Situation Épidémiologique des Leishmanioses au Niveau de la Ville d’El Hajeb (Centre du Maroc) Durant la Période de 2013 à 2017

Les leishmanioses sont des maladies infectieuses transmises à l’homme par la piqure d’un phlébotome femelle. Elles constituent la deuxième cause de mortalité mondiale d’origine parasitaire après le paludisme et elles sont endémiques dans les pays d’Asie et d’Afrique. Au Maroc, elles posent un vrai problème de santé. L’objectif de cette étude est de déterminer leur situation épidémiologique dans la ville d’EL Hajeb située au centre du Maroc, analyser leur évolution en fonction du sexe et de l’âge et apprécier leur distribution géographique selon le milieu. Pour ce faire, nous avons effectué une étude rétrospective durant la période de 2013 à 2017, colligeant tous les cas des leishmanioses déclarés au niveau de cette ville. Les données ont été collectées au niveau des registres des cas auprès de la délégation du Ministère de la santé d’El Hajeb. Au total vingt-un nouveaux cas ont été déclarés infectés. La coexistence des deux formes des leishmanioses: cutanée (80,95%) et viscérale (19,05%) avec une prédominance du milieu rurale (76,47%). Seuls les enfants sont concernés par la leishmaniose viscérale et le plus jeune âge était de 13 mois. Le sex-ratio femme/homme était de 1,1. L’âge moyen de contamination est de 3,75 années pour la forme viscérale et de 25,82 années pour la forme cutanée. L’élimination des leishmanioses au Maroc d’ici 2030 nécessite l’adoption d’une approche globale en agissant sur les foyers de contamination par une surveillance et une prise en charge appropriées, une lutte efficace contre les vecteurs et les réservoirs et une innovation dans les stratégies de sensibilisation.Leishmaniasis is an infectious disease transmitted to humans by the bite of female sand fly. These parasitic infections are the second most common cause of parasite mortality worldwide after malaria and are endemic Asian and African countries. In Morocco, they pose a real health problem. The objective of this study is to determine the epidemiological situation of these diseases in the city of El Hajeb in central Morocco, analyze their evolution according to sex and age and assess their geographical distribution according to the environment. To do this, we carried out a retrospective study during the period from 2013 to 2017, collecting all the new cases of cutaneous and visceral leishmaniasis declared in this city. Data were collected at the register level from the delegation of the Ministry of health of El Hajeb. A total of twentyone new cases were declared infected. The coexistence of the two forms of leishmaniasis: 80.95% of cutaneous forms and 19.05% of the visceral form declared only in children. The rural population is the most concerned (76.47%) the sex ratio between men women was around 1.1. the average age of contamination by the visceral form is 3.75 years by the cutaneous form. The elimination of leishmaniasis in Morocco by 2030 requires the adoption of a global approach by acting on the foci of contestation through regular surveillance, integrated management of actions against vector and reservoirs and an innovation in sensibilisation strategy

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Evaluation of the bacteriological and physicochemical risk of hospital effluents: case of the Mohamed V hospital in Meknes

Like other countries, Morocco is committed to protecting environment. One of the actions is Law 28 00 on waste because it is harmful to environment and to health. However, hospital effluents are getting out of hand. This study looked at those at Mohamed V Hospital, which serves a population of almost 2 million people. The methodology relates to physicochemical and bacteriological analyzes of representative samples of these effluents by monthly samples over a period of one year. These were carried out in front of the four wings of the hospital between 11 a.m. and noon (maximum activity period). The search for bacteria of medical interest was carried out at the medical analysis laboratory of the Mohamed V hospital. The bacterial count as well as the physicochemical analyzes were carried out at the drinking water & wastewater pollution control laboratory of the Autonomous Distribution Authority of Water and Electricity of Meknes and of the environment and health laboratory of the Faculty of Sciences of Meknes. The results showed that some parameters correlate with others and that these effluents pose a threat to the environment and to health. Indeed, the chemical pollution values are high (NH4 +, NO2-, NO3-) compared to WHO standards. The presence of pathogenic germs is demonstrated such as pseudomonas, acinetobacter, clostridium, staphylococcus and streptococcus. On the other hand, these effluents are biodegradable since the COD / DBOS ratio varies between 1.1 and 2 (<2)

Susceptibility patterns of bacteria isolated from the hospital environment towards disinfectants commonly used for surfaces and medical devices

