofacial prosthodontics in our center were included. We opted for a questionnaire with 3 variables: socio-demographics, clinical examination data, and the type of prosthetic treatment adopted. The study was conducted in the Department of Removable Prosthodontics in the Center of Consultation and Dental Treatment of Rabat Morocco (CCDTR) from September 2020 to July 2021., Results: the study population consisted of 91 patients, with a majority of male patients at 53% (n=48). During our study period, the proportion of patients under one-year-old was predominant, accounting for 38.4% (n=35) of the total sample. Among the patients in the sample, 72.5% (n=66) had no profession, while 66% (n=60) had a low income. Regarding medical insurance, the majority of our patients, 85.5% (n=78), were covered by Public Health Insurance for the Low-income Population (PHILP). Among the total sample, 57.1% (n=52) consulted for a combination of pain function and aesthetics. Additionally, 61.5% (n=56) were referred by teaching hospitals. For the type of oro-facial defect, 52.7% (n=48) of the sample consisted of newborns with congenital facial cleft. Out of the 91 patients, 36 had maxillofacial tumors, with 47.6% (n=17) of them presenting squamous cell carcinoma. Furthermore, 63.7% (n=58) of the prosthetic treatments adopted involved presurgical orthopedic treatments for newborns with facial cleft., Conclusion: the study on the epidemiological profile of patients attending the maxillofacial prosthodontics unit at Ibn Sina University Hospital in Rabat, Morocco provides important insights. The findings highlight the predominance of male patients and the prevalence of oro-facial defects in newborns. Socioeconomic factors, such as low income and lack of profession, are significant considerations. The majority of patients are covered by the PHILP, indicating the importance of medical insurance. These findings contribute to improving healthcare planning and specialized care for this patient population., Competing Interests: The authors declare no competing interests., (Copyright: Mohamed Azhari et al.)

Introduction: the chronic kidney disease (CKD), is associated with various psychiatric conditions and poorer quality of life. The main objective of this study is to estimate the prevalence of depression and anxiety among CKD patients and to assess their determinant factors., Methods: this is a cross-sectional study in a Moroccan university hospital. Patients aged ≥18 years and followed for more than one year for a stage 3 to 5 CKD, not under renal replacement therapy (RRT) were included. The data were collected using a questionnaire and the hospital anxiety and depression scale (HADS). The association between depression and anxiety sub-scores and the estimated glomerular filtration rate (eGFR) was assessed using simple and multiple linear regression., Results: eighty-three patients (mean age 61.7 ± 14.1 years, and 61.4% were women), were included. Regarding the stages of CKD, 10.7% were in stage 3, 52.2% in stage 4, and 25% in stage 5 of CKD. The median of the depression sub-score was 5.00 (IQR (2.00; 10.0)). The median of the depression sub-score was 5.00 (IQR (2.00; 10.09)), and the median of the anxiety sub-score was 6.00 (IQR (4.00; 9.00)). It also shows that 22.0% of patients had depression (stage 4 = 23.8%, stage 5 = 36.8%) and 22.2% had anxiety (stage 4 = 26.2%, stage 5 = 33.3%). Both depression and anxiety scores were significantly associated with the eGFR before (p<0.001, p= 0.001 respectively) and after adjustment (p=0.001, p=0.002 respectively)., Conclusion: according to this study depression and anxiety are strongly related to eGFR., Competing Interests: The authors declare no competing interests., (Copyright: Amina Chrifi Alaoui et al.)

Introduction: neuromeningeal tuberculosis (NMT) is a significant public health challenge in Morocco because of its acute severity and high mortality rates. This study aims to comprehensively evaluate the epidemiological, clinical, therapeutic, and disease progression characteristics of NMT in the Kenitra province., Methods: a retrospective analysis was conducted on the medical records of patients diagnosed with NMT at the Diagnostic Center of Tuberculosis and Respiratory Diseases in Kenitra from 2014 to 2017., Results: among the 33 identified NMT cases, predominantly males (57.6%) were affected, with an age range of 4-76 years and a median age of 25 years. Extrapulmonary manifestations were prevalent, constituting 78.8% (n=26) of all cases, with meningeal localization in 45.5% (n=15) of confirmed cases. Furthermore, 9.1% (n=3) of cases were associated with unconfirmed cerebral tuberculosis (TB), and 12% (n=4) exhibited miliary TB. Familial transmission and comorbidities were identified as significant factors in disease progression. More than half of the patients received standardized antibacillary treatment during hospitalization, which lasted between 9 and 12 months. Treatment outcomes were generally positive (73%), but a 12% case fatality rate and 15% loss to follow-up were observed., Conclusion: this study highlights the complex clinical and public health challenges posed by NMT in Morocco. It emphasizes the need for improved health strategies that not only increase public awareness but also enhance the accessibility and quality of diagnostic services and treatment options., Competing Interests: The authors declare no competing interests., (Copyright: Fadia Bejja et al.)

