Metric identification and mapping of reimbursable implant codes in Morocco to the global nomenclature (GMDN) and European (EUDAMED) of medical devices.

BACKGROUND: The list of medical devices (MD) eligible for reimbursement under the Compulsory Health Insurance in Morocco is set by Ministerial Order comprising 869 items between life-support equipment, external prostheses, and implants. The objective of the present study is to analyze the nomenclature of implantable medical devices (IMD) appearing on this list and compare them with the global nomenclature of MD (GMDN) and the European nomenclature of MD (EMDN). METHODS: The study deals with (i) the mapping of the codes of the IMD list with 170 DM per cardinality and (ii) a metric identification by Sørensen-Dice coefficient of terminological similarity of the IMD with respect to the two databases. RESULTS: The 170 IMD codes are mapped onto 493 terms in the GMDN and 344 terms in the EMDN. The 37.7% of implants are mapped to more than or equal to 2 terms of GMDN while 36.5% are mapped to more than or equal to 2 terms to the EMDN. The comparison of cardinality distributions has revealed no significant difference (P=0.430) between the two databases. The implants examined are divided into 11 categories whose strong similarity is given to active cardiovascular implants in the EMDN database with simDice=0.534. CONCLUSION: Healthcare authorities need to align with nomenclature standards to improve interoperability and rely on a more efficient and rational regulatory process.

Tuberculosis in southern Morocco: Retrospective analysis from 2006 to 2012.

INTRODUCTION: Tuberculosis, a global major concern, causes millions of deaths annually despite WHO strategies. A persistent gap in detection and treatment facilitates rapid spread in high-burden countries. AIMS: Analyze the clinical-epidemiological profile of tuberculosis patients in Laayoune and Tarfaya, Morocco, emphasizing risk factors and evolution of the tuberculosis Methods: Retrospective analysis of 1332 tuberculosis cases at the Respiratory Diseases Diagnosis and Treatment Center in Laayoune (2006-2012). Variables with P < 0.10 in univariate analysis were included in multivariate analysis using multiple logistic regression to define the risk factors for tuberculosis, expressed as odds ratios (OR) with a 95% confidence interval (CI). RESULTS: The analysis revealed a pulmonary predominance (≈61%), with pleural (41.3%) and lymph node (31.5%) tuberculosis prevalent among extrapulmonary cases. Among 515 extrapulmonary tuberculosis cases, intestinal tuberculosis (14 cases) showed the highest mortality rate at 14.29%. The 15 to 64 age groups had a significantly higher risk of contracting pulmonary tuberculosis to children, and the 65 and over age group also had the highest risk of developing pulmonary tuberculosis (aOR=5.83 [2.43, 14.00]). Other risk factors included rural origin, personal history of tuberculosis, and smoking, all significantly associated with pulmonary tuberculosis (aOR=2.40 [1.001, 5.76]; aOR=2.00 [1.11, 3.61]; aOR=2.38 [1.40, 4.06]). Conversely, female gender was a protective factor (aOR=0.53 [0.40, 0.70]). Regarding recovery and loss to follow-up rates, they were higher in those with pulmonary tuberculosis (39.0% vs 2.1%; aOR=33.41 [17, 66.52]; 16.9% vs 10.3%; aOR=1.57 [1.02, 2.41], respectively). CONCLUSION: Holistic initiatives across various sectors will be essential to eliminate tuberculosis by 2030.

Research cartography of implantable medical devices in the three Maghreb countries: A comparative study between Morocco, Algeria, and Tunisia.

BACKGROUND: Biosafety and efficacy are essential aspects in the use of implantable medical devices (IMD) in several medical and surgical disciplines. To this effect, and depending on the therapeutic indication, the diversity of IMD imposes enormous evaluation strategies from their design through to their impact on improving the patient's quality of life. OBJECTIVE: To elaborate cartography which traces back the research tracks published on IMD regarding the three Maghreb countries, namely Morocco, Algeria, and Tunisia, and this through laying emphasis on a comparative study in view of highlighting the similarities and differences between them. METHODS: First, the research work was concerned with studies on IMD published between 2013 and 2023, which met the inclusion criteria, and which used the above-mentioned keywords on the four databases Scopus, Web of Science, ScienceDirect and PubMed. Second, the results are processed for a comparative descriptive study. In second, a descriptive and inferential analysis of association and classification to establish a research map on IMD. RESULTS: Articles selected; 86 articles out of 1081 for Morocco, 70 out of 900 for Algeria and 136 out of 1303 for Tunisia. Unlike domains (P=0.014), the research methods used highlights similarities in methodological research (P>0.05) ranging from simple descriptions to meta-analyses for the medical sciences with an inequitable distribution whose high share in favor of patient-reports. CONCLUSION: The design of maps raises a diversity of fields that concern medical and engineering sciences, while medical economic studies have yet to be developed in all three countries.

