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PubMed1999

[Prevalence of intestinal parasitic disease in three provinces in Morocco].

A study of intestinal parasites was carried out in Taounate, Béni Mellal and Tizinit provinces in Morocco on a sample of 1682 individuals who were representative of the urban and rural area population. For each stool specimen, three microscopic examinations and a Kato test were performed. In the three provinces, about two-thirds of the study participants from rural areas and around 50% of those from urban areas had parasites. The reproducibility of the prevalence figures allowed the study results be generalized to the other provinces of the country. Among the parasite groups encountered, amoebas were the most frequent, followed by flagellates and helminths. Concerning pathogenic species, Entamoeba histolytica, in the amoebic group, was the most commonly found. All the positive cases were treated by specific medication.

Adolescent↗
PubMed1999

[Contribution of a combined approach in an analysis of training needs in two health regions in Morocco].

UNLABELLED: A study using a combination of three techniques of qualitative research (nominal group, focus group, interview) was carried out in 1996 among 72 health professionals that occupy a position of responsibility at the level of the wilayas of Fes and Marrakech (Morocco). For the entirety of the study, 14 meetings were held with experts (administrators, nurses, doctors and delegates). OBJECTIVE: To study the advantages and limitations of a combinatory approach that triangulates three methods of qualitative research to identify and analyze training needs of administrators, nurses, doctors and delegates that hold a position of responsibility at the level of the wilayas of Fes and Marrakech. RESULTS: The focus group allowed for the establishment of lists of problems encountered that were susceptible to being resolved through a training intervention: 1) Planning methods are not used and needs analysis of resources remains arbitrary; 2) Methods of management are not mastered by the people holding the responsible positions; 3) The management of human resources is centralized and there is no policy of personnel motivation. The main accompanying measures proposed by the participants were: 1) to decentralize the process of planning and to train the responsible people in the methods and techniques of planning; 2) to introduce new methods of health services administration. Training themes by order of priority were: health planning, management, regulations and legal instruments, management of human and material resources. DISCUSSION: The combinatory approach allowed for a list to be established of the training needs of health professionals. It also provided an instantaneous diagnosis of the organisations and programmes for which they are responsible. But this triangulation of techniques has several limitations related to the researchers' interpretation of these needs, to their socio-cultural system of reference and to their interests that often don't coincide with those of the experts in the field. CONCLUSION: This study allowed for the development of an outline that puts the role of experts back in the planning process of a training project and combines the needs of experts with institutional needs in order to reach a better adequacy of the triad of needs-demand-responses.

Attitude of Health Personnel↗
PubMed2000

Review of the wastewater situation in Morocco.

Recent estimations of the wastewater production of Morocco amounted to 370 million m3 per year, and this is expected to increase to 900 million m3 by the year 2020. In most cases wastewater is discharged directly into the environment, either to the sea via short outfalls or onto farmland for irrigation or infiltration. Major improvements in the quality of wastewater are needed urgently because of the strong migration of the rural population towards the towns and the very rapid demographic expansion. Studies for Sanitation Master Plans for the main towns are currently in progress and are a first step towards meeting these requirements. Development of a national master plan for liquid sewage is a way of extending this procedure over the whole territory.

Agriculture↗
PubMed2000

[Child labor in the artisan sector of Morocco: determinants and health effects].

Despite the fact that child labour is regulated through the work code, and the convention on child rights adopted by the General Assembly of the United Nations in 1989 and ratified by Morocco in 1993, multiple surveys have shown that children are often put to work at a very early age and few employers respect the work conditions laid out in the texts. The aim of this study was to assess the different situations of child labour in the handicraft sector, the reasons and the problems surrounding it, to study its repercussions on health and to propose several preventive measures. From March to July 1997, a retrospective cohort study of working children and children in school was carried out in a small neighbourhood of Casablanca. We interviewed and examined a random sample of two hundred children working in the handicraft sector. The health status of these children was compared to that of the same sample size of children in school, from the same age group and socio-economic status. Each subject was given a standardized questionnaire that was translated into dialectal Arabic and administered by a occupational health doctor and a communications specialist. The results of the study have pointed out the small school network of the working children, the painful conditions of work and the important consequences on their health state with a wide prevalence of pathologies higher than for the children attending school. The misery in addition of the rural exodus, the no-adapted educative and socio-economic systems, the splitting of the family unit often go to generate a submissive childhood without defense and "ready to be used".

