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Background: The worldwide pandemic imposed by SRAS-CoV-2 affected all aspects of daily life including those of pregnant and breastfeeding women. This work aims to explore the impact of socio-economic determinants and mental health on breastfeeding practices among a group of Moroccan women during this pandemic. Methods: This is a descriptive and observational study carried out over 6 months in a maternity hospital. Data relating to the practices and the state of stress of women were collected via an interview and a questionnaire on post-traumatic stress disorder (PTSD). Results: Early breastfeeding and skin-to-skin practice were significantly elevated among educated women (p <0.001) and housewives (p = 0.028). Compliance with respiratory and body hygiene rules was significantly higher among women: of urban origin, educated, housewives, and those with medium or high socioeconomic levels. The study of the impact of stress on breastfeeding practices revealed a statistically significant difference in early breastfeeding (p = 0.004), compliance with respiratory and body hygiene rules (p <0.001), and skin-to-skin practice (p <0.001) between the group of normal women and the group of stressed women.Our results showed the impact of socio-economic determinants and mental health on breastfeeding practice during this pandemic. Conclusion: This represents a great challenge for the health system to promote breastfeeding and reduce the consequences of psychological disorders for mothers and unborn children in Morocco. [ABSTRACT FROM AUTHOR]

Background Cannabis, as the most widely used illicit substance in the world, also remains among the most frequently used psychoactive substances by patients with schizophrenia. It is well known that cannabis use in schizophrenia patients favors relapse, resistance to antipsychotic treatments and therefore more frequent hospitalizations. However, many studies report considerable improvement in cognitive performance in substance users, while others show the opposite. Hence, the aim of our study is to examine the relationship between schizophrenia and cannabis use in clinical and socio-de- mographic aspects. Material/ Methods This is a cross-sectional study of patients with schizophrenia hospitalized for relapse at the Ar-Razi psychiatric hospital in Salé, Morocco. A questionnaire was established in order to search for socio- demographic data, evolutionary and prognostic criteria of the disease. Cannabis use was assessed using the Cannabis Abuse Screening Test (CAST), for the severity of schizophrenia symptoms we used the Positive And Negative Syndrome Scale (PANSS) and for perceptual and memory abilities we used the numerical version of the Rey's Complex Figure-A (RCF-A). Results It was found that in a sample of 115 schizophrenic patients, 47.82% (n=55) were cannabis users. The mean PANSS (negative) and (general psychopathology) scores of non-cannabis users were significantly higher than those of cannabis users with P values of (P<0.001) and (P<0.005) respectively. For the numerical assessment scores of the RCF-A, cannabis users had a significantly higher mean score than non-cannabis users (copy phase (P<0.016) and memory (P<0.001) Conclusion As one of the leading risk factors for the emergence of schizophre- nia, chronic cannabis use also has a negative influence on the prognosis of patients already suffering from schizophrenia. Nevertheless, the results of our study show that cannabis-using schizophrenic patients had fewer negative symptoms according to the PANSS and an improved cognitive performance compared to non- cannabis-using patients. [ABSTRACT FROM AUTHOR]

Background: Rubella is an acute viral disease generally mild in its clinical manifestations. However, it is most serious for pregnant women due to the high frequency of congenital abnormalities that it causes, known as congenital rubella syndrome. This study aimed to determine rubella seroprevalence among a group of Moroccan parturients and survey physicians’ opinions regarding the situation of congenital rubella syndrome in different regions of Morocco. Methods: We prospectively enrolled 1500 women hospitalized in the Maternity Souissi of Rabat for delivery and 14 pediatricians/neonatologists who were practicing in public and private centers representing different regions of Morocco. Data on rubella serological status were extracted from the medical records of mothers. The physicians involved in this study were visited to answer the survey in person, or they completed the survey by e-mail or phone discussion. Results: Among enrolled women, and after excluding those who did not bring back evidence of a serological assessment, 222 (17.5%) women performed a rubella serology of which 84.7% were immunized against rubella. The opinion poll of physicians showed an almost absence of reports on congenital rubella syndrome cases. All practitioners surveyed were interested to join the establishment of congenital rubella syndrome reporting system. Conclusion: To achieve the goals set for congenital rubella syndrome elimination, it is of primary importance to protect women from the childbearing age by vaccination and measures that help avoid any further contact with the virus. There is also a need to expand serological screening to detect and monitor seronegative women. In addition, it is necessary to diagnose and notify new cases of congenital rubella syndrome. [ABSTRACT FROM AUTHOR]

Introduction: awareness and knowledge of toxoplasmosis are particularly important, as an intervention point for the management of the disease. The aim of this study was to evaluate the awareness and knowledge regarding toxoplasmosis in a sample of postpartum Moroccan women. Methods: this was a cross-sectional descriptive survey carried out among 320 parturient at the National Reference Center for Neonatology and Nutrition at the Children's Hospital of Rabat. Results: of320 parturient women responding to the survey, 227 (71%) had never heard about toxoplasmosis. While 18.1% of parturient stated knowing the transmission routes for toxoplasmosis. Regarding the transmission route, 53 (16.6%) women pointed at a domestic cat and 31 (9.7%) at eating raw or undercooked meat. Out of all participants, 60 (18.8%) women said they had received prevention advice during their pregnancy. The great majority (90%) of participants were unaware of the severity of the congenital infection. None of the participants showed a high level of knowledge about transmission routes, measures of prevention, and severity of CT. Conclusion: according to our survey, we observed that the majority of participants had never heard any information about toxoplasmosis. It is, therefore, necessary to educate women of childbearing age and pregnant women about the disease, especially concerning the transmission route and the prevention of infection and primary infection in non-immune women. [ABSTRACT FROM AUTHOR]

Introduction: substance use disorders are becoming increasingly common among schizophrenic patients and often raise problems in their care. This work aims to assess the rate and level of substance use in schizophrenic patients hospitalized for relapse and to identify factors associated with this comorbidity. Methods: we conducted a cross-sectional study of 115 patients with schizophrenia selected by convenience sampling in the Psychiatric Hospital of Salé. A questionnaire was used to collect socio-demographic data, evolutionary and prognostic criteria of the disease. Tobacco use was assessed with the Fagerstrom test for nicotine dependence (FTND), cannabis use was assessed with the cannabis abuse screening test (CAST) and alcohol use was assessed with the alcohol use disorders test (AUDIT). Results: the results showed that tobacco was the most consumed substance, followed by cannabis and alcohol. Certain factors such as gender (P<0.016) and family smoking history (P<0.045) were significantly associated with the scale (FTND). Other factors such as social life (P<0.05) and the educational level (P<0.004) showed a significant association with CAST. Only a history of suicide attempts was significantly associated with the scale (AUDIT). Conclusion: the results confirm that the majority of schizophrenic subjects are psychoactive substance users and that a good number of them are dependent on substances. Early outpatient follow-up in specialized drug treatment centers could improve the health status of these patients. [ABSTRACT FROM AUTHOR]

