Search

Background: Cardiovascular diseases (CVD) are the major cause of disability and premature death. This is due to the ascending trend of consuming an unhealthy diet and obesity which increases the risk of hypertension and type 2 diabetes mellitus. The main aim of this review was to fill the knowledge gap by providing an up-to-date overview of the prevalence of CVD risk factors among women and to estimate the pooled prevalence among adolescent and pregnant women in Morocco. Methods: The review included original cross-sectional studies reporting the prevalence of CVD risk factors in Moroccan women aged ≥ 15 years, published between January 2008 and December 2022. The databases searched included MEDLINE, Scopus, Web of Science, Google Scholar and national government publications (PROSPERO ID: CRD42023426809). Results: Initially, 1471 articles were identified, and 76 studies were included. The most commonly reported CVD risk factor was obesity (reported in 56 studies), the prevalence of obesity varies according to the age groups of women with the rate being particularly high in urban women aged ≥ 35 years (ranging of 14–44.9%). Followed by diabetes (ranging from 7.2 to 12.6%) with a high rate in menopausal women. Hypertension prevalence ranged from 29.8 to 39.29%. Among adolescents, the overall prevalence of obesity was 3.15% (95% CI: 2.6%, 3.7%) and the prevalence of physical inactivity was 56.5% (95% CI: 36.9 − 76%). Among pregnant women, the overall prevalence of obesity was 26.8% (95% CI: 15.5 − 38.2%). Gestational diabetes and hypertension were 15.2% (95% CI: 6.3 − 24.1%) and 7.07% (95% CI: 2.5 − 11.6%), respectively. Conclusion: This review highlights the significant burden of CVD risk factors among Moroccan women, with a high prevalences of diabetes, obesity, hypertension. The prevalences of these risk factors varies with age, being notably higher in older age groups. These findings underscore the need for targeted public health interventions to address these risk factors. Future research should focus on longitudinal studies and standardized assessment tools to enhance the robustness of prevalence estimates and inform effective prevention strategies. [ABSTRACT FROM AUTHOR]

Worldwide access to medication remains a major public health problem that forces pregnant women to self-medicate with several sources, such as medicinal plants. This alternative medicine is increasing in many low- and high-income countries for several reasons. This a systematic literature review on the prevalence of herbal use during pregnancy from the World Health Organization (WHO) Eastern Mediterranean Regional Office. Cross-sectional studies were searched from January 2011 to June 2021 on PubMed, Scopus, and Web of Science. We used the Rayyan website to identify the relevant studies by screening the abstracts and titles. These were followed by reading the full texts to identify the final studies to be included. The data were extracted, and the quality of the studies was assessed using the quality appraisal tool. Of the 33 studies included in this review, 19 were conducted in Iran, 5 in Saudi Arabia, 4 in Palestine, 2 in Egypt, and 1 each in Oman, Iraq, and Jordan; the prevalence of herbal medicine use among pregnant women varied from 19.2% to 90.2%. Several plants were mentioned for pain management during the pregnancy period. The findings suggest family and friends are major motivating sources for the use of herbal medicine. The wide variety of herbal products used in this study reflects the traditions and geographic diversity of the region. Despite the importance of literature-based data about the use of herbal medicine, it is necessary to obtain knowledge, attitude, and motivation for herbal consumption among pregnant women. [ABSTRACT FROM AUTHOR]

Healthcare-associated infections (HAI), also referred to as nosocomial infections, is defined as an infection acquired in a hospital setting. This infection is considered a HAI if it was not present or incubating at the time of admission. This includes infections acquired in the hospital but appearing after discharge, and also occupational infections among staff of the facility. HAI are a major patient safety measure to be considered in hospitals. [ABSTRACT FROM AUTHOR]

The outbreak of COVID-19 still represents a real risk for the increased death rate for the whole of human kind. In this context, the present research work aims at describing evolutionary data in a population of hospitalized COVID-19 positive patients based on selected epidemiological, clinical and paraclinical data at admission. In this cross-sectional study, we examined the data obtained from 108 patients hospitalized with COVID-19 in the VINCI clinic, Casablanca (Morocco) between August and September 2020. General characteristic, clinical, radiological and biological data as well as therapeutic management were assessed. The patients’ median age was 45-50 years old. Among our studied patients, 4.6% were transferred to the intensive care unit (ICU), 16.7% were cured after more than 15 days, while 78.7% were cured within 15 days. Those transferred to the ICU unit were either smokers, obese, or over 65 years of age. The majority of patients with normal radiological and cardiac parameters were cured within

