Review of the Urinary Schistosomiasis Control in Morocco (1960-2018).

The purpose of this study is to describe the epidemiological profile and evolution of urinary schistosomiasis in Morocco, from the first confirmed case in 1960 until disease elimination, and control snails. During this period, 129,526 cases were recorded in Morocco. A majority of cases were reported in Agadir province (25%), Errachidia (18%), and Beni Mellal (13%). Other cases have been reported in the other provinces. Activities within the National Schistosomiasis Control Programme for more than three decades were focused in priori on screening in schools located in high-risk communities, treatment program, surveillance of snails in water bodies, and mollusciciding. Then, the goal of eliminating the transmission of schistosomiasis has been reached in 2004. Sixteen years later, no indigenous cases were detected in Morocco, and only 25 residual cases (resulting from bilharziasis previously treated) are detected, such as in Tata ( 40%), Errachidia (16%), and (12%) in Marrackesh. Similarly, recent national studies conducted on children and the snail reservoir hosts have indicated that no human and molluscs are currently infected with Schistosoma haematobium. Actually, timely investigation and management of imported cases has been implemented to prevent the reintroduction of the disease. The Ministry of Health is planning to implement final confirmatory surveys before requesting WHO to proceed with the formal verification process.

Entomological inventory of Phlebotomine sand flies and epidemiological study of leishmaniasis in Afourer, Azilal province, High Atlas, Morocco.

In Morocco, leishmaniases are a major public health problem due to their genetic diversity and geographical distribution. Cutaneous leishmaniasis caused by L. tropica is endemic in the center of the country; it has a high risk of transmission, with Phlebotomus sergenti as vector. This study aimed to identify the vectors of Leishmania and the epidemiological trends of cutaneous leishmaniasis in Afourer, Morocco. The entomological study used both adhesive and CDC miniature light trap to capture six different species: P. sergenti (50.21 %), P. papatasi (18.45 %), P. longicuspis (17.17 %), P. perniciosus (12.02 %), S. minuta (1.93 %) and P. chabaudi (0.21 %). The life cycle of sand flies in this area is characterized by a biphasic trend with two activity peaks, in May and November. Hence, the highest transmission levels are likely to occur from early summer to the end of autumn. However, the epidemiological status of leishmaniasis in Afourer between 2009-2013 showed a significant decreasing trend - of 87.7 %.

[Imported Malaria in the Region of Marrakech-Safi, Morocco, between 1996 and 2016]. / Le paludisme importé dans la région de Marrakech-Safi, Maroc, entre 1996 et 2016.

Since the elimination of the autochthonous malaria in Morocco in 2005, the control of imported malaria, based on epidemiological monitoring of the parasite carriers and on vector control, is a priority. This retrospective study is focused on imported malaria cases identified by optical microscopy at the Laboratory of Public Health in Marrakesh, Morocco, from 1996 to 2016. 208 cases were observed. Males accounted for 89% of cases. The cases were imported from 24 African countries, especially from Equatorial Guinea (28%), Guinea Conakry (11%), Ivory Coast (9%), Burkina Faso (8%) and Mali (7%). The highest incidence was recorded in 2012 and 2014 with 32 cases each. Plasmodium falciparum was the most frequent parasite (85%) followed by Plasmodium ovale (12%), while lower rates were detected for Plasmodium malariae (3 cases) and Plasmodium vivax (2 cases). Increasing malaria cases have been recorded since 1996. This may be related to Morocco's openness to the sub-Saharan Africa with an increase in international travels and migration flow from malaria endemic countries. To keep the status of autochthonous malaria free country, since 2011 the Ministry of Health has developed and implemented a strategy adapted to Moroccan context, to maintain malaria elimination and prevent its reintroduction.

En parallèle à l'élimination du paludisme autochtone depuis 2005 et à la certification du Maroc comme pays exempt du paludisme par l'Organisation mondiale de la santé en 2010, des cas de paludisme importés sont encore notifiés. Le présent travail est une étude rétrospective des cas du paludisme d'importation enregistrés au laboratoire de santé publique de Marrakech de 1996 à 2016. Parmi les 208 cas positifs, 89 % sont des hommes (185 patients), soit un sex-ratio de 8. Les cas sont importés de 24 pays d'Afrique subsaharienne, en majorité la Guinée équatoriale (28 %), la Guinée Conakry (15 %), la Côte-d'Ivoire (9 %), le Burkina Faso (8 %) et le Mali (7 %). Les années de plus forte incidence ont été 2012 et 2014 avec 32 cas. Les espèces trouvées sont Plasmodium falciparum dans 177 cas (85 %) et Plasmodium ovale chez 25 malades (12 %). Les autres espèces en cause étaient Plasmodium malariae dans trois cas et Plasmodium vivax dans deux cas. Le nombre de cas a récemment augmenté, probablement lié à l'accroissement des voyages internationaux et des flux migratoires à partir des pays où cette maladie sévit de façon endémique. L'élimination du paludisme autochtone au Maroc et la bonne gestion de cas importés relèvent d'une stratégie nationale de lutte structurée et bien adaptée, axée sur le dépistage, le traitement et la lutte contre les anophèles.

Organ-specific matrix self-assembled by mesenchymal cells improves the normal urothelial differentiation in vitro.

PURPOSE: Enterocystoplasty is the gold standard to perform bladder reconstruction. Since this technique has a high morbidity rate, several matrix scaffolds have been proposed to support the urothelial maturation. Unfortunately, epithelial cells failed to fully integrate the cell-matrix interactions and therefore appropriate signalling pathways of normal differentiation. Based on these observations, we proposed to culture bladder urothelial cells (BUC) onto a matrix self-assembled by bladder mesenchymal cells (BMC), to form a vesical model (VM). METHODS: Different serum proportions were assessed to obtain a manipulable matrix deposited by BMC. The BUC were then seeded onto the BMC's matrix to evolve in a three-dimensional culture. Haematoxylin-eosin staining, immunolabeling, scanning electron microscopy, western blot and matrix metalloproteinases analysis were performed for the VM characterization. RESULTS: We were able to obtain an original matrix made of collagen-I and presenting specific organization. Matrix remodelling was observed and led to a cellular compartmentalization. The reconstructed urothelium developed in a pseudostratified arrangement, displaying an adequate cellular polarity and apical membrane remodelling of superficial cells. Like native bladder, cytokeratin 14 immunolabeling was not observed in our VM, which indicate the conformity of the development sequence taken by BUC under the influence of the BMC's matrix. CONCLUSION: Thus, it was possible to elaborate a VM without the use of exogenous matrices. The particular characteristics of the BMC's matrix permitted the development of an urothelium that shared the phenotype of native tissue. The autologous character of our VM, and its appropriate urothelial maturation, could potentially promote a better integration after grafting.