In Morocco, the Ministry of Health has mobilized several efforts to improve maternal and newborn health over the past decades. Despite progress, the high risk of death during pregnancy, childbirth, ...and postnatal is still a concern. Obstetricians highly regard this and require them to undertake ongoing research to promote optimal pregnancy and birth outcomes. Medical techniques such as cesarean section have led to significant progress. However, the frequency of cesarean sections has increased recently, despite World Health Organisation (WHO) recommendations to stay within 15%. Controlling the rate of cesarean sections has become a significant public health concern, given the risk of morbidity and mortality associated with cesarean sections and the associated costs. Through a review of the literature, this research interprets and analyses the relevant data to highlight the contribution of Robson’s classification to controlling C-section indications and, consequently, their rates. Indeed, several original scientific studies recommend its adoption because of its objectivity and contribution to the effective reduction of cesarean section rates. Finally, as a main recommendation, the adoption of Robson’s classification in Morocco as a simple tool for evaluation, monitoring, and audit of cesarean section rates and its use is strongly recommended for better control of cesarean section rates and indications. The training of practitioners should support it.
Today, cesarean section rates are increasing worldwide for varied and complex reasons. To examine this more closely, several countries have adopted the 10-group classification of cesarean sections, ...also known as the Robson classification. This classification aims to monitor and compare cesarean section rates in a standard, reliable, and indication-based way. In the vision of improving the quality of care and especially rationalizing cesarean section rates, this descriptive and retrospective study, which lasted ten months, considered a population of parturients who had given birth by cesarean section at the maternity ward of the Cheikh Khalifa Hospital in Casablanca. Using Robson’s classification system, data on deliveries can be compared between different regions of Morocco or between different time periods. This allows assessment of trends, geographic outcomes, and temporal variations in environment-related obstetric outcomes, which can help identify specific maternal health issues and develop targeted policies. We first listed all cesarean deliveries and then classified them into ten groups (Robson’s classification) to highlight the contribution of each group to the overall cesarean rate and to explain the discrepancies for which we proposed recommendations. This study considered 890 cases, of which 541 required a cesarean section, a 61% rate higher than that recommended by the WHO (15%) and the national rate (21%). Robson’s classification identified group 10 as contributing most to the overall cesarean rate (43.4%). Namely, this group included singleton pregnancies with a cephalic presentation, gestational age < 37 weeks, and a scarred uterus. This group’s relative size and cesarean section rate were 68% and 63%, respectively. Cesarean section should be considered a surgical procedure, considering the potential maternal and neonatal risks involved and ensuring that the indication for cesarean section is tangible, based on the Robson classification, among other things.
OBJECTIVESPrevious researches have investigated depression in postmenopausal women (PMW) with osteoporosis and fractures, but little is known regarding Moroccan PMW without fractures. We investigated ...depression prevalence and severity in Moroccan PMW with osteoporosis without fractures and its relationship with quality of life (QoL) and physical and psychological state. METHODSThis cross-sectional study enrolled 100 PMW with osteoporosis without fractures. Depressive symptoms, QoL, self-esteem, and fatigue were evaluated using the Patient Health Questionnaire-9 (PHQ-9), Arabic version of ECOS-16 questionnaire, Rosenberg self-esteem scale, and Arabic version of the Multidimensional Assessment of Fatigue scale, respectively. A questionnaire including sociodemographic factors, bone density features, pain intensity, and sleep disturbance was completed. RESULTSOverall, 58% patients suffered from depression and 55% from pain (63.8% depressed women vs. 42.9% nondepressed patients; P = 0.03). Bone mineral density, lumbar spine T-score, ECOS-16, and self-esteem in depressed and nondepressed women were 0.791 (0.738-0.840) vs. 0.835 (0.790-0.866); -3.25 (-3.8 to -2.875) vs. -2.9 (-3.425 to -2.700), P = 0.02; 2.338 ± 0.605 vs. 1.638 ± 0.455; and 13.517 ± 5.487 vs. 18.404 ± 5.771, P < 0.0001, respectively. Depression severity correlated with pain, QoL, self-esteem, and fatigue (r = 0.367, r = -0.390, r = -0.390, and r = 0.369, respectively; P < 0.0001) as well as lumbar spine bone mineral density and T-score (r = -0.258 and r = -0.255, respectively; P = 0.01). Multiple linear regression analysis revealed impaired QoL (β = 0.526; P < 0.0001), fatigue (β = 0.177; P = 0.02), and lower self-esteem (β = -2.170; P = 0.005) as the strongest risk factors of depression. CONCLUSIONSOur study shows that even without fractures, Moroccan PMW with osteoporosis suffered from depression, pain, impaired QoL, and lower self-esteem.
