Summary Background Seasonal malaria chemoprevention (SMC) aims to prevent malaria in children during the high malaria transmission season. The Achieving Catalytic Expansion of SMC in the Sahel (ACCESS-SMC) project sought to remove barriers to the scale-up of SMC in seven countries in 2015 and 2016. We evaluated the project, including coverage, effectiveness of the intervention, safety, feasibility, drug resistance, and cost-effectiveness. Methods For this observational study, we collected data on the delivery, effectiveness, safety, influence on drug resistance, costs of delivery, impact on malaria incidence and mortality, and cost-effectiveness of SMC, during its administration for 4 months each year (2015 and 2016) to children younger than 5 years, in Burkina Faso, Chad, The Gambia, Guinea, Mali, Niger, and Nigeria. SMC was administered monthly by community health workers who visited door-to-door. Drug administration was monitored via tally sheets and via household cluster-sample coverage surveys. Pharmacovigilance was based on targeted spontaneous reporting and monitoring systems were strengthened. Molecular markers of resistance to sulfadoxine–pyrimethamine and amodiaquine in the general population before and 2 years after SMC introduction was assessed from community surveys. Effectiveness of monthly SMC treatments was measured in case-control studies that compared receipt of SMC between patients with confirmed malaria and neighbourhood-matched community controls eligible to receive SMC. Impact on incidence and mortality was assessed from confirmed outpatient cases, hospital admissions, and deaths associated with malaria, as reported in national health management information systems in Burkina Faso and The Gambia, and from data from selected outpatient facilities (all countries). Provider costs of SMC were estimated from financial costs, costs of health-care staff time, and volunteer opportunity costs, and cost-effectiveness ratios were calculated as the total cost of SMC in each country divided by the predicted number of cases averted. Findings 12 467 933 monthly SMC treatments were administered in 2015 to a target population of 3 650 455 children, and 25 117 480 were administered in 2016 to a target population of 7 551 491. In 2015, among eligible children, mean coverage per month was 76·4% (95% CI 74·0–78·8), and 54·5% children (95% CI 50·4–58·7) received all four treatments. Similar coverage was achieved in 2016 (74·8% [72·2–77·3] treated per month and 53·0% [48·5–57·4] treated four times). In 779 individual case safety reports over 2015–16, 36 serious adverse drug reactions were reported (one child with rash, two with fever, 31 with gastrointestinal disorders, one with extrapyramidal syndrome, and one with Quincke's oedema). No cases of severe skin reactions (Stevens-Johnson or Lyell syndrome) were reported. SMC treatment was associated with a protective effectiveness of 88·2% (95% CI 78·7–93·4) over 28 days in case-c...
The analysis of the agreements and disagreements between reviewers highlighted where improvements might be made. Given that no standard assessment tool exists in the WHO Programme, the transparency of the assessment process in this method provides a substantial basis for further development and for support in signalling possible preventability.
To assess the extent and severity of poisoning by Atractylis gummifera L. in Morocco, a descriptive retrospective study was conducted on all the poisoning cases listed between 1981 and 2004 to the Morocco Poison Control Center. During this period, 240 people were hospitalized for glue thistle poisoning, 72% of which are children under 16 years. The severity of the poisoning has been affirmed by significant intrahospital lethality. Indeed, among the 182 patients for whom the outcomes were known, 98 died (54%).
