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.
Adolescent ; Adolescent Behavior ; psychology ; Exercise ; psychology ; Female ; Focus Groups ; Humans ; Male ; Morocco ; Parents ; psychology ; Qualitative Research ; Risk Factors ; School Teachers ; psychology ; Social Environment ; Students ; psychology

OBJECTIVES: Envenomation from snake bites is a significant cause of morbidity and mortality worldwide. The aim of this study was to describe the epidemiological features of snake bites in Morocco and to evaluate time-space trends in snake bite incidence, the mortality rate, and the case-fatality rate.METHODS: This is a retrospective study of snake bite cases reported to the Moroccan Poison Control Center between 1999 and 2013.RESULTS: During the study period, 2,053 people were bitten by snakes in Morocco. Most victims were adults (55.4%). The average age of the patients was 26.48±17.25 years. More than half of the cases (58.1%) were males. Approximately 75% of snake bites happened in rural areas, and 85 deaths were recorded during this period. The incidence of snake bites remained generally steady over the 15-year period of this study, with a marked increase noted since 2012. The mortality rate has increased slightly, from 0.02 deaths per 100,000 inhabitants in 1999 to 0.05 in 2013. The geographical distribution of snake bite cases in the regions of Morocco showed that Tanger-Tétouan had the highest annual incidence of snake bites (1.41 bites per 100,000 inhabitants). However, the highest annual mortality rates were recorded in the Guelmim-Es Semara and Souss-Massa-Drâa regions (0.09 deaths per 100,000 inhabitants for both regions).CONCLUSION: The geographical distribution of the incidence, mortality, and case-fatality rates of snake bites in Morocco showed large disparities across regions during the three 5-year periods included in this study, meaning that certain areas can be considered high-risk for snake bites.
Adult ; Epidemiology ; Humans ; Incidence ; Male ; Morocco ; Mortality ; Poison Control Centers ; Retrospective Studies ; Snake Bites ; Snakes

OBJECTIVES: Envenomation from snake bites is a significant cause of morbidity and mortality worldwide. The aim of this study was to describe the epidemiological features of snake bites in Morocco and to evaluate time-space trends in snake bite incidence, the mortality rate, and the case-fatality rate. METHODS: This is a retrospective study of snake bite cases reported to the Moroccan Poison Control Center between 1999 and 2013. RESULTS: During the study period, 2,053 people were bitten by snakes in Morocco. Most victims were adults (55.4%). The average age of the patients was 26.48±17.25 years. More than half of the cases (58.1%) were males. Approximately 75% of snake bites happened in rural areas, and 85 deaths were recorded during this period. The incidence of snake bites remained generally steady over the 15-year period of this study, with a marked increase noted since 2012. The mortality rate has increased slightly, from 0.02 deaths per 100,000 inhabitants in 1999 to 0.05 in 2013. The geographical distribution of snake bite cases in the regions of Morocco showed that Tanger-Tétouan had the highest annual incidence of snake bites (1.41 bites per 100,000 inhabitants). However, the highest annual mortality rates were recorded in the Guelmim-Es Semara and Souss-Massa-Drâa regions (0.09 deaths per 100,000 inhabitants for both regions). CONCLUSION: The geographical distribution of the incidence, mortality, and case-fatality rates of snake bites in Morocco showed large disparities across regions during the three 5-year periods included in this study, meaning that certain areas can be considered high-risk for snake bites.
Adult ; Epidemiology ; Humans ; Incidence ; Male ; Morocco* ; Mortality ; Poison Control Centers ; Retrospective Studies ; Snake Bites* ; Snakes*