Background: Rapid antigen tests have emerged to deal with the COVID‐19 pandemic. Rapid diagnosis of SARS‐CoV‐2 infection is essential to reduce the spread of the disease. The aim of this study was to estimate the prevalence of COVID‐19 infection and test the sensitivity and specificity in Temara‐Skhirat in symptomatic adults through PANBIOS® test. Methods: A prospective observational study was conducted in mid‐September 2021. Two investigators conducted data collection from symptomatic adult patients. The diagnostic performance of the PANBIOS®, and the PCR was assessed to calculate sensitivity and the specificity. Results: Among 206 symptomatic participants, the mean age was 38 ± 12 years, and the majority were women (59%). In our population, 80% had benefited from the anti‐COVID vaccine. The median duration of symptoms was 4 days; the most common symptoms were fatigue (62%), headache (52%), fever (48%), cough (34%), loss of smell (25%), loss of taste (24%), and sore throat (22%). Results revealed 23% of cases tested positive with PANBIOS® test versus 30% with the PCR test. The calculated medical decision between PCR versus PANBIOS® test showed high specificity of 95.7% and a sensitivity of 69.4%. There was concordance between the PANBIOS® test and the PCR. Conclusion: The prevalence tested remain high, and the sensitivity and specificity of the PANBIOS® versus PCR test are similar to other literatures and close to value described in WHO recommendations. PANBIOS® is a useful test for controlling the spread of COVID‐19 allowing identification of active infection. [ABSTRACT FROM AUTHOR]

Background: Accurate mortality data associated with infectious diseases such as coronavirus disease 2019 (COVID-19) are often unavailable in countries with fragile health systems such as Somalia. We compared officially reported COVID-19 deaths in Somalia with COVID-19 deaths estimated using verbal autopsy. Methods: We interviewed relatives of deceased persons to collect information on symptoms, cause, and place of death. We compared these data with officially reported data and estimated the positive and negative predictive values of verbal autopsy. Results: We identified 530 deaths during March–October 2020. We classified 176 (33.2%) as probable COVID-19 deaths. Most deaths (78.5%; 416/530) occurred at home and 144 (34.6%) of these were attributed to COVID-19. The positive predictive value of verbal autopsy was lower for home deaths (22.3%; 95% CI: 15.7–30.1%) than for hospital deaths (32.3%; 95% CI: 16.7–51.4%). The negative predictive value was higher: 97.8% (95% CI: 95.0–99.3%) for home deaths and 98.4% (95% CI: 91.5–100%) for hospital deaths. Conclusions Verbal autopsy has acceptable predictive value to estimate COVID-19 deaths where disease prevalence is high and can provide data on the COVID-19 burden in countries with low testing and weak mortality surveillance where home deaths may be missed. [ABSTRACT FROM AUTHOR]

Background: We provide national estimates of the real-world Vaccine effectiveness (VE) based on nationally available surveillance data. The study aimed to estimate the effectiveness of the inactivated Covid-19 vaccine BBIBP-CorV (Vero Cells) Sinopharm vaccine currently deployed in Morocco against SARS- CoV-2 severe disease/ hospitalization" within 9 months after vaccination. Methods: We conducted a test-negative, case-control study among a population aged 18 years or older who were tested by rt-PCR for SARS-CoV-2 infection from February to October 2021 in Morocco. From the national laboratory COVID-19 database; we identified cases who were rt-PCR positive amongst severe and critical COVID-19 cases and controls who had a negative rt-PCR test for SARS-CoV-2. From the national vaccination register (NVR); individuals vaccinated with COVID-19 Vaccine (Vero Cell) and those unvaccinated were identified and included in the study. The linkage between databases was conducted for the study of Vaccination status based on the timing of the vaccine receipt relative to the SARS-CoV-2 rt-PCR test date. For each person, who tested positive for SARS-CoV-2, we identified a propensity score-matched control participant who was tested negative. We estimated vaccine effectiveness against SARS- CoV-2 severe disease/ hospitalization using conditional logistic regression. Results: Among 12884 persons who tested positive and 12885 propensity score-matched control participants, the median age was 62 years, 47.2% of whom were female. As a function of time after vaccination of second dose vaccination, vaccine effectiveness during the first month was 88% (95% CI, 84–91), 87% (95% CI: 83–90) during the second and third month, 75% (95% CI: 67–80) during the fourth month, 61% (95% CI: 54–67) during the fifth month, and 64% (95% CI: 59–69) beyond the sixth month. VE remained high and stable during the first three months in the two-age subgroup. In the fourth month, the VE in the older population aged 60 years and above (64%) was reduced by 20 points compared to VE in the younger population (84%). Conclusion: A Sinopharm vaccine is highly protective against serious SARS-CoV-2 infection under real-world conditions. Protection remained high and stable during the first three months following the second dose and decreases slightly beyond the fourth month especially beyond 60 years. [ABSTRACT FROM AUTHOR]

