Measuring butyrylcholinesterase activity and hematological parameters in farmers exposed to pesticides: a case and control study from Morocco.

The Farmers are exposed to a wide range of pesticides. The application of these pesticides has been documented to lead to several adverse health effects. This aim of this case-control study was to estimate risks linked to pesticide exposure among farmers in the Souss region of Morocco through the analysis of serum butyrylcholinesterase (BChE) activity and hematological parameters. This prospective study included 98 participants (49 farmers and 49 controls). A questionnaire was used to collect socio-demographic data, technical information regarding the application of pesticides, previous poisonings by pesticides, and training on the use of pesticides. The blood samples were collected for hematological parameters and BChE analysis, and the activity of BChE was measured spectrophotometrically by the butyrlthiocholine method. The results showed no significant differences in hemoglobin (HB), hematocrit, mean corpuscular volume, platelets, red blood cell, and leukocyte cell counts between both the exposed farmer and the control group. In contrast, a significant decreased in mean corpuscular HB, mean corpuscular HB concentration, eosinophils, and basophils counts were observed. In addition, the exposed group showed a significant decrease in the BChE activity (p < .001) compared to the control group. Farmers exposed to pesticides in the Souss Massa region may be at risk of hematological alterations as well as neurotoxicity, characterized by inhibition of BChE enzyme activity.

Ischemic stroke in Morocco: Prehospital delay and associated factors.

OBJECTIVES: This study aimed to estimate prehospital delay and to identify the factors associated with the late arrival of patients with ischemic stroke at the Souss Massa Regional Hospital Center in Morocco. PATIENTS AND METHODS: An observational, prospective, cross-sectional study was conducted from March 2019 to September 2019 in the Souss Massa regional hospital center, which is a public hospital structure. A questionnaire was administered to patients with ischemic stroke and to bystanders (family or others), while clinical and paraclinical data were collected from medical records. Univariate and multivariate logistic regression analyses were used to identify the factors associated with delayed arrival at emergency department. RESULTS: A total of 197 patients and 197 bystanders who fulfilled the criteria for the study were included. The median time from symptom onset to hospital arrival was 6hours (IQR, 4-16). Multiple regression analysis showed that illiteracy (OR 38.58; CI95%: 3.40-437.27), waiting for symptoms to disappear (patient behavior) (OR 11.24; CI95%: 1.57-80.45), deciding to go directly to the hospital (patient behavior) (OR 0.07; CI95%: 0.01-0.57), bystander's knowledge that stroke is a disease requiring urgent care within a limited therapeutic window (OR 0.005; CI95%: 0.00-0.36), and direct admission without reference (OR 0.005; CI95%: 0.00-0.07), were independently associated with late arrival (>4.5hours) of patients with acute ischemic stroke. In addition, illiteracy (OR 24.62; CI95%: 4.37-138.69), vertigo and disturbance of balance or coordination (OR 0.14; CI95%: 0.03-0.73), the relative's knowledge that stroke is a disease requiring urgent care and within a limited therapeutic window (OR 0.03; CI95%: 0.00-0.22), calling for an ambulance (relative's behavior) (OR 0.16; CI95%: 0.03-0.80), distance between 50 and 100km (OR 10.16; CI95%: 1.16-89.33), and direct admission without reference (OR 0.03; CI95%: 0.00-0.14), were independently associated with late arrival (>6hours) of patients with acute ischemic stroke. CONCLUSION: Patient behavior, bystander knowledge and direct admission to the competent hospital for stroke care are modifiable factors potentially useful for reducing onset-to-door time, and thereby increasing the implementation rates of acute stroke therapies.

Serum cholinesterase biomarker study in farmers - Souss Massa region-, Morocco: case-control study.

Background: Farmers and their workers are exposed to a wide variety of pesticides. The use of pesticides has been documented to lead to several adverse health effects. Inhibition of cholinesterase, primarily butyrylcholinesterase is a good indicator of occupational exposure to organophosphates and carbamates.Objective: This case-control study aims to study the risks associated with pesticide exposure among farmers and agricultural workers in the Souss Massa region by analyzing variations in the response of a pesticides exposure biomarker: Serum Cholinesterase Activity (butyrylcholinesterase (BChE)).Materials and methods: This was a prospective study conducted on 133 participants (71 farmers and 62 non-farmers). A structured questionnaire was applied collecting socio-demographic information and determining knowledge and work practices in relation to pesticide use. The activity of Serum cholinesterase was measured by the butyrulthiocholine method a spectrophotometric assay.Results: The mean age of the participants was 42.5 ± 10.66 years. The study demonstrated significantly lower BChE activity, respectively, in the plasma of farmers exposed to pesticides, compared to the control group (p < 0.05). The measured mean level of BChE activity was (7304.80 ± 1939.99 U/L) and (9746.42 ± 1699.85 U/L) in the farmers and the control group (non-farmers), respectively. In addition, a high proportion of farmers reported that empty containers are burned in the open (74.6%) for waste disposal. A proportion (11.3%) of farmers also reported that empty container waste is spilled on the farm.Conclusions: The decrease in BChE indicates a serious public health problem among farmers who use organophosphate pesticides. This study suggests that regular monitoring for blood cholinesterase and effective interventions to reduce pesticide exposure to prevent health effects should be provided to farmers.