Introduction: blood transfusion remains an essential therapeutic intervention, but the occurrence of transfusion reactions makes its administration even more complex. Vigilant reporting of such reactions by recipients of blood products is essential for effective haemovigilance. This study aimed to determine the frequency and nature of transfusion reactions., Methods: conducted over five years (2017-2021) at the Haemovigilance Department of the Rabat Regional Blood Transfusion Centre, this retrospective study exploited incident forms notified by health establishments and data from the regional blood transfusion centre's computer system., Results: from 1 January 2017 and 31 December 2021, the Rabat Regional Blood Transfusion Centre distributed 435,651 labile blood products to various healthcare establishments, which reported 191 transfusion reactions involving 191 patients. The median age of the patients was 44.3 years, with an overall cumulative incidence of transfusion reactions of 0.44 per 1000 labile blood products delivered. The predominant reactions were non-haemolytic febrile and allergic reactions, accounting for 41.36% and 35.60% respectively. Grade 1 reactions accounted for 87% of all reactions recorded. During the study period, three deaths were recorded, with ABO incompatibility and transfusion-related acute lung injury (TRALI) accounting for two and one case respectively. Transfusion reactions involving erythrocyte components were significantly more frequent than those involving platelet and plasma components., Conclusion: this study revealed a relatively low incidence of transfusion reactions (0.44%), dominated by non-haemolytic febrile and allergic reactions. Several levels of failure were identified, in particular under-reporting of reactions and inadequate training in transfusion practices and haemovigilance, as well as the need for an effective electronic transfusion reaction reporting system to facilitate reporting and identification of underlying problems and risk factors to improve the quality of transfusion care provided to patients., Competing Interests: The authors declare no competing interests., (Copyright: Ilham Lemssahli et al.)

Competing Interests: Les auteurs ne déclarent aucun conflit d’intérêt.

Introduction: antimicrobial resistance in gram-negative bacilli is one of the major concerns in public health. We aimed to evaluate gram-negative bacilli epidemiology, antimicrobial profiles, and the resistance´s mechanism for Enterobacteriaceae isolated from specimens of hospitalized patients in wards of University Hospital Center Ibn Rochd of Casablanca, Morocco., Methods: a prospective study of the patient's specimens, collected from December 2016 to 31 st March 2017. Isolation and identification were performed using conventional biochemical tests. According to the European Committee on Antimicrobial Susceptibility Testing guidelines, antibiotic susceptibility was determined. Polymerase Chain Reaction (PCR) was used to detect β-lactamase and carabapenemase genes: CTX-M, SHV, TEM, OXA-48, NDM, and VIM among the Enterobacteriaceae., Results: according to inclusion criteria, 38 Enterobacteriaceae, 25 Acinetobacter baumannii (A. baumannii), and 10 Pseudomonas aeruginosa (P. aeruginosa) were included during the study period; these bacteria were mainly responsible for bacteremia. Fifty-five percent of enterobacteria were extended-spectrum β-lactamase (ESBL), 42% EBSL and carbapenemase, and 3% carbapenemase, with high coresistances. Eighty-four percent of A. baumannii were XDR. All P. aeruginosa were MDR; amikacin showed the best activity (70% susceptibility). The genotypic approach revealed the presence of bla CTX-M , bla SHV , bla TEM in 68%, 22%, and 11% respectively. Of the 22 carbapenemase-producers, 41% were bla OXA-48 and 18% bla NDM ; none had bla VIM . Furthermore, various genes coexistence were detected: bla CTX-M +bla OXA-48 ; bla CTX-M +bla NDM ; bla CTX-M +bla SHV +bla OXA-48 ; and bla SHV +bla OXA-48 ., Conclusion: findings revealed highly resistance rate among isolates. This raises the need to control antibiotics and regular screening to identify dynamics promoting resistance. Thus, we recommend developing antimicrobial stewardship programs and improving hygiene systems to prevent the nosocomial spreading of these phenotypes in our center., Competing Interests: The authors declare no competing interests., (Copyright: Imane Zalegh et al.)

Introduction: depression in adolescents is a major health condition that can interfere with daily life, lead to suicidal thoughts and behavior, and affect a person throughout life. However, studies about adolescents´ depression in Morocco are scarce. The aim of this study was to determine the prevalence of depression symptoms among in-school adolescents from the region of Settat-Morocco, as well as assessing its relation to daytime sleepiness and poor academic achievement., Methods: the researchers conducted a cross-sectional school-based study. The sample included participants aged 12-20 years, in either urban or rural areas. We selected 722 students through a proportionate stratified sampling procedure. The participants responded to multiple questionnaires that included the Patient Health Questionnaire-9, the Epworth Sleepiness Scale, a questionnaire assessing several sociodemographic and socioeconomic variables, and finally an academic achievement questionnaire. We analyzed the collected data using descriptive statistical methods, χ2 test, and odds ratios., Results: forty-four point seven percent (44.7%) of the respondents had "moderately severe" to "severe depression symptoms" and 32.5% of the sample suffered from excessive daytime sleepiness. Nineteen point nine percent (19.9%) of the total sample reported having a poor academic achievement. Significant predictors for depression symptoms included "female gender" (OR = 2.06; p-value < 0.001), "having divorced parents" (OR = 6.00; p-value < 0.001), "poor academic achievement" (OR = 5.03; p-value < 0.001), and "excessive daytime sleepiness" (OR = 2.30; p-value = 0.002)., Conclusion: this study provides important information about Morocco adolescents´ depression symptoms. These findings can help in implementing school-based mental and sleep health programs that target the promotion of mental wellness, prevention of mental health problems, and reduction of adolescent suicide risk., Competing Interests: The authors declare no competing interests., (Copyright: Marouane Moustakbal et al.)

