[Audit of management of chronic obstructive pulmonary disease by general practitioner in Morrocco]. / Evaluation de la prise en charge des broncho-pneumopathies chroniques obstructives auprès des médecins généralistes marocains du secteur libéral.

OBJECTIVE: The purpose of this study initiated in January 2003 was to evaluate the awareness of general practitioners in Morrocco concerning the diagnosis and initial management of chronic obstructive pulmonary disease (COPD). METHOD AND RESULTS: Ten percent of the COPD patients, selected at random, participated in the study, i.e; 223 patients/2186. The proportion of COPD patients among patients attending consultations was 5 to 10% for 40% of general practitioners. Only 48.9% of the general practitioners were aware of international guidelines for the management of COPD. For 97.8%, chronic bronchial symptoms were the predominant reasons for suspecting the diagnosis of COPD; other symptoms included exercise induced dyspnea (95.1%). Only 10.8% of the general practitioners ordered a spirometry examination. Only 30.5% managed patients themselves. CONCLUSION: Our findings show that general practitioners should be implicated in the diagnosis and early management of COPD but that management practices could be improved.

Prevalence and trend of self-reported asthma and other allergic disease symptoms in Morocco: ISAAC phase I and III.

BACKGROUND: The prevalence of asthma and other allergic diseases is increasing in many parts of the world. OBJECTIVE: To determine the prevalence of asthma, rhinoconjunctivitis and skin allergy symptoms in Morocco as part of the International Study of Asthma and Allergic Diseases in Children (ISAAC). METHODS: The survey was conducted using the standardised method of ISAAC Phase III in four centres in Morocco-Casablanca, Marrakech, Ben Slimane and Boulmane-with respectively 1777, 1689, 1008 and 1254 13-14-year-old schoolchildren participating. A comparison of the results with ISAAC Phase I was carried out in two centres. RESULTS: The prevalence of self-reported symptoms of wheeze in the last 12 months (6.4-16.2%), nasal symptoms (27.9-52.8%), rhinoconjonctivitis (8.8-28%) and eczema (13.3-20.2%) varied between centres, and were highest in Casablanca, the largest city in Morocco. Significant increases in almost all symptoms were found in the two centres of Casablanca and Marrakech between ISAAC Phase I and Phase III. CONCLUSION: Morocco could be classified as a country with an intermediate burden of asthma (between 10% and 15%) and other allergic disorders. The prevalence of these symptoms has increased in the past 5 years.