Les Intoxications Accidentelles Par Les Pesticides Au Maroc Entre 2008-2014: Evolution Et Facteurs De Risque

The aim of this study was to determine the epidemiological profile of accidental poisoning by pesticides. A retrospective study of poisoning cases, declared between January 2008 to December 2014 at the Moroccan Anti poisoning and Pharmacovigilance Center (MAPPC), was conducted. During the study period, 4 110 acute accidental poisoning by pesticides cases were collected. The average age was of patients 19, 24±0,25 years. The sex-ratio (female/male) was 0.95. Poisoning mainly concerned adults between the ages of 20 and 74 (about 43%). The pesticide poisoning occurs more often in urban zones with 54.1%. These were mainly poisonings that occurred at home in 70.5% of cases. Patients were mostly symptomatic (about 65%), these poisonings occurred mainly during the spring mostly in the spring (32%) and summer (29%). Insecticides were the most commonly incriminated in 64, 13% of cases, followed by rats, pesticides, and herbicides with respectively 29%, 3.42% and 0.85%. The declarations came from all regions of Morocco, the highest incidence was recorded in the Tadla-Azilal region (4.04 per 100 000 inhabitants). The Fes Boulemane region showed a significant lethality of 6.43%. Among the 3,077 patients for whom the evolution was known, 98.1% had progressed favorably. 47 cases of death were recorded with a lethality of 1.2%

Dental amalgam risks in dental staff: systematic review

Mercury is an essential constituent of dental amalgams, several studies have shown that dental personnel who work with dental amalgams are chronically exposed to mercury vapors. The World Health Organization considers that inhaling mercury vapors can have harmful effects on the nervous, immune, pulmonary and renal systems. The objective of this review was to collect and analyze data relating to the exposure of dental personnel to mercury and the possible harmful effects on human health. All biomonitoring studies published between 2002 and 2019 measuring mercury in hair, blood, urine and nails were included. Dentists reported higher levels of mercury in their biomarkers compared to control groups. These levels reflected occupational exposures to chronic low levels of elemental mercury in dental amalgam fillings. Some studies have shown a high prevalence of neurological symptoms and memory deficit in dental staff compared to controls. Studies based on genes involved in mercury metabolism have shown associations between sources of mercury exposure and single nucleotide polymorphisms in these genes. It is important that preventive measures are strengthened to reduce exposure to mercury and that a biomonitoring program for dental professionals exposed to mercury vapors is implemented

IMPACT DE LA STRATÉGIE DE LUTTE CONTRE LES PIQÛRES ET LES ENVENIMATIONS SCORPIONIQUES SUR LES INDICATEURS DE SANTÉ DE LA RÉGION DE MARRAKECH TENSIFT EL HAOUZ (MAROC)

Morocco is one of the Mediterranean countries where the largest number of scorpion stings are recorded. The objective of this work is to evaluate the impact of the strategy against bites and scorpion envenomation in the region of Marrakech Tensift El Haouz, according to the monthly records established in 2001. The present work is a retrospective study of 84,237 cases of patients poisoned or bitten by a scorpion. The collection of information was carried out from January 2002 to December 2012. The collected data were analyzed according to several criteria to establish the evolution of indicators of morbidity and mortality in five provinces of the study area. The number of reported cases of bites from 2002 to 2012 is 84 237 cases and, and that of deaths is 332. Thus, an average incidence of 2.4 ± 0.3 per 1000 inhabitants, an average mortality of 0.009 ‰ ± 0.005, an average general lethality of 3.94‰ ± 1.76 and average specific lethality by envenomation of 32.61 ‰ ± 17.22. The average sex ratio was 0.92 in favor of the female with a highly significant difference ( x² = 168.92, P <0 The evolution of health indicators show a significant improvement in mortality and lethality, especially at the two provinces most affected by this disease