Introduction: anemia remains a major public health challenge worldwide, frequently having multifactorial causes and wide-ranging, largely underestimated repercussions. The purpose of this paper is to assess the prevalence of anemia and identify associated factors in a group of children, adults, and pregnant women., Methods: our sample consisted of a total of 1360 volunteers (group I: 410 school-aged children aged 5-11 years; group II: 533 adults aged 16 to 65 years; group III: 417 pregnant women aged 17 to 45 years) randomly selected from different towns of the M'diq-Fnideq prefecture, Morocco from March 2018 to September 2018. Data on socio-demographic, anthropometric, and dietary status were collected from a questionnaire survey. A complete blood count was performed using a hematology analyzer, Sysmex KX21N® (Sysmex Corporation, Kobe, Japan), in the hematology laboratory of the Mohamed VI Hospital of M'diq., Results: anemia was found in 31% of children, 52.4% of adults, and 22.5% of pregnant women. Microcytic hypochromic anemia was the most dominant type of anemia in children, adults, and pregnant women with percentages of 40.6%, 48.7%, and 43.5%, respectively. Mild anemia was much more common than moderate and severe anemia in all groups. Furthermore, anemia was associated with low socioeconomic and educational levels in adults (22.8% versus 27.9%) and pregnant women (18.1% versus 16.8%). Schoolchildren with illiterate parents and low socioeconomic levels are the most affected by anemia, with a prevalence of 75% and 69.44%, respectively. Also, children with insufficient stature are at a high risk for anemia compared to children of normal stature (p<0.001). As for weight for age, the odds ratio (OR) was 4.32. A significant difference between underweight and anemia was revealed (p<0.001). A frequency of meat product, vegetables, and fruit consumption lower than 1.5 times per week increases the risk of anemia in schoolchildren., Conclusion: these findings showed a significant prevalence of anemia in all study groups associated with socioeconomic, anthropometric, and nutritional factors. However, further studies are needed to focus on interventions and etiologies in order to limit potential complications, especially in schoolchildren and pregnant women., Competing Interests: The authors declare no competing interests., (Copyright: Saad Bakrim et al.)

Introduction: the pediatric emergency department is the first contact between the population and the hospital. Consequently, its dysfunction influences the quality of the general health care system. However, any successful policy must first be based on convincing results hence the need to better explore this service, diagnose the various dysfunctions, and survey disease trends to identify the needs of the local population. In this perspective, we propose to describe the epidemiological profile of children hospitalized at the emergency service of the Mother-Child hospital, University Hospital Centre Marrakech, and establish the prevalence table for childhood pathologies., Methods: a retrospective study was carried out in pediatric emergency services for 1658 hospitalized patients between March 2015 and December 2018. The collected data concerns mainly the socio-demographic, clinical profile, evolution status, mode of admission, and medical history., Results: the characterization of the studied population by sex and age showed a predominance of male with a sex ratio of 1.36, infants with 625 patients. Concerning the final diagnosis, the most frequent pathologies affected the respiratory system in 28% of cases, then the digestive system (11.3%), while infectious pathologies represented 10.7% of admissions. The death rate in the emergency department was 7.4%. Multivariate analysis of the data showed a statistically significant relationship between the final diagnosis (16 diseases by a system according to The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)) and age, season, and weight. Thus, for the association between the digestive system diseases and weight (aOR=1.052, 95% CI= 1.019-1.086, p=0.02). While for the skin and subcutaneous tissue diseases and the autumn season (aOR=11.37, 95% CI= 1.272-101.777, p=0.03) and age has a negative significance for most diseases., Conclusion: the epidemiological profile study will allow knowledge of patient´s pathologies typology for a well-supported and better definition of needs., Competing Interests: The authors declare no competing interests., (Copyright: Siham Jbari et al.)

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., Competing Interests: The authors declare no competing interest., (Copyright: Ouassima Erefai et al.)

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., Competing Interests: The authors declare no competing interests., (Copyright: Samira Natoubi et al.)

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 1 st 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., Competing Interests: Les auteurs ne déclarent aucun conflit d´intérêts., (Copyright: Mohamed Chahboune et al.)

Introduction: awareness and knowledge of toxoplasmosis are particularly important, as an intervention point for the management of the disease. The aim of this study was to evaluate the awareness and knowledge regarding toxoplasmosis in a sample of postpartum Moroccan women., Methods: this was a cross-sectional descriptive survey carried out among 320 parturient at the National Reference Center for Neonatology and Nutrition at the Children's Hospital of Rabat., Results: of 320 parturient women responding to the survey, 227 (71%) had never heard about toxoplasmosis. While 18.1% of parturient stated knowing the transmission routes for toxoplasmosis. Regarding the transmission route, 53 (16.6%) women pointed at a domestic cat and 31 (9.7%) at eating raw or undercooked meat. Out of all participants, 60 (18.8%) women said they had received prevention advice during their pregnancy. The great majority (90%) of participants were unaware of the severity of the congenital infection. None of the participants showed a high level of knowledge about transmission routes, measures of prevention, and severity of CT., Conclusion: according to our survey, we observed that the majority of participants had never heard any information about toxoplasmosis. It is, therefore, necessary to educate women of childbearing age and pregnant women about the disease, especially concerning the transmission route and the prevention of infection and primary infection in non-immune women., Competing Interests: The authors declare no competing interests., (Copyright: Kenza Hattoufi et al.)

