Health risk behaviours amongst school adolescents: protocol for a mixed methods study

Abstract Background Determining risky behaviours of adolescents provides valuable information for designing appropriate intervention programmes for advancing adolescent’s health. However, these behaviours are not fully addressed by researchers in a comprehensive approach. We report the protocol of a mixed methods study designed to investigate the health risk behaviours of Moroccan adolescents with the goal of identifying suitable strategies to address their health concerns. Methods We used a sequential two-phase explanatory mixed method study design. The approach begins with the collection of quantitative data, followed by the collection of qualitative data to explain and enrich the quantitative findings. In the first phase, the global school-based student health survey (GSHS) was administered to 800 students who were between 14 and 19 years of age. The second phase engaged adolescents, parents and teachers in focus groups and assessed education documents to explore the level of coverage of health education in the programme learnt in the middle school. To obtain opinions about strategies to reduce Moroccan adolescents’ health risk behaviours, a nominal group technique will be used. Discussion The findings of this mixed methods sequential explanatory study provide insights into the risk behaviours that need to be considered if intervention programmes and preventive strategies are to be designed to promote adolescent’s health in the Moroccan school

Légionellose: Modalités diagnostic et thérapeutique

L'infection par Legionella spp. est une cause importante de pneumopathie communautaire et nosocomiale qui se présente sous forme sporadique et épidémique. La légionellose affecte essentiellement les adultes et notamment les personnes âgées, les personnes atteintes de maladies respiratoires chroniques, de diabète, et les personnes immunodéprimées.La contamination par Legionella se fait par voie respiratoire et par inhalation d'eau contaminée diffusée en aérosols. Les sources de contamination sont principalement les systèmes de refroidissement et les réseaux d'eau.La légionellose se traduit pat un état grippal avec de la fièvre et une toux qui peuvent s'accompagner éventuellement de céphalée, de myalgie, de troubles digestifs ou neurologiques.La technique la plus utilisée pour le diagnostic des légionelloses reste actuellement la recherche de l'antigène urinaire de Legionella pneumohila. Cependant, ce test simple ne permet la détection que du sérogroupe LP 1. La PCR permet un diagnostic rapide, mais cette méthode n'est pas encore normalisée.Dans la majorité des cas, l'évolution est favorable sous traitement antibiotique adapté. Les macrolides et les fluoroquinolones sont les plus utilisés pour le traitement de la légionellose.Cette revue bibliographie est une synthèse des données disponibles sur la microbiologie, les aspects cliniques, le diagnostic et le traitement de la légionellose.

Analyse microbiologique de la viande hachée bovine commercialisée à Fès, Maroc

La viande hachée est un aliment très périssable. Cette denrée constitue un danger potentiel pour le consommateur du fait qu’elle est souvent consommée insuffisamment cuite. L’objectif de la présente étude est d’évaluer la qualité bactérienne de la viande hachée bovine commercialisée à Fès. Quarante échantillons de viande hachée ont été recueillis dans 40 boucheries choisies de façon aléatoire sur une période de trois mois. Les échantillons ont été analysés pour la recherche et la numération de certaines bactéries. Nous avons trouvé des taux élevés en coliformes fécaux et en Escherichia coli. La contamination par les staphylocoques et les anaérobies sulfito-réducteurs n’était pas homogènes. Les fréquences d’isolement des Salmonella spp. et des Shigella spp. sont respectivement de 17.5% et de 2.5%. Les échantillons de viande hachée analysés présentent dans 80%, une charge en bactéries qui dépasse les critères fixés par la réglementation marocaine. Ces niveaux élevés de contamination microbienne et la présence des bactéries pathogènes reflètent la mauvaise qualité hygiénique de la viande hachée qui pourrait être due aux mauvaises conditions de production et de transport des viandes sur les circuits de production et de distribution

Adolescents, parents and teachers’ perceptions of risk and protective factors of substance use in Moroccan adolescents: a qualitative study

