Evolution of attitudes, trends and perceptions of smoking among middle and secondary school students in the Gharb Region, Morocco, 2010­2015

Background: Tobacco use is an important public health issue. Morocco implemented a tobacco control programme, which has been ongoing among students at middle and secondary schools since 2010. Aim: This study aims to compare the trend in smoking among the programme beneficiaries with the results of the initial study conducted prior to the implementation of the programme. Setting: This study was conducted in middle and secondary schools of the Gharb Region in Morocco between 2010 and 2015. Methods: Two cross-sectional studies were conducted in 2010 and 2015 in the middle and secondary schools of the Gharb Region. Multistage cluster sampling was used. The information was collected using a self-administered questionnaire. Results: In the first study in 2010, 5312 students participated, and in the second one in 2015, 4208 students participated. The level of information on smoking and its effects was higher in 2015 (94.0%) than in 2010 (92.5%). In 2010, parents, primary schools and television and radio were more involved in student information on smoking compared to 2015. The proportion of students claiming that tobacco was not a pleasure (86.3%) and that it does not calm nerves (76.5%) was significantly higher in 2015 than in 2010. The prevalence of smoking increased significantly in 2015 (2.9%) against 2010 (1.8%). Conclusion: This study reports the general positive evolution in knowledge about smoking and its effects. Despite that the prevalence of smokers increased in 2015. The results suggest the need to address family influences on adolescent smoking and to investigate participation of schools in education and training students in tobacco dependence prevention

Efficacy Study of the Consumption of Iron Fortified Milk on the Iron Nutritional Status of Children in Morocco.

Objectives: Iron deficiency constitutes a major public health problem in Morocco. In line with the National Strategy for Nutrition 2011 – 2019, we undertook a double-blinded longitudinal efficacy study of consumption of iron fortified milk on iron status of children living in rural region at high altitude Methods: Children (n = 380), aged 7 to 9 years, living under normal conditions and without preliminary deworming, were divided in two groups: a non fortified group (NFG) received 200 ml of non fortified UHT milk and a fortified group (FG) received 200ml UHT milk fortified with iron sulfate to cover 30% of RDA. Clinical assessment, anthropometry, morbidity, alimentary and socioeconomic surveys, blood samples collection and cognitive tests (Raven test) were performed at baseline (T0), 4 months (T4) and 9 months (T9). Hemoglobin was estimated in situ by Hemocue device, ferritine and CRP were assessed in serum. Results: The prevalence of anemia (Hb<11,5 g/dl), for the FG was 2,6% at baseline and 0% at T9. For the NFG, it was 3,4% at baseline and 1,8% at T9. At T9 FG showed a reduction of iron deficiency (serum ferritine<12 μg/L) from 50% to 36,4%. Cognitive tests showed no significant difference between the two groups. Conclusions: The milk is a good vehicle for iron fortification, there was a reduction of Iron Deficiency in FG and no change in NFG. This study was performed with the support of “Fondation Centrale Laitière pour la nutrition de l’enfant”.

Iodine Fortified Milk Reduces Prevalence of Iodine Deficiency Disorder in School Children in Morocco.

Objectives: Iodine deficiencies compromise the health and the development of many school-age children worldwide. The aim of this study was to determine the efficacy of iodine fortified milk consumption among Moroccan schoolchildren (n = 193) in rural region. Methods: Iodine status was assessed in 79 children aged 7–9 y before and after consumption of 200mL UHT fortified milk (providing 30% RDA for iodine) daily for 9-months compared to a control group (n = 114) who consumed non-fortified milk. Anthropometric measurements and urine samples were collected and analysed at baseline, 4 months (T4) and 9 months (T9). Results: Severe iodine deficiency was prevalent among the intervention group. At T4 and T9, there was a marked improvement of severe iodine deficiency in the fortified group (8.9% at the baseline, 1.4% at T4 and 0% at T9). The prevalence of moderate iodine deficiency was reduced from the baseline to the end of the study ranging from 36.8% to 6.4%. While for the mild iodine deficiency, the prevalence was increased at T4 (61.9%) and then decreased at T9 (23.6%). A significant reduction of the prevalence of iodine deficiency was observed in the control group certainly due to the presence of residual iodine in the whole non fortified milk (10.4μg/100ml). Conclusions: The consumption of iodine fortified milk led to a clear improvement of iodine status among schoolchildren of rural. This study was performed with the support of "Fondation Centrale Laitière pour la Nutrition de l'Enfant".