Background: Countries in the World Health Organization (WHO) Eastern Mediterranean Region (EMR) are predisposed to highly contagious, severe and fatal, emerging infectious diseases (EIDs), and re-emerging infectious diseases (RIDs). This paper reviews the epidemiological situation of EIDs and RIDs of global concern in the EMR between 2001 and 2018. Methods: To do a narrative review, a complete list of studies in the field was we prepared following a systematic search approach. Studies that were purposively reviewed were identified to summarize the epidemiological situation of each targeted disease. A comprehensive search of all published studies on EIDs and RIDs between 2001 and 2018 was carried out through search engines including Medline, Web of Science, Scopus, Google Scholar, and ScienceDirect. Results: Leishmaniasis, hepatitis A virus (HAV) and hepatitis E virus (HEV) are reported from all countries in the region. Chikungunya, Crimean Congo hemorrhagic fever (CCHF), dengue fever, and H5N1 have been increasing in number, frequency, and expanding in their geographic distribution. Middle East respiratory syndrome (MERS), which was reported in this region in 2012 is still a public health concern. There are challenges to control cholera, diphtheria, leishmaniasis, measles, and poliomyelitis in some of the countries. Moreover, Alkhurma hemorrhagic fever (AHF), and Rift Valley fever (RVF) are limited to some countries in the region. Also, there is little information about the real situation of the plague, Q fever, and tularemia. Conclusion: EIDs and RIDs are prevalent in most countries in the region and could further spread within the region. It is crucial to improve regional capacities and capabilities in preventing and responding to disease outbreaks with adequate resources and expertise. [ABSTRACT FROM AUTHOR]

Background: People with schizophrenia are more stigmatized than those with other mental illnesses. Stigmatization can be measured using the English version of Stigma Measurement Scale contained in the explanatory model interview catalogue (EMIC). Objectives: This study aimed to translate the English version of Stigma Measurement Scale into Berber language and validate the translated version. Methods: This study was conducted in public hospitals in southern Morocco, which are predominantly Berber-speaking. The psychometric properties of the stigma scale contained in the EMIC were validated on a sample including 128 individuals. Results: According to the Cronbach's alpha (α= 0.826) and the internal convergence calculated by Pearson's statistic, that the interitem correlation was significant. Also, the intraclass correlation coefficient (ICC) was significant. The added item, concerning the COVID-19 situation has a similar psychometric value to the other items. Conclusions: According to our results, the Berber version of the Stigma Measurement Scale is culturally acceptable and can be used in Moroccan society. [ABSTRACT FROM AUTHOR]