Introductionles intoxications intentionnelles constituent un problème majeur de santé publique, aussi bien dans les pays développés que dans les pays en développement. L´objectif de la présente étude ...est de décrire le profil épidémiologique des intoxications criminelles au Maroc.Méthodesil s'agit d'une étude rétrospective de tous les cas d'intoxications criminelles recensés par le Centre Antipoison et de Pharmacovigilance du Maroc (CAPM) entre 1980 et 2014.Résultatsdurant la période d'étude, 611 cas d'empoisonnements criminels ont été enregistrés, soit 2,1% de l'ensemble des intoxications intentionnelles déclarées durant la même période. L'âge moyen des intoxiqués était de 26,4±14,3 ans. Plus d'un quart des cas étaient des enfants de moins de 15 ans (28,6%). D'après les résultats de l'étude, 55,9% étaient de sexe masculin, avec un sex-ratio (M/F) de 1,3. La majorité des cas, soit 89,4% étaient survenus en milieu urbain. Les intoxications ont été collectives dans 24,4% des cas. Les produits les plus fréquemment utilisés étaient les pesticides (19,1%) et les plantes (19%). Les signes présentés étaient variables suivant le ou les toxiques en cause, la quantité ingérée et le délai écoulé avant le traitement. Toute une gamme de troubles digestifs, neurologiques, respiratoires et cardio-vasculaires a été retrouvée. Parmi les 440 cas pour lesquels on disposait de données sur l´évolution, 27 sont décédés. Les autres cas ont survécu avec ou sans séquelles.Conclusionl'empoisonnement criminel reste un problème non négligeable. Le nombre de cas est probablement sous-estimé du fait du nombre important de cas non diagnostiqués ou non déclarés.
Plant protection products present major risks to human health. Like other countries, Morocco is adopting phytopharmacovigilance measures. These steps are part of Morocco’s integrated approach aiming ...the rational use of pesticides. A census of the various actions and measures undertaken by Morocco through the National Food Safety Office (ONSSA) in terms of monitoring and controlling the use of pesticides for agricultural use will be presented. Between 2018 and 2020, Morocco proceeded with the withdrawal of 15 active substances and 48 pesticides and the discharge of 10 tons of imported pesticides that did not comply with standards with a review of 10 active substances harmful to humans and animals. A quantity of 17641 tons of food products unfit for consumption by excess of pesticides, 136 tons of potatoes and 125 tons of mint were sent back and destroyed due to high maximum residue limits or use of unauthorized pesticides. In the same context, training workshops for farmers on the proper use of pesticides and the management of potential risks of poisoning are organized. As well as the adoption by the Moroccan government in 2020 of a law project to limit the use of dangerous pesticides and promote alternative methods.
Noise pollution has emerged as a significant concern within educational institutions, posing a considerable challenge to the educational system. This research aims to identify and analyze the sound ...level measurements conducted at the Middle School of Sidi Yahya Zaer in Morocco. Situated in a rural area, this public institution contends with various noise sources, including a weekly market, automobile workshops, and heavy road traffic. Measurements were taken using the TASi TA8151 Digital sound level meter on workdays throughout the academic year 2021/2022, covering various locations within the establishment, such as the principal entrance, classrooms, hallways, schoolyard, sports grounds, administration department, and the school's exterior perimeter. According to the findings, the average sound level inside classrooms exceeds the recommended value by normative standards, as observed in other areas of the school. The principal objectives of the study is to demonstrate scientifically and methodologically the presence of a risk of noise pollution on students and educational staff. Consequently, underscores the potential negative impact of such noise on the performance of Moroccan institutions and highlights the multiple health effects caused by continuous exposure to this type of noise.
Covid-19 disease has confronted the world with an unprecedented health crisis, faced with its quick spread, the health system is called upon to increase its vigilance. So, it is essential to set up a ...quick and automated diagnosis that can alleviate pressure on health systems. Many techniques used to diagnose the covid-19 disease, including imaging techniques, like computed tomography (CT). In this paper, we present an automatic method for COVID-19 Lung Infection Segmentation from CT Images, that can be integrated into a decision support system for the diagnosis of covid-19 disease. To achieve this goal, we focused to new techniques based on artificial intelligent concept, in particular the uses of deep convolutional neural network, and we are interested in our study to the most popular architecture used in the medical imaging community based on encoder-decoder models. We use an open access data collection for Artificial Intelligence COVID-19 CT segmentation or classification as dataset, the proposed model implemented on keras framework in python. A short description of model, training, validation and predictions is given, at the end we compare the result with an existing labeled data. We tested our trained model on new images, we obtained for Area under the ROC Curve the value 0.884 from the prediction result compared with manual expert segmentation. Finally, an overview is given for future works, and use of the proposed model into homogeneous framework in a medical imaging context for clinical purpose.