Hyperbaric oxygen therapy in carbon monoxide poisoning in Moroccan patients.

Describe the epidemiological, clinical characteristics of acute carbon monoxide poisoning (COP), and the therapeutic effect of hyperbaric oxygen therapy on patient's clinical outcome. This is the first study in this field in Morocco. It studies retrospectively 309 victims of acute COP with major neurological signs. All patients have been treated with hyperbaric oxygen therapy, and have been admitted by the emergency department of the Mohammed V military training hospital in Rabat, between January 2015 and December 2018. All poisonings were accidental and occurred especially in winter (50%), with a predominance in urban areas (93%). The poisoning was often caused by a non-compliant water heater (91%), multi-causality was in half of the cases, and affected adults and women (mean age: 21 ± 17 years, gender (male:female) 1:1.5. The average admission time to the hyperbaric chamber lasted 9 h 04 min (± 12 h 32 min). Clinical signs were mainly unconsciousness (151 cases), headache (85 cases), vomiting (63 cases), nausea (53 cases), and dizziness (51 cases). All the patients benefitted from hyperbaric oxygen therapy sessions. The clinical outcome was positive in the majority of cases, but 23% of the cases presented minor or major sequelae. Patients with sequelae had a longer length of admission than those who had not. COP is a major public health problem in Morocco. Through this study, we suggest the interest of hyperbaric oxygen therapy, especially when it is administered timely without delay.

Prevalence, socio-demographic and economic determinants of violence against ever-married women in Morocco.

Background: Violence against women is a public health issue worldwide, affecting the physical and mental wellbeing of women, children and families. Aim: To determine the socio-demographic and economic factors contributing to violence against women in Morocco and offer recommendations for the prevention and reduction of violence. Methods: Data for this study was obtained from the 2018 National Population and Family Health Survey. We applied the Chi-square test and t-test to study the possible associations between some socio-demographic and economic variables and violence against women. We performed a logistic regression to indicate the simultaneous association of the variables. Results: Among 9969 ever-married women aged 15-49, 15.0% [CI (95%): 14.3-15.7%] had suffered an act of violence in the last 12 months preceding the survey (17.0% in urban and 11.9% in rural areas). Violence against women depended significantly on age, age at first marriage, marital status, total children ever born, educational level, wealth index, being a household head, employment status, decision-maker regarding employment, number of marriages ever had, smoking, relationship with the husband, husband's age, husband's educational level, husband's polygamy, area of residence, and region of residence (P < 0.05). Conclusion: Violence against women has reached endemic proportions in Morocco and this has serious consequences for population health and the country's economy. There is a need to reinforce and better structure public health programmes to sustainably prevent or reduce violence against women in the country. It is also important to take actions to mitigate the risk factors and provide adequate and quality care for victims.

Clinical and histopathological pattern of lung cancer in Morocco.

Introduction: lung cancer is the most common cancer and the leading cause of cancer death worldwide. This study aimed to provide an overview of the epidemiology of primary lung cancer in Morocco. The distribution of histological subtypes by sex and smoking status was also assessed. Methods: this was a retrospective and descriptive study using medical records of patients with primary lung cancer, diagnosed at two university hospitals in Morocco between 2014 and 2017. Results: a total of 606 patients (average age = 58.5 ± 10.64 years, men = 521) were included. Four hundred and forty-three men had a history of smoking against sex women. Most patients (85.68%) had respiratory symptoms at diagnosis. Over half of patients (53.03%) had a performance status <2 and 38.94% had at least another pulmonary disease at presentation. Chronic obstructive pulmonary disease (COPD) and tuberculosis were present in 23.43% and 18% of patients, respectively. The majority (72.27%) of men practiced an occupation associated with a significant risk of lung cancer. Adenocarcinoma was the main histological type in our series with 60.40%. Most (79.55%) patients were diagnosed at stage IV. Only 7.83% of patients benefited from surgery. The distribution of histological subtypes by sex and smoking habits showed that adenocarcinoma was more frequent in women (p=0.011), and squamous cell carcinoma in men (p=0.014). No differences between smokers and non-smokers were noted. Conclusion: our results showed a decrease in the age of diagnosis and a late stage of the disease. Adenocarcinoma was the most frequent histological type.

