Latifa Adarmouch

IgG anti-toxoplasma antibodies among asymptomatic HIV-infected patients in Marrakesh-Morocco

Detection and monitoring of anti-Toxoplasma gondii antibodies are of a great interest among human immunodeficiency virus (HIV)-infected patients, since cerebral toxoplasmosis is a life-threatening opportunistic infection within this vulnerable population. The IgG anti-T. gondii seroprevalence was assessed in 95 asymptomatic HIV-infected adults living in Marrakesh city and its surrounding areas. Our results showed a seroprevalence of 62.1%, which is high compared to most other countries. The mean of CD(4+) T-cells count of involved patients was 381.9cells/μl. Given these results, HIV-infected patients in Marrakesh region could be at high risk to develop toxoplasmosis disease, especially when CD(4+) T-cells count falls below 100cells/μl. Accordingly, there is a serious need of widening antiretroviral therapy and chemoprophylaxis against toxoplasmosis, when indicated, to ovoid toxoplasmosis reactivation among this population.

Psychometric Properties of a Moroccan Version of the Summary of Diabetes Self-Care Activities Measure

Background. The Summary of Diabetes Self-Care Activities (SDSCA) is a widely used self-report measure for diabetes self-management. It is an interesting tool for practice and research. Objectives. To translate and culturally adapt the SDSCA to the Moroccan context and to assess psychometric properties of the adapted version among type 2 diabetic patients. Methods. The Moroccan version was obtained following forward and backward translations. An expert panel issued a final version. The adapted version was administered to patients aged 30 years and older who have type 2 diabetes. Psychometric evaluation consisted of assessing validity through internal consistency (Cronbachs alpha, item-to-scale and interitem correlations) and exploratory factor analysis and reproducibility (test-retest reliability). Results. Seventy-five participants were included. Cronbachs alpha ranged from 0.20 (diet) to 0.99 (exercise). Moderate to good interitem and item-to-scale correlations were found. Factor analysis resulted in a Moroccan SDSCA version consisting of 8 items, organized in four subscales that explained 89.6% of the variance: diet, exercise, blood sugar testing, and foot-care. Intraclass correlations ranged from 0.27 to 0.52 for subscales. Conclusion. This study provides preliminary evidence for suitability of use of the Moroccan SDSCA among type 2 diabetic patients in order to assess diabetes self-management.

Biomedical Research Law in Morocco

In 2015, Morocco passed a law governing research entitled: « Protection of Persons Participating in Biomedical Research » This law constitutes an important step forward in promoting biomedical research and ensuring the protection of the rights and welfare of research participants in Morocco. Yet, it is only a first step to address the multiple and evolving challenges facing research governance in the Moroccan context. Accordingly, this chapter aims to perform an ethical analysis of the law by using the framework developed by Emanuel and colleagues. I will discuss the implications of this analysis.

Short-term effectiveness of a culturally tailored educational intervention on foot self-care among type 2 diabetes patients in Morocco

Background Self-management education (SME) is an important yet unacknowledged aspect of diabetes care. Despite the raise of diabetes and its complications with significant burden in developing countries, research on SME interventions in Morocco is lacking. Aims To assess the effectiveness of a culturally tailored SME intervention on foot-care self-management practices among type 2 diabetes patients and to identify factors associated with practices variation. Methods We designed a pre-post prospective quasi-experimental study and recruited patients with type 2 diabetes aged 30 years old or above. The intervention consisted of an interactive group discussion using different materials: a narrative video, a PowerPoint presentation and a printed guide. Foot-care practices were assessed prior to the session and one month later using 2 items from the Summary of Diabetes Self-Care Activities (SDSCA). Binary logistic regression was performed to identify factors associated with a favorable variation, defined as an increase in the mean frequency score of foot-care by a minimum of 1 day/week. Results A total of 199 participants were recruited and 133 completed the second assessment. Mean age was 55.2 ± 11.2 years old. Women represented 67% and 72% of participants was illiterate. The foot-care score mean increased from 3.5 ± 2.9 days to 5.9 ± 1.8 days one month after the intervention (mean variation was 2.4 ± 3.1 days; p < 0.001). A favorable variation was found among 75 (37.7%) participants. In multivariate analysis, literacy was associated with higher likelihood of a favorable variation of foot-care practices (OR = 2.82; 95%CI: 1.09–7.31) while previous education about diabetic foot was associated with lower likelihood of a favorable variation (OR = 0.26; 95%CI: 0.08–0.78). Conclusions There was a general improvement in foot-care practices after the intervention. Our findings suggest the role of literacy and previous patient education in shaping the observed variation. Culturally tailored interventions targeting other disease management domains are needed in our context.