Introduction: microvascular and macrovascular complications of type 2 diabetes mellitus (T2DM) are one of the major causes of morbidity and mortality worldwide among patients with T2DM. This study aims to estimate the prevalence of these chronic complications and identify the associated risk factors among Moroccan patients with T2DM., Methods: this cross-sectional study was conducted on 505 T2DM patients followed by the healthcare Centers of the Casablanca-Settat region from January 2017 to July 2018. The socio-demographic, anthropometric, biochemical, and clinical data were recorded using a structured survey. For statistical analysis, SPSS version 20 is used. Univariate and multivariate logistic regression analyses are used to determine the risk factors associated with chronic complications of T2DM., Results: among the 505 Moroccan patients with T2DM, 84.98% were women. The average age of the patients was 57.27±10.74 years. Diabetic eye disease was the most frequent complication (29.5%) followed by cardiovascular diseases (CVDs) (22.4%), kidney disease in diabetes (9.8%), diabetes foot (2.8%), and neuropathy (1.8%). Logistic regression analysis showed that the CVDs was associated with hypertension (OR: 2.41; 95% CI: 1.11-5.22; p=0.026), hypolipidemia treatment (OR: 2.20; 95% CI: 1.06-4.59; p=0.034), insulin use (OR= 0.39; 95%CI: 0.15-0.96, p=0.043) and LDL-C (OR: 1.01; 95% CI: 1-1.02; p=0.035) in T2DM patients. However, the major risk factors for the development of kidney disease in T2DM patients were a lack of regular physical activity (OR: 3.77; 95% CI: 1.22-11.67; p=0.021), hypolipidemia treatment (OR: 8.31; 95% CI: 1.86-36.97; p=0.005), and high serum creatinine (OR: 1.33; 95% CI: 1.16-1.53; p≤0.001). In addition, LDL-C levels were found to be a significant risk factor for diabetes eye disease (OR: 1.01; 95% CI: 1.00-1.03; p=0.008)., Conclusion: this study shows that the increased duration of diabetes, insulin use, lack of regular physical exercise, hypertension, hypolipidemia treatment, high serum creatinine, and LDL-C were significant risk factors for chronic complications of T2DM in Moroccan patients., Competing Interests: The authors declare no competing interest., (Copyright: Houda El Alami et al.)

Introduction: given the lack of information about monoclonal gammopathies, our primary study outcome was to describe the epidemiological, clinical and biochemical profiles of monoclonal gammopathies in the Souss-Massa region, in southern Morocco., Methods: we conducted a retrospective study, by selecting only complete medical records. We used records of patients diagnosed with monoclonal gammopathy at the local oncology center during a period of over 10 years., Results: one hundred and seventeen patients were included in the study, with a high male predominance (65%) and a male/female sex-ratio of 1.85. The average age of our study population was 61.44 (ET 14.54) years. Diagnoses (based on frequency) included: multiple myeloma 82.0% (n=96), solitary plasmacytoma 8.5% (n=10), monoclonal gammopathies of undetermined significance 2.6% (n=3), lymphoma 2.5% (n=3), secondary plasma cell leukaemia 1.7% (n=2), Waldenström´s disease 1.7%(n=2) and chronic lymphoid leukemia (n=1). The isotype distribution was as follows: IgG Kappa 33.7% (n=28), IgG lambda 21.7% (n=18), IgA Kappa 12.0% (n=10), IgA lambda 7.2% (n=6), IgM kappa 3.6% (n=3), and IgD lambda 2.4% (n=2). Biconal peak was reached in two cases, with a percentage of 2.4%., Conclusion: diagnostic delay was observed compared to international studies due to the unavailability of electrophoresis in the care structures., Competing Interests: Les auteurs ne déclarent aucun conflit d´intérêts., (Copyright: Aissam El Maataoui et al.)

Self-denial and sense of duty are fundamental ethical principles in health care. Since the outbreak of health crisis, healthcare workers have been the first bulwark against the spread of coronavirus, and therefore, the occupational category at higher risk of contamination. In this regard, in a statement dated 23 March 2020, the World Health Organization published a guidance regarding the management of the disease caused by Covid-19 in health workers, but also in workers employed in all sectors exposed to the risk of contamination. In Morocco, the Ministry of Health published on April 6, on its official website, a condolence message to the families of the first two doctors died following contraction of coronavirus, while specifying that coronavirus infection was not due to the exercise of their professional functions. The Minister of Labor and Professional Integration recently appointed an internal committee to undertake a reflection on this issue. At present, given Morocco's law, what are the chances to categorize coronavirus as an occupational disease?, Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts., (Copyright: Meryem Bouchalta et al.)