Drug errors related to self-medication in Morocco

Introduction: Self-medication refers to the act of obtaining a drug without a prescription in order to use it for treatment. The objective of this study is to describe the epidemiological characteristics of drug errors related to self-medication in Morocco. Method: This is a retrospective study of drug errors related to self-medication, reported to the Moroccan Poison Control Center between 2014 and 2018. Results: During the study period, 99 medication errors were recorded, of which 31.6% concerned children under the age of 15 years. The average age of the patients was 26.6 years. The sex ratio was balanced, with 4 breastfeeding women. Almost all of cases (94.9%) occurred at home. Drugs acting on the nervous system accounted for 39.4% of notifications. This was a medicine error in 47.5% of cases. The patient himself was responsible for the error in 57.6% of cases. Drug administration was oral in 84.5% of cases. Of all error cases, 32.7% were symptomatic. Conclusion: The dangers of self-medication are multiple. Sometimes, self-medication can lead to severe complications. It therefore strongly recommended to follow the medical prescription and the pharmacist’s instructions as well as to educate the public about the risks associated with self-medication

L’intoxication au

Objectif. Peganum harmala L. connu sous le nom de Harmel, Rue sauvage est l’une des plantes les plus utilisées en médecine traditionnelle pour ses vertus sédatives et comme emménagogue. Son emploi à des fins thérapeutiques expose au risque de surdosage et d’intoxication. L’objectif de notre étude était d’analyser une série de 200 cas d’intoxications colligés au Centre Antipoison et de Pharmacovigilance du Maroc afin d’en décrire les caractéristiques sociodémographiques, cliniques, thérapeutiques et évolutives et de mettre le point sur la toxicité de cette plante utilisée essentiellement à visée thérapeutique. Méthodes. Il s’agit d’une étude rétrospective réalisée sur une durée de vingt-quatre ans allant de janvier 1984 à décembre 2008. Résultats. L’âge moyen de nos patients était de 24,4 ± 16,8 ans avec une nette prédominance féminine (167 femmes contre 33 hommes). La circonstance thérapeutique occupait la première place avec 32,5 %, suivie par le suicide (28,5 %) et l’avortement (13,5 %). Le tableau clinique des patients était dominé par les signes neurologiques, digestifs et cardio-vasculaires avec respectivement 34,4 %, 31,9 % et 15,8 %. L’évolution a été précisée dans 114 cas, 7 décès ont été déplorés avec un taux de létalité de 6,2 %

Snakebites notified to the poison control center of Morocco between 2009 and 2013

Abstract Background Snakebites cause considerable death and injury throughout the globe, particularly in tropical regions, and pose an important yet neglected threat to public health. In 2008, the Centre Anti Poison et de Parmacovigilance du Maroc (CAPM) started to set up a specific strategy for the control of snakebites that was formalized in 2012. The aim of the present study is to describe and update the epidemiological characteristics of snakebites notified to CAPM between 2009 and 2013. Methods This retrospective five-year study included all cases of snakebites notified to CAPM by mail or phone. Results During the study period, 873 snakebite cases were reported to CAPM, an average incidence of 2.65 cases per 100,000 inhabitants with 218 cases each year. The highest incidence was found in Tangier-Tetouan region with 357 cases (40.9 %) followed by Souss Massa Draa region with 128 cases (14.6 %). The average age of patients was 26.8 ± 17.2 years. The male to female sex ratio was 1.67:1 and 77 % of cases occurred in rural areas. The bites occurred mainly in spring (44 %) followed by summer (42 %). Snake species was identified in 54 cases (6.2 %): colubrids represented 31 % (n = 18) and vipers 67 % (n = 36), mainly Daboia mauritanica, Bitis arietans and Cerastes cerastes. In 311 cases (35.6 %), the patients showed viper syndrome. Thrombocytopenia was observed in 23.5 % of viper syndrome cases, whereas, compartment syndrome was observed in 7.6 % patients. FAV-Afrique® was administered in 41 patients (5 %). In patients treated with antivenom, 38 patients recovered and three died. Twenty-seven deaths were reported (3.9 %). Conclusion Despite specific efforts to better understand the epidemiology of snakebites in Morocco (incidence, severity, snake species involved), it remains underestimated. Therefore, further work is still necessary to ensure accessibility of appropriate antivenom against venomous species and to improve the management of envenomation in Morocco