Purpose: Sugar consumption in Morocco is high, which is involved in triggering serious health conditions. Hence, assessing the recognition threshold of sweet taste among Moroccans is strongly needed. This study aims to determine the threshold of sweet taste recognition and to evaluate differences by sex, age and body mass index among a sample of Moroccan population. Design/methodology/approach: This single-blind trial was conducted among 199 healthy participants to determine the sweet taste. Age and anthropometric characteristics were registered. Nine sucrose solutions of the following concentrations (0; 0.111; 0.333; 1; 3; 9; 27; 81; 243 mmol/L) were prepared. Sweet taste perception thresholds were determined based on the validated 3-alternative forced choice test method. Findings: The average age of the sample population was 21.5 ± 26.1. And more than half (51.7%) detected the taste at the concentration of 9 mmol/L, while 91.9% recognized it at a concentration of 27 mmol/L. In terms of sex, the recognition of taste was not different between females and males (p > 0.05). The mean values of the threshold among women were significantly lower (20 ± 20.8 mmol/L) compared to men (23.9 ± 33.2 mmol/L). The age group 49–59 years old had the lowest threshold with a mean of 13.4 ± 10.2 mmol/L, and the groups with BMI in the overweight category had mean of 16.9 ± 18.2 mmol/L. However, no statistical difference was observed among either age groups or BMI categories. Originality/value: The sweet recognition threshold among the studied population is high. Therefore, it is strongly recommended to educate the population about the necessity of a progressive reduction of sugar in food items to combat non-communicable disorders. [ABSTRACT FROM AUTHOR]

Background: Available data suggest that polyphenols from tea can inhibit iron absorption from ferric sodium EDTA (NaFeEDTA), but previous studies were done in small groups of mostly nonanemic adults. Morocco recently introduced national wheat flour fortification with NaFeEDTA, but tea is the national beverage and is consumed with most meals.Objectives: Our objective was to quantify bioavailability of iron from NaFeEDTA when added to a wheat flour-based meal in both nonanemic women and women with iron deficiency anemia (IDA), when consumed with and without traditional Moroccan green tea.Methods: We recruited 2 groups of healthy Moroccan women (n = 46): women with IDA (n = 25; hemoglobin <12 g/dL,  serum ferritin <15 μg/L) and nonanemic women (n = 21). Each group received in random order 2 standardized test meals containing 6 mg Fe as isotopically labeled NaFeEDTA and either 300 mL of tea or water. Fractional iron absorption (FIA) was measured by the erythrocyte incorporation of stable iron isotopes after 14 d. We performed linear mixed-model analysis and post hoc sample t tests to assess the effects of group and tea on FIA.Results: The polyphenol content of the tea serving was 492 mg. Tea consumption reduced iron absorption from NaFeEDTA by >85% in both IDA and nonanemic women. There were group (P < 0.001) and tea (P < 0.001) effects on FIA, but no group by tea interaction (P = 0.312). Median (IQR) FIA (%) in women with IDA from test meals consumed without and with tea was 36.7 (24.2-39.8) and 4.1 (2.8-6.1), respectively (P < 0.001). Median (IQR) FIA (%) in nonanemic women from test meals consumed without and with tea was 16.7 (9.2-24.2) and 1.4 (0.8-2.9), respectively (P < 0.001).Conclusions: FIA from wheat flour-based meals without and with tea was ∼2-fold higher in women with IDA than in nonanemic women. Providing fortificant iron as NaFeEDTA cannot overcome the inhibition of tea polyphenols on iron absorption, even in IDA, where iron absorption is strongly upregulated. This trial was registered at www.clinicaltrials.gov as NCT02175888. [ABSTRACT FROM AUTHOR]

Background: The epidemic of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19), presents a significant and urgent threat to global health. This alarming viral infection, declared as pandemic by the WHO in February 2020, has resulted millions of infected patients and thousands of deaths around the world. In Morocco, despite the efforts made by the authorities, the SARS-CoV-2 continues to spread and constitutes a burden of morbidity and mortality. The objective of this study is to describe clinical characteristics of COVID-19 Moroccan patients and to establish the relationship between specific clinical symptoms, namely ageusia and/or anosmia, with these characteristics. Methods: We performed a descriptive, non-interventional cross-sectional study analyzing data from 108 patients admitted to the VINCI clinic, Casablanca (Morocco). The database includes 39 parameters including epidemiological characteristics, anthropometric measurements and biological analyzes. Results: The average of age of the patients was 43.80 ± 15.75 years with a sex ratio of 1:1. The mean body mass index of the patients was 25.54 ± 4.63 Kg/m2. The majority of patients had, at least, one comorbidity and among 75% symptomatic patients, about 50% had, at least, three symptoms namely, fever (40.7%), cough (39.8%), myalgia (28.7%), and anosmia and/or ageusia (20.4%). From biological analyzes, we noticed lymphopenia and an elevated protein C reactive and lactate dehydrogenases levels in 24.1, 36.1, and 35.2% of patients, respectively. A disturbance in liver function markers was observed in 15.7% of cases. For the other hemostasis parameters, high levels of prothrombin and platelets were reported in 14.6 and 14.8% of patients, respectively. Comparisons related to the presence of anosmia and/or ageusia did not show any difference for demographic and anthropometric characteristics, while a possibility of a significant difference was revealed for certain biological parameters, particularly the levels of lymphocytes, D-dimer and troponin. Conclusion: This study provides significant findings that will be used not only to supplement previous studies carried out in Morocco in order to resume the epidemiological situation in comparison with other countries, but also to improve the quality of the diagnosis of COVID-19 patients by identifying all the symptoms of the disease and better understanding its clinical outcomes. [ABSTRACT FROM AUTHOR]

The article discusses a study that evaluated the effect of postpartum high dose vitamin A (VA) supplementation and provision of VA fortified oil on plasma and milk retinol concentrations on lactating Moroccan women during the first six months after giving birth. Results indicate that combining supplementation and fortification has a more sustained impact on milk retinol concentrations than supplementation alone. Fortification appears to be an effective solution for VA deficiency.

Background. In Morocco, pediatric pneumonia remains a serious public health problem, as it constitutes the first cause of mortality due to infectious diseases. The etiological diagnosis of acute respiratory tract infections is difficult. Therefore, it is necessary to use Multiplex real-time polymerase chain reaction assay tests in a routine setting for exact and fast identification. Objectives. In this paper, we present the clinical results of pediatric pneumonia and describe their etiology by using molecular diagnosis. Study design: Tracheal secretion was collected from infants presenting respiratory distress isolated or associated with systemic signs, attending the unit of Neonatology between December 1, 2016, and Mai 31, 2018. Samples were tested with the multiplex RespiFinder® SMART 22 FAST which potentially detects 18 viruses and 4 bacteria. Results. Of the 86 infants considered in this study (mean age 31 ± 19 days) suspected of acute respiratory tract infections, 71 (83%) were positive for one or multiple viruses or/and bacteria. The majority of acute respiratory tract infections had a viral origin (95%): respiratory syncytial viruses (A and B) (49%), rhinovirus (21%), coronaviruses 229E (11%), humain metapneumovirus (5%), influenza A (3%), influenza H1N1 (1%), adenovirus (2%), and parainfluenza virus type 4 (2%). Among our patients, 6% had Mycoplasma pneumoniae. Coinfections were not associated with severe respiratory symptoms. Conclusion. The clinical spectrum of respiratory infections is complex and often nonspecific. Thus, the early and fast detection of related causative agents is crucial. The use of multiplex real time polymerase chain reaction may help choose an accurate treatment, reduce the overall use of unnecessary antibiotics, preserve intestinal flora, and decrease nosocomial infection by reducing the length of hospitalization. [ABSTRACT FROM AUTHOR]

