Parents' perceptions of morbidities and some functional abilities in people with down syndrome in Morocco.

Objective: This study aimed to assess parental perceptions of morbidity and certain functional abilities in people with Down syndrome (DS) and their variability according to age and sex in Morocco. Material and Methods: A retrospective and analytical survey was conducted between May 2014 and November 2017, and addressed to the parents of 279 individuals with DS, including 161 boys (57.7%) aged 1-40 years. The sample was subdivised to tree age groups, children under 10 years old, adolescents aged 10-18 years and adults aged ≥ 18 years. Information about the identity of parents, age and sex of people with DS, their morbidity during the two years preceding the survey, and some functional abilities was collected. Data were entered and analyzed using the statistical program SPSS statistics software for Windows (version 20.0). Chi-square (χ2) test was used for testing statistical significance. Differences were considered significant when the p-value < 0.05. The multivariate analysis were used to identify the causes of morbidies independently associated with age and sex of child. Associations were measured in Odds ratio (OR) with 95% confidence intervals (95% Cl). Results: The most common factors of morbidity registered in the study sample with DS, included respiratory infections, visual disturbances, oral pathologies, and cardiac problems (75.4%, 72.1%, 59.3%, and 44.9%, respectively). The hearing deficit, cardiac problems, respiratory infections, and oral pathologies showed statistically significant differences among the three age groups. According to the participants parents' perceptions, half of them (50%) were able to walk at 30 months, talk at 72 months, sit at 16 months, crawl at 16 months and eat alone at 48 months old. Conclusion: People with DS at different ages present a set of potentially treatable diseases that require multidisciplinary medical monitoring. They also need early paramedical care to improve their functional abilities.

Bio-demographic characteristics of children with Down syndrome, their siblings, and their parents in Moroccan population.

OBJECTIVE: In this study, we present the results of bio-demographic characteristics of households and associated factors with Down syndrome (DS) birth in Morocco. METHODS: We conducted a retrospective survey between 2014 and 2017 addressed to 277 families with 925 siblings and at least one child with DS (279 with DS). The data are collected using a standardized questionnaire in Marrakech-Safi region. Data were entered and analyzed using the statistical program SPSS statistics software for Windows (version 20.0). Chi-square (χ2) and student t tests were used for testing statistical significance. Differences were considered significant when the p-value <0.05. RESULTS: The binary logistic regression analysis between DS and non-DS children in their bio-demographic characteristics studied (sex, breastfeeding, duration of exclusive breastfeeding, birth weight, maternal age at birth, paternal age at birth, oral contraceptive use, duration of oral contraceptive use before pregnancy, child age and rank of birth) showed that only maternal age and paternal age at birth, duration of exclusive breastfeeding, birth weight and child age (OR= 1.08; 95%Cl: 1.04-1.13, OR= 1.04; 95%Cl: 1.00-1.08, OR= 0.95; 95%Cl: 0.92-0.98, OR= 0.31; 95%Cl: 0.22-0.44 and OR= 0.90; 95%Cl: 0.87-0.93, respectively). In the other hand, the comparison between some of socio and bio-demographic characteristics of households studied with data from National Population Survey and Family health (2018) showed a higher level of education in women and men in our sample. Similar results were shown in proportion of men and women in paid employment, the proportion of smoking and alcohol consumption among men and the rate of oral contraceptive use before pregnancy among women. CONCLUSION: Highlighting the bio-demographic characteristics of people with DS will help families to take good care of this group. .

Bio-demographic characteristics of households and risk factors for Down Syndrome in Morocco.