Academic burnout among trainee teachers during the COVID-19 pandemic: Effect of sociodemographic factors.

BACKGROUND: The trainee teacher seems to be more and more faced with frustration and stress during the training phase, caused by accumulation of requirements and duties, making them susceptible to the risk of burnout. The purpose of this work is to study the academic burnout of trainee teachers at the Rabat-Sale-Kenitra region's Regional Center for Education and Training Professions during the COVID-19 pandemic. MATERIALS AND METHODS: Seven hundred thirty-nine trainee teachers responded to a self-questionnaire comprising the Maslach Burnout Inventory-Student Survey scale in its French validated version, as well as stress factors during the academic year 2020-2021. Both inferential and descriptive methods of data analysis were used to represent the effect of sociodemographic variables on burnout levels during the COVID-19 pandemic. RESULTS: In agreement with the literature, most of trainee teachers show moderate and high levels of academic exhaustion; the main stressors presented are financial instability and training overload, and the level of study influences the scale of burnout among trainee teachers. CONCLUSION: The result of this study can serve as a predictor of academic burnout among Moroccan trainee teachers.

The development and validation of an academic burnout questionnaire among Moroccan trainee teachers using the maslach burnout inventory-student survey.

BACKGROUND: Stress and burnout syndrome are more common for people who work in professions that include direct contact with humans, such as education and the medical field. To contribute to the prevention of this syndrome, the Maslach Burnout Inventory-Student Survey (MBI-SS) has been validated and used in different countries worldwide except for Morocco. The main purpose of this study is to develop and validate a special version of the MBI-SS scale to assess academic burnout among Moroccan trainee teachers during their training period. MATERIALS AND METHODS: A self-administered questionnaire was carried out to assess the sociodemographic factors and certain stressors of the interviewees as well as the MBI-SS. Two hundred fifty-five trainee teachers of the CRMEF (Regional Centre for Education and Training) participated to assess the validity of the MBI-SS scale in its French version and its three components during the academic year 2020/2021 of the Rabat-Salé-Kénitra region. The inferential method of data analysis was used by Cronbach's alpha to determine the overall reliability of the instrument as well as the three components of the assessment. After that, exploratory factor analysis was carried out. RESULTS: Sixty five percent of the participant were male, and most of them were between the ages of 20 and 30 years. The results demonstrated a satisfactory psychometric characteristic for its dimensions and validated the 3-dimensional structure of the MBI-SSM, yet they indicate the necessity to remove two items to guarantee their reliability. The Cronbach's alpha value of the MBI-SSM was greater than (0.7). The Cronbach's alpha also showed a good homogeneity for the three dimensions of the MBI-SSM, (0.853) for emotional exhaustion, (0.570) for cynicism, and (0.776) for academic efficacy. CONCLUSIONS: It is concluded that the MBI-SSM is determined to be an objective and a valid instrument and can be used to assess academic burnout in the Moroccan context.

Epidemiology of Cardiovascular Diseases in Morocco: A Systematic Review.

OBJECTIVE: To provide a systematic review of studies on cardiovascular diseases (CVD) and their risk factors in the Moroccan population. METHODS: A systematic analysis was performed based on PRISMA guidelines by retrieving data bases (Medline, Embase, and other) using technical keywords in addition to manual research on official websites. Published studies in the English or French language, conducted in Morocco or concerning the Moroccan population within the last two decades, were identified. RESULTS: This is the first systematic review of CVD in Morocco. Data from 159 studies were retrieved and analyzed. Most studies were written in the English language (75.89%) and published between 2010 and 2019 (85.47%). The mortality rate caused by CVD in Morocco has reached 38%, with ischemic heart disease and stroke as the main events causing death (31.0% and 22.5% respectively). The risk factors present in the population studied were headed by tobacco smoking (45- 50%), followed by physical inactivity (21.1%), elevated rate of hypertension (25.3%), and depression (5.47%). Impacted by a high rate of illiteracy and poverty and an unprepared health care system in Morocco, these numbers are expected to increase over the next decade. CONCLUSIONS: Based on these alarming incidences, investment in scientific research and epidemiological studies should be increased to determine the needs of the local population. The available evidence shows that the risk of cardiovascular disease and the associated mortality is very high in Morocco and will rise in the next years prospectively, which calls for urgent multi-sectorial approaches and treatment strategies.

