ABSTRACT
INTRODUCTION: The aim of this study is to document time intervals in cervical cancer care pathways, from symptom onset to disease detection and start of treatment, and evaluate how clinical, sociodemographic, and treatment factors influence delays throughout a patient's clinical pathway. METHODS: A retrospective study was conducted at the FEZ Oncology Hospital of the Hassan II University Hospital Center in Morocco. RESULTS: 190 medical records of cervical cancer patients were collected. The dominant age group was 35-44, the median patient delay (PD) was 6 days, the median healthcare provider's delay (HCP) was 21 days, the median referral delay (RD) was 17 days, the median diagnostic delay (DD) was 9.5 days, the median total diagnostic delay (TDD) was 16 days, the median treatment delay (TD) was 67 days, and the median health system interval (HSI) was 92 days. Multivariate analysis revealed that age was associated with the patient delay, the healthcare provider's delay, the diagnosis delay, and the health system interval. The diagnosis year (the year in which the patient was diagnosed (either before 2012 or during 2012 as well as the other study years (from 2013 to 2017))), all investigations done prior to admission to the oncology hospital, and the age of first sexual activity were significantly associated with healthcare provider's delay. CONCLUSION: The integration of a model and standard care pathway into the Moroccan health system is essential in order to unify cervical cancer care in the country.
ABSTRACT
BACKGROUND: Breast cancer is the most frequent cancer among Moroccan women. Environmental and occupational factors may play a role in breast cancer etiology. This study aimed to investigate the association between occupation, industry, and breast cancer risk among Moroccan women. METHODS: A total of 300 breast cancer cases and 300 controls (matched by age and area of residence) were included in this study. Full occupational history was collected, with a detailed description of each job held for at least 6 months. Occupations were coded according to the International Standard Classification of Occupations (ISCO 08) and the Moroccan Analytical Classification of Professions (2001). Industries were coded according to the Statistical Classification of Economic Activities in the European Community (2008). Odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for potential confounders were estimated by using conditional logistic regression. RESULTS: An overall decreased risk of breast cancer was observed among women doing only household work (OR = 0.32; 95% CI = 0.18-0.55). An increased risk of breast cancer was observed among women in agricultural occupations, particularly those employed as agricultural laborers (ISCO 08 code: 921; OR = 2.91; 95% CI = 1.51-5.60) and the risk increased with duration of employment (P trend = .01). Analyses by industry corroborated these findings. CONCLUSIONS: Our findings suggest that occupational exposures may be associated with increased risk of breast cancer among female agricultural workers in this population. Further investigations, with advanced methods of occupational exposure assessment, are warranted to clarify the role of chemicals involved in this high-risk occupation and to suggest preventive actions and screening.
Subject(s)
Breast Neoplasms/epidemiology , Industry/statistics & numerical data , Occupational Diseases/epidemiology , Occupational Exposure/adverse effects , Occupations/statistics & numerical data , Adult , Agriculture/statistics & numerical data , Breast Neoplasms/etiology , Case-Control Studies , Female , Humans , Logistic Models , Middle Aged , Morocco/epidemiology , Occupational Diseases/etiology , Occupational Exposure/analysis , Odds Ratio , Risk FactorsABSTRACT
This survey aims at assessing knowledge, attitudes and practices towards standard precautions (SP) among caregivers at Hassan II University Teaching Hospital in Fes. This is a cross-sectional prospective and evaluative study that covers a two-month period. Data were collected using an anonymous and selfadministered questionnaire. Sampling population was divided into 307 nurses (53.8%), 210 hospital doctors (36.77%) and 57 support staff (9.45%), belonging to other various categories working in different departments. This is a young population since 79.7% are under 30 years old. The results have shown that only 28.72% of health care professionals had received training in SP. Moreover, 87.7% claimed to practice hands' hygiene while moving from one patient to another. In contrast, 75.7% emphasized the need to change gloves each time they work on a new patient. However, individual protection measures were rarely mentioned in several risky situations.
Subject(s)
Health Knowledge, Attitudes, Practice , Hospitals, Teaching , Medical Staff, Hospital/psychology , Universal Precautions , Adult , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Morocco , Prospective Studies , Surveys and Questionnaires , Young AdultABSTRACT
This survey aims at assessing knowledge, attitudes and practices towards standard precautions [SP] among caregivers at Hassan II University Teaching Hospital in Fes. This is a cross-sectional prospective and evaluative study that covers a two-month period. Data were collected using an anonymous and self-administered questionnaire. Sampling population was divided into 307 nurses [53.8%], 210 hospital doctors [36.77%] and 57 support staff [9.45%], belonging to other various categories working in different departments. This is a young population since 79.7% are under 30 years old. The results have shown that only 28.72% of health care professionals had received training in SP. Moreover, 87.7% claimed to practice hands' hygiene while moving from one patient to another. In contrast, 75.7% emphasized the need to change gloves each time they work on a new patient. However, individual protection measures were rarely mentioned in several risky situations
La présente enquête avait pour objectif d'évaluer le niveau de connaissances, les attitudes et pratiques vis-à-vis des précautions standard [PS] parmi le personnel soignant du Centre hospitalier universitaire Hassan II de Fès. Il s'agit d'une étude d'évaluation, transversale et prospective, sur une période de deux mois. Les données ont été recueillies au moyen d'un questionnaire auto-administré. La population étudiée était répartie en 307 infirmiers [53,8%], 210 médecins [36,77%] et 57 personnels d'appui [9,45%] appartenant aux autres catégories travaillant dans différents services. Cette population est très jeune puisque 79,7% ont moins de 30 ans. Les résultats ont montré que seulement 28,72% du personnel soignant avait reçu une formation aux PS. D'autre part, 87,7% déclarent pratiquer le lavage des mains entre deux patients et 75,7% reconnaissent la nécessité de changer de gants entre deux patients. Par contre, les mesures de protection individuelle ont été faiblement citées dans plusieurs situations à risqué
كان الهدف من هذا المسح هو تقييم مستوى المعلومات والاتجاهات والممارسات العملية مقابل الاحتياطات القياسية لدىالقائمن عى تقديم الرعاية في مستشفى الحسن الثاني الجامعي بفاس. فهي دراسة تقييمية مقطعية دامت شهرين. وقد تم جمع،)% البيانات من خال استبيان يملؤه المستجيبون بأنفسهم. وأخذت عينات من مجموعة الدراسة الذي شمل 307 ممرضة ) 53.8210 طبيباً ) 36.77 %( و 57 من موظفي الدعم ) 9.45 %( الذين يعملون في فئات أخرى في الخدمات المختلفة. إن عينة هذه الدراسةكانت شابة، إذ تقل أعار 79.7 % منهم عن 30 عاماً. وأظهرت النتائج أن 28.72 % فقط من العاملن في مجال الصحة قد تلقوا تدريباًعى الاحتياطات القياسية. ومن ناحية أخرى، أفاد 87.7 % من عينة الدراسة أنهم يلتزمون بممارسة غسل الأيدي عند الانتقال منمريض لآخر، وفي المقابل أفاد 75.7 % منهم أنه من الروري تغير القفازات عند الانتقال من مريض لآخر. وخلاصة القول، فإنالالتزام بتدابر الحماية الشخصية كانت ضعيفة في العديد من الحالات المعرَّضة للمخاطر