Background: The most studied risk factors for Down Syndrom (DS) were: region of residence, exposure to chemicals, parents' education level, cigarette and alcohol use by father or mother or both, and oral contraceptive (OC) use. Objective: The aim of this study was to compare certain variables considered as risk factors on DS such as parental age at birth, OC use, child's sex, and rank of birth between children with DS and their siblings without DS as well as to determine the socio-bio-demographic characteristics of the families studied compared with the general Moroccan population. Material and Methods: We conducted a cross-sectional analysis of 277 families with 925 siblings and at least one child with DS (279 with DS) between 2014 and 2017. The data are collected using a standardized questionnaire in MarrakechSafi region. Data were entered and analyzed using the statistical program SPSS statistics software for Windows (version 20.0). Chi-square (χ2) and Student t tests were used for testing statistical significance. Differences were considered significant when the p-value <0.05. Results: The binary logistic regression analysis between DS and non-DS children in their bio-demographic characteristics studied (sex, maternal age at birth, paternal age at birth, oral contraceptive (OC) use, length of oral contraceptive use before pregnancy and rank of birth) showed that only maternal age and paternal age at birth and OC use were associated with DS birth (OR= 1.16; 95% CL: 1.11-1.21, OR= 1.05; 95%CL: 1.01-1.09 and OR= 0.01; 95%CL: 0.00-0.003, respectively). In the other hand, the comparison between socio and bio-demographic characteristics of households studied with data from National Population Survey and Family health (2018) showed a higher level of education in women and men in our sample. Similar results were shown in rate of men and women in paid employment, the rate of smoking and alcohol consumption among men and the rate of OC use before pregnancy among women. Conclusion: These results will help to sensitize the Moroccan population about risk factors for DS.

Characteristics of Menarcheal Age, Menstrual Hygiene and Socio-Demographic Factors in Girls with Down Syndrome in Morocco.

The purpose of this study was to determine the characteristics of menarcheal age, menstrual hygiene and their associated socio-demographic factors in girls with Down syndrome (DS) in Morocco. An analytical cross-sectional study was conducted between May 2014 and November 2017, including 59 parents/guardians of girls with Down syndrome aged 9-32 years. Data were collected through a standardized questionnaire providing information about socio-demographic and cultural conditions of parents, nutritional status and some functional abilities of girls. The median age at menarche was estimated using retrospective and status-quo methods, respectively. Data were entered and analyzed using the statistical program SPSS statistics software for Windows (version 20.0). Chi-square (χ2) and Mann-Whitney tests were used for testing statistical significance. The age at menarche ranged from 9 to 16 years old. The median was 13.0 (IQR, 11.0-14.0) years. The median age of menarche by probit analysis was 12.55 years. The relationship between menarcheal age, menstrual hygiene and the selected parameters showed a significant difference in age at menarche only regarding the parameter of number of siblings (Z = 2.14; p = .03), and in menstrual hygiene regarding mother's level of education, family size and age of talking (χ2 = 5.04, p = .02; χ2 = 3.75, p = .05 and χ2 = 4.99, p = .02, respectively). Most girls with DS attain menarche at the usual age as their counterparts in the general population and do not have enough knowledge about menstruation. Mobilization of all interventionists is urgent to develop adolescent skills about practices related to menstruation and menstrual hygiene.

Prevalence and predictors of dysmenorrhea among a population of adolescent's schoolgirls (Morocco).

Dysmenorrhea is the most common gynaecological problem among young females. In Arabic countries, few studies on gynaecological problems of adolescent's girls were published. OBJECTIVE: the aim of the study was to determine the prevalence of dysmenorrhea and associated factors among adolescents in public schools at Marrakesh. METHODS: we conducted a cross-sectional study; our data was collected via a questionnaire and the statistical analysis was done using SPSS version 21. Our random sample counted 364 post-menarcheal girls aged between 12 and 20 years who participated voluntarily in our study. RESULTS: the mean age at menarche was 12.89 ±â€¯1.34 years; the prevalence of dysmenorrhea was 78% and 58.1% of them suffering from severe dysmenorrhea that increased clearly with the chronological age. Dysmenorrhea was cause for missing school among 13% of girls and the most common symptoms associated with it were backache, fatigue, irritability and anxiety. The gynecological age was found to be the only predictive factor of dysmenorrhea among schoolgirls. CONCLUSION: reproductive health education should be improved enough by including them in the school curriculum to prepare girls for menstruation and inform them about problems related to this phenomenon, especially dysmenorrhea.