BACKGROUND: Human papillomavirus (HPV) is the most common sexually transmitted agent worldwide. HPV is the main causative agent for cervical cancer. The HPV oncoprotein E6 binds to the tumor suppressor gene product p53, promoting its degradation; the Arg allele of TP53 R72P polymorphism binds more ardently with HPV E6 than the Pro variant. Here, we investigated whether TP53 R72P gene variant, rs104252, was associated with susceptibility to HPV infection in women with human immunodeficiency virus (HIV). METHODS: We analyzed 200 HPV-positive and 68 uninfected women with HIV. Genomic DNA was isolated from cervical swab. The TP53 R72P polymorphism was genotyped by PCR-RFLP. Unconditional logistic regression was used to assess the association between polymorphism and the clinical, lifestyle, and behavioral data. RESULTS: The genotype and allele frequencies of rs104252 variant did not differ between women without or with HPV infection (P > 0.05). Moreover, the p53 polymorphism was not associated with cervical cytology. In contrast, when we analyzed according to behavior factors, the P72P genotype was more frequent among HPV-positive smoker women. However, no significant relationship was found between alcohol, contraceptive use, and number of partners with TP53 R72P genotype distributions among HPV-positive cases (P > 0.05). CONCLUSIONS: The R72 variant of p53 R72P is not associated with HPV infection and progression of lesions. There was no association between this variant and behavior factors in HPV-positive cases. The P72P genotype may be more frequent among HPV-positive smoker women.
Alleles ; Case-Control Studies* ; DNA ; Female ; Gene Frequency ; Genes, Tumor Suppressor ; Genotype ; HIV* ; Humans* ; Life Style ; Logistic Models ; Morocco* ; Papillomavirus Infections* ; Uterine Cervical Neoplasms

OBJECTIVES: To determine the epidemiological profile and risk factors of voluntary poisoning by pesticides. METHODS: A retrospective analysis was conducted of all cases of voluntary poisoning by pesticides registered at the Anti-Poison and Pharmacovigilance Center of Morocco between January 2008 and December 2014. RESULTS: During the study period, 2,690 cases of acute pesticide poisoning were registered. The region of Rabat-Salé-Zemmour-Zaer accounted for the largest proportion, with 598 cases. The average age of the patients was 24.63±10.29 years. The sex ratio (female-to-male) was 0.45. Adults and teenagers were most affected by this type of poisoning, with 1,667 cases (62.0%) and 806 cases (30.0%), respectively. Suicide attempts accounted for 98.4% of the cases (2,469 cases). Pesticide poisoning occurred more often in urban zones (64.8%). Insecticides were incriminated in 14.0% of cases, with a mortality rate of 4.2%. Among the 1,635 patients for whom the outcomes were known, 154 died, corresponding to a mortality rate of 5.7%. CONCLUSIONS: Voluntary intoxication by pesticides presents a real scourge that affects public health, and in this study, we developed an epidemiological profile of this phenomenon. Nevertheless, this study has limitations in that it did not evaluate the impact of the socioeconomic and psychological factors that are important contributors to this type of poisoning.
Adolescent ; Adult ; Epidemiology* ; Humans ; Insecticides ; Morocco* ; Mortality ; Pesticides ; Pharmacovigilance ; Poisoning* ; Psychology ; Public Health ; Retrospective Studies ; Risk Factors* ; Sex Ratio ; Suicide

OBJECTIVES: To determine the epidemiological profile and risk factors of voluntary poisoning by pesticides.METHODS: A retrospective analysis was conducted of all cases of voluntary poisoning by pesticides registered at the Anti-Poison and Pharmacovigilance Center of Morocco between January 2008 and December 2014.RESULTS: During the study period, 2,690 cases of acute pesticide poisoning were registered. The region of Rabat-Salé-Zemmour-Zaer accounted for the largest proportion, with 598 cases. The average age of the patients was 24.63±10.29 years. The sex ratio (female-to-male) was 0.45. Adults and teenagers were most affected by this type of poisoning, with 1,667 cases (62.0%) and 806 cases (30.0%), respectively. Suicide attempts accounted for 98.4% of the cases (2,469 cases). Pesticide poisoning occurred more often in urban zones (64.8%). Insecticides were incriminated in 14.0% of cases, with a mortality rate of 4.2%. Among the 1,635 patients for whom the outcomes were known, 154 died, corresponding to a mortality rate of 5.7%.CONCLUSIONS: Voluntary intoxication by pesticides presents a real scourge that affects public health, and in this study, we developed an epidemiological profile of this phenomenon. Nevertheless, this study has limitations in that it did not evaluate the impact of the socioeconomic and psychological factors that are important contributors to this type of poisoning.
Adolescent ; Adult ; Epidemiology ; Humans ; Insecticides ; Morocco ; Mortality ; Pesticides ; Pharmacovigilance ; Poisoning ; Psychology ; Public Health ; Retrospective Studies ; Risk Factors ; Sex Ratio ; Suicide

