The prevalence of neural tube defects and their prevention by folic acid supplementation.

BACKGROUND & AIMS: Folate is crucial for the development of the fetal neurological system. Moroccan Health authorities promote Folic acid (FA) supplementation, before and during pregnancy, as a significant protection against fetal neural tube defects (NTDs). Thus, the current study aims to investigate the effect of FA supplementation guidelines on NTDs prevalence and to assess the health professionals' (HPs) knowledge, attitude, and practice (KAP) regarding FA supplementation in Morocco. METHODS: To assess the prevalence of NTDs, epidemiological data were collected from local and regional medical facilities and enhanced through a literature study. In addition, an auto-administered questionnaire was implemented to evaluate KAP among HPs on the FA supplementation national program. RESULTS: The study results showed that from 2017 to 2023, the national prevalence rate of NTDs ranged from 4.26 to 21 per 10,000 live births, according to the region. Lack of information about FA supplementation is evident among HPs; while, 13.7% of the participants confused FA with vitamin B12; merely 50% recognized the significance of FA; and 11.9% had no idea which foods contained the most folate. Consequently, HPs' attitude and practice towards FA supplementation were deemed inadequate. Additionally, only 35.8% of respondents stated that they occasionally inquire about their patients' nutrition, 55.9% do not prescribe FA, and 44.1% are unwilling to report cases of NTDs. CONCLUSION: NTDs remain a serious public health problem in Morocco. Despite the significant incidence of these diseases, HPs' knowledge, attitudes and practices in terms of prevention present gaps and inadequacies. According to the results of this study, the preparation of specific training sessions and the start of preconception consultations constitute an urgent and important issue.

A Comprehensive Pathophysiologic, Histologic, and Biochemical Analysis of Buthus paris (C. L. Koch, 1839) Venom.

INTRODUCTION: Buthus species, including B paris, are classified as one of the most dangerous scorpion genera in Morocco, implicated in several cases of human death. Our objective is to characterize, for the first time, the toxicity and histopathologic and biochemical impacts of B paris venom. METHODS: We investigated the experimental pathophysiology of B paris venom by examining histologic changes in vital organs (heart, kidneys, liver, and lungs) and assessing biochemical enzymatic markers (alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatine phosphokinase, urea, and creatinine) in mice injected subcutaneously with 2 doses of 400 and 450 mg·kg-1. RESULTS: Our results showed that the subcutaneous median lethal dose of B paris venom was around 0.52 mg·kg-1. Histologic findings revealed significant tissue damage in the previously mentioned vital organs, confirmed through biochemical analysis indicating impaired heart and liver functions. Additionally, an increase in urea, creatinine, and glucose levels occurred following B paris venom injection. CONCLUSION: Our findings show that B paris venom exhibits a high level of experimental toxicity. These results highlight the potentially lethal nature of this venom and emphasize the potential medical importance of this species.

Congenital Malformations in the Moroccan Surveillance System: Contribution to Prevalence Estimation.

Background: Congenital malformations (CMs) are a group of structural or functional anomalies present at birth. These anomalies result in a high rate of mortality, morbidity, and disability in children. CMs are a major public health problem and place a heavy burden on healthcare systems in both developed and developing countries including Morocco, which has had a CMs surveillance system in place since 2011. The aim of this study is to determine the prevalence of CMs in Morocco. Methods: In this study, the epidemiology of CMs in Morocco was assessed retrospectively using the national surveillance system data gathered from case notification forms from 2017 to 2021. Results: The main results showed that the prevalence of CMs in Morocco is 3.91/1000 live births (LBs), and the minimum annual prevalence of CMs was reached in 2017 (3.10/1000 LBs) while the maximum annual prevalence was recorded in 2018 (4.55/1000 LBs). The majority of CMs are unspecified CMs (68.55%), neural tube defects (NTDs) account for (21.13%), and orofacial clefts (OFCs) account for (10.32%). In addition, the majority of CMs (61.73%) were from rural areas. According to region, the Dakhla-Oued Eddahab region recorded the highest prevalence of CMs in Morocco, with 8.81/1000 LBs, while the lowest prevalence was recorded in the Rabat-Sale-Kenitra region, with 2.02/1000 LB. Conclusions: This study reveals that the national prevalence of CMs is high and may be underestimated, as most of the CMS reported is unspecified. The use of a CM registry with detailed reporting of all CMs and the promotion of preventive measures are urgently recommended.

Molecular diversity assessed by MALDI mass spectrometry of two scorpion species venom from two different locations in Morocco.