Adolescent↗
PubMed2000

[Intestinal parasitosis and environmental pollution: 1343 pediatric cases in Beni-Mellal, Morocco].

This study was undertaken to determine the possible health risk associated with raw wastewater use in agricultural purposes, particularly, the transmission of parasite infections among children of five regions in Beni-Mellal, Morocco. In a randomly-selected sample of 1343 children, 740 of them were from five regions using raw wastewater for agriculture, and 603 were from 4 control regions that do not practice wastewater irrigation. One or more parasite infections were identified in 50.8% of the children living in the wastewater re-use regions and in 8.2% only of the others. The seven parasites identified were Entamoeba histolytica, Giardia intestinalis, Ascaris lumbricoides, Trichuris trichiura, Enterobius vermicularis, Hymenolepis nana, Taenia saginata, which infected 34.3%, 5.1%, 20.5%, 0.4%, 5.2%, 7.2%, 0.5% in the exposed population and 4.3%, 0.3%, 3.8%, 0.3%, 1.0%, 0.6% and 0.0% in the control population respectively. In conclusion, raw wastewater use in Beni-Mellal lead to a high risk of parasite infections. Adequate treatment of wastewater is highly recommended.

Agriculture↗
PubMed1999

Snow algae of the Sierra Nevada, Spain, and High Atlas mountains of Morocco.

Snow algae (Chlorophyta) are reported from the Sierra Nevada mountains in southern Spain and the High Atlas mountains of Morocco. Populations of the snow algae Chlamydomonas sp., coloring the snow orange-red, were collected from Pico de Veleta, Spain, while snow samples from Mt. Neltner in the High Atlas mountains, contained resting spores of an orange-green colored Chloromonas sp. Other microbes observed in snow samples include bacteria, fungi, heterotrophic euglenids, diatoms, nematodes, and heterotrophic mastigotes (flagellated protists). This is the first report of snow algae from the Sierra Nevada mountains of Spain and from the Afro-alpine environment.

Altitude↗
PubMedDate not supplied

[The quality of trichiasis surgery in the kingdom of Morocco].

In December 1998, a survey was carried out on the quality of trichiasis surgery, based on a random sample of 750 people chosen from the surgical records of 13 health centres of the provinces of Zagora and Errachidia (Kingdom of Morocco). Among those, 740 people were examined (participation ratio: 98.6%). The study population was mainly composed of women (63.8%) and people > 40 years (83.5%). The average age was 51.8 (48.5 for women and 57.4 for men). The most common surgical technique was the bilamellar tarsal rotation procedure. In 98.7% of cases, the operation concerned one of the upper eyelids, and in 58.5% of cases the right eye. At the time of the interviewers' visit, 11.1% of the people examined were blind (vision < 1/20 for the best eye) and 28.9% were visually impaired (vision > 1/20 but < 3/10). In addition, 17.6% of the eyes whose eyelids had been operated on rated as blind and 29% of them as visually impaired. The definition of recurrence was the presence of at least one or more eyelashes in contact with the eyeball. The recurrence rate is estimated to be 15.8%, divided into 2 categories: (1) Severe or total recurrence (2.4%) - At least one eyelash from the median part of the lid margin is in contact with the cornea - and, (2) Partial recurrence "One or more eyelashes affect the corners of the eyelids but never rub against the cornea" (13.4%). 14. 3% of the patients operated on were removing their eyelashes regularly which is a clear indicator of the failure of the operation. The following constitute risk factors for recurrence: being aged over 40, having been operated on in Errachidia province, having been operated on by a general practitioner or by an ophthalmologist. However, "time elapsed since the operation" does not appear to influence the recurrence rate in each of the three cohorts which were subsequently formed using the date of the operation (retrospectively). Most recurrences seem to develop during the first twelve months after the operation. The post-operational complications/sequelae detected were rarely sight-threatening, except in four cases, i.e., three ptoses and one case of tegumental necrosis with permanent exposure of the cornea. The most common complications were excessive rotation of the lid margin (over-correction) (2.3%) and cutaneous necroses with no exposure of the cornea (3.6%). In this series, 15.7% of the eyes examined presented central corneal opacity and 2.1% xerosis. In 1.6% of cases the eyeball was either destroyed (phthisis bulbi) or absent. A majority of patients (51.8%) was affected by persistent lacrimation or secretions.