Background: Gestational Diabetes Mellitus (GDM) testing and management in Morocco is associated with delays resulting in late commencement of treatment. To reduce delays and to increase access of women to GDM care, a country-adapted intervention targeting primary health care providers was designed to test the hypothesis that detection and initial management of GDM at the primary level of care improves newborn outcomes in terms of lower birthweights and less cases of macrosomia and impacts on maternal weight gain, glucose balance and pregnancy outcomes. Materials and methods: We conducted a cluster randomized controlled trial in two districts of Morocco. In each district, 10 health centers were randomly selected to serve either as intervention or control sites. Pregnant women attending antenatal care in the study facilities were eligible to participate. At the intervention sites, women were offered GDM screening by capillary glucose testing following International Association of Diabetes in Pregnancy Study Groups/WHO criteria. Women diagnosed with GDM received counselling on nutrition and exercise and were followed up through their health center whereas at control facilities routine practice was applied. Primary outcome was birthweight and secondary outcomes maternal weight gain, glucose control and pregnancy complications. We further assessed GDM prevalence in the intervention arm. Statistical analysis was performed on 210 recruited women. Continuous variables were reported using means while categorical variables using frequencies with tests of independence applying chi-squared tests. Differences of outcome variables between the two groups were estimated by mixed-effects regression models and effect sizes adjusted for confounders. The trial is registered under NCT02979756 at ClinicalTrials.gov. Results: GDM prevalence reached 23.7% in Marrakech. Birthweight in the intervention group was 147grams lower than in the control group (p = 0.08) as was the proportion of macrosomes (3.5% versus 18.4%; p< 0.001). In the intervention arm, women did two times more follow-ups than at control sites (p = 0.001) and mean follow-up intervals were shorter (11.3 days versus 18.7 days; p < 0.001). Overall, 30% more fasting blood sugar values were balanced (p = 0.005) and mean weekly maternal weight gain 49 grams lower (p = 0.032) in the intervention group. More women from control facilities had a delivery complication whereas more newborn complications were observed in women from intervention facilities. No difference between the two groups existed regarding mode of delivery and mean gestational age at delivery. One of the main limitations of the study was the Hawthorn-effect at control sites that might have led to an underestimation of the effect size. Conclusion: A high GDM prevalence in Morocco calls for a context-adapted screening and management approach to enable early interventions. GDM detection and care through antenatal care at primary health facilities may have positively impacted on newborn birthweight but findings are inconclusive. Results of this study will contribute to the decision on a potential upscaling of the intervention in Morocco. Future research could examine long term metabolic changes including diabetes type 2 in the cohort of women and their children. [ABSTRACT FROM AUTHOR]

Introduction: Morocco has recently developed a plan of reducing sugar consumption to reinforce prevention of non-communicable diseases and to contribute to the achievement of global voluntary targets for non-communicable diseases set by ICN2 by 2025. The objective of the present study was to assess acceptance of yogurts with different percentage reduction of sugar by the Moroccan population. Methods: A total of 201 participants (age > 15 y.) were recruited to determine the level of sugar reduction in yogurt. Sucrose was added to a plain yoghurt in the following different concentrations 166.5; 149.8; 133.2; 116.5; 99; 83.2 mM/l, corresponding to the reduction of sugar of 0%, -10%, -20%, -30%, -40% and -50%, respectively, compared available yogurt in local market. Overall, the acceptability scores of the different yoghurts were based on liking, "Just About Right" (JAR) and purchase intent scales was used to score the different yoghurts. Results: Yogurts containing -20% and -30% added sugar were highly accepted by 81% and 74% of respondents. Based on JAR score, yoghurt with 20% (133.2mM/l) and 30% (116.5 mM/l) reduction were considered as "just about right" by 42.7% and 44.3% respectively. Best average score of purchase intent was obtained for sucrose concentration of 149.8 mM/l. 35.8% and 40.3% for yoghurt with sucrose concentration of 133.2 mM/l and 116.5 mM/l respectively. Conclusion: The finding from this study indicated that yogurts containing -20% and -30% added sugar were most accepted by respondents. Advocacy before dairy industry to have them commit towards sugar reduction in yogurt is needed, in order to help achieving the national sugar reduction strategy in Morocco. [ABSTRACT FROM AUTHOR]

Introduction: The objective of this study was to assess knowledge and practices of general practitioners, nurses and midwives working at primary health care facilities in Morocco regarding screening and management of gestational diabetes (GDM).Methods: Structured interviews with 100 doctors, midwives and nurses at 44 randomly selected public health care centers were conducted in Marrakech and Al Haouz. All data were descriptively analyzed. Ethical approval for the study was granted by the institutional review boards in Belgium and Morocco.Results: Public primary health care providers have a basic understanding of gestational diabetes but screening and management practices are not uniform. Although 56.8% of the doctors had some pre-service training on gestational diabetes, most nurses and midwives lack such training. After diagnosing GDM, 88.5% of providers refer patients to specialists, only 11.5% treat them as outpatients.Discussion: Updating knowledge and skills of providers through both pre- and in-service-training needs to be supported by uniform national standards enabling first line health care workers to manage women with GDM and thus increase access and provide a continuity in care. Findings of this study will be used to pilot a model of GDM screening and initial management through the primary level of care. [ABSTRACT FROM AUTHOR]

Background: Morocco is facing a growing prevalence of diabetes and according to latest figures of the World Health Organization, already 12.4% of the population are affected. A similar prevalence has been reported for gestational diabetes (GDM) and although it is not yet high on the national agenda, immediate and long-term complications threaten the health of mothers and future generations. A situational analysis on GDM conducted in 2015 revealed difficulties in access to screening and delays in receiving appropriate care. This implementation study has as objective to evaluate a decentralized GDM detection and management approach through the primary level of care and assess its potential for scaling up. Methods: We will conduct a hybrid effectiveness-implementation research using a cluster randomized controlled trial design in two districts of Morocco. Using the health center as unit of randomization we randomly selected 20 health centers with 10 serving as intervention and 10 as control facilities. In the intervention arm, providers will screen pregnant women attending antenatal care for GDM by capillary glucose testing during antenatal care. Women tested positive will receive nutritional counselling and will be followed up through the health center. In the control facilities, screening and initial management of GDM will follow standard practice. Primary outcome will be birthweight with weight gain during pregnancy, average glucose levels and pregnancy outcomes including mode of delivery, presence or absence of obstetric or newborn complications and the prevalence of GDM at health center level as secondary outcomes. Furthermore we will assess the quality of life /care experienced by the women in both arms. Qualitative methods will be applied to evaluate the feasibility of the intervention at primary level and its adoption by the health care providers. Discussion: In Morocco, gestational diabetes screening and its initial management is fragmented and coupled with difficulties in access and treatment delays. Implementation of a strategy that enables detection, management and follow-up of affected women at primary health care level is expected to positively impact on access to care and medical outcomes. Trial registration: The trial has been registered on clininicaltrials.gov; identifier NCT02979756; retrospectively registered 22 November 2016. [ABSTRACT FROM AUTHOR]