Abstract Background Substance use in adolescents is a global public health concern that continues to draw attention from academics, policy experts, and government officials. In Morocco, few studies have investigated the influencing factors of substance use in adolescents. Here, we aimed to fill this gap and to better understand factors that protect or influence substance use in adolescents. Methods We conducted a qualitative study using focus group discussions. The semi-structured interview guides were based on the socio-ecological model as a theoretical framework to explore perceptions of students, parents, and teachers regarding substance use risks and protective factors in adolescents. Data from each group were audio-recorded, transcribed, and analyzed using thematic analysis. Results From May to July 2016, 17 focus group discussions were conducted at two middle schools in Taza city, Morocco, which included 8 groups of 7 adolescents (28 boys and 28 girls) aged 14 to 16 years, 5 groups of parents (5 females and 21 males), and 4 groups of teachers (13 males and 5 females). Thematic analysis resulted in six common themes that represented the most salient perceived risk and protective factors regarding substance use among adolescents: perceived benefits of substance use, awareness and beliefs, family influence, peer influence, easy accessibility of substances, and social norms. Conclusions Our results demonstrate that multilevel prevention programs in adolescents should address influencing factors from the individual to the societal level, including social norms and the government’s policy toward substance use. Health education programs included as part of the school curriculum can contribute to promoting awareness and reducing risky behaviors of Moroccan adolescents

Level and potential social-ecological factors associated with physical inactivity and sedentary behavior among Moroccan school-age adolescents: a cross-sectional study

Abstract Background Creating a successful intervention that supports an active lifestyle and prevents sedentary one requires a better understanding of the factors associated with physical inactivity (PI) and sedentary behavior (SB). However, these factors have not been assessed among Moroccan adolescents. This study aimed to determine prevalence of PI and SB and to explore their potential social-ecological associated factors in school-age adolescents. Methods In this cross-sectional study, 764 students (age range, 14–19 years) were enrolled from six schools in Taza city, Morocco. The Global School-based Student Health Survey was used to collect data about variables. We used bivariate and multivariate analyses to assess relations between dependent and independent variables. Results Overall, the prevalence of PI was 79.5% and SB was 36.5%. Among girls, these rates were higher (87.0 and 39.1%, respectively) than rates shown in boys (70.9 and 33.6%, respectively). In the multivariate logistic regression analysis, PI was associated with the following variables: illiterate father, hunger, suicidal ideation, inadequate vegetable consumption, and absence from physical education classes. Age, inadequate vegetable consumption, and absenteeism were associated with SB. Conclusions The prevalence of PI and SB is high, especially among girls. Thus, there is an urgent need to implement appropriate interventions to reduce PI and SB levels in secondary school-age adolescents and the associated factors identified can be useful

Perspectives of adolescents, parents, and teachers on barriers and facilitators of physical activity among school-age adolescents: a qualitative analysis

Abstract Background Physical activity levels are low among adolescents in Morocco; however, the influences on physical activity behavior of adolescents have not yet been explored in a qualitative study. Here, we explored potential social-ecological barriers and facilitators of physical activity in Moroccan adolescents with the goal of developing a successful intervention program aimed at improving their physical activity level. Methods For this study, we conducted 17 focus group discussions (100 participants, composed of 56 adolescents, 26 parents, and 18 teachers from two middle schools in Taza city, Morocco). Discussions during focus groups were facilitated by a semi-structured interview guide. Guide questions were underpinned by the social-ecological model as a theoretical framework. Data analysis was carried out by two coders using thematic analysis. Results We found that barriers and facilitators of physical activity in adolescents are organized into six themes that belong to different levels of the social-ecological model. Three themes belonged to the intrapersonal level (perceived motivating and limiting factors, physical activity awareness, and time constraints), two themes were classified into the interpersonal/cultural level (social support and gender and cultural norms), and one theme belonged to the environmental level (access to opportunities). Most of the themes were at the individual level, with each theme including both barriers and facilitators. Conclusions Adolescent participation in physical activity can be facilitated or hampered by many factors. Results from the focus group discussions showed that these factors belonged to different levels of the social-ecological model, but most were at the individual level. Our findings have several implications. First, they may offer suggestions for a tailored intervention program aimed at improving adolescent physical activity. Second, they can improve quantitative research by enriching the battery of questions of physical activity instruments (e.g., a question related to physical disability). Third, the proposed thematic map can contribute to understanding interactions and causal pathways in the social-ecological model