Adult↗
PubMedDate not supplied

[Accumulation and biomagnification of organochlorine insecticides in molluscs and fish of the Moulay Bouselham lagoon, Morocco].

We studied the contamination by organochlorine insecticides of the clams and eels in Moulay Bousselham lagoon, on the west coast of Morocco. DDT and its metabolites, DDE and DDD, were found to have accumulated in the lipids of all specimens. Organochlorine concentration in clams was highest for samples taken from the mouth of channels draining agricultural land. Organochlorine content was more than 100 ng/g in some cases in this area, whereas it was less than 40 ng/g in the rest of the lagoon. Organochlorine content peaked in May and then decreased after egg laying. Marked concentration of these pesticides was observed in eels, which are mobile and carnivorous. Organochlorine content peaked in November, mainly among the large specimens preparing to migrate to the ocean. DDT was stored in lipids, at concentrations up to 2,000 ng/g. However, even this high concentration is below the upper limit for human consumption. The higher proportion of DDE than of DDT shows that most of the contamination is not recent. BHC and cyclodienes were also detected, at low concentrations. The contamination of eels and clams in the Moulay Bouselham does not currently pose a threat to public health.

Animals↗
PubMedDate not supplied

[Contamination of the Moulay Bouselham Lagoon, Morocco with organochlorine pesticides and nitrates].

In the lagoon system of Moulay Bouselham, on the Atlantic coast of Morocco, drainage bring nutriments and sediments from irrigation systems to the open lagoon. The recent intensification of farming in the surrounding area is the chief cause of this. We studied the chemical pollution of the lagoon, which serves as a nature reserve, by analyzing the nitrate content of the water and the organochlorine pesticide content of the sediment. Comparison with similar ecosystems showed that the sediments were only moderately contaminated. However, the level of nitrates in the water was found to exceed the upper limit of the range of concentrations considered safe for human health in European regulations. The level of nitrate pollution in the area seems to be increasing, whereas organochloride pesticide pollution is on the decrease. The washing out of fertilizer during winter is responsible for much of the nitrate pollution in this season whereas in summer, urban effluents is the chief cause of nitrate contamination.

Agrochemicals↗
PubMed2000

[Algae in dam reservoirs used for drinking water production in Morocco].

As part of the study of water quality of dam reservoirs used for drinking-water production, the Water Quality Laboratory of the National Office for Drinking Water in Morocco prepared a micrographic atlas of the main species of planktonic algae found in 22 reservoirs over a period of 25 years. The atlas includes 321 micrographs representing 156 taxons with an indication of the sample location and an enlargement ratio for each micrograph. In some cases, information is also provided on algae associations, algal counts and monthly occurrence.

Colony Count, Microbial↗
PubMedDate not supplied

[The value of occupational health in the national campaign against tuberculosis in Morocco].

