Epidemiology of Cutaneous Leishmaniasis in the province of Al Hoceima, Morocco, 2012-2016

We conducted a retrospective descriptive study of all cases of cutaneous leishmaniasis reported in the province of Al Hoceima, to describe the epidemiological profile and the clinical and progressive aspects of the disease at the provincial level between 2012 and 2016.During this period, 86 cases of cutaneous leishmaniasis were recruited. A low male predominance was noted (61.54%). the average age was 26.8 years. The origin of our patients was dominated by the eastern part of the province on the border of the province of Driouach. The average duration of disease progression was 1 month.For most of our patients, the lesions were found in the areas discovered with predominance of both cheeks in 54.32%. All patients had received a skin smear for a direct examination for leishmania bodies on peri-lesional serosities and which was positive in 100% of cases.In conclusion, cutaneous leishmaniasis is a pathology weakly found at the provincial level. But strengthening epidemiological surveillance remains an effective way to detect possible cases that escape this system and also and to detect early any change in the epidemiological profile of the disease

Epidemiological profile and factors influencing severity in acute poisoning at the province of Al Hoceima, Morocco, 2013-2015

We conducted a descriptive and analytical study of 410 cases of acute poisoning collected in the province of Al Hoceima between January 2013 and December 2015. Its objectives were to describe the epidemiological and clinical profiles of patients, then to identify the factors associated with severe poisoning occurrence in that province. We performed descriptive and bivariate analysis using EPI Info 7. Incidence during the study period was generally stable with an average of 33.72 cases per 100,000 population per year. The average age was 26.33 ± 14.83 years old. The Sex-ratio female to male was 1.02. Poisoning was caused mainly by gas products, food, medicines and household products. The circumstances of the poisoning were accidental in 82.38% of the cases. Acute intoxications were severe in 33 cases.A percentage of 22.73% among the cases required hospitalization. The fatality rate was 2.93% at 95% confidence interval = [1,3% - 4,6%] during the study period. Gaseous products were the leading cause of death. The identified factors of severity were household and industrial products (p-value = 0.0035), rural residency (p-value = 0.0032) and suicide attempts (p-value: 0.0003). The mandatory notification of poisoning cases to both the primary health care facilities and the private sector and the standardization of the poisoning report form are required to improve toxicovigilance in Al Hoceima and at National level. Raising the population awareness as to carbon monoxide via education and social media is also needed

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