Knowledge and Experiences of Health Professionals in the Peripheral Management of Leishmaniasis in Morocco (ELHajeb).

BACKGROUND: Morocco hopes to eliminate leishmaniases by 2030. These diseases exist in cutaneous and visceral forms and constitute a serious public health problem. The fight against these parasitoses is carried out within the framework of a national program to control leishmaniases, which offers free treatment. However, the screening rate in public health structures does not exceed 35%. OBJECTIVE: To determine the knowledge and experience of the social actors directly involved in the fight against leishmaniasis to contribute to analyse and understand the factors of this underreporting and to draw scientific recommendations to improve screening and control activities. METHODS: Using a self-administered questionnaire, we conducted an exploratory survey during April and May 2019 among all health professionals working in public health structures in the province of ELHajeb in central Morocco. RESULTS: We found that most of the health professionals had good knowledge about the clinical signs of each form of leishmaniasis, but they had erroneous information about the true vector of the disease, the reservoirs, and the mode of transmission. 76% recognized the national leishmaniases control program and only 17% received continuing education. 85% of these professionals focused on the curative aspects of the program. 47% stated that patients do not adhere to the antileishmaniasis treatment, and 25% stated that the population uses the concept of "Hboub of Chniwla" to refer to cutaneous leishmaniasis. CONCLUSION: The study concluded that the operationalization of the activities of the leishmaniases control program recognizes some weaknesses which explain the underscreening of cases. Improvement of this situation requires the implementation of continuous training programs for caregivers and awareness-raising programs for citizens which should focus on the mode of transmission, preventive measures against reservoirs, sand flies bites, and recognition of lesions using the popular names of the disease as a starting point.

Monitoring air pollution at Mohammedia (Morocco): Pb, Cd and Zn in the blood of pigeons (Columba livia).

The concentrations of Pb, Cd and Zn were investigated in the blood of pigeons (Columba livia) in order to assess the degree of pollution by heavy metal. For this, wild city pigeons were caught at four different locations in Mohammedia classified according to their industrial activity and road traffic density. Significant difference in heavy metal concentrations were observed between sites studied, the highest lead and cadmium levels were found in industrial area and center town, while the highest zinc level was found in the less contaminated area. These results indicate that the industrial activities and the road traffic are the most important source of pollution.

[Fluoride content in well water in rural areas in Morocco]. / Teneur en fluorures des eaux de puits des régions rurales au Maroc.

The aim of our study was to determine fluorides (F-) content in the well water consumed as drinking water by some Moroccan populations in rural areas. All samples were collected between April and October 2011. Measurements were performed by an ion selective electrode. Thirty wells spread to cover most of the country and locally chosen based on the number of inhabitants who consume its water. All wells were in rural areas. The mean (+/- SD) of F- was 1.84 +/- 1.6 mg/L with a range from 0.42 to 8.95 mg/L Concentrations of F- in phosphate regions were higher than those found in other regions. More than half of the samples exceeded the current standard. Our study showed that water of some Moroccan regions is naturally rich in F-exposing people who consume it at high risk of fluorosis.

[Ophidian envenomation in the region Souss-Massa-Drâa in Morocco]. / Les envenimations ophidiennes dans la région de Souss-Massa-Drâa au Maroc.

The present study aims to determine the main characteristics of ophidian envenomation in the Souss-Massa-Drâa region in Morocco. It consisted of a descriptive retrospective analysis of all snakebite cases recorded by the Moroccan Poison Control and Pharmacovigilance Center, from 1980 to 2008. According to reported data, this region is the most affected in Morocco with 479 cases, that is 27.6% (17 cases/year). The average age of victims was 26.07 ± 18.28 years. The patients developed clinical signs (55%) dominated by disorders of the digestive system (35.5%), cardiovascular diseases (21.4%), and heart rhythm disorders (16.8%). The lethality and sequelae rates were 12% and 1.9%, respectively.

Assessment of the metals contamination of the low Sebou sediments (Morocco).

The heavy metals contamination of the lower Sebou sediments was studied to determine the average degree of contamination and to assess the extent of anthropogenic contamination. The spatial and temporal distribution of these metals and the results of the contamination indices showed very serious metallic contamination principally of Cr, Pb and Hg. However accurate analysis of the situation in the river mouth was complicated by the fact that the metals could be moved by the tides and currents.

[Contamination of the Moulay Bouselham Lagoon, Morocco with organochlorine pesticides and nitrates]. / Contamination par les pesticides organochlorés et les nitrates de la lagune de Moulay Bouselham, Maroc.

In the lagoon system of Moulay Bouselham, on the Atlantic coast of Morocco, drainage bring nutriments and sediments from irrigation systems to the open lagoon. The recent intensification of farming in the surrounding area is the chief cause of this. We studied the chemical pollution of the lagoon, which serves as a nature reserve, by analyzing the nitrate content of the water and the organochlorine pesticide content of the sediment. Comparison with similar ecosystems showed that the sediments were only moderately contaminated. However, the level of nitrates in the water was found to exceed the upper limit of the range of concentrations considered safe for human health in European regulations. The level of nitrate pollution in the area seems to be increasing, whereas organochloride pesticide pollution is on the decrease. The washing out of fertilizer during winter is responsible for much of the nitrate pollution in this season whereas in summer, urban effluents is the chief cause of nitrate contamination.

[Accumulation and biomagnification of organochlorine insecticides in molluscs and fish of the Moulay Bouselham lagoon, Morocco]. / Accumulation et biomagnification des insecticides organochlorés dans les mollusques et les poissons de la lagune de Moulay Bouselham, au Maroc.

We studied the contamination by organochlorine insecticides of the clams and eels in Moulay Bousselham lagoon, on the west coast of Morocco. DDT and its metabolites, DDE and DDD, were found to have accumulated in the lipids of all specimens. Organochlorine concentration in clams was highest for samples taken from the mouth of channels draining agricultural land. Organochlorine content was more than 100 ng/g in some cases in this area, whereas it was less than 40 ng/g in the rest of the lagoon. Organochlorine content peaked in May and then decreased after egg laying. Marked concentration of these pesticides was observed in eels, which are mobile and carnivorous. Organochlorine content peaked in November, mainly among the large specimens preparing to migrate to the ocean. DDT was stored in lipids, at concentrations up to 2,000 ng/g. However, even this high concentration is below the upper limit for human consumption. The higher proportion of DDE than of DDT shows that most of the contamination is not recent. BHC and cyclodienes were also detected, at low concentrations. The contamination of eels and clams in the Moulay Bouselham does not currently pose a threat to public health.