Tuberculosis is a major public health problem in Marocco, with an incidence of 100 cases per 100,000 people. Occupational health could make a substantial contribution to the national anti-tuberculosis campaign, as the principal aims of occupational health are to protect and to improve the physical, mental and social well-being of the workforce. Occupational health thus devotes considerable attention to the promotion of health in general, and the fight against tuberculosis in particular. Occupational health physicians can play a major in several areas: prevention, screening, management of patients, compensation and epidemiology. The generalization of medical cover in the work environment in Morocco requires the application of laws already in place, the creation of occupational health departments, the training of occupational health physicians and the raising of their awareness concerning the anti-tuberculosis, and the involvement of doctors in municipal hygiene offices in the framework of a national health program for the entire workforce.

Health Priorities↗
PubMed2001

[Study of tuberculosis in health care workers in the public sector of Morocco].

SETTING: Tuberculosis is one of the most important causes of disease in Morocco, with an annual incidence of 100 cases per 100,000 population. There is a permanent risk of tuberculosis for health care workers in contact with bacillary positive tuberculosis patients. OBJECTIVE: To evaluate the risk and incidence of tuberculosis in health care workers and to study its distribution by cohort analysis. METHODS: A questionnaire was sent to all of the provinces and prefectures of the kingdom to gather information on tuberculosis cases notified between 1994 and 1997 in health care workers. RESULTS: Over the 4-year period, 130 new cases of tuberculosis were notified among health care workers in 30 provinces and prefectures: 73 men (56%) and 57 women (44%), with a mean age of 41.3 +/- 8.9 and 38.6 +/- 8.4 years, respectively (P = 0.093). The mean cumulative incidence was 85.3/100 000 health care workers; for doctors in specialist diagnostic centres for tuberculosis it was 1,094.8/100,000. The survey showed no significant difference between the mean annual cumulative incidences for doctors (83.4), nurses (78.5) and administrative staff (94.3). The cohort analysis indicated a mean annual success rate of 89.2%, failure rate of 0.9%, lost to follow-up 0.8%, death 3.8% and transfer out 3.1%. Several studies have shown weaknesses in the conditions of hygiene and security in the health centres (such as lack of gloves and masks, and meals taken within the workplace). CONCLUSION: The risk of tuberculosis is not much higher in health care workers in general than in the general population; however, it is significantly higher in the specialist diagnostic centres for tuberculosis. The recent creation of health units for personnel working in the health centres should result in improvements in working conditions if the recommended preventive measures are respected.

Adult↗
PubMedDate not supplied

[The Ninard collection, a documentary collection focusing on Morocco at the Institut du monde arabe].

Dr. Bernard Ninard, a former director of the Biology Laboratory in Rabat, has given his library to the Institut du monde arabe (IMA). There are 2,400 books and periodicals devoted to Morocco, which may be consulted at the IMA, 1 rue des Fossés Saint-bernard, Paris 5e. The topics represented in this collection are very varied. One may particularly find numerous studies in ethnology, that help to understand the development of the Moroccan Society in the XIXth century.

Arab World↗
PubMed1993

[Dentistry in Turkey and Morocco].

Some information is given on the number of dentists in Turkey and Morocco and the dental condition of the inhabitants. This information concerns prevention, caries, periodontic diseases as well as other dental diseases and diseases of the mouth.

Adolescent↗
PubMed1975

Obstacles to family planning practice in urban Morocco.

Sixty in-depth interviews with mothers living in a urban slum of Morocco probed resistances to practicing modern methods of fertility control and began to shed light on some of the reasons family planning programs often fail to reach illiterate target populations. Economic insecurity and the disintegration of the support networks of the traditional extended family complicate the difficult lives of young mothers in the urban slum. While such factors tend to encourage smaller families, the uncertainties and complexities of the socioeconomic structure contribute to the problems blocking access to modern methods of fertility control.

Abortion, Induced↗
PubMed2002

[Respiratory symptoms and ventilatory disorders among a group of cement workers in Morocco].