This study aimed to evaluate the bactericidal activity of common disinfectants used for surfaces and medical devices. Sodium hypochlorite (D1), disinfectant (D2) composed of N-(3-aminopropyl)-N-dodecylpropane-1,3-diamine, chloride de didecyldimethylammonium, and disinfectant (D3) composed of Didecyldimethylammonium chloride and Polyhexamethylene biguanide hydrochloride, were tested against 15 strains isolated from the hospital environment and four reference bacteria. The microdilution method was performed to assess antimicrobial activity. The susceptibility was evaluated by comparing the minimum inhibitory dilution with the dilution of disinfectant recommended by the manufacture. D1 and D2 were active against Staphylococcus epidermidis, Staphylococcus saprophyticus, Enterobacter cloacae, Escherichia coli, Pseudomonas fluorescens, Methicillin-resistant Staphylococcus aureus, Bacillus spp, Corynebacterium spp, Gram-positive bacillus, Escherichia coli ATCC 25922, Bacillus subtilis ATCC 3366, and Pseudomonas aeruginosa ATCC 27853 strains but not active against Micrococcus spp, and Staphylococcus aureus ATCC 29213. D3 was ineffective against Micrococcus spp, Bacillus Gram Positive, Staphylococcus epidermidis, and Escherichia coli ATCC 25922. Therefore, D1 and D2 can eliminate most pathogenic bacteria in hospitals, in comparison to D3. It is necessary to monitor the antibacterial activity of disinfectants against reference strains but also against those usually present on surfaces. The obtained results could have promising applications in controlling the emergence of nosocomial infections

Bio contamination of surfaces and medical devices in controlled environment areas at a hospital in Morocco

The hospital environment, especially medical devices and surfaces, represents a secondary reservoir for pathogens. This work aims to evaluate the microbiological quality of surfaces and medical equipment of controlled environment services (burn unit, operating room, and sterilization service) at a hospital in Meknes (center of Morocco). This study was carried out for three months (September-December of 2017). A total of 63 samples were taken by swabbing technique from different surfaces and medical equipment after bio-cleaning. Identification was performed according to conventional bacteriological methods and by microscopic observation for fungi. The study showed that 68% of the surface was contaminated. The operating room recorded a rate of 93% of contamination (p-value <0.01), 83% for sterilization service, and 47% for burn unit. A percentage of 67% of the isolates were identified as Gram-positive bacteria against 32% Gram-negative bacteria (p-value <0.05). Bacterial identification showed Coagulase-negative Staphylococci (45%), Enterobacter cloacae (14%), Micrococcus sp (10%), Klebsiella pneumoniae, peptostreptococcus sp and Pseudomonas fluorescens (7% for each one), Escherichia coli, and Methicillin-resistant Staphylococcus aureus (5% for each one). These results require corrective action represented by rigorous cleaning and disinfection procedures

Infectious Risk of the Hospital Environment in the Center of Morocco: A Case of Care Unit Surfaces

Background. Equipment and hospital surfaces constitute a microbial reservoir that can contaminate hospital users and thus create an infectious risk. The aim of this work, which was carried out for the first time at a hospital in Meknes (regional hospital in the center of Morocco), is to evaluate the microbiological quality of surfaces and equipment in three potential risk areas (burn unit, operating room, and sterilization service). Methods. This study was carried out over a period of 4 months (February–May 2017). A total of 60 samples were taken by swabbing according to the standard (ISO/DIS 14698-1 (2004)) in an environment of dry area and equipment after biocleaning. Isolation and identification were performed according to conventional bacteriological methods and by microscopic observation for fungi. Results. The study showed that 40% of surface samples were contaminated after biocleaning. The burn unit recorded a percentage of 70% contamination (p value <0.001), 13% for the sterilization service, and 7% for the operating room. 89% of the isolates were identified as Gram-positive bacteria against 11% for fungi (p value <0.001). Bacterial identification showed coagulase-negative staphylococci (32%), Bacillus spp. (16%), Corynebacterium (8%), and oxidase-negative Gram-positive bacillus (40%) while fungal identification showed Aspergillus niger (n = 2) and Aspergillus nidulans (n = 1). Conclusion. To control the infectious risk related to equipment and hospital surfaces, it would be necessary to evaluate the disinfection protocol applied in these units