The impact of knowledge and attitudes on adherence to tuberculosis treatment: a case-control study in a Moroccan region

Background: Although tuberculosis (TB) care is provided free of charge in Morocco, a high number of patients voluntarily interrupt their treatment before the end. Treatment Default is a major obstacle in the fight against the disease. The purpose of this study was to describe the impact of knowledge and attitudes toward TB on treatment adherence. Methods: Case-control study of 290 TB patients (85 defaulters and 205 controls). A defaulter was defined as a TB patient who interrupted treatment for two months or longer. Socio-demographic measurements, knowledge and attitude were collected by face to face anonymous questionnaire. Khi-square test was conducted to examine differences in TB attitudes and knowledge according to treatment adherence. Results: The mean age of participants was 31.7 ± 12.0 years. Monthly income was under 2000 MAD (180 ?) for 82 % of them. Over sixty four percent were illiterate or had a basic educational level. Microbial cause was known by 17.2% respondents; 20.5% among adherent patients versus 9.4% (p=0.02). The fact that the disease is curable was more known by adherent patients: 99.0% versus 88.2% (p<0.01). Eighty tree per cent of patients had been informed about treatment duration and consequences of not completing treatment: 89.0% among adherent patients versus 69.7% (p<0.001). The main reason evoked for defaulting was the sensation of being cured (72.9% of defaulters). Conclusion:  This study shows a poor knowledge on TB especially among non adherent patients. This finding justifies the need to incorporate patient?s education into current TB case management. Pan African Medical Journal 2012; 12:5

Descriptive Epidemiological study of COVID-19 in Maghreb and European countries

An outbreak of 2019 novel coronavirus diseases (COVID-19) has spread quickly world wide. We performed a descriptive epidemiological study of COVID-19 in Mediterranean North African countries and South European countries. Cases data were collected through May 3, 2020 from WHO. Data analysis included: 1) geo-temporal analysis of viral spread in 6 countries (Morocco, Algeria, Tunisia, Spain, France and Italy), 2) epidemiological curve construction, 3)mortality and cured rates, 4) study  factors that led to differences of the spread of the virus in these 6 countries, and 5) comparison between Morocco and three European countries. The number of infected cases between North African and Southern European countries were different, which might be related to restriction conditions, age, geographic location, and lifestyle. We observed that The COVID-19 epidemic has spread very quickly in Southern European compared to North African countrie

Digestive cancers in Morocco: Fez-Boulemane region

Introduction: To describe the epidemiological and pathological aspects of gastrointestinal cancers in Fez-Boulemane. Methods: This was a retrospective descriptive study of 1120 gastrointestinal cancers diagnosed between 2004 and 2010 in the department of Pathology of Hassan II University Hospital in Fez Morocco. Results: The average age of our patients was 53 years with a male predominance in 52% of cases. Digestive cancers in this study are distinguished by the predominance of colorectal and stomach location. Conclusion: Gastrointestinal cancers are the most frequent cancer in our region. An epidemiological monitoring program is needed.Pan African Medical Journal 2012; 13:4

Hypertension and type 2 diabetes: a cross-sectional study in Morocco (EPIDIAM Study)

Background: In Morocco, there are no studies that focused on the hypertension and its associated risk factors through patients with type 2 diabetes. Different findings show that the frequency of type 2 diabetes has risen rapidly in Morocco. The main objective of this study was to assess the prevalence of hypertension and its associated risk factors among a group of patients with type 2 diabetes and to examine the level of control of hypertension among type 2 diabetic patients with hypertension. Methods: A cross-sectional study was carried out on 525 type 2 diabetics in three Moroccan regions. The structured questionnaire was used to gather information on sociodemographic variables, history of hypertension, use of anti-hypertensive medications and duration of diabetes. Anthropometric measurements including weight and height were measured by trained staff. Blood pressure was measured using standardized sphygmomanometers. Results: The prevalence of hypertension was 70.4%. The logistic regression indicated that hypertension was positively associated with age (p<10-4), BMI (p<0.0002) and duration of diabetes (p Conclusion: Hypertension is a common co-morbidity among Moroccan diabetic patients with high rate of ignorance of hypertension among study subjects. The focus must be on patients and family education, counseling and behavioral interventions designed to modify lifestyle such as increasing physical activity and adopting recommended dietary changes, as well as compliance with medications

Existing models of maternal death surveillance systems : protocol for a scoping review