Protective Efficacy Evaluation of Four Inactivated Commercial Vaccines Against Low Pathogenic Avian Influenza H9N2 Virus Under Experimental Conditions in Broiler Chickens.

Avian influenza vaccines are commonly used in the poultry industry. The objective of this study was to compare, under experimental conditions, the protective efficacy of four imported commercial inactivated H9N2 vaccines (A, B, C, and D) in broiler chickens. A total of 150 one-day-old chicks were divided into six groups: four experimental groups, each containing 30 chicks, received one of the vaccines (A, B, C, or D) delivered in a 0.3-ml dose subcutaneously at 1 day of age, whereas the control, Group T, was not vaccinated but challenged and Group E was kept unvaccinated and unchallenged. At 21 days postvaccination, Groups A, B, C, D, and T were challenged with 107 embryo infective dose 50% of A/Chicken/Morocco/01/2016 (H9N2). All chicks were observed daily for clinical signs during the 12 days postchallenge (dpc). At 5 and 12 dpc, chicks were euthanatized for necropsy examination. Blood samples were collected weekly for serologic analysis and oropharyngeal swabs were collected for virus detection by real-time RT-PCR. Respiratory signs started at 48 hr pc and maximum severity was observed on 9 dpc. Chiefly, the birds vaccinated with vaccine B showed significantly more respiratory signs than did their counterparts. Serologic analysis revealed that the sera of Groups A and D birds showed a decrease in antibody (Ab) levels up to day 26; then a slight increase of Ab level was observed until day 31, while Group B and C birds showed a stabilization of the titers from day 21 until the end of the experiment. The viral shedding rate was significantly lower in Groups C and A (40%-50% of the birds shed virus for <7 days) compared with other challenged groups (60%-75% of the birds shed virus for ≥9 days). This experiment illustrated that vaccination applied on the first day in the hatchery with the four vaccines tested did not provide an acceptable protection against H9N2 in comparison with the controls that did not receive any vaccine. However, at first glance, we might favor vaccines A and C for their ability to reduce and shorten viral shedding as compared with vaccines B and D.

Evaluación de la eficacia protectora de cuatro vacunas comerciales inactivadas contra el virus de la influenza aviar H9N2 de baja patogenicidad bajo condiciones experimentales en pollos de engorde. Las vacunas contra la influenza aviar se utilizan comúnmente en la industria avícola. El objetivo de este estudio fue comparar, en condiciones experimentales, la eficacia protectora de cuatro vacunas H9N2 inactivadas comerciales importadas (A, B, C y D) en pollos de engorde. Un total de 150 pollitos de un día se dividieron en seis grupos: cuatro grupos experimentales, cada uno con 30 pollitos, recibieron una de las vacunas (A, B, C o D) administradas en una dosis de 0.3 ml por vía subcutánea al día. de edad, mientras que el control, Grupo T, que no fue vacunado y desafiado y el Grupo E que se mantuvo sin vacunar y sin desafiar. A los 21 días después de la vacunación, los Grupos A, B, C, D y T fueron desafiados con 107 dosis infecciosas de embriones al 50% del virus A/Chicken/Marruecos/01/2016 (H9N2). Todos los pollos fueron observados diariamente para detectar signos clínicos durante los 12 días posteriores al desafío (dpc). A los cinco y 12 días después del desafío, los polluelos fueron sacrificados humanitariamente para un examen de necropsia. Se recolectaron muestras de sangre semanalmente para análisis serológicos y se recolectaron hisopos orofaríngeos para la detección de virus mediante RT-PCR en tiempo real. Los signos respiratorios comenzaron a las 48 horas después del desafío y la severidad máxima se observó a los nueve días después del desafío. Principalmente, las aves vacunadas con la vacuna B mostraron significativamente más signos respiratorios que sus contrapartes. El análisis serológico reveló que los sueros de las aves de los Grupos A y D mostraron una disminución en los niveles de anticuerpos (Ab) hasta el día 26; luego se observó un ligero aumento del nivel de anticuerpos hasta el día 31, mientras que las aves de los Grupos B y C mostraron una estabilización de los títulos desde el día 21 hasta el final del experimento. La tasa de excreción viral fue significativamente menor en los Grupos C y A (40% -50% de las aves excretaron el virus durante <7 días) en comparación con otros grupos desafiados (60% -75% de las aves excretaron el virus durante ≥9 días). Este experimento ilustró que la vacunación aplicada el primer día en la incubadora con las cuatro vacunas probadas no proporcionó una protección aceptable contra el virus H9N2 en comparación con los controles que no recibieron ninguna vacuna. Sin embargo, a primera vista, podríamos favorecer las vacunas A y C por su capacidad para reducir y acortar la diseminación viral en comparación con las vacunas B y D.

