Economic burden of lung cancer in Morocco: A cost of illness study.

INTRODUCTION: Lung cancer is the most common cancer in men and the second most common cancer in women. It is associated with substantial economic impact in terms of direct and indirect costs. The main objective of this study is to estimate the direct medical cost of lung cancer management in Morocco MATERIALS AND METHODS: A cost-of-illness study was conducted among patients treated at the Mohammed VI Center of Cancer (Casablanca) in 2019. The costs were estimated from the societal perspective using a bottom-up approach. The materials and procedures used were identified and quantified retrospectively from the information system and files. Their monetary value was calculated according to official prices published by the national health insurance agency. The horizon time adopted was 12 months. RESULTS: The study included 271 patients, with an average age of 62.5 ± 9.5 years. Of these, 93.4 % were men and 92.1 % were former smokers. In terms of cancer staging, 68.3 % of patients were in stage IV while 28.8 % were in stage III. Adenocarcinoma was present in 43.5 % of cases. Patients underwent an average of 10.6 ± 5.1 radiological investigations, 56.1 ± 30.9 biological tests, and 24.1 ± 11.7 consultations. The average direct medical cost was 4455.3 USD (95 % CI: 4037.4-4873.2). Chemotherapy accounted for 19.9 % of the total cost, while radiological investigations and drugs accounted for 18.7 % and 17.6 %, respectively. Diagnostic tests and radiotherapy each accounted for 7.6 % of the total cost, while biological tests accounted for 7.5 % and hospitalizations accounted for 7.1 %. The cost was statistically higher in young patients (p = 0.017), in patients with adenocarcinoma (p < 0.0001), in patients with stage II tumor (< 0.00001), in patients who have undergone surgery (p = 0.002), chemotherapy (p < 0.0001), radiotherapy (p < 0.001) and in those without metastases (p < 0.0001). CONCLUSION: These results provide evidence to support the ratification of the Framework Convention on Tobacco Control and the full adherence of the Kingdom of Morocco to the MPOWER measures.

Preparedness and health risks associated with Moulay Abdellah Amghar moussem, Morocco, 2009-2010.

The objective of this study was to describe the risks and human health outcomes associated with attendance at the Moulay Abdellah Amghar moussem (a pre-planned mass gathering attracting more than 360 000 participants) for the purposes of public health prevention, planning, preparedness and response. We performed an environmental health risk assessment and retrospectively reviewed local health centre records before, during and after the event. In addition, standardized interviews with key stakeholders were performed to qualitatively evaluate local public health preparedness and response capacities. During the event, average daily health centre visits increased 5-fold. The sex ratio of health-care visits changed significantly from an average of 1.8:1 female:male visits per day to 1.2:1. The proportion of injuries varied from an average of 3.7% pre- and post-event to 14.8% (P < 0.01) during the event. A significant increase in digestive diseases was also observed during the event. Recommendations include increasing accessibility to free sanitation and hygiene facilities and improving health communications concerning hand washing and food and water safety.

Effects of two systemic fungicides: Artea (Propiconazole+cyproconazole) and Punch (Flusilazole) on the physiology and the respiratory metabolism of durum wheat (Triticum durum L.).

The present work aimed at the study of the effects of Artea and Punch; two systemic fungicides on durum Wheat (Triticum durum L. cv. GTA dur). Seeds were grown in a medium containing respectively 25, 50, 75 and 100 ppm of Artea and Punch under controlled conditions. After measuring root number and length, eight-day-old-root tips were used to determine Catalase (EC 1.11.1.6), Ascorbate-Peroxidase (EC 1.11.1.11) and Guaïacol-Peroxidase (EC 1.11.1.7) enzymatic activities. Root respiratory activity was also determined using a polarographic method (Clark electrode). Fungicide treatment triggered a decrease in root number and length for both fungicides. On the other hand, treatment with Artea and Punch resulted in an enhancement of the respiratory activity and increased antioxidative enzymatic levels in durum wheat roots. Activities of Catalase, Ascorbate-Peroxydase and Guaïacol-Peroxydase increased proportionally and were more meaningful at high concentrations (75 and 100 ppm) compared with controls. Modulations in respiratory metabolism and antioxidant system could probably be the result of Artea/Punch-induced toxicity which could lead to an oxidative stress status. The present study enhances previous works relevant to the toxic effects induced by systemic fungicides on plants.