Estimating completeness of foodborne disease registration in North West Morocco

This study aims to estimate the total number of poisoning cases and completeness of foodborne disease surveillance in the region of Tanger-Tétouan-Al Hoceima in North West Morocco. This retrospective study was conducted to assess the completeness of food poisoning surveillance system in the Tanger-Tétouan-Al Hoceima region over a three-year period from January 1, 2014 to December 31, 2016. The data used for this study were obtained from two sources, including the national poisoning database of the Moroccan Poison Control Center (MPCC) and provincial hospital registries in the study area. The completeness of foodborne disease reporting was estimated using the capture-recapture method. During the study period, 235 cases of foodborne diseases were reported to the Moroccan Poison Control Center, 725 cases were notified to the provincial hospital registries and 98 cases were common to both sources. The estimated total number of poisoning cases was 1,739 (95% CI: 1,494-1,983). The completeness of foodborne disease surveillance for the national database of poisoning and hospital registries was estimated to be 13.5% and 41.7%, respectively. Improvement of the completeness of poisoning surveillance system is needed to estimate the true incidence of poisoning in Morocco

Deliberate self-poisoning with drugs among adolescents in Morocco

Introduction: Suicide is a serious public health problem and one of the leading causes of adolescent death in the world. The aim of this study is to determine the epidemiological profile of suicidal poisoning with drugs among adolescents in Morocco. Methods: This is a retrospective study of deliberate self-poisoning cases, reported to the Moroccan Poison Control Center between 1980 and 2014. Results: A total of 3,856 cases of suicidal poisoning among adolescents 15 to 19 years old were recorded, with 13 cases of successful suicide and 41 repeated suicide attempts. The average age of the patients was 15.5 years. According to the results, 84.7% were female with a female-male ratio of 5.5. The majority of cases occurred at home (97.8%). The signs and symptoms presented by the patients were varied, depending on the amount of drug ingested and the delay before treatment. Conclusion: Suicide and suicide attempts in children and adolescents continue to be a major public health problem, and topical research and surveys have clearly highlighted suicide as one of the commonest causes of death among young people

Role of the Poison Control Centre of Morocco in the Improvement of Public Health

Background: Poison Control Centre of Morocco (MPCC) plays a key role in promoting health. This study was aimed to demonstrate the role of the MPCC in improving public health and poisoning management. Methods: This was a retrospective study of poisoning cases reported to the MPCC between 1980 and 2011. The collected data included number of poisoning cases, profession of interlocutor who called the poison centre, time of poisoning (year), gender of poisoned patient, age of poisoned patient, toxic agent and intention of poisoning.  Data were analyzed using Epi Info software. The activities of MPCC were evaluated by three indicators including structural indicators, process indicators and impact indicators Results: Between 1980 and 2011, the MPCC received 401148 notifications which 73.1% of them involved scorpion stings and 26.9% were about other toxic agents. The main causes of poisoning, excluding scorpion stings, were pharmaceuticals (6.1%) followed by food (5.9%) and carbon monoxide (4.5%) poisoning. The MPCC devised five protocols through a consensual method and distributed to practitioners in hospitals around the country considering gastric emptying, management of PPD poisoning, management of scorpion stings, management of carbon monoxide poisoning and the management of snakebite. Gastric emptying decreased from 45% to 4% of cases during this period. A national strategy was set up for the management of scorpion stings leading to a decrease in mortality from 1.54% to 0.22%. Conclusion: During the period of more than two decades, the achievements of the MPCC have not been limited to providing toxicological information, but also activating a proper toxicovigilance system. In fact, a poison control centre is not a luxury structure. It is an integral part of every health system. Its impact on reducing morbidity and mortality is no longer discussed and its observatory role on poisonings should be strengthened.   How to cite this article: Rhalem N, Aghandous R, Chaoui H, Eloufir R, Badrane N, Windy M, et al. Role of the Poison Control Centre of Morocco in the Improvement of Public Health. Asia Pac J Med Toxicol 2013;2:82-6