Scorpion venom is a cocktail of molecules whose composition is remarkably plastic, controlled by several factors. The Moroccan scorpion fauna is characterized by its richness and high rate of endemism and the venom molecular variability of many species is not yet well characterized. The aim of the present study was to highlight the molecular variability of the venom composition of Androctonus amoreuxi and Buthacus stockmanni (endemic species), both belonging to the Buthidae family, collected from two Moroccan regions, Zagora and Tan-tan. Characterization of the molecular mass fingerprints (MFPs) of each specimen was performed by Matrix-assisted laser desorption ionization-mass spectrometry (MALDI-MS) using a sandwich (Sand) and a dried-droplet (DD) sample preparation and dilutions. Considering these two methods, a total of 828 ion signals were detected, and Sand method produced more adducts (56%) than DD (44%). We observed interspecific variations in the venom composition between these two species showing they share 235 ion signals, while 226 and 367 are specific for these two species, respectively. Moreover, B. stockmanni specimens showed a clear difference in their MFPs between the two geographical areas studied, suggesting intraspecific variations. Moreover, specimens from each population also show an intraspecific variability. In addition, for the same individual, a variation in the venom composition was also recorded depending on the milking frequency. Our results confirmed the presence of characteristic components in each extracted venom sample. In conclusion, MFPs assessed by MALDI-MS represent a fast, non-supervised, sensitive, reliable and cost-efficient approach for taxonomic identification and molecular variability characterization. This study undoubtedly represents a step forward for understanding the scorpion venom plasticity, intra/inter variations, and their temporal and geographical variability.

Clinical, epidemiological and faunistic characterization of scorpionism in Azilal, Central High Atlas (Morocco).

The province of Azilal is one of the most scorpion-infested areas in Morocco. The current study aims to investigate the clinical and epidemiological characteristics of scorpion envenomation in the Azilal province, as well as to contribute to the study of its scorpio-faunistic diversity. We examined clinical and epidemiological data from 5684 scorpion stings recorded between 2017 and 2021. Prospections on the ground were carried out in the study area. The species were identified using the taxonomic keys. Distribution maps of inventoried species have been created using SIG. 5684 scorpions stings were reported in the study area, with 18 cases of deaths. Most of the cases was reported in the summer especially at night (64%). A positive significant correlation was found between scorpion stings incidence and season (P < 0.005; r = 0.56). A positive correlation was found between scorpion stings incidence and mortality (r = 0.09). Pediatric mortality was higher compared to lethality in adults (P < 0.05). A positive correlation was found between the number of stung children (Age <15 years) and the number of patients presenting clinical signs of severe envenomation (Class III) (r = 0.40). The percentage of patients that use traditional remedies was significantly higher in the rural areas (P < 0.05). Most scorpion stings occurred in human habitat (54.5%) or in their neighbourhood (24.5%). Six species were identified in the study area. The findings of this study have highlighted the extent of scorpion envenomation and have elucidated certain characteristics of the scorpio-faunistic biodiversity in the Azilal province.

Epidemiological, toxicological and physiopathological characteristics of scorpion stings and their management in Morocco: A literature review.

All around the world, scorpion envenomation represents a public health issue. In Morocco, it represents the first cause of poisoning. The aim of this review is to highlight the epidemiological, toxicological and physiopathological characteristics of scorpion stings and envenomation in Morocco as well as their management. According to the bibliography, the most areas affected by scorpion stings and envenomation are those in the center and south of Morocco. Lethality rate is more important in children than adult. Age, admission class, season, serum venom concentration, and the time elapsed between the scorpion sting and medical intervention are risk factors for a poor prognosis. Until now, we have only known the LD50 of 14 scorpion species from three genera: Androctonus, Buthus and Hottentota, and only 6 species, out of 61 moroccan scorpions, have been assessed for their venom toxicity on mice organs. The venom of harmful moroccan scorpions induces several histopathological changes in the myocardium, brain, liver, pulmonary alveoli, and kidneys in rats, as well as severe consequences in the lungs with intra-alveolar hemorrhage. There was also a significant increase in serum enzyme levels of aspartate transaminase (AST), alanine transaminase (ALT), creatine phosphokinase (CPK), and lactate dehydrogenase (LDH), as well as high levels of plasma albumin, creatine and glucose. In the absence of a specific treatment, the management of scorpion envenomation is based only on symptomatic therapy. We noted a widely use of traditional remedies. Despite the magnitude of the scorpion problem in Morocco, it remains understudied and continues to claim lives, particularly given the lack of an efficient etiological cure.

Assessment of SARS-CoV-2 Stability in human and environmental matrices, and potential hazards.