Introduction: the problem of malnutrition among children is a phenomenon associated with a rapid nutrition transition in Morocco and all developing countries. The objective of this study is to evaluate the nutritional status by anthropometry, food consumption and iron deficiency anemia among primary school children aged 6-12 years in Kenitra city (Morocco)., Methods: the survey covered 271 students (55% of boys and 45% girls) aged 6 to 12. Information concerning food consumption patterns, socioeconomic status and other lifestyle factors was obtained using questionnaires and interviews. Anemia was defined when haemoglobin < 11.5 g/dl., Results: the results showed that, 6.3%, 2.2% and 17.3% children were stunted, thin and overweight respectively. No significant association was found between gender and nutritional status of children. 16.2% children were anemic and food consumption found not to be varied and below recommendations., Conclusion: the finding in this study showed that overweight and obesity occurred more frequently than the various forms of under nutrition in the population studied. The finding support the urgent need to improve the nutritional status of children by implementing preventive strategy for the problem of malnutrition among school-aged children., Competing Interests: The authors declare no competing interests., (Copyright: Imane Achouri et al.)

Introduction: intentional poisoning is a major public health problem in both developed and developing countries. The purpose of this study is to describe the epidemiological features of criminal intoxication in Morocco., Method: we conducted a retrospective study of all cases of criminal intoxication identified by the Morocco Poison Control and Pharmacovigilance Centre (MPCPC) between 1980 and 2014., Results: during the study period, 611 cases of criminal poisoning were recorded, reflecting a rate of 2.1% of all intentional poisoning reported during the same period. The average age of intoxicated patients was 26.4±14.3 years. More than a quarter of the subjects were children under the age of 15 (28.6%). According to the study results, 55.9% were male, with a sex-ratio (M/F) of 1.3. The majority of cases (89.4%) occurred in urban areas. Collective intoxications were reported in 24.4% of cases. The most frequently used products were pesticides (19.1%) and plants (19%). Patients developed different symptoms based on the toxic substances used, the amount ingested and the time elapsed before treatment. A range of digestive, neurological, respiratory and cardiovascular disorders were reported. Out of 440 patients with outcome data available, 27 died. The remainder of patients survived with or without sequelae., Conclusion: criminal poisoning is a major issue. The number of cases is probably underestimated due to a large number of undiagnosed or unreported cases., Competing Interests: Les auteurs ne déclarent aucun conflit d´intérêts., (Copyright: Sara Boukhorb et al.)

Introduction: the association of diabetes with pregnancy is a frequent gestational situation that constitutes a real public health problem with prevalence and risk factors varying according to the population type. The present study aims to determine the prevalence of gestational diabetes (GD) and associated risk factors (socio-demographic characteristics, medical and obstetric history) in pregnant women from the Moroccan province of Safi., Methods: this cross-sectional, descriptive and analytical study was conducted during the period from October 2018 to February 2019, on 208 pregnant women, attending the antenatal consultation services of four health centers equally distributed between urban and rural areas of Safi Province in Morocco. The data on blood glucose levels and the risk factors for gestational diabetes generally described in the literature were collected. The statistical Chi-square test and the logistic regression were used to check the association between gestational diabetes and the risk factors., Results: the mean age of the pregnant women sample was 28.9 ± 6.8 years and the prevalence of GD was 24.5%. Using multivariate logistic regression, the most significantly associated risk factors were the diabetic inheritance of a primary relative (OR=2.616 [95% CI: 1.281-5.341]; p=0.008) and the high education level (OR=2.301 [95% CI: 1.123-4.716] p=0.023)., Conclusion: the results show that gestational diabetes is a frequent pathology among the study population. The data revealed also that the diabetes inheritance (primary relative) and the high level of education are the main risk factors of this pathology in the surveyed pregnant women in the study province., Competing Interests: The authors declare no competing interests., (Copyright: Hamid Chamlal et al.)

Introduction: despite major strides in the prevention, diagnosis and management of tuberculosis, the disease continues to be one of the most pressing global health problems, particularly in developing countries. The purpose of the present study was to describe the epidemiological profile among tuberculosis patients in Laayoune, Morocco., Methods: a retrospective study was conducted among tuberculosis patients (having extrapulmonary tuberculosis and pulmonary tuberculosis), registered in the diagnosis of tuberculosis and respiratory diseases reference center of Laayoune, between January 2017 and May 2018. Demographic characteristics, clinical presentation of TB and apparent risk factors of the disease were obtained from the medical case records of all patients., Results: during the study period, a total of 211 patients (125 males and 86 females) with tuberculosis were enrolled. The majority of cases (93.40%) were newly diagnosed and the segment with the pulmonary tuberculosis was 63.50%. The highest disease burden was found in the ≥15 year age group (92.40%; p=0.022). Men were more frequently affected by pulmonary tuberculosis (70.90%), while extrapulmonary tuberculosis was more commonly detected in women (61%) (p<0.0001). The most common sites of extrapulmonary disease were lymphatic (32.47%), pleural (16.88%) and spinal tuberculosis (15.58%). HIV infection and smoking seem to be the most important risk factors that affect host defense against TB infection., Conclusion: the results obtained in tuberculosis patients in Laayoune, Morocco, showed that active tuberculosis was associated with risk factors such as sex, age and smoking., Competing Interests: The authors declare no competing interests., (Copyright: RkiaEddabra et al.)