Introduction: Vitamin D insufficiency to pregnant women has been associated with a number of adverse consequences, and has been recognized as a public health concern. The aim of this study was to evaluate vitamin D status of Morrocan pregnant women and their newborns. Our study is being the first of its kind in Morocco, as it supports the program of systematic supplementation of pregnant women in the third quarter. Its results have established a new program for the fight against the deficit of various nutrients, thereby intake of vitamin D has become routine. So this work is a true example of action research. Methods: It's an observational and a cross sectional study. The data was collected prospectively from the 1st January to 31 December 2012 in the labor room of the Souissi maternity hospital, at the Ibn Sina university center of Rabat in Morocco. Women included were consented to participate in the study. Data on epidemiological, sociodemographic and clinical characteristics was recolted by interview, physical exam and biochemistry parameters. Hypovitaminosis D is defined as serum level of vitamin D = 50 nmol/l (20 ng/ml). Results: Our study included 102 cases of mother-newborn pairs. The average age of mothers was 28.3 +/- 6.7 years (range 17-43 years), 90.1% of women enrolled had a hypovitaminosis D, the average weight of newborns was 3377.9 +/- 509g (2270 - 4880g). Hypovitaminosis D is not correlated with the origin, season, body mass index, birth interval and birth weight. It was positively correlated with maternal serum calcium (p=0.000). Conclusion: the maternal hypovitaminosis D is real public health problem. The prevention is necessary, by the systematic vitamin D supplementation for pregnant women. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer is the most common cancer in morocco women were it occupies the first place in term of incidence and mortality. The aim of the present paper is to evaluate the risk factors associated with a breast cancer in a population of Moroccan women. Methods: A casecontrol study was conducted with population women whose age is less than 40 years during 2008-2010 at the National Institute of Oncology of Rabat. These women were interviewed for Epidemiological information and risk factor for breast cancer. Results: Included in this study were 124 cases and 148 age matched controls. No statistically significant case-control difference was found for the early age of menarche (OR = 2.474; CI 95%: 1.354-4.521), and family antecedents of first degree of breast cancer (OR = 11.556; 95% CI: 2.548-52.411). However physical activity (OR = 0.507; 95% CI: 0.339-0.757) early maternity age (OR = 0.212; 95% CI: 0.087 - 0.514), multiparity (OR = 0.742; 95% CI: 0.359-1.539) and breastfeeding than 6 months (OR = 0.739; 95% CI: 0.357-1.523) appear as significant protective factors. Conclusion: This study show the criminalization of only part of the known risk factors of breast cancer in this age group and confirms the probable protective role of physical activity and factors related to life reproductive women in our study (early childbearing, multiparity and lactation). [ABSTRACT FROM AUTHOR]

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Background Several pathogenesis and genetic factors influence predisposition to antituberculosis druginduced hepatotoxicity (ATDH) especially for isoniazid (INH). However, the major susceptibility genes for ATDH are N-acetyltransferase 2 (NAT2) and cytochrome P450 2E1 (CYP2E1). NAT2 gene determines the individual's acetylator status (fast, intermediate or slow) to metabolize drugs and xenobiotics, while CYP2E1 c1/c1 genotype carriers had an increased risk of ATDH. Polymorphisms of the NAT2 and CYP2E1 genes vary remarkably among the populations of different ethnic origins. The aim of this study was to determine, for the first time, the frequency of slow acetylators in Moroccan population by genotyping of NAT2 gene variants and determining the genotype c1/c1 for CYP2E1 gene, in order to predict adverse effects of Tuberculosis treatment, particularly hepatotoxicity. Results The frequencies of specific NAT2 alleles were 53%, 25%, 2% and 4% for NAT2*5, NAT2*6, NAT2*7 and NAT2*14 respectively among 163 Moroccan studied group. Genotyping of CYP2E1gene, by real-time polymerase chain reaction using TaqMan probes, revealed frequencies of 98.5% for c1/c1 and 1.5% for c1/c2 among 130 Moroccan studied group. Conclusion The most prevalent genotypes of NAT2 gene in Moroccans are those which encode slow acetylation phenotype (72.39%), leading to a high risk of ATDH. Most Moroccans are homozygous for c1 allele of CYP2E1 gene which aggravates hepatotoxicity in slow acetylators. This genetic background should be taken into account in determining the minimum dose of INH needed to treat Moroccan TB patients, in order to decrease adverse effects [ABSTRACT FROM AUTHOR]

Summary: This study aimed to estimate the prevalence of hypertension among a group of adolescents and to assess the relationship of systolic and diastolic blood pressure (SBP, DBP) with body fat mass (BFM), body mass index (BMI) and waist circumference (WC). A total of 167 subjects aged 11–17 years were recruited, 29.3% and 12.6% were overweight and obese respectively. BMI, WC, SBP and DBP were determined using standardized equipment. BFM was estimated by the deuterium oxide dilution. Hypertension (HT) and prehypertension (pre-HT) were observed in 17.4% and 9.6%, of the study population, respectively. The prevalence of HT and pre-HT was significantly higher in boys and in overweight-obese groups (p =0.044; p =0.003 respectively). Both SBP and DBP were significantly higher in overweight-obese compared to healthy-weight groups (p <0.001; p =0.002 respectively). SBP was significantly higher in boys than girls (p =0.013). With some exceptions, SBP and DBP were significantly correlated with BMI, WC and BFM in the study population and different weight-status groups of both genders. The relationship of blood pressure with BMI appeared to be more significant than with WC and BFM. The prevalence of hypertension was higher in boys than girls and in overweight-obese than healthy-weight adolescents. Overall SBP and DBP were associated with BFM, BMI and WC. However, the strong association between these variables was seen in girls, and the greater risk of developing hypertension could be associated with increasing BMI. [Copyright &y& Elsevier]

Obesity is a real public health problem whose prevalence continues to increase throughout the world. It affects all age groups and does not spare pregnant women. This work aims to determine the prevalence of obesity and to study its association with maternal and neonatal characteristics and the morbidity profile of pregnancy. This is a descriptive and cross-sectional study carried out in the maternity ward of the prefectural hospital center called "Sidi Lahcen" in Témara, Morocco, over a 12-month period. Maternal and neonatal data are collected through a preestablished questionnaire, and anthropometric parameters were recorded. 390 participants, aged between 18 and 43 years, were included in this study, with a prevalence of overweight and obesity of 34.9% and 41%, respectively. Correlation results revealed that the prevalence of overweight and obesity was significantly elevated in women over 25 years p < 0.001 . The rate of caesarean section was four times higher in obese women compared to women of normal weight (53.8% versus 12.8%; p = 0.018). The over-term was significantly high in the obese group compared to the nonobese group (33.8% versus 20.2%; p = 0.013). A statistically significant positive correlation was found between gestational body mass index and newborn birth weight (r = 0.29; p < 0.001) as well as a high prevalence of macrosomia in newborns of comparatively obese women compared to newborns of nonobese women (17.6% versus 9.6%; p = 0.041). The correlation analysis with the morbidity profile showed a significantly high preponderance of gestational diabetes, anemia, and toxemia of pregnancy in the obese group compared to the normal group p < 0.001 . This study clearly demonstrated that obesity during pregnancy is associated with higher risks of maternal and neonatal complications, the management of which places a burden on the health system as well as families. These data reinforce the need to improve antenatal care for the prevention of obesity and its preventable complications. [ABSTRACT FROM AUTHOR]