In the context of the ongoing pandemic of COVID-19, SARS-CoV-2 was detected in human excreta and environmental matrices. The occurrence of SARS-CoV-2 in environmental compartments raises questions on its fate and stability in these matrices and its potential to spread in the exposed communities. This review focused on the stability of the SARS-CoV-2 in human excreta, wastewater, soils, crops, and other environmental matrices, that may be reached through human excreta and sewage products spreading. Little is known about the persistence and survival of SARS-CoV-2 in the environment. Up to now sewage sludge, soil and crops are seldom investigated implying the convenience of considering future researches focusing on SARS-CoV-2 in soils receiving wastewater and sewage sludge, as well as on grown crops. Information regarding SARS-CoV-2 persistence in environmental media is crucial to establish and implement effective policies and measures for mitigating the transmission of COVID-19 and tackling eventual future outbreaks.

Epidemiological and faunistic characterization of scorpionism in the Beni Mellal-Khenifra region, Central Morocco.

Scorpionism is a serious public health problem in several parts of the world including Morocco, where is considered as the first cause of intoxication. The Beni Mellal-Khenifra region is one of the most affected regions by this health problem. The aim of this study is to describe the epidemiological and faunistic characteristics of scorpionism in this area. A retrospective epidemiological study was conducted based on the data of 16,388 cases of scorpion stings recorded between 2016 and 2020. In the laboratory, the collected scorpions were determined morphologically based on the valid taxonomic keys. Statistical and descriptive analyses were performed using Excel 2016. Statistical significance was determined by P-value < 0.05. The study comprised 16,388 stung patients. The scorpion stings incidence was 123.58 cases/100,000 population/year and was significantly higher at Azilal province (217.69 cases/100,000 population/year). We found a positive correlation between the scorpion stings incidence and the percentage of the rural population (r = 0.72) and between the scorpion stings incidence and the number of harmful species found in each province (r = 0.69). The general lethality rate was on average of 0.30% with a higher rate in Fquih Ben Salah province (0.63%) followed by Azilal province (0.32%). Children have the highest lethality than adults (p < 0.05). In the study area, eight species were identified, belonging to the families Buthidae and Scorpionidae, including dangerous species. Scorpionism is a real health problem in the Beni Mellal-Khenifra region, which is a rich and diverse area of scorpion fauna. Our findings can be useful for better understanding the problem of scorpionism in this region in order to better control it.

Androctonus genus species in arid regions: Ecological niche models, geographical distributions, and envenomation risk.

AIM: The objective of this study was to establish environmental factors related to scorpion species occurrence and their current potential geographic distributions in Morocco, to produce a current envenomation risk map and also to assess the human population at risk of envenomation. MATERIALS AND METHODS: In this study, 71 georeferenced points for all scorpion species and nine environmental indicators were used to generate species distribution models in Maxent (maximum entropy modeling of species geographic distributions) version 3.3.3k. The models were evaluated by the area under the curve (AUC), using the omission error and the binomial probability. With the data generated by Maxent, distribution and envenomation risk maps were produced using the "ESRI® ArcGIS 10.2.2 for Desktop" software. RESULTS: The models had high predictive success (AUC >0.95±0.025). Altitude, slope and five bioclimatic attributes were found to play a significant role in determining Androctonus scorpion species distribution. Ecological niche models (ENMs) showed high concordance with the known distribution of the species. Produced risk map identified broad risk areas for Androctonus scorpion envenomation, extending along Marrakech-Tensift-Al Haouz, Souss-Massa-Draa, and some areas of Doukkala-Abda and Oriental regions. CONCLUSION: Considering these findings ENMs could be useful to afford important information on distributions of medically important scorpion species as well as producing scorpion envenomation risk maps.

Anti-scorpion venom activity of Thapsia garganica methanolic extract: Histopathological and biochemical evidences.

ETHNOPHARMACOLOGICAL RELEVANCE: Thapsia garganica, is a herbal medicine traditionally used as diuretic, emetic and purgative. It is also used as anti-scorpion venom in Morocco; however, its protective effects against scorpion venom remain elusive. AIM OF THE STUDY: The present study was undertaken to evaluate anti-venom activity of T. garganica in vivo through histological and biochemical studies. MATERIALS AND METHODS: Methanolic leaves extract of T. garganica was evaluated for anti-venom activity against buthus. occitanus under in vivo conditions. Histopathological and biochemical changes in envenomed and treated mice were also examined. Phytochemical screening was conducted to estimate the major constituents whereas DPPH, ß -Carotene-linoleic acid and reducing power assays were performed to evaluate the anti-oxidant activity of T. garganica extract. RESULTS: Methanolic leaves extract of T. garganica (2g/kg) increased the survival time (> 18h) of mice injected with lethal doses of B. occitanus venom, with remarkable recovery of histology damage. Furthermore T. garganica induced a significant decreased of biochemical markers of kidney, liver and heart function. Phytochemistry screening revealed the presence of phenolic compounds, flavonoids, tannins and steroids/terpenoids, which might explain the bioactivity of the extract. It was also shown that the extract has an exceptionally high antioxidant activity compared to well-known antioxidants used as standards. CONCLUSION: The present study provides strong evidence that support the use of T. garganica as anti-scorpion venom in traditional medicine in Morocco. However, additional studies are required to isolate and identify the metabolites responsible for the activity.