Introduction: this work aims to bring out the epidemiological characteristics of extrapulmonary tuberculosis (EPTB) in the province of Larache (Morocco) and to investigate the effect of gender and age on its localization and treatment outcome., Methods: it consists in a retrospective study based on 2962 cases of EPTB, reported during the period 2000 to 2012., Results: the mean age was 31.74 ± 18.83 years, with a median age of 26. Males are more affected by this form of tuberculosis, with a male to female sex-ratio of 1,15. The EPTB affects particularly the young population whose age is between 15 and 34 years. The pleural and lymph node localizations are the most common with 45% and 28% respectively. The statistical analysis reveals that younger patients are preferentially affected by lymph node tuberculosis whereas oldest ones are more likely to suffer from urogenital and pericardial tuberculosis. Regarding the treatment outcome, we demonstrated that age is significantly associated with the treatment outcome and that deaths occur preferentially in the oldest patients. Finally, we found out a significant association between males and pleural ETB localization, and between females and lymph node and peritoneo-itestinal ETB localizations., Conclusion: special attention must be paid to the mentioned most vulnerable categories of EPTB patients., Competing Interests: The authors declare no competing interests., (Copyright: Adil Sbayi et al.)

Introduction: coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 was first reported in Wuhan, China. Clinical spectrum of this disease has nonspecific symptoms shared by many other frequent infectious diseases of the respiratory tract and other respiratory tract diseases. This study explains the importance of differential diagnosis between COVID-19 and other lung diseases., Methods: we analyzed in this study, the demographic features, clinical presentations, laboratory data and radiologic findings of the COVID-19 patients in comparison to those with other respiratory infections or diseases., Results: the mean age of all patients was 38.04 years; 35 patients were later confirmed to be positive for SARS-CoV-2 infection. The most common symptoms reported by both groups included nonproductive cough and myalgia. Two of the non-COVID-19 patients were having below 92% oxygen saturation and low systolic blood pressure. The patients shared relatively similar laboratory findings except 3% of the non-COVID-19 patients who had lympho-neutropenia and 22.6% had high levels of C-reactive protein. Pulmonary tuberculosis and autoimmune disease respiratory disorder were suspected in 2 of the non-COVID-19 patients respectively., Conclusion: we emphasize the importance of good screening protocols, rapid detection of SARS-CoV-2 and other most common respiratory pathogens, which may help for a better control of COVID-19 spread and avoid delayed care of other lung diseases., Competing Interests: The authors declare no competing interests., (Copyright: Khadija Krati et al.)

The potential threat of COVID-19 pandemic on the continuity of care for cancer patients is thought to be significant. Oncologists are weighing up the balance of risks and benefits carefully when planning daily cancer care and making treatment decisions in the face of rapid change during this public health crisis. This report describes management strategies and care models that have been adopted by a single Medical Oncology department in a North Africa, Morocco., Competing Interests: The authors declare no competing interests., (©Nada Benhima et al.)

Introduction: in order to implement an influenza vaccination program for high-risk-groups in Morocco, as recommended by the World Health Organization, an epidemiological study indicating the influenza virus effect in the development of complicated influenza for subjects with co-morbidity was required. The present study aims to evaluate the risk factors for severe acute respiratory infections caused by influenza in risk groups., Methods: this research is based on the epidemiological and virological surveillance data of severe acute respiratory infections and influenza-like illness during the 2016/2017 and 2017/2018 seasons. It was realized using a retrospective series study with a descriptive and analytical purpose., Results: the over-recruitment of pediatric cases with a severe acute respiratory infection has been significantly rectified because cases of severe acute respiratory infections under 15 years old in the 2017/2018 season represent only 57.9%, whereas they represented 75.9% of the total cases of severe acute respiratory infections during the 2016/2017 season. The influenza positivity rate has increased globally and specifically by age group, clinical service and co-morbidity. The risk factors considered were significantly associated with hospitalization for influenza-associated severe acute respiratory infections. The multivariate logistic regression analysis considers male sex (OR=2.1), age ≥65 years (OR=5.4), presence of influenza cases in the surroundings (OR=0.1), diabetes (OR=7.5) and chronic respiratory disease (OR=10.9) as risk factors influenza-associated severe acute respiratory infections., Conclusion: the risk assessment of influenza-associated severe acute respiratory infections in high-risk groups revealed national epidemiological findings, particularly for diabetics and the elderly. An influenza vaccination program for these high-risk-groups becomes much recommended in Morocco., Competing Interests: The authors declare no competing interests., (Copyright: Hind Ezzine et al.)