Over the last few decades, there have been significant dietary and lifestyle changes worldwide. In Morocco, these changes have led to serious nutritional disorders and increased risk of morbidity and mortality particularly among vulnerable groups such as women of childbearing age. We aimed to assess the average daily energy and macronutrient intakes and to investigate their association with socioeconomic factors and weight status among women aged 19–49 years in urban areas. A total of 542 women attending public health centers were recruited. Socioeconomic and demographic data were collected using a questionnaire. Anthropometric measurements were taken using standardized equipment. Food consumption data were obtained through the 24-hour dietary recall method, and the macronutrient composition of foods was estimated based on the Moroccan food composition table and the Nutrilog software. The average daily energy intake among the study population was 1591 kcal, composed of 56% from carbohydrates, 28% from fats, and 16% from protein. Reported energy intake by the majority of women (81.5%) was lower than recommended daily allowances for energy. There was a significant positive correlation between educational level and energy (p = 0.001), carbohydrates (p = 0.001), proteins (p = 0.004), and fats intakes (p = 0.032), respectively. A significant negative association of household size with protein intakes was also observed (p = 0.034). Carbohydrates, proteins, and fats intakes tended to decrease; however, these associations were not statistically significant. Further studies and appropriate interventions are needed to address the trends in energy and macronutrients intakes in the development of policy initiatives aimed at nutrition education and chronic disease prevention among childbearing age women. [ABSTRACT FROM AUTHOR]

Iodine is required for the production of the thyroid hormones essential for the growth and development of the brain. All forms of iodine deficiency (ID) affect the mental development of the child. Our study aims to assess the impact of ID on the intellectual development of Moroccan schoolchildren and to evaluate the effect of consumption of fortified milk on reducing ID. In a double-blind controlled trial conducted on schoolchildren, children were divided into two groups to receive fortified milk (30% of cover of RDI iodine) or nonfortified milk for 9 months. Urinary iodine was analyzed using the Sandell-Kolthoff reaction, a dynamic cognitive test using Raven’s Standard Progressive Matrices to assess learning potential was performed at baseline and end line, and anthropometric assessment was done only at baseline. The study included schoolchildren who were severely iodine deficient. The prevalence of malnutrition was high in both groups; in this study, we found improvements in iodine status and in cognitive abilities among Moroccan schoolchildren. Our study showed that the consumption of fortified milk led to a clear improvement in iodine status and also appeared to have a favorable effect on the cognitive ability of Moroccan schoolchildren in a rural mountainous region. [ABSTRACT FROM AUTHOR]

Résumé: Introduction: Les malformations congénitales représentent l’une des principales causes de morbidité et mortalité néonatale. L’étiologie de ces malformations est multifactorielle, déterminée par un ensemble de facteurs génétiques et environnementaux. L’objectif de ce travail était d’analyser les principaux facteurs impliqués dans la survenue des malformations congénitales dans notre contexte. Patients et méthodes: Il s’agissait d’une étude prospective à visée descriptive et analytique réalisée à la maternité Souissi de Rabat sur une période d’une année de janvier 2010 à décembre 2010. Cette étude a consisté en l’exploitation des dossiers obstétricaux et de périnatologie d’un échantillon de la population. Une fiche de recueil a été remplie pour chaque nouveau-né comportant les données sociodémographiques, obstétricales, maternelles, suivi et surveillance de la grossesse, de l’accouchement ainsi que les données néonatales. Le groupe des nouveau-nés sains et celui des malformés ont été comparés puis analysés. Les malformations considérées sont celles qui sont cliniquement décelables. Résultats: Mille naissances ont été colligées, 960 étaient saines et 40 porteuses de malformations. Les malformations retrouvées sont la fente palatine (10 cas), l’anencéphalie (4 cas), les polymalformés (12 cas), l’hydrocéphalie (4 cas), l’imperforation anale (2 cas) et le spina-bifida (8 cas). Les facteurs de risque significativement liés à la survenue des malformations congénitales sont la prise de médicaments (antiépileptiques) et/ou de plantes (fenugrec) durant la grossesse (p <0,001), la présence de pathologie chronique chez la mère essentiellement le diabète (p <0,001), l’histoire familiale de malformation congénitale (p <0,001) et la grossesse gémellaire (p =0,028). Conclusion: L’étude des malformations congénitales doit être faite dans chaque pays afin de déterminer leurs prévalences, leurs natures, les causes et les facteurs de risques associés et permettre des mesures de prévention spécifiques. [ABSTRACT FROM AUTHOR]

Objectives: Development and validation of bioelectrical impedance prediction model for Moroccan adolescents. Subjects and methods: The total sample included 143 adolescents (34 boys and 109 girls) aged 11-17 years-old who were recruited from high schools of the capital city (Rabat) of Morocco. The study population was divided into developmental and validation sample. Anthropometric measurements performed by a trained technician were body weight, standing height, body mass index and waist-to-hip ratio. Body composition was measured by deuterium oxide dilution (D2O) (0.5 g of ²H2O for one kg of body weight) and by bioelectrical impedance analysis (4000 Bodystat Quadscan). Resistance (R50) and reactance (Xc50) were measured at 50 kHz. Pubertal status was determined. Results: The model is FFM (kg) determined by D2O = 0.578xHeight²/R50 (cm²/Ω) + 0.176xBody weight (kg) - 2.296xGender (boy=0, girl=1) + 0.791xAge (years) - 3.768; with R²=0.93 and SEE = 1.89 kg. In the validation sample, there was no significant difference between FFM measured by D2O (37.32±6.58 kg) and that estimated with model (37.22±6.37 kg) with p-value = 0.647. Bland and Altman analysis showed no significant association between the difference and the average of the two methods. The bias was 0.103 ± 1.891 kg of FFM with 95% confidence interval equal to -0.34 and +0.55 kg. The limits of agreement were -3.60 and +3.81 kg of FFM. Conclusions: The model is accurate to be used to assess body composition and nutritional status in Moroccan adolescents. [ABSTRACT FROM AUTHOR]