Correlates of perceived stress with anxiety symptoms sleep quality and academic performance among Moroccan students

Introduction: The main objective of this study was to verify the association of perceived stress with anxiety, sleep quality, and academic performance among Moroccan medical students. Methods: This cross-sectional study included 222 students enrolled at the Faculty of Medicine and Pharmacy of Fez in Morocco. An online self-administrated questionnaire, for the sociodemographic characteristics, Perceived Stress Scale (PSS-10), Test Anxiety Scale, and Pittsburgh Sleep Quality Index questionnaire were used for the assessment. A descriptive and correlational design was used in this investigation. Results: One hundred and thirty-two students completed the survey. A high level of stress was found. A significant positive correlation was observed between the stress level among our population and their levels of anxiety. Stress was also positively correlated with the decrease of students’ sleep quality and academic performance. Conclusion: The results of this investigation present worthy data that highlight the need for this subset of students to anti-stress programs that must be integrated into their curriculum to help them to better manage this psychological issue. Resumen: Introducción: El principal objetivo de este estudio fue verificar la asociación del estrés percibido con la ansiedad, la calidad del sueño y el rendimiento académico entre estudiantes de medicina marroquíes. Métodos: Este estudio transversal incluyó a 222 estudiantes matriculados en la Facultad de Medicina y Farmacia de Fez en Marruecos. Para la evaluación se utilizó un cuestionario autoadministrado en línea para las características sociodemográficas, la Escala de estrés percibido (PSS-10), la Escala de ansiedad ante los exámenes y el cuestionario del Índice de calidad del sueño de Pittsburgh. En esta investigación se utilizó un diseño descriptivo y correlacional. Resultados: Ciento treinta y dos estudiantes completaron la encuesta. Se encontró un alto nivel de estrés. Hubo una correlación positiva significativa entre los niveles de estrés y ansiedad. El estrés también se correlacionó positivamente con la disminución de la calidad del sueño y el rendimiento académico de los estudiantes. Conclusión: Los resultados de esta investigación presentan datos valiosos que resaltan la necesidad de que este subconjunto de estudiantes reciba programas antiestrés que deben integrarse en su plan de estudios para ayudarlos a gestionar mejor este problema psicológico

Noninvasive predictors of presence and grade of esophageal varices in viral cirrhotic patients Case series Open Access

Abstract Predicting the presence and the grade of varices by non-invasive methods is likely to predict the need for prophylactic beta blockers or endoscopic variceal ligation. The factors related to the presence of varices are not well-defined. Therefore, the present study has been undertaken to determine the appropriateness of the various factors in predicting the existence and also the grade of esophageal varices. Patients with diagnosis of liver cirrhosis due to hepatitis C or B were included in a retrospective study between January 2001 and January 2010. All the patients underwent detailed clinical evaluation, appropriate investigations, imaging studies (ultrasound with Doppler) and endoscopy at our center. Five variables considered relevant to the presence and grade of varices were tested using univariate and multivariate analysis (logistic regression). Three hundred and seventy two patients with viral liver cirrhosis were included, with 192 (51.6%) males. Platelet count and abundance of ascites were significantly associated with the presence of esophageal varices. However, abundance of ascites, prothrombin time, diameter of the spleen and portal vein were significantly associated with a large varice. In multivariate analysis, platelet count inferior to 100000 was associated with presence of varices (p=0.04) and only abundance of ascites was associated with large varice. Low Platelet count (< or equal 100000) is associated with the presence of varices in viral cirrhotic patients and abundance of ascites is correlated with the presence of large varices