Background: Early-onset neonatal sepsis is recognized as a common and serious problem for neonates. The clinical manifestations of neonatal sepsis are nonspecific and have varied clinical features. Therefore, their diagnosis is based on a combination of clinical presentation, the use of biological tests, and anamnestic arguments. The present study aimed to describe the infection risk factors, as well as clinical, paraclinical, and evolutionary characteristics of newborns with suspected early-onset neonatal sepsis and highlight the importance of C-reactive protein(CRP) to diagnose neonatal sepsis. Methods: This retrospective analytical study was conducted at the National Reference Center for Neonatology and Nutrition at Children's Hospital, University Hospital Centre IbnSina of Rabat, from January 1 to December 31, 2016. Results: During the study period, 1,199 newborns met the inclusion criteria. Upon admission, 52% of cases were under the age of one day. Symptomatic newborns represented 67.4% of the cases. The hospitalized cases with one or more infection risk factors were represented 80.3% of cases. The CRP was positive (> 20 mg/L) in 698 (58%) newborns. Univariate analysis pointed out that CRP value was significantly associated with age groups (P<0.001), presence of at least one infectious risk factor (P<0.001), as well as the presence of respiratory (P<0.001), cutaneous (P<0.001), circulatory (P=0.02), and neurological (P=0.008) symptoms. The diagnosis of early-onset neonatal infection with a meningeal, pulmonary, or ocular location was retained in 5%, 2%, and 0.2% of cases, respectively. The mortality rate was reported as 7%. Conclusion: Screening, management, and reduction of early-onset neonatal infection remain a crucial challenge, requiring coordination between pediatricians and obstetricians to obtain reliable data and identify newborns at risk. [ABSTRACT FROM AUTHOR]

Copyright of Eastern Mediterranean Health Journal is the property of World Health Organization and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Dietary habits in Morocco are changing and the causes are not well understood. This study aimed to analyse socio-demographic factors associated with adherence to the Mediterranean diet (MeDi) in a national random sample of the adult Moroccan population. Methods The data collected in this cross-sectional survey included socio-demographic factors and a food frequency questionnaire. MeDi adherence was assessed in 2214 individuals with complete dietary data. MeDi adherence was measured according to a simplified MeDi score based on the weekly frequency of intake of eight food groups (vegetables, legumes, fruits, cereal or potatoes, fish, red meat, dairy products and olive oil) with the use of the sex specific medians of the sample as cut-offs. A value of 0 or 1 was assigned to consumption of each component according to its presumed detrimental or beneficial effect on health. Logistic regression was used to estimate the association between MeDi adherence (low score 1-4 vs. high 5-8) and other factors. Results Mean age of the sample was 41.4 (standard deviation 15.3) years, 45.4% were men and 29.9% had a low MeDi adherence. Married subjects (adjusted odds ratio ORa=0.68, 95% CI 0.55-0.84) were less likely to have a low MeDi adherence compared to single, divorced or widowed persons. Persons from rural areas (ORa=1.46, 95% CI: 1.02-2.08), were more often low MeDi adherents compared to those from urban areas. Obese persons (ORa=1.56, 95% CI: 1.16-2.11) were more prone to low MeDi adherence than normal weight individuals. Conclusion MeDi is far from being a universal pattern in the Moroccan population. Intervention strategies should be implemented in target groups to maintain the traditional MeDi pattern considered as the original diet in Morocco.

Background: Pandemic confinement of COVID-19 may influence dietary behaviors and physical activity, and increases the risk of stress, especially among adolescents. This increases the subsequent risk of degenerative diseases such as obesity, diabetes, cardiovascular disease, etc., which can lead to a higher risk of death. This study aims to evaluate the effect of confinement on the weight load, physical activity and dietary behavior of higher education students during the period of confinement. Methods: Data was collected by an anonymous online questionnaire with 406 students. Physical activity was evaluated with the International Physical Activity Questionnaire. A reference score of the National Nutrition and Health Program (PNNS-GS) was used to determine the dietary habits. Stress appreciation was assessed by using a psychological instrument known as the “Perceived Stress Scale” provided by Mind Garden. Results: More than a quarter of the students were overweight or obese. During the confinement of COVID-19, most of the students suffered from nutritional disorders, only one-third were moderately physically active, and the majority of students were at risk of stress. Multivariate analysis showed that the concept of threat of Stress increases the risk of weight gain at a risk level of 2.4 [95% CI 1.09–5.43], low physical activity increases the risk level to 1.9 [95% CI 1.18–3.04]. However, a balanced diet is protective against the occurrence of weight gain (ORa = 0.30, [95% CI 0.15–0.61]). Conclusion: The study showed that confinement appeared to contribute to weight gain and those students were more sedentary than active with unhealthy eating behaviors. Understanding these behaviors during COVID-19 confinement will help public health authorities implement future policies on recommendations when new pandemics arrive and confinement policies are implemented. [ABSTRACT FROM AUTHOR]

