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The use of wastewater and excreta in agriculture constitutes an important source of spread Salmonella strains and protozoan infections into the environment. This practice has been used in El Azzouzia (the wastewater-spreading area of Marrakesh city, Morocco) for several years. The available circumstantial evidence gained from epidemiological and microbiological investigations suggests that the use of untreated wastewater causes an excess of protozoan infections among children living in El Azzouzia (72%) compared with those from a control area (45%). The pathogenic protozoan infections observed were giardiasis (39%) and amoebiasis (28%). For Salmonella infection, 21.34% of the exposed children were infected, while this rate did not exceed 1.14% in the control group. The serogroups B and C were the most commonly isolated. The sewage farming children are therefore more exposed to detectable risk from pathogenic micro-organisms than the control children.

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To address the problem of water scarcity, wastewater has long been used for agricultural purposes in Marrakech (Morocco) and its benefits have long been recognized. However, the benefits of urban wastewater reuse may be limited by its potential health hazards associated essentially to the danger of transmission of pathogenic organisms to human beings. The current study aimed to evaluate the risks associated with raw wastewater reuse for agricultural purposes, and the incidence of geohelminthic infections among the children of the wastewater spreading area of Marrakech as compared to a control group. Faecal samples from 610 individuals were examined for Ascaris spp. ova and Trichuris spp. ova (323 children for the exposed group and 287 for the control group). The study duration was two months and a half, and was carried out in the summer period. A questionnaire-interview with children and parents was used to collect data on possible demographic, hygiene and behavioural-contact factors such as gender, age, family size, source of water supply, parental occupation. The investigations resulted in the detection of Ascaris spp. ova in 43 samples indicating a point-prevalence of 13.3% in the exposed group versus 1.7% for the control group. Trichuris spp. ova was detected in 43 faecal samples indicating a point-prevalence of 13.3% in the exposed group, and 3.8% in the control group. The Chi-square test showed that the differences observed between the exposed and control group are statistically significant (p < 0.01). Males are more infected with ascariasis and trichuriasis than females and children of 2-8 years of age are heavily infected as compared to 9 - 14-year-old children. Based upon the findings of this study, it is concluded that wastewater reuse for agricultural purposes presents an increased risk of infection in the exposed group.

Cystic echinococcosis is a parasitic infection of major public health concern. The infection is generally acquired during childhood and the disease incubation period can last many years. The occurrence and characteristics of the disease in children were not well studied. The present study aimed to explore the pattern and features of cystic echinococcosis in children in rural and urban environments in Morocco. A total of 338 children diagnosed and treated for cystic echinococcosis were investigated. The trend of the infection, risk and exposure factors and the distribution of the anatomic locations of cysts were studied. A non-uniform decrease in proportions of infected children was found. Children from rural environs had significantly higher infection rates than children from urban environs (p \ 0.001). Males were significantly more infected than females. Children aged 7-11 years were the most affected. For cysts locations, single organ involvement was found in 94.4% of the children versus 5.6% with multi-organ localization. Despite control program, active transmission of echinococcosis still occurred in children and remains a major public health problem. The infection in younger population may have some features that need to be considered in the prevention and control programs in endemic areas.

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