Objectives: Determination of body composition by deuterium oxide dilution, development and validation of bioelectrical impedance prediction equation for Moroccan women in the 1st trimester of pregnancy. Subjects and methods: 26 pregnant women in the 1st trimester aged 19-40 years from urban area were included. Anthropometric parameters were measured, total body water, fat-free mass and fat mass were determined by deuterium oxide dilution, whereas resistance and reactance were measured at 50 kHz by bioelectrical impedance. Results: The prediction equation is: fat-free mass by ²H2O in kg = 0.788 × Height² in cm²/Resistance in Ω + 0.279 × Body weight in kg - 6.824; with R² = 0.92 and standard error of the estimate = 2.06 kg. The bias = -1.26 kg, confidence interval was -2.80, +0.26 kg and the pure error was 2.53. Conclusions: The BIA equation is accurate, precise and valid to be used to assess body composition in Moroccan pregnant women during the 1st trimester. [ABSTRACT FROM AUTHOR]

Background and Aims: We undertook this study to assess the prevalence of obesity and overweight in children enrolled in government primary schools in the city of Rabat, Morocco. Methods: Twenty three schools were randomly selected. A cross-sectional study was conducted between April 2010 and June 2010. The survey was conducted on the basis of two questionnaires for both parents and children. The references used are those of the WHO (2007). Results: Our study involved a sample of 1570 children with an average age of 9.7 ± 0.95 years. The prevalence of overweight and obesity was 8.7%. Overweight affected 5.1% and obesity affected 3.6%. The majority of our population consisted of children of low socioeconomic status where 59% of fathers are laborers and 85% of mothers are unemployed. Conclusion: Overweight and obesity do not spare the most underprivileged social strata of our country. Therefore, prevention strategies and programs to raise awareness of risks and threats involved must be a public health priority. [Copyright &y& Elsevier]

L'épidémie de coronavirus-2 du syndrome respiratoire aigu sévère (SRAS-CoV-2), à l'origine de la maladie à coronavirus 2019 (COVID-19), présente une menace importante et urgente pour la santé mondiale. Cette infection virale alarmante, déclarée pandémique par l'OMS en février 2020, a entraîné des millions de patients infectés et des milliers de morts dans le monde. Au Maroc, malgré les efforts fournis par les autorités, le SRAS-CoV-2 continue de se propager et constitue un fardeau de morbidité et de mortalité. L'objectif de cette étude est de décrire les caractéristiques cliniques des patients marocains COVID-19 et d'établir la relation entre des symptômes cliniques spécifiques, à savoir l'agueusie et/ou l'anosmie, avec ces caractéristiques. Nous avons réalisé une étude transversale descriptive et non interventionnelle analysant les données de 108 patients admis à la clinique VINCI, Casablanca (Maroc). La base de données porte sur 39 paramètres comprenant des caractéristiques épidémiologiques, des mesures anthropométriques et des analyses biologiques. La moyenne d'âge des patients était de 43,35 ± 15,75 ans avec une sex-ratio de 1 :1. L'indice de masse corporelle moyen des patients était de 25,54 ± 4,66 kg/m2. La majorité des patients présentaient au moins une comorbidité et parmi les 75 % des cas symptomatiques, environ 50 % présentaient au moins trois symptômes à savoir : fièvre (40,7 %), toux (39,8 %), myalgie (28,7 %) et anosmie et/ou agueusie (20,4 %). À partir des analyses biologiques, nous avons remarqué une lymphopénie et une élévation des taux de protéine C réactive et du lactate déshydrogénases chez 24,1 %, 36,1 % et 35,2 % des sujets, respectivement. Une perturbation des marqueurs de la fonction hépatique a été observée dans 15,7 % des cas. Pour les autres paramètres d'hémostase, des taux élevés de prothrombine et de plaquettes ont été rapportés respectivement chez 14,6 % et 14,8 % des patients. Les comparaisons liées à la présence d'anosmie et/ou d'agueusie n'ont pas montré de différence pour les caractéristiques démographiques et anthropométriques, alors qu'une possibilité de différence significative a été révélée pour certains paramètres biologiques, en particulier les taux de lymphocytes, de D-dimère et de troponine. Cette étude fournit des résultats significatifs qui seront utilisés non seulement pour compléter les études précédentes menées au Maroc afin de reprendre la situation épidémiologique par rapport à d'autres pays, mais aussi pour améliorer la qualité du diagnostic des patients COVID-19 en identifiant tous les symptômes de la maladie et pour une meilleure compréhension de ses résultats cliniques. [ABSTRACT FROM AUTHOR]

Objectives: Analogous to the Near Miss Maternal approach, the concept of Near Miss Neonatal (NNM) is an approach recently developed to identify newborns who survive near-fatal complications during the first 28 days of ectopic life. The objective of this study is to shed light on the cases of Neonatal Near Miss and identify its factors associated with live births., Methods: A prospective cross-sectional study was conducted to identify factors associated with Neonatal Near Miss in newborns admitted to the National Reference Center in Neonatology in Rabat, Morocco from January 1 to December 31, 2021. A pre-tested, structured questionnaire was used to collect the data. These data were entered using Epi Data software and exported to SPPS23 for analysis. To identify the determinants of the outcome variable, binary multivariable logistic regression was used., Results: Among the 2676 selected live births, 2367 (88.5%; 95% CI: 88.3-90.7)) were cases of NNM. Factors in women which were significant predictors of NNM included being referred from other health care facilities [AOR: 1.86; 95% CI: 1.39-2.50], residing in a rural area [AOR: 2.37; 95% CI: 1.82-3.10], having less than four prenatal visits [AOR: 3.17; 95% CI: 2.06-4.86], and having gestational hypertension [AOR: 2.02; 95% CI: 1.24-3.30]., Conclusions: This study revealed a high proportion of NNM cases in the study area. The factors associated with NNM which were found to increase these cases demonstrates the primary health care program must be further improved to avoid preventable causes of neonatal mortality.

Point-of-care (POC) testing for Toxoplasma infection has the potential to revolutionize diagnosis and management of toxoplasmosis, especially in high-risk populations in areas with significant environmental contamination and poor health infrastructure precluding appropriate follow-up and preventing access to medical care. Toxoplasmosis is a significant public health challenge in Morocco, with a relatively heavy burden of infection and, to this point, minimal investment nationally to address this infection. Herein, we analyse the performance of a novel, low-cost rapid test using fingerstick-derived whole blood from 632 women (82 of whom were pregnant) from slums, educational centres, and from nomad groups across different geographical regions (i.e. oceanic, mountainous) of Morocco. The POC test was highly sensitive and specific from all settings. In the first group of 283 women, sera were tested by Platelia ELISA IgG and IgM along with fingerstick whole blood test. Then a matrix study with 349 women was performed in which fingerstick - POC test results and serum obtained by venipuncture contemporaneously were compared. These results show high POC test performance (Sensitivity: 96.4% [IC95 90.6-98.9%]; Specificity: 99.6% [IC95 97.3-99.9%]) and high prevalence of Toxoplasma infection among women living in rural and mountainous areas, and in urban areas with lower educational levels. The high performance of POC test confirms that it can reduce the need for venipuncture and clinical infrastructure in a low-resource setting. It can be used to efficiently perform seroprevalence determinations in large group settings across a range of demographics, and potentially expands healthcare access, thereby preventing human suffering.