Determination of Mineral Composition and Phenolic Content and Investigation of Antioxidant, Antidiabetic, and Antibacterial Activities of Crocus sativus L. Aqueous Stigmas Extracts.

The aim of this study is to investigate the in vitro antioxidant, antidiabetic, and antibacterial activities of Moroccan and Italian Crocus sativus (L.) stigmas extracts. The antioxidant activity was evaluated by DPPH radical scavenging assay, and the results showed that the Moroccan extract has a powerful antioxidant activity with an IC50 of 0.32 ± 0.059 µg/mL compared to the Italian extract (IC50 of 3.14 ± 0.021 µg/mL). Additionally, the antidiabetic activity was evaluated by using alpha-amylase and alpha-glucosidase inhibition assay, and both extracts showed significant antidiabetic activity. However, the antibacterial activity was evaluated by the disc diffusion method to determine the inhibitory diameters and microplate dilutions method to determine the minimum inhibitory concentration. Our findings revealed that both Moroccan and Italian extracts were more effective against Gram-positive than Gram-negative bacteria. From this study, we can conclude that the studied extracts of C. sativus are rich in natural compounds and could have a broad application in the pharmaceutical, food, and medical fields.

[Criminal poisoning in Morocco: data from the Morocco Poison Control and Pharmacovigilance Centre (1980-2014)]. / Empoisonnement criminel au Maroc: données du Centre Antipoison et de Pharmacovigilance du Maroc, 1980-2014.

INTRODUCTION: intentional poisoning is a major public health problem in both developed and developing countries. The purpose of this study is to describe the epidemiological features of criminal intoxication in Morocco. METHOD: we conducted a retrospective study of all cases of criminal intoxication identified by the Morocco Poison Control and Pharmacovigilance Centre (MPCPC) between 1980 and 2014. RESULTS: during the study period, 611 cases of criminal poisoning were recorded, reflecting a rate of 2.1% of all intentional poisoning reported during the same period. The average age of intoxicated patients was 26.4±14.3 years. More than a quarter of the subjects were children under the age of 15 (28.6%). According to the study results, 55.9% were male, with a sex-ratio (M/F) of 1.3. The majority of cases (89.4%) occurred in urban areas. Collective intoxications were reported in 24.4% of cases. The most frequently used products were pesticides (19.1%) and plants (19%). Patients developed different symptoms based on the toxic substances used, the amount ingested and the time elapsed before treatment. A range of digestive, neurological, respiratory and cardiovascular disorders were reported. Out of 440 patients with outcome data available, 27 died. The remainder of patients survived with or without sequelae. CONCLUSION: criminal poisoning is a major issue. The number of cases is probably underestimated due to a large number of undiagnosed or unreported cases.

Depression, Quality of Life, and Self-Esteem of Moroccan Postmenopausal Women with Osteoporosis before the Occurrence of Fractures.