Background: The epidemic of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19), presents a significant and urgent threat to global health. This alarming viral infection, declared as pandemic by the WHO in February 2020, has resulted millions of infected patients and thousands of deaths around the world. In Morocco, despite the efforts made by the authorities, the SARS-CoV-2 continues to spread and constitutes a burden of morbidity and mortality. The objective of this study is to describe clinical characteristics of COVID-19 Moroccan patients and to establish the relationship between specific clinical symptoms, namely ageusia and/or anosmia, with these characteristics. Methods: We performed a descriptive, non-interventional cross-sectional study analyzing data from 108 patients admitted to the VINCI clinic, Casablanca (Morocco). The database includes 39 parameters including epidemiological characteristics, anthropometric measurements and biological analyzes. Results: The average of age of the patients was 43.80 ± 15.75 years with a sex ratio of 1:1. The mean body mass index of the patients was 25.54 ± 4.63 Kg/m2. The majority of patients had, at least, one comorbidity and among 75% symptomatic patients, about 50% had, at least, three symptoms namely, fever (40.7%), cough (39.8%), myalgia (28.7%), and anosmia and/or ageusia (20.4%). From biological analyzes, we noticed lymphopenia and an elevated protein C reactive and lactate dehydrogenases levels in 24.1, 36.1, and 35.2% of patients, respectively. A disturbance in liver function markers was observed in 15.7% of cases. For the other hemostasis parameters, high levels of prothrombin and platelets were reported in 14.6 and 14.8% of patients, respectively. Comparisons related to the presence of anosmia and/or ageusia did not show any difference for demographic and anthropometric characteristics, while a possibility of a significant difference was revealed for certain biological parameters, particularly the levels of lymphocytes, D-dimer and troponin. Conclusion: This study provides significant findings that will be used not only to supplement previous studies carried out in Morocco in order to resume the epidemiological situation in comparison with other countries, but also to improve the quality of the diagnosis of COVID-19 patients by identifying all the symptoms of the disease and better understanding its clinical outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Eastern Mediterranean Health Journal is the property of World Health Organization and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A longitudinal study was carried out in Middle atlas, Morocco (locality of Had Oued Ifrane) in a population of 255 dogs from three localities, including two categories of dogs (owned and stray dogs). The dogs were investigated three times over a period ranging from 4 to 8 months between December and August. At each investigation, dogs were treated with arecoline, inducing defecation and allowing feces collection. Dogs were further treated with praziquantel to clear them from Echinococcus granulosus. Microscopic examination of feces was performed to assess the infection status of dogs at each investigation, and positive samples underwent copro-PCR to determine the circulating strain of E. granulosus. A high prevalence of infestation ranging from 23.5% to 38.8% and from 51.3% to 68.5% was, respectively, found in owned and in stray dogs. The PCR results revealed the presence of G1 strain in all positive samples. A logistic regression model was used to determine the incidence of infestation and showed that stray dogs underwent a significantly higher risk of infection (odds ratio = 14; 95% confidence interval: 6–30; p < 0.001) compared with owned dogs. Only anthelmintic treatment intervals of 2 months efficiently prevented egg shedding in owned and stray dogs. The seasonal effect was also significant, with the highest risk of reinfestation in winter and the lowest risk in summer. This study confirms that stray dogs undergo an increased risk of infestation by E. granulosus and indicate that infective pressure is influenced by season. [ABSTRACT FROM AUTHOR]

