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

Prevalence and Population Attributable Risk for Chronic Airflow Obstruction in a Large Multinational Study

Rationale: The Global Burden of Disease programme identified smoking, and ambient and household air pollution as the main drivers of death and disability from Chronic Obstructive Pulmonary Disease (COPD).Objective: To estimate the attributable risk of chronic airflow obstruction (CAO), a quantifiable characteristic of COPD, due to several risk factors.Methods: The Burden of Obstructive Lung Disease study is a cross-sectional study of adults, aged≥40, in a globally distributed sample of 41 urban and rural sites. Based on data from 28,459 participants, we estimated the prevalence of CAO, defined as a post-bronchodilator one-second forced expiratory volume to forced vital capacity ratio Measurements and Main Results: Mean prevalence of CAO was 11.2% in men and 8.6% in women. Mean PAR for smoking was 5.1% in men and 2.2% in women. The next most influential risk factors were poor education levels, working in a dusty job for ≥10 years, low body mass index (BMI), and a history of tuberculosis. The risk of CAO attributable to the different risk factors varied across sites.Conclusions: While smoking remains the most important risk factor for CAO, in some areas poor education, low BMI and passive smoking are of greater importance. Dusty occupations and tuberculosis are important risk factors at some sites

Association of respiratory symptoms and lung function with occupation in the multinational Burden of Obstructive Lung Disease (BOLD) study

Background Chronic obstructive pulmonary disease has been associated with exposures in the workplace. We aimed to assess the association of respiratory symptoms and lung function with occupation in the Burden of Obstructive Lung Disease study. Methods We analysed cross-sectional data from 28 823 adults (≥40 years) in 34 countries. We considered 11 occupations and grouped them by likelihood of exposure to organic dusts, inorganic dusts and fumes. The association of chronic cough, chronic phlegm, wheeze, dyspnoea, forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1)/FVC with occupation was assessed, per study site, using multivariable regression. These estimates were then meta-analysed. Sensitivity analyses explored differences between sexes and gross national income. Results Overall, working in settings with potentially high exposure to dusts or fumes was associated with respiratory symptoms but not lung function differences. The most common occupation was farming. Compared to people not working in any of the 11 considered occupations, those who were farmers for ≥20 years were more likely to have chronic cough (OR 1.52, 95% CI 1.19–1.94), wheeze (OR 1.37, 95% CI 1.16–1.63) and dyspnoea (OR 1.83, 95% CI 1.53–2.20), but not lower FVC (β=0.02 L, 95% CI −0.02–0.06 L) or lower FEV1/FVC (β=0.04%, 95% CI −0.49–0.58%). Some findings differed by sex and gross national income. Conclusion At a population level, the occupational exposures considered in this study do not appear to be major determinants of differences in lung function, although they are associated with more respiratory symptoms. Because not all work settings were included in this study, respiratory surveillance should still be encouraged among high-risk dusty and fume job workers, especially in low- and middle-income countries.publishedVersio

Cohort Profile: Burden of Obstructive Lung Disease (BOLD) study

The Burden of Obstructive Lung Disease (BOLD) study was established to assess the prevalence of chronic airflow obstruction, a key characteristic of chronic obstructive pulmonary disease, and its risk factors in adults (≥40 years) from general populations across the world. The baseline study was conducted between 2003 and 2016, in 41 sites across Africa, Asia, Europe, North America, the Caribbean and Oceania, and collected high-quality pre- and post-bronchodilator spirometry from 28 828 participants. The follow-up study was conducted between 2019 and 2021, in 18 sites across Africa, Asia, Europe and the Caribbean. At baseline, there were in these sites 12 502 participants with high-quality spirometry. A total of 6452 were followed up, with 5936 completing the study core questionnaire. Of these, 4044 also provided high-quality pre- and post-bronchodilator spirometry. On both occasions, the core questionnaire covered information on respiratory symptoms, doctor diagnoses, health care use, medication use and ealth status, as well as potential risk factors. Information on occupation, environmental exposures and diet was also collected

Nutritional transition, associated factors and emergence of chronic diseases in Morocco : cross-sectional survey in Moroccan Adults