Introduction: Morocco launched a national salt reduction strategy in 2019. The commitment of bakeries is key in the success of this strategy. However, the evaluation of such a commitment is not yet done. This study aims to examine knowledge of bakers about the national strategy of salt reduction and evaluate their commitment in implementing the specific recommendation related to salt reduction in bread., Methods: a quantitative exploratory study targeted bakeries (N=432) from all the administrative regions of Morocco. Data was collected using a questionnaire composed of three sections: knowledge of bakers related to national strategy of salt, current contribution of bakers in implementing the national strategy and future commitment towards implementing the national strategy., Results: about 73% (n=317) bakers lack of knowledge about the recommendations on the progressive reduction of the salt content in bread. Radio and TV were the most used sources to obtain information by bakers (45.2% (n=52) and 35.6% (n=41) respectively). None of the bakers was informed about the process of gradual reduction of salt content in bread, and none of them was committed to it. A total of 60.32% (n=252) of bakeries do not respect the national recommendations of 10g of salt/Kg of flour while 89.6% (n=387) of bakers express their interest in getting committed to the process in the next 2 years., Conclusion: increasing the knowledge of bakers is highly recommended to guarantee their commitment toward contributing to the strategy of reducing salt in bread. Dissemination of messages via TV and radio could be appropriate., Competing Interests: The authors declare no competing interests., (Copyright: Meryem Bouhamida et al.)

Globally, congenital toxoplasmosis remains a significant cause of morbidity and mortality, and outbreaks of infection with T. gondii represent a significant, emerging public health burden, especially in the developing world. This parasite is a threat to public health. Disease often is not recognized and is inadequately managed. Herein, we analyze the status of congenital toxoplasmosis in Morocco, Colombia, the United States, and France. We identify the unique challenges faced by each nation in the implementation of optimal approaches to congenital toxoplasmosis as a public health problem. We suggest that developed and developing countries use a multipronged approach, modeling their public health management protocols after those in France. We conclude that education, screening, appropriate treatment, and the development of novel modalities will be required to intervene successfully in caring for individuals with this infection. Gestational screening has been demonstrated to be cost-effective, morbidity-sparing, and life-saving. Recognition of the value and promise of public health interventions to prevent human suffering from this emerging infection will facilitate better patient and societal outcomes.

Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: Dr. Rima McLeod worked on a literature review for Sanofi Pasteur.

Anterior meningo-encephaloceles (AME) are congenital malformations characterized by herniation of brain tissue and meninges through a defect in the cranium, in frontal, orbital, nasal and ethmoidal regions. The management of this complex congenital malformation is controversial according to whether use, an intracranial, extra-cranial or combined approach. This is the first largest series published in Africa, in which we present our experience in the operative management of AME; we share our recommendation in technical consideration for surgical approach with review of the literature. All patients beneficed of neuro-radiological investigations including Plan X rays, Spiral Three dimensional CT scan and MRI. Ophthalmologic and maxillo-facial evaluations were done in all the cases. MEA are surgically approached in various ways, mainly on the basis of its location and type, by cranio-facial approach in one-step, or in two stages by intracranial approach followed by facial approach, only by cranial approach or facial approach. The surgical results were evaluated in the follow up on the basis of disappearance of cranio-facial tumefaction with correction of hypertelorism. 60 children with AME were treated in our department between January 1992 and December 2012. The mean age at time of surgery was 14 months (20 days to 18 years) with slight men predominance (28 females/32 males). Cranio-facial team operated 21 patients, 16 were operated in two stages by intracranial approach followed by facial approach, 20 cases beneficed the neurosurgical approach and three only the facial approach Some post operative complications were observed: 2 cases of post operative hydrocephalus underwent shunt; CSF fistulas in three cases cured by spinal drainage, one death due to per operative hypothermia, 3 cases of recurrence how needed second surgery. After mean follow up for 80 months (1 year to 19 years) theses techniques permitted a good cosmetics results in 42 cases, average cosmetics results in 8 cases, poor results in 5 cases and worse cosmetics results in 4 cases, The AME are rare conditions we used the multiples approach first intracranial approach followed by facial approach, but after 1998 we used one-step correction by combined approach, only cranial approach when needed or facial correction.

Sanjad-Sakati syndrome (SSS) or hypoparathyroidism-retardation-dysmorphism syndrome (HDR) is a rare autosomal recessive disorder. It is characterized by the association of congenital hypothyroidism, growth retardation, psychomotor retardation, epilepsy, dysmorphic features (microcephaly, facial, eye, and dental anomalies), and abnormalities of the extremities. The prevalence of SSS is unknown. Reported patients are were almost exclusively from the Arabian Peninsula. They are were all homozygous for the ancestral mutation c.155- 166del of the TBCE gene, also known as "the Bedouin mutation." We report on the first clinical and molecular description of a Moroccan patient with Sanjad-Sakati syndrome. He is was a carrier for the Bedouin mutation, not surprising, knowing that part of the Moroccan population has Arabian origin. This diagnosis allowed us to provide an appropriate management to the patient, to make a genetic counseling to his family, and to enrich genetic data on the Moroccan population.

Klebsiella pneumoniae is one of the Gram-negative bacilli most commonly found in urine of pregnant women and causing neonatal sepsis. The aim of this study was to analyse in terms of epidemiology and antimicrobial resistance of 23 K. pneumoniae isolates collected from vaginal swabs or urine of pregnant women, from pharyngeal and ear swabs of apparently healthy newborns and from peripheral cultures and hemocultures of newborns with suspected invasive neonatal infection in Rabat, Morocco. The prevalence of K. pneumoniae was 0.6 and 0.9% among pregnant women and neonates, respectively. These strains showed lower antimicrobial resistance levels regarding the developed countries. Thus, only one strain from a neonate presented an ESBL. This is the first report of a K. pneumoniae strain causing neonatal sepsis harbouring the blaCTX-M-15 gene in an IncFII plasmid and belonging to ST466 in this area., (© FEMS 2014. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objectives: To evaluate the impact of the body mass index (BMI) before pregnancy and the weight gain during pregnancy, on the occurrence of maternal and neonatal morbidity in the Moroccan population, as well as to analyze the quality of the weight gain depending on the BMI., Methods: A study was carried out over a period of one year from October 1, 2010 to October 1, 2011, using data collected from a descriptive-transversal study. We recruited nondiabetic women without several HTAs, delivering singletons from 37 completed weeks up to 42 weeks gestation., Results: Total of 1408 were analyzed. The risks of moderate hypertension, macrosomia, dystocia, and resort to cesarean section were higher among overweight or obese women, as well as among women whose weight gain was >16 kg. The differences were significant <0.05., Conclusion: This study demonstrates that overweight women before pregnancy and weight gain during pregnancy are associated with higher risks of maternal and neonatal complications. These data provide ideas on prevention opportunities.

