Estimating attributable fraction of lung cancer linked to smoking in Morocco

The objective of this research was to estimate the attributable fraction [AF] of lung cancer linked to smoking in Morocco. The estimation was based on the SAMMEC [Adult Smoking-Attributable Mortality, Morbidity and Economic Costs] method based on the Levin formula to calculate AF linked to tobacco. Data about frequencies, association measures and relative risks were taken from available sources. The AF of lung cancer linked to smoking was about 87%, and around 3049 cases of this cancer in men could be avoided if tobacco use could be prevented. About a 10% reduction in smoking prevalence would result in a reduction of 346 lung cancer cases. Our study provides additional important elements for further advocacy to policy-makers to implement a tobacco control strategy based on a prevention policy in line with the epidemiological situation which could avoid a huge burden on the country

[Assessment of the methodological quality of these submitted to the faculty of medicine Fez]

A thesis in medicine is a scientific work which allows a medical student to acquire a Doctor of Medicine degree. It is therefore recommended that theses presented by students fulfill essential methodological criteria in order to obtain scientifically credible results and recommendations. The aim of this study was to assess the methodology of thesis presented to the Faculty of Medicine in Fez in 2008. We developed an evaluation table containing questions on the different sections of the IMRAD structure on which these theses were based and we estimated the proportion of theses that conformed to each criterion. There were 160 theses on various specialties presented in 2008. The majority of the theses [79.3%] were case series. Research questions were clearly expressed in 62.0% but the primary objectives were pertinent in only 52.0%. Our study shows that there were important deficiencies in the methodological rigor of the theses and very little representation of the theses in publications

Factors associated with treatment default by tuberculosis patients in Fez, Morocco

Interruption in tuberculosis [TB] treatment still remains the most important challenge for control of the disease. This study aimed to identify the determinants of TB treatment default in Fez, Morocco. A 1:2 pair-matched case-control study was carried out in the TB control units in Fez. Cases were defaulters to TB treatment and were matched by age and sex to non-defaulters [controls]. Of the 320 patients [108 defaulters, 212 controls], 80.6% were male. The main reason for defaulting reported by patients was the sensation of being cured. Predictive factors for treatment default in the multivariate conditional logistic regression analysis, were: relapsed case [adjusted OR = 4.49; 95% CI: 1.87-10.8], current smoking [aOR = 2.10; 95% CI: 1.07-4.14], alcohol use [aOR = 2.92; 95% CI: 1.04-8.19], being more than 30 minutes away from the health centre [aOR = 3.34; 95% CI: 1.06-10.5] and perception of having received insufficient explanation about the disease [aOR = 2.87; 95% CI: 1.53-5.36]. The rate of defaulting in Fez can be lowered through targeted and realistic measures

Knowledge and attitude about antismoking legislation in Morocco according to smoking status

Despite tobacco control legislation enacted in Morocco in 1996, the Moroccan population appears to have little interest in or awareness of tobacco control measures. This household survey aimed to assess knowledge and attitudes about tobacco legislation among Moroccans, according to their smoking status. A cross-sectional study was conducted on a random sample of 9195 Moroccans. Only 33.3% knew about the antismoking legislation: 38.7% of smokers versus 323% of non-smokers. Among the 3050 people who knew about the law, 60.1% knew about the ban on smoking in public areas and 22.4% knew there was an obligatory health warning on tobacco packaging. The attitude questions showed that 27.2% agreed that the price of tobacco products should increase sharply and 45.0% that antismoking legislation should prohibit tobacco sales to children. These data demonstrate low levels of information among Moroccans concerning current tobacco control legislation

Burden of smoking in Moroccan rural areas

The aim of this study was to estimate the prevalence and characteristics of current smoking among rural Moroccans. The population study included 3438 individuals aged 15 years and above from both sexes. The crude prevalence of current smoking [currently smoked and had smoked > 100 cigarettes in lifetime] was 16.9% in the adolescent and adult rural population: 31.0% among men and 1.1% among women. The majority of smokers [74.4% of men and 68.8% of women] began smoking before age 20 years. Multiple logistic regression analysis showed that age, sex, marital status, occupation and region of residence were the strongest determinants of current smoking. These results showed a high prevalence of smoking among males in the rural population of Morocco

Prevalence of the nosocomial infection and risk factors

The prevalence of the nosocomial infection was 6, 7%, in the first study done at the University hospital center. The results were considered as underestimated. This study was done to determine the prevalence and risk factors associated with to create a new strategy against NI in this UHC. A cross sectional study was conducted. All the patients hospitalized the day of the study in this establishment were included and were examined to look for NI. The following risk factors were also looked for: the presence of a catheter, a urinary sound and surgical intervention. The statistical analysis was carried out using the software Epi info version 6. Chi-square test was used for comparing categorical data, and the Student's t-test for comparing the means. Significance was taken as P < 0.05. 276 patients were hospitalized the day of the study. Sex Ratio [Men/Women] was 0.92. The average age was 35.25 +/- 21 years with [0 - 84]. More than a third of the investigated patients [40.9%] had surgery and 36.2% of them had a vascular catheter, 13.8% had a urinary sound and 4.3% benefited from artificial ventilation. The prevalence of NI was 11.2% in all departments. 79, 3% of patients got NI on the same day of study and in the same hospitalised department The two main factors associated with the occurance of NI were surgicl operations [p = 0.04] and duration of hospitalisation [15 days or more] [p = 0, 002]. The results between the present and previous study [2004 and 2006 respectively] shows a significant increase of the NI prevalence [p = 0, 036]. The results of this study 2006 allowed estimating the NI prevalence evolution with a more relevant collection of data, consequently, a rational and adequate decision-taking

[Prevalence and risk factors for nosocomial infections in Hassan II University Hospital, Fes, Morocco]

We determined the prevalence and risk factors for nosocomial infection at Hassan II university hospital and the causative microorganisms among 282 inpatients. The mean duration of hospitalization was 16.4 [SD = 15] days. The prevalence of nosocomial infection was 6.7%. Infections at the site of the operation were the commonest. No catheter-related infection was noted. The main organisms isolated were Escherichia coli, Klebsiella pneumoniae and Candida albicans. The occurrence of a nosocomial infection was significantly associated with surgical operation [P = 0.005], presence of urinary catheter [P = 0.002] and length of hospital stay greater than 3 weeks [P = 0.04]