Il est actuellement bien établi que les facteurs nutritionnels sont les principaux déterminants de l’émergence des maladies chroniques. Au Maroc, il n’existe pas à ce jour de données étayant ces propos, bien que ce pays soit en pleine transition épidémiologique. L’objectif de la thèse était d’étudier la relation entre les facteurs nutritionnels et l’obésité ou surpoids chez un échantillon représentatif des adultes marocains âgés de 18 ans et plus obtenu par tirage au sort et stratification sur le sexe et l’origine. Au total, 2896 sujets ont participé à cette enquête transversale. L’obésité et le surpoids étaient très fréquents (13,5% et 29,9% respectivement) avec de grandes disparités socioéconomiques. Pour mieux décrire le comportement alimentaire des marocains, très probablement en rapport avec l’émergence de ce phénomène, plusieurs approches complémentaires ont été utilisées. D’abord, l’adhérence au régime de type méditerranéen, a été mesurée par un score construit selon une approche confirmatoire. Puis, l’identification des principaux profils de consommation spontanément observés par des méthodes exploratoires (analyse en composantes principales). Il s’avère que le régime méditerranéen n’était pas le régime communément suivi par toute la population marocaine. De plus, quatre principaux profils étaient identifiés et décrivent mieux le phénomène de transition nutritionnelle dont la spécificité au Maroc est le maintien de certains aliments traditionnels tels les céréales et légumes en plus de l’introduction des aliments occidentalisées tels les produits laitiers. Ces profils étaient associés aux caractéristiques sociodémographiques des individus. Une association significative a été notée entre l’obésité et les profils alimentaires occidentalisés mais pas avec le régime méditerranéen qui était, par ailleurs, associé au surpoids.It is now well established that nutritional factors are the main determinants of the emergence of chronic diseases. In Morocco, there is currently no data to support this evidence, although this country is experiencing an epidemiological transition. The aim of the thesis was to study the relationship between nutritional factors and overweight or obesity in a representative sample of Moroccan adults aged 18 years and above. This sample was obtained by a simple random technique after stratification by sex and origin. In total, 2896 subjects have participated in this cross-sectional survey. Obesity and overweight were very frequent (13.5% and 29.9% respectively) with large socioeconomic disparities. To better describe the behavior of Moroccan food, most likely related to the emergence of this phenomenon, several complementary approaches were used. First, adherence to Mediterranean diet was measured by a score constructed using a confirmatory approach. Then, the identification of major patterns of consumption observed spontaneously by exploratory methods (Principal Component Analysis). Mediterranean diet was not the commonly diet followed by the entire Moroccan population. In addition, four major patterns were identified and describe better the nutritional transition in Morocco whose specificity is the maintenance of some traditional foods such as cereals and vegetables with some Westernized foods newly introduced such as dairy products. These profiles were associated with sociodemographic characteristics of individuals. A significant association was found between obesity and westernized dietary patterns but not with the Mediterranean diet which was associated with overweight

Nutritional transition, associated factors and emergence of chronic diseases in Morocco : cross-sectional survey in Moroccan Adults

Il est actuellement bien établi que les facteurs nutritionnels sont les principaux déterminants de l’émergence des maladies chroniques. Au Maroc, il n’existe pas à ce jour de données étayant ces propos, bien que ce pays soit en pleine transition épidémiologique. L’objectif de la thèse était d’étudier la relation entre les facteurs nutritionnels et l’obésité ou surpoids chez un échantillon représentatif des adultes marocains âgés de 18 ans et plus obtenu par tirage au sort et stratification sur le sexe et l’origine. Au total, 2896 sujets ont participé à cette enquête transversale. L’obésité et le surpoids étaient très fréquents (13,5% et 29,9% respectivement) avec de grandes disparités socioéconomiques. Pour mieux décrire le comportement alimentaire des marocains, très probablement en rapport avec l’émergence de ce phénomène, plusieurs approches complémentaires ont été utilisées. D’abord, l’adhérence au régime de type méditerranéen, a été mesurée par un score construit selon une approche confirmatoire. Puis, l’identification des principaux profils de consommation spontanément observés par des méthodes exploratoires (analyse en composantes principales). Il s’avère que le régime méditerranéen n’était pas le régime communément suivi par toute la population marocaine. De plus, quatre principaux profils étaient identifiés et décrivent mieux le phénomène de transition nutritionnelle dont la spécificité au Maroc est le maintien de certains aliments traditionnels tels les céréales et légumes en plus de l’introduction des aliments occidentalisées tels les produits laitiers. Ces profils étaient associés aux caractéristiques sociodémographiques des individus. Une association significative a été notée entre l’obésité et les profils alimentaires occidentalisés mais pas avec le régime méditerranéen qui était, par ailleurs, associé au surpoids.It is now well established that nutritional factors are the main determinants of the emergence of chronic diseases. In Morocco, there is currently no data to support this evidence, although this country is experiencing an epidemiological transition. The aim of the thesis was to study the relationship between nutritional factors and overweight or obesity in a representative sample of Moroccan adults aged 18 years and above. This sample was obtained by a simple random technique after stratification by sex and origin. In total, 2896 subjects have participated in this cross-sectional survey. Obesity and overweight were very frequent (13.5% and 29.9% respectively) with large socioeconomic disparities. To better describe the behavior of Moroccan food, most likely related to the emergence of this phenomenon, several complementary approaches were used. First, adherence to Mediterranean diet was measured by a score constructed using a confirmatory approach. Then, the identification of major patterns of consumption observed spontaneously by exploratory methods (Principal Component Analysis). Mediterranean diet was not the commonly diet followed by the entire Moroccan population. In addition, four major patterns were identified and describe better the nutritional transition in Morocco whose specificity is the maintenance of some traditional foods such as cereals and vegetables with some Westernized foods newly introduced such as dairy products. These profiles were associated with sociodemographic characteristics of individuals. A significant association was found between obesity and westernized dietary patterns but not with the Mediterranean diet which was associated with overweight