More than 2 years has passed since the pandemic was declared in 2019 due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was later declared to be the pathogen causing coronavirus disease 2019 (COVID-19). During this time, many healthcare systems faced numerous challenges to control the high morbidity and mortality of the disease. Unlike previous pandemics, the actions against this pandemic started quickly on both the global and country levels. These actions were, scientifically, to study the virus as well as transmission process and to develop medications and vaccines against it. Also, we had to protect people from transmission by knowing how best to apply precautionary methods. However, there were some unexpected negative consequences of the pandemic and one of those the World Health Organization (WHO) called ‘infodemic’. This term infodemic refers to the manipulation of a population’s behavior in the assessment of information (or, more accurately, lack of assessment) related to the use of medications, particularly vaccines. Unfortunately, even with positive development in science, there was limited and often contradictory amount of information on the safety and efficacy profile of drugs and vaccines. Therefore, this made it harder for public health agencies to determine the impact of the incidence of adverse reactions and events associated with interventions such as vaccines. Hence, risk communication needs to be emphasized during any pandemic, as ignoring risk communications to different stakeholders could undermine all well-intended therapeutic interventions. Given this, it is important that the different stakeholders involved (health authorities, societies, healthcare professionals, etc.) assess the different behavioral patterns within their respective populations and propose appropriate strategies to act. Such an approach complement having risk management and communication plans for this and future pandemics. The aim of this article is to explore how information management, risk management, and risk communication during the pandemic can provide valuable lessons for the future. Plain language summary Impact of risk communication on patient’s safety during the pandemic More than 2 years have gone by since the pandemic was declared in 2019 due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Many challenges have been confronted by the healthcare system during this time to control the high impact of this disease. This pandemic, unlike others that humanity has faced, is characterized by a special feature: today, we have an enormous amount of information only a click away. This situation has been of great benefit to humanity and has allowed the development of science; nevertheless, misinformation (infodemics) has been a major problem, which has revealed the behavior of the population regarding the evaluation of information (or better, lack of assessment) related to the use of medications and particularly of vaccines. Given this, it is important that the different people involved (health authorities, societies, healthcare professionals, etc.) assess the behavior and propose appropriate strategies to act and have plans for this and future pandemics. This article intends to explore from the authors’ perspective how information management, risk management, and risk communication during the pandemic can provide valuable lessons for the future.
Objectives: In Morocco the large number of cosmetic products is sold freely without control or registration. The lack of knowledge of the composition of these products make therapeutic management in case of poisoning very difficult and sometimes causes unnecessary health spending even if these poisoning are often benign. The objective of this study is to establish the epidemiological profile of a poisoning by lightening creams collected at the Moroccan Poison Control and Pharmacovigilance Center. Methods: This is a retrospective study of poisoning case by lightening creams collected at the Moroccan Poison Control and Pharmacovigilance Center between 1992 and 2008. Results: During the study period, 95 cases were collected. The mean age is 20 years ± 1.4 [1-70 ans], and the F/M sex ratio is 1.73. In 90 (95%) cases, the route of poisoning was oral. The Suicide attempts represent 33 % of cases. Women are often voluntarily intoxicated. However, men were concerned by involuntary intoxication (p = 0.003). Eighty three cases were urban (87%) and 90 cases occured at home (95%). The digestive disorders were found in 68 cases associeted or not with a neurological disorders (33 cases), cardiovascular disorders (14 cases), and respiratory distress (6 cases). The evolution was favorable in all cases. Conclusions: The implementation of the new law recording to the registration of cosmetic products in the ministry of health before marketing will ensure certainly a better orientation of the poisoning case management and improve the patient safety.
On March 23, 2020, the Moroccan Ministry of Health issued a circular authorizing the off label use of hydroxychloroquine or chloroquine in combination with azythromycin as first-line treatment for all COVID-19 patients. The aim of this study is to detect, assess and manage safety signals from individual cardiovascular adverse events (AE) reported. Methods: During the COVID19 pandemic, pharmacovigilance surveillance was based on spontaneous targeted notification in all health facilities. Newsletters with a suitable reporting form were sent and reporting of AEs was mandatory. The AEs collected were analyzed for causality assessment using the WHO method and the Preventavility method was used to detect any preventable ADR. Safety signals were detected and analyzed using a qualitative pharmacovigilance method. Results: As of December 31, 2020, a total of 527 adverse events have been reported to the NPC related to Hydroxychloroquine or Chloroquine among the Covid 19 patients. We received 09 cases of preventable AEs related to medication error including one drug interaction for 3 cases, dose errors for 5 cases and one case with both errors, these cases have been validated ad managed as safety signals. Discussion and conclusion: The detected signal concerned the QT prolongation, hypokalaemia and arrythmias, due to high dose of azithromycin and to drug interactions with hypokalaemic drugs. The signal was analyzed and validated during the technical committee, and recommendations were established to avoid the occurrence of similar cases.
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