Background. In Morocco, pediatric pneumonia remains a serious public health problem, as it constitutes the first cause of mortality due to infectious diseases. The etiological diagnosis of acute respiratory tract infections is difficult. Therefore, it is necessary to use Multiplex real-time polymerase chain reaction assay tests in a routine setting for exact and fast identification. Objectives. In this paper, we present the clinical results of pediatric pneumonia and describe their etiology by using molecular diagnosis. Study design: Tracheal secretion was collected from infants presenting respiratory distress isolated or associated with systemic signs, attending the unit of Neonatology between December 1, 2016, and Mai 31, 2018. Samples were tested with the multiplex RespiFinder® SMART 22 FAST which potentially detects 18 viruses and 4 bacteria. Results. Of the 86 infants considered in this study (mean age 31 ± 19 days) suspected of acute respiratory tract infections, 71 (83%) were positive for one or multiple viruses or/and bacteria. The majority of acute respiratory tract infections had a viral origin (95%): respiratory syncytial viruses (A and B) (49%), rhinovirus (21%), coronaviruses 229E (11%), humain metapneumovirus (5%), influenza A (3%), influenza H1N1 (1%), adenovirus (2%), and parainfluenza virus type 4 (2%). Among our patients, 6% had Mycoplasma pneumoniae. Coinfections were not associated with severe respiratory symptoms. Conclusion. The clinical spectrum of respiratory infections is complex and often nonspecific. Thus, the early and fast detection of related causative agents is crucial. The use of multiplex real time polymerase chain reaction may help choose an accurate treatment, reduce the overall use of unnecessary antibiotics, preserve intestinal flora, and decrease nosocomial infection by reducing the length of hospitalization. [ABSTRACT FROM AUTHOR]

Background: The aim of this systematic review is to determine the epidemiological and etiological profiles, the influential factors of the prehospital delay, thrombolysis management, the acute and 3-month mortality rate and the genetic aspect of ischemic stroke in Morocco.Methods: The present work is a systematic review that was conducted according to the recommendations of the "Preferred reporting items for systematic reviews and meta-analysis". We used Pubmed, Sciencedirect, Scopus, Clinicalkey, and Google scholar databases for the raking of the gray literature during the time frame 2009 and 2018. The protocol of the review was registered in the PROSPERO register (CRD42018115206). These studies were analyzed based on: Age, sex ratio, risk factors, etiological profile according to Trial of ORG classification 10,172 in Acute Stroke Treatment, prehospital delay average and its influential factors, thrombolyzed patients' proportion, acute and 3-month mortality and the genetic factors of ischemic stroke in Morocco.Results: Twenty-nine (n = 29) studies were selected. The average age ranged from 49 ± 15.2 to 67.3 ± 9.9 years old. Moreover, we reported male predominance within all ages in 13 studies. High blood pressure, diabetes, smoking and heart disease were the four identified main risk factors by the prementioned studies. Atherosclerosis and cardioembolic were the main described etiologies of cerebral ischemia, and the average prehospital time ranged from 26 to 61.9 h. The proportion of thrombolysed patients ranged from 1.8% to 2.9%, the mortality rate varied in the acute phase from 3 to 13%, and the 3-month mortality ranged from 4.3 to 32.5%. It is also important to highlight that most of these studies, which were conducted in hospital environment, have a reduced sample size and no confidence interval.Conclusions: Ischemic stroke is affecting more likely the young population with male predominance. Moreover, the long prehospital delay and the low proportion of thrombolysed patients are alarming. This indicates the need to investigate in depth the key factors influencing the access to care for Moroccan patients in order to improve the management of this neurologic deficit in Morocco. [ABSTRACT FROM AUTHOR]

Copyright of Eastern Mediterranean Health Journal is the property of World Health Organization and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Limited national information is available in Morocco on the prevalence and distribution of HPV-sub-types of cervical cancer and the role of other risk factors. The aim was to determine the frequency of HPV-sub-types of cervical cancer in Morocco and investigate risk factors for this disease.Methods: Between November 2009 and April 2012 a multicentre case-control study was carried out. A total of 144 cases of cervical cancer and 288 age-matched controls were included. Odds-ratios and corresponding confidence-intervals were computed by conditional logistic regression models.Results: Current HPV infection was detected in 92.5% of cases and 13.9% of controls. HPV16 was the most common type for both cases and controls. Very strong associations between HPV-sub-types and cervical cancer were observed: total-HPV (OR = 39), HPV16 (OR = 49), HPV18 (OR = 31), and multiple infections (OR = 13). Education, high parity, sexual intercourse during menstruation, history of sexually transmitted infections, and husband's multiple sexual partners were also significantly associated with cervical cancer in the multivariate analysis.Conclusions: Our results could be used to establish a primary prevention program and to prioritize limited screening to women who have specific characteristics that may put them at an increased risk of cervical cancer. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to translate and adapt the original version of the Skindex-16 questionnaire from English to Moroccan Arabic language, refining its terms and adapting it to Moroccan culture. Methods: After translation and cross-cultural adaptation, the questionnaire was tested on skin diseases patients. Internal consistency was tested using Cronbach's α coefficient, the test-retest reliability using intraclass correlation coefficient (ICC). Construct validity was assessed by examining item convergent and divergent validity. Results: The questionnaire was administered to 120 patients. The mean age of patients was 39 years (SD: 16), 49.6% were married. 76.9% of all participants lived in an urban area. The average time to complete the Skindex-16 questionnaire was 5 min. Questionnaire reliability was assessed using Cronbach's α coefficient, in which the values were all > 0.7. All items exceeded the 0.4 criterion for convergent validity. Conclusion: In general, the findings of this study indicated that the authors have developed a semantically equivalent translation of Skindex-16 into Moroccan Arabic. It is a reliable and valid measure of the effects of skin disease on the quality of life in Moroccan patients. [ABSTRACT FROM AUTHOR]