OBJECTIVES: Previous researches have investigated depression in postmenopausal women (PMW) with osteoporosis and fractures, but little is known regarding Moroccan PMW without fractures. We investigated depression prevalence and severity in Moroccan PMW with osteoporosis without fractures and its relationship with quality of life (QoL) and physical and psychological state. METHODS: This cross-sectional study enrolled 100 PMW with osteoporosis without fractures. Depressive symptoms, QoL, self-esteem, and fatigue were evaluated using the Patient Health Questionnaire-9 (PHQ-9), Arabic version of ECOS-16 questionnaire, Rosenberg self-esteem scale, and Arabic version of the Multidimensional Assessment of Fatigue scale, respectively. A questionnaire including sociodemographic factors, bone density features, pain intensity, and sleep disturbance was completed. RESULTS: Overall, 58% patients suffered from depression and 55% from pain (63.8% depressed women vs. 42.9% nondepressed patients; P = 0.03). Bone mineral density, lumbar spine T-score, ECOS-16, and self-esteem in depressed and nondepressed women were 0.791 (0.738-0.840) vs. 0.835 (0.790-0.866); -3.25 (-3.8 to -2.875) vs. -2.9 (-3.425 to -2.700), P = 0.02; 2.338 ± 0.605 vs. 1.638 ± 0.455; and 13.517 ± 5.487 vs. 18.404 ± 5.771, P < 0.0001, respectively. Depression severity correlated with pain, QoL, self-esteem, and fatigue (r = 0.367, r = -0.390, r = -0.390, and r = 0.369, respectively; P < 0.0001) as well as lumbar spine bone mineral density and T-score (r = -0.258 and r = -0.255, respectively; P = 0.01). Multiple linear regression analysis revealed impaired QoL (ß = 0.526; P < 0.0001), fatigue (ß = 0.177; P = 0.02), and lower self-esteem (ß = -2.170; P = 0.005) as the strongest risk factors of depression. CONCLUSIONS: Our study shows that even without fractures, Moroccan PMW with osteoporosis suffered from depression, pain, impaired QoL, and lower self-esteem.

Skin flora and bacterial contamination of diversion pouch and recovered platelet components in Moroccan blood donors.

OBJECTIVE: The objective of this study was to evaluate bacterial reduction procedures used during whole-blood donations in Morocco. BACKGROUND: Bacterial contamination still poses serious challenges to blood safety, especially in countries with limited resources. METHODS: In the first part of this study, we analysed 233 swab samples taken from blood donors' antecubital fossa. After donation, a second batch of samples was analysed from the diversion pouches of corresponding donors. In addition, we searched for the prevalence of bacterial contamination in 568 randomly chosen platelet components at their expiration date in order to control for the entire blood unit preparation process. RESULTS: The most frequently found bacterial species at the antecubital fossa of healthy blood donors were coagulase-negative Staphylococcus, aerophilic Corynebacterium, Staphylococcus aureus, Bacillus sp. and Micrococcus sp. After donation, 5.15% of the diversion pouches were contaminated with bacterial species, the most notable being Bacillus sp., aerophilic Corynebacterium, coagulase-negative Staphylococcus, Staphylococcus aureus and Pseudomonas aeruginosa. Of 568 platelet components, 18 were contaminated with three bacterial species: Bacillus sp., coagulase-negative Staphylococcus and Staphylococcus aureus. CONCLUSION: All three bacterial species found in platelet components were detected on the skin of blood donors. Serious measures need to be taken and enforced to ensure blood safety.

Antidiabetics and antihypertensive medications use in Morocco: A pharmacoepidemiological descriptive study.

 Background: In Morocco, and many other African countries, there is a paucity of antihypertensive and antidiabetics use amongst the general population. AIM: To investigate the epidemiological profile of antihypertensive and antidiabetics use and analysis their adverse reactions. SETTING: This study was conducted in the prefecture of Figuig, Morocco. METHODS: A cross-sectional descriptive study. Data was collected using semi-structured questionnaire about their pharmacological treatment and presented using descriptive statistical analysis. RESULTS: Sample of 244 subjects, predominantly women 58.15% (p 0.03) composed of diabetic patients 56.96% (n = 139) and hypertensive patients 43.03% (n = 105). After adjustments, 60.24% of all patients were under monotherapy. The diabetics were being treated using the Biguanide class (26.92%), insulin (20.0%) and sulfonylureas (10.0%) while hypertensive patients were treated by Calcium Channel Blockers (27.36%), Angiotensin Converting Enzyme Inhibitors (21.05%), Angiotensin T-Blockers (16.84%), Diuretics (7.36%) and ß-adrenergic receptors blockers (3.15%). In total, 23.00% of all subjects have experienced negative side-effects, mostly, reported (90.38%) to health professionals and 23.52% of them have interrupted temporarily or try to change their treatment. Gastro-intestinal problems were the most adverse reactions reported (11.11%) followed by headache, dizziness and tinnitus (6.66%) and asthenia, feeling sick and feeling of faintness (5.33%). CONCLUSION: Managing diabetes and hypertension entails a lot of public challenges and requires more focus and interest, especially amongst the illiterate population in remote areas. Some of the suggested ways to help face the problem include the introduction of new innovative measures, systems of fellow-up and adverse reactions.

