Development of two monovalent antivenoms against two Moroccan viper venoms– daboia Mauritanica and Cerastes Cerastes

Snake envenomation entails more than 5 million people bitten yearly, out of whom 100,000 died and more than 300,000 are permanently disabled. This prompted the World Health Organization to classify snake envenoming as a neglected tropical disease in 2017. In North Africa, we have more than 400.000 cases of envenomation with 50 deaths per year. These numbers are underestimated with the Cerastes cerastes (Cc) and Macrovipera mauretanica (Mm)are the most medically important snake species. To this day, the only medication for snake envenomation is immunotherapy. The lack of a specific antivenom against Cc and Mm venoms in North Africa, prompted us to develop two monospecific Fab\u272 antivenoms in collaboration with the Butantan Institute in Brazil: one is produced against Moroccan Cc venom and the other against Moroccan Mm. While we determiated the paraspecific cross-reactivity of the antivenoms developped, the in vitro paraspecifity study surprisingly revealed a cross reactivity between the two monospecific Fab\u272 antivenoms developped towards Mm and Cc venoms venoms from Morocco, Algeria and Tunisia Please click Download on the upper right corner to see the full abstract

Les barrières à une bonne prise en charge des diabétiques dans les structures de première ligne de la province de Khouribga (MAROC)

Introduction: Le diabète constitue un important enjeu de santé publique au Maroc et représente un défi auquel les médecins généralistes sont confrontés dans leur pratique quotidienne. Le but de ce travail était de décrire les barrières entravant une bonne prise en charge des patients diabétiques dans les structures de 1ère ligne de la province de khouribga. Méthodes: Il s'agit d'une étude transversale menée de décembre 2010 à mars 2011, chez les 54 médecins généralistes (MG) exerçants dans les centres de santé de la province. La collecte des données a été réalisée à l'aide d'un questionnaire prétesté et auto administré et la saisie et l'analyse effectuées sur le logiciel SPSS 16. Résultats: Huit pourcent des MG disposaient de registre informatisé pour le suivi des diabétiques. Les principales barrières à une prise en charge correcte des patients étaient le statut socio-économique faible des patients (94%), leur niveau scolaire bas (86%), le manque de moyens de traitement et de suivi (80%), le nombre insuffisant de diabétologues (80%), le manque de coordination avec les structures de 2ème ligne (74%) et l'insuffisance des séminaires de formation continue (58%). Conclusion: Les médecins généralistes sont confrontés à de nombreux obstacles concernant la prise en charge des patients diabétiques. L'équipement des centres de santé en moyens diagnostiques et thérapeutiques suffisants, l'amélioration de l'accessibilité des diabétiques aux soins et la formation continue des médecins pourraient être des solutions pour améliorer cette prise en charge surtout devant la pénurie de spécialistes dans notre pays.Pan African Medical Journal 2012; 13:4

Emerging and re-emerging viral diseases

Emerging infectious diseases can be defined as infections that have either newly appeared in a population, or existed, but are rapidly increasing in incidence or geographical range. Even thought there was considerable development regarding prevention, control and elimination of some of the infectious diseases through proper use of hygiene and sanitation practices in addition to development of anti- biotics (bacteria) and vaccination, some infectious diseases remained as the leading causes of morbidity and mortality worldwide. There are many factors involved in the emergence of new infectious diseases or the re-emergence of “old” infectious diseases. Increasing global epidemiological surveillance, improving public health systems, education and research into new antibiotics and new vaccines will allow us to effectively combat the constantly renewed threat of infectious diseases. This review summarizes the work on aspects of virus emergence

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

The impact of serum glucose, total cholesterol and triglyceride levels on Breast Cancer risk: A retrospective study