Background: In Morocco, cervical cancer is the second most common cancer in women. The cases of cervical cancer are diagnosed at a late stage: 43.7% presented at stage II of diagnosis (FIGO) and 38.1% in advanced stage (stage III and IV). The main objective of this study is to investigate factors associated to late the diagnosis of cervical cancer in Morocco as measured by the stage at diagnosis and delays between first symptoms and diagnosis of cancer. Methods: Cross-sectional studies, conducted from June-2008 to June-2010 at two main oncological centers. Two-hundred cases were recruited. Stages I & II were identified as "early-stage". The dates of first-symptoms, first-consultation and first-diagnosis were used to define "Patient", "Medical" and "Total" delays. Results: Elevated risks for late stage was observed for women unmarried (OR=5.0; 95%CI: 1.43-16.66); living > 100 km from center of diagnosis (OR=4.51; 95%CI: 1.35-15.11); without a familial history of cancer (OR=14.28; 95%CI: 2.22-100) and whose was the first symptom not bleeding (OR=25; 95%CI: 1.62-300). Frequency of housewives was significantly higher for women with a patient-delay ≥1 month. Frequency of patients who had symptoms of bleeding was significantly higher for women with a "patient-delay" <1 month. Frequency of patients from urban area was significantly higher for women with a "Medical-delay" < 1 month. Elevated risks for a long "Total-delay" was observed for women aged < 50 years (OR=2.44; 95%CI: 1.24-4.76); illiterate (OR=3.85; 95%CI: 1.45-10.00) and from rural-area (OR=2.56; 95%CI: 1.25-5.26). Conclusion: Our results may represent an important tool in guiding the actions for an early diagnosis of cervical cancer. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To estimate the prevalence of sunlight exposure and sun protection behaviors and to identify the main determinants of sun protection in a representative sample of the Moroccan population. Methods: Cross-sectional survey was carried out during May 2008 among Moroccan adults aged 18 and over, using stratified cluster sampling in origin and sex. Results: A total of 2896 subjects were included. More than half (52.1%) of the participants were regularly exposed to the sun during midday hours (11–16h) for more than 2h per day. Among those exposed to the sun during midday hours, 16.4% didn''t use any means of protection. The subjects who were more protected were women (odds ratio=0.47, 95% confidence interval=[0.35–0.64]), rural residents (odds ratio=2.33, 95% confidence interval=[1.97–2.77]) and worker subjects and students (p<0.0001). Conclusion: This survey has highlighted a high prevalence of sun exposure in the Moroccan population with few protection practices. It is therefore important to promote sun protection in order to maintain the incidence rate of skin cancer at its lower level. [Copyright &y& Elsevier]

• Data on COVID-19 infections in healthcare workers (HCWs) in fragile settings are limited. • This was the first of such information from Somalia comparing groups of HCWs. • This study revealed that the highest risk of infection was in hospital ancillary staff. • Data on infection risk should guide policy-making to protect HCWs. • Countries that are short-staffed for HCWs should prioritize frontline HCWs for vaccination. Somalia, a country with a long history of instability, has a fragile healthcare system that is consistently understaffed. A large number of healthcare workers (HCWs) have become infected during the coronavirus disease-19 (COVID-19) pandemic. This report presents the preliminary findings of COVID-19 infection in Somali HCWs, the first of such information from Somalia. This preliminary retrospective study analysed available data on infection rates among Somali HCWs. As of 30 September 2020, 3700 cases of COVID-19, including 98 deaths, had been reported in Somalia; 191 (5%) of these cases were HCWs. During the first 180 days of the outbreak, 311 HCWs were tested for COVID-19 and 191 tested positive (positivity rate: 61%). During the epidemic's peak, HCWs represented at least 5% of cases. Of the 191 infected cases, 52 (27%) were doctors, 63 (33%) were nurses, seven (4%) were laboratory technicians, and 36% were other staff. More information must be sought to put measures in place to protect the health and safety of HCWs in Somalia's already understaffed and fragile healthcare system. [ABSTRACT FROM AUTHOR]