Pharmacovigilance in Covid-19 vaccines Bahouq, Hanane; Bahouq, Madiha; Soulaymani, Abdelmajid ...
E3S Web of Conferences,
01/2021, Volume:
319
Journal Article, Conference Proceeding
Peer reviewed
Open access
The ongoing pandemic coronavirus disease of 2019 (COVID-19), originated from Wuhan, China, has caused universal challenging and threatening with considerable health impact and economic losses. ...Therefore, vaccination, as preventive and protective medical countermeasure, remains an excellent issue for reducing morbidity and mortality of this emerging infectious disease. As of April 2021 and by Emergency Use Authorization (EUA) process, 16 vaccines were authorized by at least one national regulatory authority for public use: two Ribonucleic Acid (RNA) vaccines (Pfizer–BioNTech and Moderna), seven conventional inactivated vaccines (BBIBP-CorV manufactured by Siinopharm, CoronaVac, Covaxin, WIBP-CorV, CoviVac, Minhai-Kangtai and QazVac), five viral vector vaccines (Sputnik Light, Sputnik V, Oxford–AstraZeneca, Convidecia, and Johnson & Johnson) and two protein subunit vaccines (EpiVacCorona and RBD-Dimer). As other countries, Morocco has established an anti-COVID-19 vaccine strategy in order to effectively contribute to the monitoring of vaccine safety supported by the national platform health vigilance and regulated by the National Anti-Poison and Pharmacovigilance Center (CAPM). In this review, we recorded the main current developed COVID-19 vaccines and discussed pharmacovigilance strategies and tools related safety and tolerability of those therapies. In parallel, a review of the Moroccan experience in this field is also conducted.
The National Survey on Population and Family Health (NSPFH) is an important source of data in Morocco. Its objective is to assess, periodically, the state of population health and the impact of ...policies and programs put in place, by updating the main demographic and health indicators. The report of the sixth NSPFH, conducted during the period October 2017-January 2018, illustrates updated socio-demographic data and the new prevalence of several diseases. As the NSPFH results are a reference for decision-makers, researchers and professionals, it seems necessary to promote them and give them more credibility. The objective of this paper is to verify the reliability of the NSPFH data and results using demographic data quality assessment methods (graphic methods: age-gender pyramid and distribution by gender and area of residency, and statistical methods: non-response rate and age accuracy indexes) to ensure if they are of good quality. This study showed that the NSPFH-2018 data were of good quality. Indeed, the non-response rate did not exceed 1.1% for all questionnaires (household 1.1%, woman 0.5% and elderly 1.1%). The age-gender pyramid confirmed the demographic transition towards ageing and the downward trend of fertility in Morocco. The distribution by area of residency confirmed the trend towards urbanization of the country (61% urban and 39% rural). The Whipple (1.05), Myers (4.73), Bachi (2.31) indexes and the United Nations Combined Index (31.21) were all within the standards for a good quality of age declaration. In addition, the results were consistent with each other and in line with the national and international health context.
The analysis of the economic burden for childhood poisoning has great value in Morocco where there still exists a paucity of information on the subject. The objective of this study was to explore the ...economic costs of unintentional and intentional poisoning in children in the region of Rabat-Salé-Kénitra, Morocco.
A prospective study of children younger than 15 years with a poisoning diagnosis conducted between March and July 2016 in the Children's University Hospital of Rabat, Morocco. The source of data for this study was questionnaire that collected information on the costs, the epidemiological and the socio-economic characteristics of childhood poisoning.
Eighty-seven patients were interviewed during the study period (39 females and 48 males). The majority of poisoning cases (98.85%) were accidental and 1.15% were intentional. Drugs, snake bites and scorpion stings, carbon monoxide, food, plants, household products, illegal drugs, pesticides, petroleum and industrial chemicals products were caused the poisoning. Of all the hospitalized patients, 77 (88.5%) were admitted to the emergency department and 5 (5.7%) were admitted to the intensive care unit. The average direct medical costs and the average direct non-medical costs of providing poison treatment were USD 127 and USD 30 per child, respectively. Total average direct cost of USD 157 (127 + 30) represented 60% of the national minimum wage per month in Morocco. Total direct medical costs accounted for 80%, as against 20% direct non-medical costs. The mean ± SD length of stay (LOS) for children with poisoning was 2.15 ± 1.87 days with a range variated between 0 day and 10 days.
Overall, this study confirms that the costs of childhood poisoning are not negligible costs in Morocco. Therefore, the prevalence and the costs of childhood poisoning can be reduced by monitoring an open communication between parents, the Poison Control Centre of Morocco (MPCC) and physicians in order to increase the vigilance of parents against the risks related to unintentional poisoning that can be prevented with more awareness.
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