Peripheral and central effects of intracerebroventricular microinjection of Hottentotta gentili (Pallary, 1924) (Scorpiones, Buthidae) venom.

Central effects of scorpion venom toxins have been neglected, due both to the common belief that scorpion venoms act by targeting peripheral organs and also to the misunderstanding that these peptides do not cross the brain-blood barrier (BBB). Determining whether scorpion neurotoxicity is restricted to peripheral actions or whether a central mechanism may be partly responsible for systemic manifestations could be crucial in clinical therapy trends. The present study therefore aims to assess histopathological damages in some organs (heart, kidney, liver, and lungs) and the related biochemical impairments, together with a neurobehavioral investigation following an intracerebroventricular (i.c.v) micro-injection of Hottentotta gentili (Scorpiones, Buthidae) venom (0.47 µg/kg). I.c.v. injection of venom produced focal fragmentation of myocardial fibers, while lungs showed rupture of the alveolar structure. Concurrently, there was a significant rise in the serum enzymes levels of ASAT, ALAT, CPK and LDH. Meanwhile, we observed behavioral alterations such as a hypoactivity, and in addition the venom seems to have a marked anxiogenic-like effect. The present investigation has brought new experimental evidence of a peripheral impact of central administration of H. gentili venom, such impact was manifested by physiological and behavioral disturbances, the last of these appearing to reflect profound neuro-modulatory action of H. gentili venom.

Pathophysiological and neurobehavioral injuries in mice experimentally envenomed with Androctonus liouvillei (Pallary, 1928) scorpion venom.

The genus Androctonus is represented by 7 scorpion species in Morocco. All studies conducted on the characterization of Androctonus species venom are limited to Androctonus mauritanicus. However, there is other species which arouses also interest of scientists due to their high toxicity. Thus, we chose to assess the toxic effect of Androctonus liouvillei venom by sublethal injection and the effects on some vital organs, by a histological and a biochemical tools. In addition, we aimed to characterize the neurobehavioral impairments, in Swiss mice, 3h, 6h and 12h following envenomation. The LD50 of A. liouvillei scorpion venom was found to be 0.29mg/kg by subcutaneous injection route. Venom administration induced glomerular destruction and disorganization in the Bowman's spac. Examination of lungs showed a remarkable focal rupture of the alveolar structure and intra-alveolar hemorrhage. Concurrently, there was a significant enhancement in the serum enzymes levels of AST, ALT, CPK and LDH, and a high level of glucose and creatinine. Proteinuria was also observed. Regarding the behavioral effects we noted a hypoactivity and anxiogenic-like effect, manifested by an increased time spent in the open arms in groups tested 30min and 12h after the injection. Concomitantly with an increased immobility time in the tail suspension test. The present finding show an obvious profound neuromodulatory effect of A. liouvillei venom manifested by an impaired neurobehavioral and physiological patterns in mice that may in part explain the toxic effect of the venom in human as one of the potent death agents.

Behavioral, histopathological and biochemical impairments observed in mice envenomed by the scorpion: Hottentota gentili (Pallary, 1924).

Hottentota gentili is a black scorpion which has been considered as dangerous specie by many authors. However there are no data regarding minimal lethal dose and effects of the scorpion venom till now. We therefore aimed, by the present investigation, to assess on the one hand, the LD50 of H. gentili venom by sublethal injection and the effects on some vital organs, by a histological and a biochemical tools. On the other hand, the possible neurobehavioral impairments, in Swiss mice, 3 h, 6 h and 12 h following envenomation. The LD50 of H. gentili scorpion venom was found to be 0.46 mg/kg by subcutaneous injection route. Venom produced focal fragmentation of myocardial fibers, while lungs showed rupture of the alveolar structure. Intestines showed selective histopathological changes. Concomitantly, there was a significant rise in the serum enzymes levels, as well as hyperkalemia and a high level of plasma albumine and creatine. Proteinuria was also observed. The observed behavioral effects were a hypoactivity in the both experiments 30 min and 3 h after injection. The envenomation produced an increased immobility time only 30 min and 3 h post injection in the tail suspension test (TST).