Introduction: Le cancer au Maroc représente un problème majeur de santé publique, sa prise en charge doit être globale, active et complète pour tous les patients. L'objectif de ce travail était d'estimer la fréquence des perdus de vue « PDV » en oncologie au Maroc durant la première année de suivi et de déterminer les facteurs associés à ce problème. Méthodes: par une étude rétrospective portant sur 2854 dossiers de malades hospitalisés dans les trois principaux centres d'oncologie au Maroc depuis janvier 2003 jusqu'à juin 2007 et concernant les cinq principales localisations de cancer au Maroc, nous avons cherché la date des dernières nouvelles des patients ayant un recul de 18 mois minimum afin de déterminer le statut de ces malades après un an de suivi. Résultats: La moyenne d'âge était de 52±14 ans, une proportion féminine de 63%, les sujets actifs constituaient 28%, les mariés 71%, les analphabètes 51%, 70% des patients habitaient en milieu urbain et seulement 11% des malades disposaient d'une couverture sociale. La localisation cancéreuse la plus fréquente était le poumon (23,8%) suivie du colon-rectum (23,5%) puis le col (21,9%), le sein (20,4%) et les lymphomes (10,4%). Le taux des «PDV» à un an de suivi était de 48%, ce statut était significativement lié au sexe, à l'âge, au NSE et au statut matrimonial. Sur le plan médical, le statut «PDV» était lié à la localisation du cancer, au stade de diagnostic et au type de traitement reçu. Conclusion: Notre étude a mis en évidence la grande ampleur du problème des PDV en cancérologie au Maroc ainsi que ces déterminants. Ces résultats incitent tous les acteurs dans le domaine de la cancérologie à collaborer ensemble pour prendre les mesures qui s'imposent pour y pallier. [ABSTRACT FROM AUTHOR]

Diffuse gliomas are growing brain tumors that occur in adult life. This study was designed to determine whether the immunohistochemical analysis of IDH1, HIF-1alpha, or TP53 can provide useful biomarkers of clinical severity and progression of diffuse gliomas. Also, it is hypothesized that the expression of IDH1 mutant induces HIF-1alpha. Immunohistochemical staining for HIF-1alpha, IDH1, and TP 53 was performed in biopsy or resection (sub-total or gross-total) tissue from diffuse gliomas in a clinical series of 32 patients. Associations of the HIF-1alpha, IDH1, and TP53 with clinical characteristics were evaluated and the co-expression of two biomarkers (HIF-1alpha and IDH1) was tested. Our data revealed that each biomarker is expressed in a subset of gliomas (IDH1 was positive in 56% cases, HIF-1alpha was positive in 50% cases and TP53 was positive in 44% cases). While no associations were found between clinical characteristics and the expression of HIF-1alpha, and TP53, IDH1 expression was associated with less severe clinical presentation (Karnofsky Performance Status) and disease progression and was more often expressed in females than males. In addition, there was no clear association between IDH1 and HIF-1alpha expression (21.9% of patients co-expressed IDH1 and HIF-1alpha). The current series provides clinical and immunohistochemical findings that can be useful for the clinical management of patients with diffused gliomas. [Display omitted] • Diffuse gliomas are growing brain tumors that occur in adult life. • The expression of HIF-1α is variable in diffuse glioma, and is an indicator of intra-tumoral hypoxia. • A high expression of HIF-1α is associated with a poor prognosis in diffuse glioma. • The co-expression of HIF-1α and IDH1 can predict disease progression. • It is important to personalise treatment according to the molecular signature of diffuse glioma. [ABSTRACT FROM AUTHOR]