Human Papillomavirus genotypes distribution and associated risk factors among women living in Southern Morocco.

Purpose: The aim of this work was to investigate potential risk factors associated with HPV infection and to determine the HPV genotype prevalence among women from the Southerns areas of Morocco. Methods: A total of n = 308 sexually active women provided their written consent to participate in this study. A detailed questionnaire was used to collect data, related to the age and life style of participants. HPV L1 gene detection was performed by a nested PCR method using consensus primers. HPV genotypes were determined using direct Sanger sequencing method. Statistical analysis of the results obtained was carried out using R software. Results: We detected HPV in 42.5 % of the total investigated samples. HPV infection was significantly associated with the following risk factors: age of the first intercourse (OR = 2.27, 95 % CI: 1.03-5.10, p = 0.044), and previous history of STIs (OR = 3.13, 95 % CI: 1.12-9.63, p = 0.034). High risk-HPV and Low risk-HPV genotypes were found in 26.6 % and 5.5 % of the participants, respectively. The most prevalent genotypes were HPV16 (22 %), HPV18 (2.6 %), HPV11 (1.6 %) and HPV83 (1.3 %). Multiple infections were found in 3.2 %. The genotypes covered by the bivalent, quadrivalent and nonavalent HPV vaccines account for 57.5 %, 62.8 % and 66.6 %, respectively. Conclusion: HPV infection prevalence reported in this study among women from the Southerns areas of Morocco is one of the highest reported in the country so far. Our finding confirm that the current HPV vaccines directed against the most prevalent HPV16 genotype, recently introduced in the country, should offer a good protection to the most vulnerable population if implemented properly. These results highlight the importance of HPV screening and vaccination programs in this region.

The association of Chlamydia trachomatis and human papillomavirus co-infection with abnormal cervical cytology among women in south of Morocco.

PURPOSE: Evidence indicates that human papillomavirus (HPV) and Chlamydia trachomatis (CT) co-infection increases the risk of developing cervical pathogenesis. This study aims to assess the prevalence and possible risk factors of CT and HPV/CT co-infection in women from South of Morocco with normal and abnormal cytology. METHODS: Participants were recruited after signing an informed consent. Cervical samples were collected and analysed for the presence of HPV or CT. Detection of genomic DNA of both pathogens was performed by nested polymerase chain reaction. HPV genotypes defined by Sanger sequencing method. The association between demographic features and co-infection status was determined using a logistic regression model. A possible association between the presence of HPV and CT and cytological abnormality patterns was also investigated. RESULTS: We recruited n = 438 women, aged between 18 and 86 years. Around 59% of participants underwent a pap smear test for the first-time. Genomic DNA of HPV, CT and HPV/CT co-infection was detected in 32.3%, 17.7%, and 13.4% of the total samples, respectively. The identified risk factors associated with CT infection were history of sexually transmitted infections and marital status. By contrast, only smoking was found to be associated with HPV/CT co-infection. Evidence showed that co-infection was associated with an increased risk of developing cervical abnormalities (OR 3.18, 95% CI 0.96-9.21; p = 0.040). CONCLUSION: HPV and CT rates were high among the studied population. Evidence suggests that HPV/CT co-infected women were more susceptible to developing abnormal cytology.

Awareness and knowledge associated to Human papillomavirus infection among university students in Morocco: A cross-sectional study.

Worldwide, cervical cancer is a real health issue, however, gaps exist in the public's awareness of the causal role of Human papillomavirus (HPV) in the development of this disease. This study aims to determine the level of awareness, knowledge and the associated factors on HPV among university students in Morocco. A cross-sectional study was conducted with a descriptive and analytical aim, among students attending Ibn Zohr University, in Agadir, Morocco. An interview questionnaire was used to collect information about the participants: demographic data, awareness and level of knowledge on HPV infection, and awareness of cervical cancer. Logistic regression analyses were used to determine the associated factors with awareness and level of knowledge on HPV. A total of 479 students participated in this study (mean age 21.82 ± 2.091). Most participants n = 391 (81.6%) were aware of cervical cancer, while only n = 7 (1.5%) identified HPV as a sexually transmitted infection. Among students, 10.0% (n = 48) were aware of HPV but only half of them n = 23 (47.9%) confirmed that HPV is associated with cervical cancer, and n = 29 (60.4%) showed low knowledge on HPV. Multivariate analysis revealed that HPV awareness has a strong association with a higher level of education (OR 4.04; 95% CI: 1.92-8.52), and with being a biology student (OR 5.20; 95% CI: 2.12-12.73), while high HPV knowledge was only associated with the female gender (OR 3.76; 95% CI: 1.01-13.92). The data suggest that university students in Morocco did not show sufficient knowledge of HPV infection and its consequences. This supports that earlier incorporation of sexual health education programs, especially related to HPV and cervical cancer, must be implemented in the university to reduce the burden of HPV-associated diseases among the population at risk.

Kallmann Syndrome with Syndactyly.

Kallmann syndrome is a rare genetic disorder marked by hypogonadotropic hypogonadism (HH) and anosmia, affecting 1 in 50,000 females. It is due to a defect of gonadotropin-releasing hormone (GnRH)-secreting neurons migration from the nasal olfactory epithelium to the basal hypothalamus. Non-reproductive, non-olfactory symptoms can also be present, depending on the genetic form of disease. The management includes hormone replacement therapy and fertility treatment. We report a case of Kallmann syndrome in an 18-year girl who presented with primary amenorrhea with poor, secondary sexual characteristics' development, poor sense of smell and syndactyly. The plasma levels of luteinising hormone, follicle stimulating hormone, and estradiol were very low, while chromosome analysis showed 46, XX karyotype. Pelvic MRI confirmed the presence of uterus and ovaries. MRI of brain was normal. Treatment was started with cyclic conjugated estrogen and progestin with good response. She is now on regular follow-up to monitor treatment.

Paraneoplastic syndromes revealing ovarian teratoma in young and menopausal women: report of two cases.

Paraneoplastic syndromes are a heterogeneous group of clinical and biological manifestations caused by underling neoplasms. They can reveal ovarian teratoma which express neuroendocrine proteins, or contain mature or immature neural tissue inducing an autoimmune response. The etiological investigation is then crucial to early identification of the tumor in order to optimize the prognosis and to limit neurological sequelae. In case of ovarian teratoma, management is essentially based on surgical resection sometimes associated with immunotherapie. We report two new cases of ovarian teratoma revealed by paraneoplastic syndromes in young and menopausal woman.

Posterior reversible encephalopathy syndrome in patient of severe preeclampsia with Hellp syndrome immediate postpartum.

Posterior reversible encephalopathy syndrome (PRES) is a rare clinico-neuroradiologic condition, not commonly reported in the literature. PRES is an uncommon complication of severe preeclampsia/eclampsia. We report the management of one patient with postpartum preeclampsia as an association of HELLP syndrome presenting with status-epileptics. Early diagnosis along with timely supportive therapy resulted in the successful management of this challenging case. Recent understanding on the pathophysiology of this uncommon condition is discussed. We highlight the importance to obstetricians, intensive-care physicians and anesthesiologists of recognizing such cases.