Introduction:  This study aims is to explore the relationship of serum glucose, triglyceride and total cholesterol levels and breast cancer (BC).Methods: We analyzed data in 100 women with confirmed BC and in the same number of age-matched disease-free controls. Cancer antigen 15-3 (CA15-3) and carcinoembryonic antigen (CEA) levels were estimated using chemiluminescent microparticle immunoassay technology. Glucose, triglyceride and total cholesterol levels were evaluated using dry chemistry method.Results: In this study no significant differences were found comparing glucose and total cholesterol levels in BC cases and controls. The adjusted ORs were 0.84 (95% CI: 0.48-1.49) and 0.62 (95% CI: 0.28-1.37) respectively. However, a significant inverse association between BC risk and increasing levels of triglycerides was observed, particularly at postmenopausal stage (OR= 0.32, 95%CI: 0.14-0.77). Based on CEA and CA15-3 levels measurement and BC duration, we showed that diabetes and lipid status did not influence the course of the malignancy.Conclusion:  Our study highlights the absence of the effect of diabetes and dyslipidemia on the risk and progression of BC. Further prospective investigations are required to confirm this important issue

Connaissances des médecins généralistes de Mohammedia (Maroc) concernant le dépistage du cancer du sein

Introduction: le cancer du sein représente un problème de santé publique majeur au Maroc. C'est le premier cancer chez la femme. L'objectif de ce travail était d'évaluer les connaissances des médecins généralistes (MG) en matière de dépistage du cancer du sein dans la préfecture de Mohammedia Maroc. Méthodes: nous avons mené une étude transversale, descriptive, exhaustive incluant les 97 MG exerçant dans les établissements de soins de santé de base du secteur public et privé de la province de Mohammedia. Résultats: le taux de participation était de 87%. L'âge moyen des MG était de 49,6 ± 8,1. Quatre-vingt pour cent (n=55) des MG ont donné une incidence incorrecte, 77,6% (n=85) ont reconnu l'existence d'un plan national de prévention et de contrôle du cancer (PNPCC) au Maroc, et 67,1 des MG ont rapporté l'existence d'un registre du cancer au Maroc. Le secteur d'activité était associé significativement avec les connaissances des MG sur le PNPCC et sur l'existence d'un guide de détection précoce du cancer du sein avec respectivement (p=0,003 et p=0,001). Une association significative entre l'ancienneté et l'existence d'un guide de détection précoce du cancer du sein et d'un registre du cancer du sein a été retrouvée avec (respectivement p=0,005 et p=0.002). Conclusion: à la lumière de ces résultats il faudra renforcer les connaissances et les pratiques des MG par la promotion de la formation initiale et continue sur le dépistage.The Pan African Medical Journal 2016;2

Les barrières à une bonne prise en charge des diabétiques dans les structures de première ligne de la province de Khouribga (MAROC)

Abstract Introductio

Maternal postpartum morbidity in Marrakech: What women feel what doctors diagnose?

Background: Information about postpartum maternal morbidity in developing countries is limited and often based on information obtained from hospitals. As a result, the reports do not usually reflect the true magnitude of obstetric complications and poor management at delivery. In Morocco, little is known about obstetric maternal morbidity. Our aim was to measure and identify the causes of postpartum morbidity 6 weeks after delivery and to compare women's perception of their health during this period to their medical diagnoses. Methods: We did a cross-sectional study of all women, independent of place of delivery, in Al Massira district, Marrakech, from December 2010 to March 2012. All women were clinically examined 6 to 8 weeks postpartum for delivery-related morbidities. We coupled a clinical examination with a questionnaire and laboratory tests (hemoglobin). Results: During postpartum consultation, 44% of women expressed at least one complaint. Complaints related to mental health were most often reported (10%), followed by genital infections (8%). Only 9% of women sought treatment for their symptoms before the postpartum visit. Women who were aged ≥30 years, employed, belonged to highest socioeconomic class, and had obstetric complications during birth or delivered in a private facility or at home were more likely to report a complaint. Overall, 60% of women received a medical diagnosis related to their complaint, most of which were related to gynecological problems (22%), followed by laboratory-confirmed anemia (19%). Problems related to mental health represented only 5% of the diagnoses. The comparative analysis between perceived and diagnosed morbidity highlighted discrepancies between complaints that women expressed during their postpartum consultation and those they received from a physician. Conclusions: A better understanding of postpartum complaints is one of the de facto essential elements to ensuring quality of care for women. Sensitizing and training clinicians in mental health services is important to respond to women's needs and improve the quality of maternal care. © 2013 Assarag et al. licensee BioMed Central Ltd.SCOPUS: ar.jinfo:eu-repo/semantics/publishe