Economic evaluation of the direct cost resulting from childhood poisoning in Morocco: micro-costing analysis.

BACKGROUND: The analysis of the economic burden for childhood poisoning has great value in Morocco where there still exists a paucity of information on the subject. The objective of this study was to explore the economic costs of unintentional and intentional poisoning in children in the region of Rabat-Salé-Kénitra, Morocco. METHODS: A prospective study of children younger than 15 years with a poisoning diagnosis conducted between March and July 2016 in the Children's University Hospital of Rabat, Morocco. The source of data for this study was questionnaire that collected information on the costs, the epidemiological and the socio-economic characteristics of childhood poisoning. RESULTS: Eighty-seven patients were interviewed during the study period (39 females and 48 males). The majority of poisoning cases (98.85%) were accidental and 1.15% were intentional. Drugs, snake bites and scorpion stings, carbon monoxide, food, plants, household products, illegal drugs, pesticides, petroleum and industrial chemicals products were caused the poisoning. Of all the hospitalized patients, 77 (88.5%) were admitted to the emergency department and 5 (5.7%) were admitted to the intensive care unit. The average direct medical costs and the average direct non-medical costs of providing poison treatment were USD 127 and USD 30 per child, respectively. Total average direct cost of USD 157 (127 + 30) represented 60% of the national minimum wage per month in Morocco. Total direct medical costs accounted for 80%, as against 20% direct non-medical costs. The mean ± SD length of stay (LOS) for children with poisoning was 2.15 ± 1.87 days with a range variated between 0 day and 10 days. CONCLUSIONS: Overall, this study confirms that the costs of childhood poisoning are not negligible costs in Morocco. Therefore, the prevalence and the costs of childhood poisoning can be reduced by monitoring an open communication between parents, the Poison Control Centre of Morocco (MPCC) and physicians in order to increase the vigilance of parents against the risks related to unintentional poisoning that can be prevented with more awareness.

Space-time COVID-19 monitoring in Morocco.

INTRODUCTION: In Morocco, the first case was detected on March 02, 2020. Few days later, new cases are notified, followed by deaths. The government decided to adopt large-scale drastic measures against the epidemic. This study aims to describe and analyse the COVID-19 distribution in Morocco, according to key measures taken to curb this health problem. METHODS: An observational study of all cases daily reported by the Ministry of Health of Morocco from 02 March to 05 May 2020, was carried out. A mapping was performed. RESULTS: Before the implementation of the state of health emergency, 86 confirmed cases out of 471 biological examinations carried out have been reported and the highest cumulative incidence (0.43 cases per 100,000 inhabitants) was recorded in Fes-Meknes region. During the 1st quarantine, 2,960 positive cases out of 15,915 examinations carried out have been detected. Marrakech-Safi region was the most affected (15.33 cases per 100,000 inhabitants). Halfway through extended quarantine, 2,173 confirmed cases out of 49,570 biological examinations realized have been notified, the highest cumulative incidence has observed in Draa-Tafilalet region (27.45 cases per 100,000 inhabitants). The highest mortality was observed in Marrakech-Safi region (1.05 deaths per 100,000 inhabitants) and the highest case fatality rate (13.46%) was registered in Souss-Massa region. CONCLUSION: The strategy adopted by Morocco has enabled it to avoid a health catastrophe. But, it's not over yet. Morocco should continue the massive efforts and reinforce the existing measures against the virus, especially in regions very affected by the epidemic.

Antidiabetics and antihypertensive medications use in Morocco: a pharmacoepidemiological descriptive study

Background: In Morocco, and many other African countries, there is a paucity of antihypertensive and antidiabetics use amongst the general population. Aim: To investigate the epidemiological profile of antihypertensive and antidiabetics use and analysis their adverse reactions. Setting: This study was conducted in the prefecture of Figuig, Morocco. Methods: A cross-sectional descriptive study. Data was collected using semi-structured questionnaire about their pharmacological treatment and presented using descriptive statistical analysis. Results: Sample of 244 subjects, predominantly women 58.15% (p < 0.03) composed of diabetic patients 56.96% (n = 139) and hypertensive patients 43.03% (n = 105). After adjustments, 60.24% of all patients were under monotherapy. The diabetics were being treated using the Biguanide class (26.92%), insulin (20.0%) and sulfonylureas (10.0%) while hypertensive patients were treated by Calcium Channel Blockers (27.36%), Angiotensin Converting Enzyme Inhibitors (21.05%), Angiotensin T-Blockers (16.84%), Diuretics (7.36%) and ß-adrenergic receptors blockers (3.15%). In total, 23.00% of all subjects have experienced negative side-effects, mostly, reported (90.38%) to health professionals and 23.52% of them have interrupted temporarily or try to change their treatment. Gastro-intestinal problems were the most adverse reactions reported (11.11%) followed by headache, dizziness and tinnitus (6.66%) and asthenia, feeling sick and feeling of faintness (5.33%). Conclusion: Managing diabetes and hypertension entails a lot of public challenges and requires more focus and interest, especially amongst the illiterate population in remote areas. Some of the suggested ways to help face the problem include the introduction of new innovative measures, systems of fellow-up and adverse reactions