Introduction: the purpose of this study was to bring out some epidemiological and clinical characteristics of metabolic syndrome., Methods: a total of 300 subjects willingly participated in the present study which was conducted at Ibn Zohr regional hospital in Marrakesh. We were interested in socio-demographic variables, body mass index (BMI) which assesses the degree of obesity of each subject. The blood parameters were determined by an adequate biochemistry automaton. All statistical analyses were performed using SPSS software., Results: among the 300 subjects who participated in the study, 57.3% were females and 42.7% were males with a sex-ratio of 0.74. The average age was 51.6 ± 13.42 years old. Seventy nine of the participants (26.3%) had a metabolic syndrome, with a predominance of women: 60 women (34.9%) and 19 men (14.8%). Illiterates (33.8%) and married subjects (25.6%) were the most affected by the metabolic syndrome. The high waist circumference found in 97.5% was the predominant criteria in our study. Finally, the statistical analysis showed a significant association between high waist circumference, BMI and the presence of metabolic syndrome (P = 0.001>) and (P < 0.001) respectively., Conclusion: the metabolic syndrome is slowly but surely setting. Implementing prevention strategies and encouraging healthy lifestyles will surely minimize serious public health problems in the city., Competing Interests: The authors declare no competing interests., (Copyright: Zineb Hannoun et al.)

Introduction: COVID-19 is an infectious disease caused by a new coronavirus. The first cases were identified in Wuhan. It rapidly spread causing a pandemic worldwide. The incidence and severity of this disease are likely to be different in children compared with adults. Few publications of COVID-19 in children have been published. Our Moroccan paediatric series is among the first studies on this disease in Africa., Methods: We included all children with COVID-19 who were admitted and treated at the hospital from March 25 to April 26, 2020. We have collected information, including demographic data, symptoms, imaging data, laboratory results, treatments and clinical progress from patients with COVID-19., Results: Since the outbreak of 2019 novel coronavirus infection (2019-nCoV) in Morocco, a total of 145 COVID-19 confirmed cases have been reported in the Cheikh Khalifa's Hospital. Among this cases, 15 children were registered. The median age of patients was 13 years. There were 7 boys and 8 girls. Five children are asymptomatic, 8 have mild symptoms and 2 have a moderate respiratory difficulty. The RT-PCR test results were positive in all patients. Radiologically, we found in 2 cases, multiple nodules with ground-glass opacities on the chest scan. The treatment was based on the combination of hydroxychloroquine and azithromycin. Evolution under treatment was good for all patients., Conclusion: This study describes the profile of COVID-19 in child in a Moroccan hospital and confirms that the severity of illness in children with COVID-19 to be far less than adults., Competing Interests: The author declares no competing interests., (© Nabila Chekhlabi et al.)

Introduction: In Morocco, the first case was detected on March 02, 2020. Few days later, new cases are notified, followed by deaths. The government decided to adopt large-scale drastic measures against the epidemic. This study aims to describe and analyse the COVID-19 distribution in Morocco, according to key measures taken to curb this health problem., Methods: An observational study of all cases daily reported by the Ministry of Health of Morocco from 02 March to 05 May 2020, was carried out. A mapping was performed., Results: Before the implementation of the state of health emergency, 86 confirmed cases out of 471 biological examinations carried out have been reported and the highest cumulative incidence (0.43 cases per 100,000 inhabitants) was recorded in Fes-Meknes region. During the 1st quarantine, 2,960 positive cases out of 15,915 examinations carried out have been detected. Marrakech-Safi region was the most affected (15.33 cases per 100,000 inhabitants). Halfway through extended quarantine, 2,173 confirmed cases out of 49,570 biological examinations realized have been notified, the highest cumulative incidence has observed in Draa-Tafilalet region (27.45 cases per 100,000 inhabitants). The highest mortality was observed in Marrakech-Safi region (1.05 deaths per 100,000 inhabitants) and the highest case fatality rate (13.46%) was registered in Souss-Massa region., Conclusion: The strategy adopted by Morocco has enabled it to avoid a health catastrophe. But, it's not over yet. Morocco should continue the massive efforts and reinforce the existing measures against the virus, especially in regions very affected by the epidemic., Competing Interests: The author declares no competing interests., (© Fatine Hadrya et al.)

Introduction: given its frequency and severity, colorectal cancer is a major public health problem. Diet plays a key role in preventing this type of cancer. The purpose of our study was to determine dietary risk factors for colorectal cancer in our Moroccan context., Methods: we conducted a case-control study including patients with colorectal cancer compared with controls. The statistical analysis of results was carried out using R software., Results: our study included 225 patients treated for cancer at the Mohammed VI Hospital Center and 225 controls. The average age of our study population at the time of diagnosis was 55.49±14.06 years, including 119 men (52.9%) and 106 women (47.1%) with a sex ratio of 1.12. Associations were found between the highest intakes of red meats, cold meats, sausages and the risk of colorectal cancer (p = 0.0001) with F4 (4-7 times / week) vs F1 (never): OR = 4.4 (1.6-11.9); (p = 0.001), OR = 1.7 (0.5-5.7); (p = 0.003), OR = 5.7 (1.2-27.4)). On the other hand, consumption of fish was associated with a reduced risk of colorectal cancer (p = 0.0001; OR = 0.3 (0.11-0.7)), while consumption of poultry and grilled eggs was not associated with colorectal cancer. We also found that consumption of fresh vegetables and cooked vegetables was low in patients compared to controls (p = 0.0001). Furthermore, a high intake of black coffee was associated with a reduced risk of colorectal cancer (p = 0.0001; F4 vs F1: OR = 0.2 (0.1-0.4))., Conclusion: our study highlights that dietary changes can prevent or impede the growth of colorectal cancer. It is essential to promote balanced diet, rich in fish, vegetables, fruits and fibers without exceeding recommended levels of red meat and avoiding cold meats and sausages., Competing Interests: Les auteurs ne déclarent aucun conflit d’intérêts., (© Fatima Ezzahra Imad et al.)