[Association between physical activity level, body mass index and body fat mass in young people of school age in the Wilaya of Marrakesh (Morocco)]. / Association entre le niveau d'activité physique, l'indice de masse corporelle et la masse grasse chez des jeunes scolarisés dans la Wilaya de Marrakech (Maroc).

INTRODUCTION: Physical activity is a good indicator of health state and well-being. The purpose of this study is to assess physical activity level and to study its association with body mass index and body fat mass in young people of school age in the Wilaya of Marrakech. METHODS: A sample of 1173 young people of school age (aged 15- 20 years) was recruited in the city of Marrakech (urban area) and in the Al Haouz Province (rural area). Physical activity level was determined by measuring the energy expenditure compared to the recommended levels of physical activity. Logistic regression was used in the statistical study of these associations. RESULTS: Forty-one point one percent (41.1%) of respondents were physically active for three hours and more per week, 31.1% practiced less than three hours per week, while 27.3% (41.1% of girls against 14.2% of boys; p < 0.001) do not practice any sport activity in their free time outside the school. Boys were more active than girls (OR = 3.16; p < 0.001). Rural students were more active than urban dwellers (OR = 1.9; p < 0.001). Among girls, passing from the level of "sedentary" lifestyle to the level "very active" lifestyle, the means of body-mass index (BMI) and body fat mass decreased by 1.9 kg/m2 (F = 8.03; p < 0.001) and 6.28% (F = 15.80; p < 0.001) respectively. Among boys, the decrease in BMI was 0.85 kg/m2 (F = 1.17; p = 0.17) and 2.77% (F = 5.15; p = 0.006) in body fat. CONCLUSION: Physical activity is significantly associated with body fat mass and BMI. Physical activity promotion in young people into their daily activities as well as during their leisure time, is a basic need to cope with the downstream effects of sedentary lifestyle on their health.

Lifestyle and Sociodemographic and Economic Characteristics of Patients with Lung Cancer in Morocco.

Background: Lifestyle maintenance is a crucial condition before and after lung cancer disease. According to the previous research in the scientific databases, the effect of the interaction between socioeconomic and demographic factors on the lifestyle of lung cancer patients in Southern Morocco regions remains unexamined. Accordingly, this study was designed to examine the relationship between socioeconomic factors, demographic factors, and the lifestyle of lung cancer patients. Methods: A total of 133 patients with lung cancer were divided into 103 men and 30 women with a sex ratio of 3.43 and ages varying between 28 and 82 years, and they served as informants for the study and filled in a questionnaire to provide information on their sociodemographic background, various economic characteristics, and their lifestyle. These patients have also been submitted to an anthropometric examination following the standardized procedure recommended by the World Health Organization. The survey was conducted from July 2013 to March 2015 at the Oncology and Radiotherapy Department, at Mohammed VI Hospital Center in Marrakech, Morocco. Results: The preliminary results showed that the average age of patients was 59 ± 9 years. A proportion of 81% lived in the Marrakech-Safi region and 19% lived in four other southern regions. Among the patients, 6% were smokers, while 14% were nonsmokers and 80% were ex smokers. Following the discovery of the disease, 26% revealed that they had sleep disorders and 98% were reported to have a lack of appetite. Obesity, normal weight, and underweight were also taken as criteria to categorize the patients; thus, obese informants represented 23% of the total number, those having normal weight reached 67% and the patients having underweight represented 10%. Conclusion: Sociodemographic variables and various economic characteristics were shown to have a negative impact on the lifestyle of lung cancer patients.

Self-Esteem and HIV Infection in Morocco: Associated Factors Among People Living with HIV-Results from a Community-Based Study.