PURPOSE: To fight animal rabies, Moroccan veterinary authorities organize annual dog mass vaccination campaigns using Rabivac vaccine, an inactivated adjuvanted cell culture veterinary rabies vaccine. Two experiments were undertaken to assess the efficacy and immunogenicity of Rabivac. MATERIALS AND METHODS: The first experiment involved 13 caged dogs (8 vaccinated and 5 negative controls). Dogs were bled at day 0 (D0) and at days D7, D14, D21, D28, D35, D49, D56, D64, D70, D77, D84, D91, D98, D105, D112, and D119 post-vaccination. At D121, a virulent challenge was performed. After 70 days monitoring period, seven out of eight vaccinated dogs survived the challenge (one dog succumbed to a mesenteric torsion accident) and four out of five controls succumbed. All vaccinated dogs seroconverted and the control dogs remained negative. The second experiment consisted in a field study involving 919 owned dogs randomly selected in eight Moroccan districts located in different parts of the country. The dogs were identified and vaccinated by the parenteral route and bled on the vaccination day (D0) and on D30. RESULTS: Ninety-two percent of dogs developed a positive rabies virus neutralizing antibody response to vaccination and 24% were positive at D0, suggesting that dogs were previously vaccinated. The increase in rabies antibody titers was highly significant in all districts. No significant difference seemed occurring between the geographical status (rural, semiurban, or urban) of the districts on the results obtained. CONCLUSION: Rabivac is efficacious both in experimental and field conditions. This supports its use in dog mass vaccination campaigns.
Animals* ; Antibodies, Neutralizing ; Cell Culture Techniques ; Dogs ; Mass Vaccination ; Morocco* ; Rabies Vaccines ; Rabies virus ; Rabies* ; Vaccination

Unexpected iatrogenic facial nerve paralysis not only affects facial disfiguration, but also imposes a devastating effect on the social, psychological, and economic aspects of an affected person's life at once. The aims of this study were to postulate where surgeons had mistakenly drilled or where obscured by granulations or by fibrous bands and to look for surgical approach with focused on the safety of facial nerve in mastoid surgery. We had found 14 cases of iatrogenic facial nerve injury (IFNI) during mastoid surgery for 5 years in Korea. The medical records of all the patients were obtained and analyzed injured site of facial nerve segment with surgical technique of mastoidectomy. Eleven patients underwent facial nerve exploration and three patients had conservative management. 43% (6 cases) of iatrogenic facial nerve injuries had occurred in tympanic segment, 28.5% (4 cases) of injuries in second genu combined with tympanic segment, and 28.5% (4 cases) of injuries in mastoid segment. Surgeons should try to identify the facial nerve using available landmarks and be kept in mind the anomalies of the facial nerve. With use of intraoperative facial nerve monitoring, the avoidance of in order to avoid IFNI would be possible in more cases. Many authors emphasized the importance of intraoperative facial nerve monitoring, even in primary otologic surgery. However, anatomical understanding of intratemporal landmarks with meticulous dissection could not be emphasized as possible to prevent IFNI.
Facial Nerve Injuries* ; Facial Nerve* ; Humans ; Iatrogenic Disease ; Korea ; Mastoid ; Medical Records ; Morocco ; Paralysis ; Surgeons