Background: Epidemiological and experimental evidence support the role of host genetics in treatment response and viral clearance in chronic hepatitis C (CHC). Recently, the CC genotype of IL28B single-nucleotide polymorphism (SNP) rs12979860 has been associated with spontaneous viral clearance and a better treatment response. The distribution of this polymorphism varies according to populations. Frequency of rs12979860 SNP alleles in the Moroccan population is unknown. The aim of our study was to estimate the frequency of the C allele of this SNP in the Moroccan population and, in parallel, in a cohort of Moroccan patients with CHC treated with pegylated interferon-alpha and ribavirin., Methods: We used real-time polymerase chain reaction assay based on TaqMan technology to determine the allele frequency of the rs12979860 SNP in 100 Moroccan newborn infants. We also compared the frequency of the CC genotype between two groups of patients with genotype 1-CHC treated by combination therapy: group1, n=30 patients, responders who achieved sustained viral response (SVR) and group2, n=30 patients, nonresponders., Results: The rs12979860 C allele frequency was estimated to be 73% in the Moroccan population. The frequency of this allele in the group of patients with CHC was only 58.3%, and the CC genotype is more prevalent in group1 (62.5%) than in group 2., Conclusions: This is the first report providing genetic data related to the frequency of genetic polymorphisms of IL28B in Morocco. The C-allele frequency of the IL28B gene SNP rs12979860 in Morocco is higher than in the African populations. Distribution of this SNP distinguishes in a population of CHC between SVR and nonresponders. This result merits consideration and should be studied by analyzing a larger sample size of patients.

Objective: Frameshift mutation p.G352fsdelG in the PAH gene was recently reported as the most common mutation in Moroccan patients with phenylketonuria (PKU). This result, if confirmed, would considerably facilitate genetic counseling and molecular diagnosis of the disease in Morocco. Given that the incidence of PKU in the Mediterranean region is estimated at between 1/4000 and 1/10,000, this mutation would be harbored by many Moroccans. We aimed to estimate the frequency of heterozygotes for the p.G352fsdelG mutation in Moroccan newborns., Materials and Methods: In this study, we used a reliable TaqMan(®) real-time polymerase chain reaction to detect the mutation p.G352fsdelG in the PAH gene in 250 unrelated Moroccan newborns. DNA was extracted from umbilical cord blood with maternal consent., Results: The supposed recurrent mutation p.G352fsdelG was found in none of the 250 tested newborns. Therefore, the frequency of heterozygotes for this mutation would be less than 1/250, and the incidence of patients with PKU homozygous for this mutation would not exceed 1/100,000., Conclusion: The p.G352fsdelG mutation in the PAH gene does not appear to be prevalent in the Moroccan population and would be responsible for only few cases of PKU. The previous report of this anomaly as being responsible for 62.5% of PKU patients in Morocco could be explained by selection bias.

The cytochromes P450 are a superfamily of oxidative enzymes, which are implicated in the metabolism of a large number of endogenous substances as well as exogenous chemicals. The cytochrome P450 (CYP3A5) appears to play an important role in drug metabolism activity. The most frequent mutation in the CYP3A5 gene, affecting its activity, consists of a G6986A transition within intron 3. In this study, we determined the allelic frequency of CYP3A5*3 in a Moroccan population, consisting of 108 individuals including 10 renal transplant patients. About 8.33% (9/108) of the subjects were homozygous wild-type (CYP3A5*1/*1), 37.04% (40/108) were heterozygous (CYP3A5*1/*3), and 54.63% (59/108) were homozygous (CYP3A5*3/*3). Therefore, CYP3A5*3 variant was the most frequent allele detected at 73.15%. In the second part of this work, we assessed the influence of the CYP3A5 polymorphism on tacrolimus doses required for 10 renal transplant patients who are receiving tacrolimus as immunosuppressive therapy. Our results showed that, during the first 3 months after kidney transplantation, the tacrolimus daily requirements for heterozygous patients (CYP3A5*3/*1) were higher compared with homozygous patients (CYP3A5*3/*3) (0.133 ± 0.026 vs. 0.21 ± 0.037 mg/kg/day). After the third month the difference was also observed, whereby the mean of tacrolimus daily requirements for patients with CYP3A5*3/*3 and CYP3A5*1/*3 was 0.053 ± 0.013 and 0.08 ± 0.014 mg/kg/day, respectively. This first study in Morocco provides genetic data related to the frequency of genetic polymorphisms of CYP3A5 and opens the perspective to develop other pharmacogenetic studies.

Xeroderma pigmentosum (XP) is an autosomal recessive inherited disease which is genetically heterogeneous. The prevalence of this genodermatosis is estimated to be 1/1 000 000 in the USA; it is more common in Japan and probably in other populations with high levels of consanguinity. The molecular diagnosis and identification of mutation in patients requires the knowledge of the causative gene by the determination of XP complementation groups. Soufir et al. have reported that XPC is the major disease-causing gene with a recurrent mutation in the Mediterranean region. The mutation c.1643&#95;1644delTG (p.Val548AlafsX25) represents alone 74% of all the XP probands tested and 87% in XP type C in North African patients with founder effect. We used molecular epidemiological methods in the present study to calculate the frequency of heterozygote for this mutation in Moroccan newborns and estimate the prevalence of XP in the Moroccan population. DNA extracted from umbilical cord blood samples of 250 newborns were tested for the recurrent XPC mutation c.1643&#95;1644delTG using real-time polymerase chain reaction. Heterozygotes profiles were confirmed by direct sequencing. Among 250 newborns tested, one subject was heterozygous for the mutation c.1643&#95;1644delTG. The carrier frequency was estimated to be 1/250 which would imply that the prevalence of XP would be approximately 1/80 504 considering the effect of consanguinity. This is the first report of the prevalence of XP in an Arab country and it shows that the prevalence of xeroderma pigmentosum is higher than that found in Europe and the USA., (© 2011 Japanese Dermatological Association.)

Spinal muscular atrophy (SMA) is one of the most common autosomal recessive diseases caused by homozygous deletion of exon 7 of the survival motor neuron 1 (SMN1) gene in approximately 95% of SMA patients. Carrier frequency studies of SMA have been reported for various populations. The aim of our study was to estimate the carrier frequency of the common SMN1 exon 7 deletion in the Moroccan population to achieve an insight into the prevalence of SMA in Morocco. In this study, we used a reliable quantitative real-time polymerase chain reaction assay with SYBR Green I dye to determine the copy number of the SMN1 gene. Analysis of 150 Moroccan newborns predicts a carrier frequency of approximately 1:25, which would mean a calculated SMA prevalence of 1:1800 after correction due to consanguinity. These results show as expected that the SMA carrier frequency in Morocco is higher than in the European populations and is close to those of Middle Eastern countries. Genetic carrier testing for genetic counseling should be recommended particularly to families with a clear clinical history of SMA.

Diffuse arterial calcified elastopathy is a very rare and little known hereditary disease, characterized by diffuse calcifications of the arterial wall. It seems common in North Africa and in the Caucasian region. Its incidence appears to be underestimated in Morocco. Clinical pattern is dominated by renovascular hypertension often associated with symptoms of heart failure. Risk of sudden death from myocardial infarction is particularly important. Thus, the diagnosis of diffuse arterial calcified elastopathy must always be suspected in front of an apparently unexplained heart failure or renovascular hypertension occurring in an infant. We report a case of diffuse arterial calcified elastopathy discovered in a neonatal intensive care unit, during management of a cardiogenic shock in a 3-months old infant. This observation demonstrates the importance of systematic measurement of the arterial tension, family screening and the impact of the ultrasound in the detection of vascular calcifications. Treatment remains essentially symptomatic.