People living with HIV (PLHIV) face specific issues regarding mental quality of life (QoL), in particular self-esteem. The objective of this study was to measure self-esteem and to identify associated factors among PLHIV in Morocco. A 125-item questionnaire was administered to 300 PLHIV. The dependent variable was adapted from Rosenberg's self-esteem scale (range 0-4). A weighted multiple linear regression was performed. The mean level of self-esteem was 2.4 ± 1.0. The factors independently associated with self-esteem were: feeling of loneliness (p = 0.001), perceived seriousness of infection (p = 0.006), thinking serostatus disclosure was a mistake (p = 0.007), thinking HIV infection will last for life (p = 0.008), sexual orientation (p = 0.050), satisfaction with sexual life (p = 0.019) and perceived treatment efficacy (p = 0.009). These results underline the need for evidence-based interventions (e.g. anti-discrimination measures, interventions to prevent social isolation of PLHIV, support in the serostatus disclosure process), in order to improve the social environment and eventually improve their self-esteem and QoL.

Factors associated with HIV status disclosure to one's steady sexual partner in PLHIV in Morocco.

The objective of the present study was to determine the factors independently associated with disclosure of seropositivity to one's steady sexual partner in people living with HIV (PLHIV) who are recipients of services provided by Association de Lutte Contre le Sida, a Moroccan community-based organization (CBO) working on AIDS response. Between May and October 2011, 300 PLHIV were interviewed about their sociodemographic and economic characteristics, their sexual life and disclosure of their serostatus to their friends, family and to their steady sexual partner. A weighted logistic regression was used to study factors associated with serostatus disclosure to one's steady sexual partner. We restricted the analysis to people who declared they had a steady sexual partner (n = 124). Median age was 36 years old, 56 % were men and 62 % declared that they had disclosed their serostatus to their steady sexual partner. The following factors were independently associated with disclosure: living with one's steady sexual partner [OR 95 % CI: 9.85 (2.86-33.98)], having a higher living-standard index [2.06 (1.14-3.72)], regularly discussing HIV with friends [6.54 (1.07-39.77)] and CBO members [4.44 (1.27-15.53)], and having a higher social exclusion score [1.24 (1.07-1.44)]. Unemployment (as opposed to being a housewife) was negatively associated with disclosure [0.12 (0.02-0.87)]. Despite the potential positive effects for the prevention of HIV transmission and for adherence to HIV treatment, many PLHIV had not disclosed their serostatus to their steady sexual partner. Some factors shown here to be significantly associated with such disclosure will help in the development of future support interventions.

[Obstetric care: Supply and demand care in three valleys of the western High Atlas region of Morocco (Anougal, Azgour and Imnane)]. / Demande et offre de soins obstétricaux dans le Haut Atlas occidental.

This article analyses the data of an exhaustive retrospective survey of maternal morbidity among 656 women from 3 valleys of the Western High Atlas mountains of Morocco who gave birth within the previous 5 years and from the obstetric register of the hospital providing obstetric care in the study area. This analysis reveals a very large gap between the prevalence of symptoms of maternal morbidity recorded in the High Atlas valleys we studied and those measured on a regional and national scale. Only a minority of women have either prenatal or postnatal care, and delivery in a medically monitored environment is uncommon. Although morbidity during pregnancy should lead women to give birth in such a setting, only one third of the women with morbidity during pregnancy gave birth in a medical facility. This situation increases the risk of complications and morbidity during pregnancy, delivery and the postpartum period. This inadequate utilisation of preventive and curative healthcare appears to be related not only to sociocultural representations and socio-economic conditions but also to inadequate provision of obstetric care by the health-care system for complications and the poor quality of pre- and postnatal consultations. The proportion of serious complications of pregnancy or delivery complications requiring emergency obstetric care admitted to the hospital does not exceed 4.5%, while the acceptable level is 15%. Among these cases, nearly half were subsequently referred to Marrakech, to a second-level referral centre.