Cervical cancer is a major public health problem in Morocco. The cervical cancer has a long precancerous period that provides an opportunity for the screening and treatment. Improving screening tests is a priority goal for the early diagnosis of cervical cancer. This study was conducted to evaluate the combination of p16INK4a protein expression, human papillomavirus (HPV) typing, and histopathology for the identification of cervical lesions with high risk to progress to cervical cancer among Moroccan women. A total of 96 cervical biopsies were included in this study. Signal amplification in situ hybridization with biotinylated probes was used to detect HPV. Immunohistochemistry was used to evaluate the expression of p16INK4a protein. HPV DNA was detected in 74.0% of the biopsies (71/96). Of the seventy-one positive HPV cases, we detected 67.6% (48/71) of high risk (HR)-HPV (HPV 16 and 18), 24% of low risk-HPV (HPV 6 and 11), 1.4% intermediate risk-HPV (HPV 31, 33, and 35), and 7% coinfections (HPV 6/11 and 16/18). Overexpression of p16INK4a protein was observed in 72.9% (70/96) of the biopsies. In addition, p16INK4a protein detection was closely correlated with recovery of HR HPV. Our result showed that p16INK4a expression level is correlated with HR-HPV status.
Biopsy ; Coinfection ; Cyclin-Dependent Kinase Inhibitor p16 ; DNA ; Early Diagnosis ; Female ; Humans* ; Immunohistochemistry ; In Situ Hybridization ; Mass Screening ; Morocco ; Public Health ; Uterine Cervical Neoplasms*

BACKGROUND: Recently, the pharmaceutical manufacturing industry has been growing rapidly in many countries in the world, including in Arab countries. Pharmaceuticals reach aquatic environments and are prevalent at small concentrations in wastewater from the drug manufacturing industry and hospitals. Such presence also occurs in domestic wastewater and results from the disposal of unused and expired medicines. Therefore, the objective of this study was to analyze and compare the quantity and quality of publications made by researchers in Arab countries on pharmaceutical wastewater. METHODS: To retrieve documents related to pharmaceutical wastewater, we used the Scopus database on November 21, 2015. All documents with terms related to pharmaceutical wastewater in the title or abstract were analysed. Results obtained from Arab countries were compared with those obtained from Turkey, Iran and Israel. RESULTS: Globally, a total of 6360 publications were retrieved while those from Arab countries, Iran, Turkey and Israel, were 179, 113, 96 and 54 publications respectively. The highest share of publications belonged to Kingdom of Saudi Arabia (KSA) with a total of 47 (26.2 %) publications, followed by Egypt (38; 21.2 %), Tunisia (17; 9.5 %) and Morocco (16; 8.9 %). The total number of citations was 1635, with a mean of 9.13 and a median (inter quartile range) of 3 (1.0–10.0). The study identified 87 (48.6 %) documents with 32 countries of international collaboration with Arab countries. It was noted that Arab researchers collaborated mainly with authors in Western Europe (54; 30.2 %), followed by authors from the Asiatic region (29; 16.2 %) and Northern America (15; 8.4 %). The most productive institution was King Saud University, KSA (13; 7.3 %), followed by the National Research Centre, Egypt (10; 7.3 %). CONCLUSIONS: This study showed that KSA has the largest share of productivity on pharmaceutical wastewater research. Bibliometric analysis demonstrated that research productivity, mainly from Arab countries in pharmaceutical wastewater research, was relatively lagging behind. More research effort is required for Arab countries to catch up with those of non-Arab Middle Easter countries on pharmaceutical wastewater research.
Arab World ; Arabs* ; Bibliometrics ; Cooperative Behavior ; Efficiency ; Egypt ; Europe ; Humans ; Iran ; Israel ; Middle East* ; Morocco ; North America ; Saudi Arabia ; Tunisia ; Turkey ; Waste Water*