There are 8 cement works in Morocco employing 3 600 people and producing 8 million tons annually. The aim of our study is to determine the prevalence of respiratory symptoms and to propose some preventive measures. The study involved a group of workers of whom 280 were exposed to cement dust (who were further subdivided into three categories according to the intensity of exposure) and 73 who were not. It included a medical history with a standardised questionnaire, a clinical examination and spirometry. 65% of those exposed had clinical symptoms as opposed to 34.2% of the non-exposed. Cough, expectoration rhinitis, chronic bronchitis and asthma were significantly more common with incidences of 56.1%, 52.5%, 49.3%, 29.3% and 14.3% respectively in the exposed against 19.2%, 24.6%, 26%, 9.6% and 6.8% in the non-exposed. Among the exposed the prevalence of chronic bronchitis increased significantly with the degree of exposure, from 11.4% in category 1 to 41.6% in category 3. Age did not seem to influence the development of chronic bronchitis but on the other hand a smoking history of more than 10 years did. Exposure is responsible for the development of respiratory problems because among non smokers the exposed (55.6% are more symptomatic than the non-exposed (13.3%). Tobacco smoking potentiates the effects of occupational airborne contamination because exposed smokers (73.6%) and ex-smokers (67.8%) have more respiratory problems than exposed non-smokers (55.6%). The incidence of abnormalities of respiratory function is significantly higher in the exposed than in the non-exposed (32.5% against 13.7%). Among the exposed workers presenting disorders of ventilatory function 72.5% have no more than a disorder of the small airways or a slight deficit. Among the exposed the prevalence of impaired respiratory function is greater in smokers and ex-smokers (47.9% than in non-smokers (10.4%). Tobacco smoking augments the impairment of respiratory function. Prevention depends therefore on a programme of technical (collective and individual) and medical protection of the workforce.

Adult↗
PubMed2002

[Clinical evolution and circulating venom levels in scorpion envenomations in Morocco].

We conducted a clinical and biological study in Morocco in order to assess the efficacy of antivenom therapy against scorpion stings. Epidemiological and clinical data were collected in 275 patients envenomed by Androctonus mauretanicus mauretanicus and Buthus occitanus scorpions. Patients received antivenom or symptomatic drugs. Blood samples were collected upon hospital admission, at 1 hr and 3 hrs after the treatment. An enzyme linked immunosorbent assay (ELISA) was set up to quantify the venom levels in serum of envenomed patients. Mean serum venom concentrations showed an association between clinical signs and the venom level. The venom concentration at admission, in patients who received 10 ml of antivenom, was significantly reduced after antivenom therapy. The decrease was less important in patients who received only 2 to 5 ml of antivenom. No difference was shown in the venom concentration of patients not treated with antivenom. The clinical signs decreased significantly after antivenom treatment. The absence of antivenom administration increased the risk to develop clinical signs at the end of hospitalisation. This risk was much higher when the delay between scorpion sting and hospital admission increased. The results of our study have demonstrated the efficacy of antivenom in reducing circulating venom and symptoms. Antivenom therapy is more efficient when administered as soon as possible after envenomation and with appropriate quantities of antivenom. This study is favourable to the use of SAS but a prospective study would be useful to confirm these data.

Adolescent↗
PubMedDate not supplied

[Epidemiologic and parasitologic survey concerning the Hassan Addakhil dam and branches to the Tafilalet province (Morocco, May-June 1975)].

In conclusion we know human and animal gathering is usually required for the development of water invertebrate populations, and particularly Bulinus contortus or Culicidae larvae, in a water system polluted with excrements or sewage. Such conditions are not those of Hassan Addakhil lake and the latter is not to-day, on its surface, a source of contamination. As we report p. 486, the study of an eventual increase of malaria and bilharzia endemia due to new aval more or less distant irrigations, belongs to the control of the Hygiene Institute of Morocco and collaborators of physicians of the Tafilalet province. This item will be discussed later on.

Animals↗