Laboratoire de la géo-biodiversité et patrimoine naturel, centre GEOPAC, institut scientifique-Rabat, Université Mohamed V. Maroc AbstractLeishmaniasis is an infectious disease transmitted to humans by the bite of female sand fly. These parasitic infections are the second most common cause of parasite mortality worldwide after malaria and are endemic Asian and African countries. In Morocco, they pose a real health problem. The objective of this study is to determine the epidemiological situation of these diseases in the city of El Hajeb in central Morocco, analyze their evolution according to sex and age and assess their geographical distribution according to the environment. To do this, we carried out a retrospective study during the period from 2013 to 2017, collecting all the new cases of cutaneous and visceral leishmaniasis declared in this city. Data were collected at the register level from the delegation of the Ministry of health of El Hajeb. A total of twentyone new cases were declared infected. The coexistence of the two forms of leishmaniasis: 80.95% of cutaneous forms and 19.05% of the visceral form
The impact of climate factors on the epidemiology of diseases in general and leishmaniasis in particular continues to be a subject of research and analysis. Changes in climatic parameters contribute to the creation of ecological conditions favorable to the multiplication of the vectors of certain diseases. With this in mind, this study presents an entomological survey conducted in Meknes prefecture and the study of the link between the abundance of sandflies, an indicator of the risk of leishmaniasis in a given area, and the climatic factors. Monthly trapping of this fauna was carried out during a year from March 2016 until April 2017 using adhesive traps. Climatic data from the region were used to determine the effect of climate on the distribution of sandflies. A total of 941 leishmaniasis vector specimens were captured. The dominant species is Ph. sergenti (73.32), followed by Ph. longicuspis (8.25%), then Ph. perniciosus (7.94%) and Ph. papatasi (6.31%). The sex ratio study showed that males are more abundant than females for all species. The seasonal fluctuation is bimodal with two peaks, the first in July and the second in September. The results show a positive correlation between temperature and abundance of sandflies (r = 0.99) and a negative correlation with humidity and precipitation with a correlation coefficient of r = −0.87 and r = −0.72. Indeed, the medium-term climatological forecasts are essential tools to develop a warning system for leishmaniasis.
Background. Morocco hopes to eliminate leishmaniases by 2030. These diseases exist in cutaneous and visceral forms and constitute a serious public health problem. The fight against these parasitoses is carried out within the framework of a national program to control leishmaniases, which offers free treatment. However, the screening rate in public health structures does not exceed 35%. Objective. To determine the knowledge and experience of the social actors directly involved in the fight against leishmaniasis to contribute to analyse and understand the factors of this underreporting and to draw scientific recommendations to improve screening and control activities. Methods. Using a self-administered questionnaire, we conducted an exploratory survey during April and May 2019 among all health professionals working in public health structures in the province of ELHajeb in central Morocco. Results. We found that most of the health professionals had good knowledge about the clinical signs of each form of leishmaniasis, but they had erroneous information about the true vector of the disease, the reservoirs, and the mode of transmission. 76% recognized the national leishmaniases control program and only 17% received continuing education. 85% of these professionals focused on the curative aspects of the program. 47% stated that patients do not adhere to the antileishmaniasis treatment, and 25% stated that the population uses the concept of “Hboub of Chniwla” to refer to cutaneous leishmaniasis. Conclusion. The study concluded that the operationalization of the activities of the leishmaniases control program recognizes some weaknesses which explain the underscreening of cases. Improvement of this situation requires the implementation of continuous training programs for caregivers and awareness-raising programs for citizens which should focus on the mode of transmission, preventive measures against reservoirs, sand flies bites, and recognition of lesions using the popular names of the disease as a starting point.
Background. Cutaneous leishmaniasis is a neglected parasitic dermal disease transmitted to humans through the bite of an infected female sand fly. Morocco hopes to eliminate all forms of leishmaniasis by 2030. These dermatoses pose a real public health problem in the country. Although the information is available on the disease, individual knowledge of cutaneous leishmaniasis and sand fly is not yet developed. Exploring people’s beliefs and popular behaviours about cutaneous leishmaniasis and its vector allows health officials to know the sociocultural aspects of the disease and to improve prevention and control actions. Objectives. To identify the knowledge of cutaneous leishmaniasis and its vector in the population in central Morocco. Methods. Based on the epidemiological data of leishmaniases in the province of El Hajeb, we conducted a field survey and personal interviews in April and May 2019, among 281 persons belonging to the localities where leishmaniases were registered. Results. Our results show that the participants use the concept of “Chniwla” (61.6%) for sand fly and the concept of “Hboub Chniwla” (50.8%) for cutaneous leishmaniasis; 24.6% of the respondents do not know how the disease is transmitted to humans and 43.7% use traditional treatments and home remedies to cure themselves. 44% of participants believe that sand fly does not transmit the disease to humans and only 6.4% were aware of their responsibility in vector control. Conclusions. The study concluded that there is a need to simplify the scientific terminology in the health education of citizens regarding these dermatoses and their vector by integrating the popular concepts obtained in this study to raise public awareness and facilitate their involvement as active actors in the prevention of cutaneous leishmaniasis.
Sand flies are insect vectors of several diseases including leishmaniases. These vector-borne diseases represent a public health problem in several countries around the world, including Morocco. The objective of this study was to assess simultaneously the knowledge of health professionals and inhabitants on sand flies; a cross-sectional survey was conducted between April and June 2019 among 424 people, 34% of whom were health professionals and 66% of whom were inhabitants of the province of El Hajeb in central Morocco; 46.3% of doctors, 50.7% of nurses, 66.7% of midwives and 69.4% of inhabitants showed a low knowledge of sand flies. Most participants believed that sand flies breed in stagnant and polluted waters. Negative attitudes were found among 72.2% of the inhabitants. Factors associated with a high level of knowledge included continuing education among health professionals and information on vector-borne diseases among residents. The conceptual and cognitive gaps in the knowledge of sand flies reflect the lack of information and training on sand flies. The results of the sand fly knowledge review can be integrated into the national leishmaniases control program and the integrated vector management strategy to raise public awareness on the health risks of sand flies.
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