Infectious complications of endoarterial interventional radiology: protocol for an observational study of a longitudinal national cohort of patients assessed in the French hospital discharge database (MOEVA study).

Around seven million patients undergo endoarterial interventional radiology procedures (EAIRP) annually worldwide. These procedures have become part of the standard repertoire of vascular surgery. However, the healthcare-associated infections related to these procedures are relatively unknown. Prevalence and adverse outcome of infectious complication (IC) post-EAIRP may be underestimated. We aim to provide national trend estimation of EAIRP incidence and outcome in France. METHODS AND ANALYSIS: From the French Common Classification of Medical Acts, we will define four categories of EAIRP. We will collect procedures via the French nationwide hospital discharge database, called Programme de Médicalisation des Systèmes d'Information (PMSI) and derived from the Diagnosis Related Group system. Various combinations to identify the numerator will be employed according to a pre-established algorithm. Technical data wrangling tools facilitating the use of PMSI will be developed to obtain a clean and well-structured database ready for statistical analysis. This protocol will require competences in medicine, epidemiology, statistics, data processing and techniques through various stages of the study. The cohort will contain the denominator (the first act of the first stay of each patient) and the corresponding numerator (the IC which will occur during the first stay). ETHICS AND DISSEMINATION: No nominative, sensitive or personal data on patients have been collected. The study of the MOrtality and infectious complications of therapeutic EndoVAscular interventional radiology (MOEVA) study does not involve humans, and falls within the scope of the French Reference Methodology MR-004 according to 2016-41 law dated 26 January 2016 on the modernisation of the French health system. Our study involves the reuse of already recorded data, which require neither information or non-opposition of the included individuals. Access to linked ANOnymous (ANO) file in the PMSI databases was approved by the French National Commission for Data Protection and Liberties (CNIL number 1564135). The results will be disseminated through a peer-reviewed publication.

Epidemiological Profile of Drug Overdose Reported in South-East Morocco from 2004 to 2016.

BACKGROUND: Drug overdose, either accidental or intentional, is the most common cause of acute poisoning worldwide. OBJECTIVE: The aim of this study was to determine the epidemiological profile of drug poisoning recorded in the south east of Morocco and to identify the proportion of intentional versus accidental drug overdose. METHODS: This was an epidemiological study of 180 cases of medicinal poisoning registered with the Provincial Delegation of Health in Errachidia between January 2004 and December 2016. Information on demographic and drug overdose characteristics was obtained from the regional poison center. Drugs were categorized according to the anatomical therapeutic chemical (ATC) classification system. RESULTS: Adults were the most affected group, with a median age of 21 years and a sex ratio of three females to every male. Drug poisoning mainly occurred in urban areas (83% of cases). Regarding clinical signs, 55.2% of patients presented with digestive signs and 27.6% with neurological signs. Other signs were also present: respiratory (5.1%), combined neurological and digestive (4.5%), cardiovascular (3.8%), and general (3.8%). Women represented 88.9% of those who had intentionally overdosed and 64.3% of those who had unintentionally overdosed. Benzodiazepine derivatives and other related drugs were involved in 21.5% of cases of drug poisoning, with other drugs found in patients with drug overdose as follows: paracetamol 3.3%, ethinyl estradiol/levonorgestrel 5%, and cyproheptadine 1.6%. CONCLUSION: Our results indicate that the number of reported cases of drug poisoning in south-east Morocco increased between 2004 and 2016. The intentional use of drugs in overdose was mostly  among adults, especially women. The drugs involved were predominantly psycholeptic drugs, followed by analgesics. Mortality was low, but investigation in a representative sample will show  the real severity and outcomes of drug overdoses.