Introduction: Obesity is a serious public health problem having a direct impact on physical and psychological health of individuals. The purpose of this study was to determine the prevalence of obesity and overweight in a child population attending urban and rural schools in the oasis of Tafilalet., Methods: We conducted a cross-sectional descriptive study within the urban and rural public schools in of the oasis of Tafilalet. We recruited a representative sample of 3,684 children attending 39 public primary schools., Results: The average age of patients was 9.81 ± 2.13 years. The total sample was divided into 1,794 boys (48.70%) and 1,890 girls (51.30%). Two thousand three hundred and nine lived in an urban area (62.70%) and 1,375 in a rural area (37.30%). According to the World Health Organization References, our study showed a rate of obesity of 1.9% and of 10.8% for overweight. Overweight and obesity were not significantly associated with children sex., Conclusion: The prevalence of obesity in the oasis of Tafilalet is less than the national and international values; lifestyle and dietary habits of this population appear to be a protective factor against overweight and obesity., Competing Interests: Les auteurs ne déclarent aucun conflit d’intérêts., (© Karima Azekour et al.)

Rubella is a generally benign but dangerous viral infection in early pregnancy, due to the teratogenic potential of the virus. Indeed, it causes spontaneous abortions, in-utero fetal death, premature labor and congenital malformations known as congenital rubella syndrome. The purpose of this study is to determine the immune status of rubella in pregnant women in southern Morocco. A prospective, multicentre study was conducted in 2017 for the detection of rubella IgG and IgM antibodies in 380 pregnant women aged 17 to 46 years, using the Architect i1000 chemiluminescent microparticle immunoassay. Eigthy for percent (84.7%) of women were seropositive. Ten percent of multiparous women remained seronegative despite recommendations for vaccination after delivery. Preventive measures against congenital rubella need to be strengthened, and vaccination is needed in non-immunized women. Vaccination awareness campaigns, especially among non-immunized multiparous women, remain essential., Competing Interests: The authors declare no competing interests., (© Hanane Zahir et al.)

Introduction: Colorectal cancer is a true scourge and a major public health problem. The main purpose of this study was to identify the impact of socio-economic factors and education level on the onset of colorectal cancer and of diagnosis stage in the Moroccan population., Methods: We conducted a case-control study of patients treated for cancer at the Mohammed VI center from January 2015 to January 2017. We interviewed, on a prospective basis and using a structured and pre-tested questionnaire, 225 patients and 225 eligible and consenting subjects., Results: The average age of patients was 55.49± 14.06 years. In 53% of cases diagnosis was made at early-stage colorectal cancer while in 47% at advanced stage. In addition, a detailed analysis of the studied population according to the socio-economic status (SES), showed a proportion of 25.33% (patients) versus 17.33% (control) in the low SES group, while, equivalent rates (45.33% patients versus 45.33% control) in the middle SES group. In the high SES group, the rate of patients was only 16.89% patients versus 37.34% control (p = 0.0001). Education and SES were strongly correlated with diagnosis stage, with a significant difference. Then 36.44% of illiterate patients were diagnosed in advanced stage versus 5.33% of patients who had completed their secondary education level or university course (p = 0.02). Similarly 20.45% of patients with low SES were diagnosed in late stage versus 5.33% of patients with higher SES (p = 0.03)., Conclusion: Our results highlight that the risk of developing colorectal cancer is strongly dependent on the education and the socio-economic status of patients. A more thorough investigation is needed to clarify the causes of this inequality., Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts., (© Fatima Ezzahra Imad et al.)

Introduction: Lung cancer is the most common cancer in men living Eastern Morocco. We here present the first report on the clinical, pathological and therapeutic features of lung cancer in Eastern Morocco., Methods: We conducted a retrospective study of 738 patients diagnosed with lung cancer at the Hassan II, Oncology Center between October 2005 and December 2014., Results: Among the cases studied, 671 patients were men and 67 women; 95.01% of men and 1.54% of women were smokers. The average age of patients was 59.1 ± 11.9 years. Most patients (97%) were diagnosed at advanced stage disease. Only 4 out of 227 patients with advanced adenocarcinoma underwent molecular test. In addition, no patient in our series received targeted therapy. In this series, 20.46% of patients had less than 50 years. Compared to patients aged 50 years and older, cannabis consumption was higher (p<0.001) in patients less than 50 years and as well as a higher rate of adenocarcinoma (p<0.01). By contrast, in these patients, tobacco consumption was lower (p<0.001) as well as the rate of squamous cell carcinoma (p<0.01) and small cell cancer (p<0.05)., Conclusion: Unlike Western countries, in Eastern Morocco lung cancer is diagnosed late, affects younger people and access to molecular tests is still very limited. These results justify the need to implement effective programs against lung cancer as well as to facilitate access to molecular tests and new therapeutic tools in Eastern Morocco., Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts., (© Mohammed Bellaoui et al.)