Background: Maternal mortality measurement remains a critical challenge, particularly in low and middle income countries (LMICs) where little or no data are available and maternal mortality and morbidity are often the highest in the world. Despite the progress made in data collection, underreporting and translating the results into action are two major challenges that maternal death surveillance systems (MDSSs) face in LMICs. Objective: This paper presents a protocol for a scoping review aimed at synthesizing the existing models of MDSSs and factors that influence their completeness and usefulness. Methods: The methodology for scoping reviews from the Joanna Briggs Institute was used as a guide for developing this protocol. A comprehensive literature search will be conducted across relevant electronic databases. We will include all articles that describe MDSSs or assess their completeness or usefulness. At least two reviewers will independently screen all articles, and discrepancies will be resolved through discussion. The same process will be used to extract data from studies fulfilling the eligibility criteria. Data analysis will involve quantitative and qualitative methods. Results: Currently, the abstracts screening is under way and the first results are expected to be publicly available by mid-2017. The synthesis of the reviewed materials will be presented in tabular form completed by a narrative description. The results will be classified in main conceptual categories that will be obtained during the results extraction. Conclusions: We anticipate that the results will provide a broad overview of MDSSs and describe factors related to their completeness and usefulness. The results will allow us to identify research gaps concerning the barriers and facilitating factors facing MDSSs. Results will be disseminated through publication in a peer-reviewed journal and conferences as well as domestic and international agencies in charge of implementing MDSS

Complementary medicine use among Moroccan patients with cancer: A descriptive study

tter inform his patients

Evaluation of the cost of cervical cancer at the National Institute of Oncology, Rabat

Introduction: The Cervical Cancer (CC) is one of the heavy and costly diseases for the population and the health system. We want to know through this study, the first in Morocco, the annual cost of the treatment of this disease at the National Institute of Oncology (NIO) in Rabat, we also want to explore the possibility of flat-rate management of this disease in order to standardize medical practices and improve reimbursement by health insurance funds. Methods: 550 patients were treated for their cervical cancer in the Rabat's NIO. Data of all of medical and surgical services offered to patients were collected from the NIO registry. The cost of care was assessed using the method of micro-costing. We will focus to the total direct cost of all the services lavished to patients in NIO. Results: The global cost was about US$1,429,673 with an average estimated at US$ 2,599 ± US$ 839. Radiotherapy accounts for 55% of total costs, followed by brachytherapy (27%) and surgery (7%). This three services plus chemotherapy influence the overall cost of care (p <0.001). Other services (radiology, laboratory tests and consultations) represent only 10%. The overall cost is influenced by the stage of the disease, this cost decreased significantly evolving in the stage of CC (p <0.001). Conclusion: The standardization of medical practices is essential to the equity and efficiency in access to care. The flat-rate or lump sum by stage of disease is possible and interesting for standardizing medical practices and improving the services of the health insurance plan.Pan African Medical Journal 2016; 2

Chronic obstructive pulmonary disease and associated healthcare resource consumption in the Middle East and North Africa: The BREATHE study

SummaryData on COPD-related healthcare resources use are rarely documented in developing countries. This article presents data on COPD-related healthcare resource consumption in the Middle East, North Africa and Pakistan and addresses the association of this variable with illness severity. A large survey of COPD was conducted in eleven countries of the region, namely Algeria, Egypt, Jordan, Lebanon, Morocco, Pakistan, Saudi-Arabia, Syria, Tunisia, Turkey and United Arab Emirates, using a standardised methodology. A total of 62,086 subjects were screened. This identified 2,187 subjects fulfilling the “epidemiological” definition of COPD. A detailed questionnaire was administered to document data on COPD-related healthcare consumption. Symptom severity was assessed using the COPD Assessment Test (CAT). 1,392 subjects were analysable. Physician consultations were the most frequently used healthcare resource, ranging from 43,118 [95% CI: 755–85,548] consultations in UAE to 4,276,800 [95% CI: 2,320,164–6,230,763] in Pakistan, followed by emergency room visits, ranging from 15,917 [95% CI: 0–34,807] visits in UAE to 683,697 [95% CI: 496,993–869,737] in Turkey and hospitalisations, ranging from 15,563 [95% CI: 7,911–23,215] in UAE to 476,674 [95% CI: 301,258–652,090] in Turkey. The use of each resource increased proportionally with the GOLD 2011 severity groups and was significantly (p < 0.0001) higher in subjects with more symptoms compared to those with lower symptoms and in subjects with exacerbations to those without exacerbations. The occurrence of exacerbations and the CAT score were independently associated with use of each healthcare resource. In conclusion, the BREATHE study revealed that physician consultation is the most frequently COPD-related healthcare resource used in the region. It showed that the deterioration of COPD symptoms and the frequency of exacerbations raised healthcare resource consumption