Objective: In Morocco, the association between obesity/overweight and sociodemographic and lifestyle factors is poorly understood. The present study aimed to investigate this association in a representative sample of the Moroccan population aged 18 years and above. Design: This is a cross-sectional study using a questionnaire including demographic, socio-economic and physical activity items. Height and weight were measured and BMI was computed. The association between obesity (BMI $ 30?0 kg/m 2 ) or overweight (25?0 # BMI , 29?9 kg/m 2 ) and the other variables was analysed using multiple binomial logistic regression, separately in men and women. Setting: The whole Moroccan territory. Subjects: A total of 2891 subjects took part in the survey (1430 men and 1461 women). Results: The prevalence of obesity was 20?9 % in women and 6?0 % in men (P , 0?0001). The prevalence of overweight was 32?9 % in women v. 26?8 % in men (P , 0?0001). In women, the risk of obesity and overweight increased with age, with the highest risk being in individuals aged 45-54 years (OR 5 3?02, 95 % CI 2?06, 4?44) compared to individuals ,35 years old. Married women were more prone to obesity and overweight (OR 5 2?42, 95 % CI 1?50, 3?91) than single women. In men, the risk of obesity and overweight increased with average family income (OR 5 2?62, 95 % CI 1?40, 4?87 for family income $5000 MAD/month compared to ,2000 MAD/month) and in married persons (OR 5 3?75, 95 % CI 1?78, 7?81) compared to single individuals. Conclusions: These results contribute to target groups in whom prevention programmes could be implemented.

IntroductionStudies have shown an association between smoking and tuberculosis (TB) infection, disease and TB-related mortality. We thus documented the impact of smoking and others factors on TB treatment default.MethodsA cohort of 1039 new TB cases matched on smoking status was followed between 2004 and 2009 in eight Moroccan regions. Treatment default was defined according to international criteria. Univariate analyses were used to assess associations of treatment default with smoking status and demographic characteristics. Multivariate logistic regression was used to adjust for potential confounding.ResultsPatients’ mean age was 35.0 ±13.2 years. The rate of treatment default was 30.2%. Default was significantly higher among men, smokers, persons living in urban areas and non-religious Muslims. After adjusting for confounding variables, factors that remained significantly associated with treatment default were: being male (OR = 3.2; 95% CI: 1.2-8.7), being a non-religious Muslim (OR = 2.0; 95% CI: 1.4-2.9) and living in an urban area OR = 3.0; 95% CI: 1.8-4.9).ConclusionThe high rate found for default suggests important program's inadequacies and an urgent need for change. Therefore continued research of predictors of default and strategies to reinforce adherence is recommended.

Cigarette smoking remains an important public health problem in Morocco. A comprehensive strategy for tobacco control is needed.

BackgroundWorldwide, cervical cancer is the second most common cancer in women. High-risk human papillomavirus (HPV) play a crucial role in the etiology of cervical cancer and the most prevalent genotype is HPV16. HPV 16 intratypic variants have been reported to differ in their prevalence, biological and biochemical properties. The present study was designed to analyze and identify HPV type 16 E6 variants among patients with cervical cancer in Morocco.MethodsA total of 103 HPV16 positive samples were isolated from 129 cervical cancer cases, and variant status was subsequently determined by DNA sequencing of the E6 gene.ResultsIsolates from patients were grouped into the European (E), African (Af) and North-American (NA1) phylogenetic clusters with a high prevalence of E lineage (58.3%). The Af and NA1 variants were detected in 31.1% and 11.6% of the HPV16 positive specimens, respectively, whereas, only 3% of cases were prototype E350T. No European-Asian (EA), Asian (As) or Asian-American (AA) variants were observed in our HPV16-positive specimens. At the amino acid level, the most prevalent non-synonymous variants were L83V (T350G), H78Y (C335T), E113D (A442C), Q14D (C143G/G145T) and R10I (G132T), and were observed respectively in 65%, 41.8%, 38.8%, 30.1% and 23.3% of total samples.Moreover, HPV16 European variants were mostly identified in younger women at early clinical diagnosis stages. Whereas, HPV16 Af variants were most likely associated with cervical cancer development in older women with pronounced aggressiveness.ConclusionThis study suggests a predominance of E lineage strains among Moroccan HPV 16 isolates and raises the possibility that HPV16 variants have a preferential role in progression to malignancy and could be associated with the more aggressive nature of cervical cancer.

BackgroundDetermining risky behaviours of adolescents provides valuable information for designing appropriate intervention programmes for advancing adolescent’s health. However, these behaviours are not fully addressed by researchers in a comprehensive approach. We report the protocol of a mixed methods study designed to investigate the health risk behaviours of Moroccan adolescents with the goal of identifying suitable strategies to address their health concerns.MethodsWe used a sequential two-phase explanatory mixed method study design. The approach begins with the collection of quantitative data, followed by the collection of qualitative data to explain and enrich the quantitative findings. In the first phase, the global school-based student health survey (GSHS) was administered to 800 students who were between 14 and 19 years of age. The second phase engaged adolescents, parents and teachers in focus groups and assessed education documents to explore the level of coverage of health education in the programme learnt in the middle school. To obtain opinions about strategies to reduce Moroccan adolescents’ health risk behaviours, a nominal group technique will be used.DiscussionThe findings of this mixed methods sequential explanatory study provide insights into the risk behaviours that need to be considered if intervention programmes and preventive strategies are to be designed to promote adolescent’s health in the Moroccan school.

BMI below 22 kg/ m(2) is a risk factor for 13-year mortality in older people, but our findings suggest that overweight and obesity may not be associated to mortality after adjustment for established mortality risk factors.

BackgroundLimited national information is available in Morocco on the prevalence and distribution of HPV-sub-types of cervical cancer and the role of other risk factors. The aim was to determine the frequency of HPV-sub-types of cervical cancer in Morocco and investigate risk factors for this disease.MethodsBetween November 2009 and April 2012 a multicentre case-control study was carried out. A total of 144 cases of cervical cancer and 288 age-matched controls were included. Odds-ratios and corresponding confidence-intervals were computed by conditional logistic regression models.ResultsCurrent HPV infection was detected in 92.5% of cases and 13.9% of controls. HPV16 was the most common type for both cases and controls. Very strong associations between HPV-sub-types and cervical cancer were observed: total-HPV (OR = 39), HPV16 (OR = 49), HPV18 (OR = 31), and multiple infections (OR = 13). Education, high parity, sexual intercourse during menstruation, history of sexually transmitted infections, and husband’s multiple sexual partners were also significantly associated with cervical cancer in the multivariate analysis.ConclusionsOur results could be used to establish a primary prevention program and to prioritize limited screening to women who have specific characteristics that may put them at an increased risk of cervical cancer.

These findings suggest that the relationship between long-term mortality and dyspnea is strong, consistent and independent of other covariates in the elderly.