Secular trends in consultations for asthma in early childhood, the 16 administrative regions of Morocco, 2004–2012

Abstract

BackgroundLittle is known about asthma trend in Morocco, particularly in early childhood. Furthermore, when dealing with asthma related environmental risk factors in Morocco, decision-making focus is in one region R9, while 16 regions make up the country. This work aims at studying 9-year trends in consultations for asthma in under-5 children in the 16 individual regions with respect to area and age group.MethodsDirect method use, based on the only available national data from the open access files of the ministry of health, standardizing data for three age groups (0–11 ; 12–23 and 24–59 months). We compared age-adjusted rates, stratified by area (urban and rural areas) within each region (Wilcoxon's signed ranks test), and between all regions emphasizing on R9. Secular trends are examined (Kendall's rank correlation test). We also compared directly standardized rates as a rate ratio for two study populations (that of R9 and any region with highest rates). We finally compared rates by age group in selected regions.ResultsSecular increase in prevalence rates was shown in both urban and rural Morocco, particularly in urban areas of R10, R14, R16 and R5, and in rural areas of R14 and R16. In urban area of R10 (the highest age-adjusted prevalence rates area) the rates showed secular increase from 6.82 at 95 % CI = [6.44 to 7.19] per 1000 childhood population in 2004 to 20.91 at 95 % CI = [20.26 to 21.56] per 1000 childhood population in 2012 (P = 0.001). Rates were higher in urban than rural Morocco, particularly in R8, R9, R10, R14, R15 ; R6 was an exception. Rates in R10 were 1.63 higher than that in R9 in 2004 and rose to be 2.55 higher in 2012 ; rates in urban area of R14, about 3 times lower than that in R9 in 2004, increased to be similar in 2012. The highest-prevalence age group varied according to region and area.DiscussionThe regions that worth decision making attention are the urban areas of R10 (the highest prevalence rates Moroccan area, showing continuous increase), of R9, of R14 and the rural area of R6. The rates in the urban area of R9 (a current continuous decision making focus) remained high but stable within the study period and less important than those in R10. Environmental factors (biological particules, non-biological particules or gazes) are suspected.The potential unavailability of treatment at regular basis at the primary health care centers may reduce frequency of consultations for asthma in early childhood : outpatients may consult only if asthma causes problems in an attempt to get free medicines ; chances of outpatients' follow-up by the primary health care center's physicians are therefore reduced and optimal asthma control is not achieved.ConclusionSocial, health care policy and environmental factors, to which decision-making has to be responsive, are suspected to be affecting both frequency of and time secular trend in consultations for asthma in early childhood in Morocco.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2262-8) contains supp...

Characteristics of Patients with Asthma and Asthma Control: A Retrospective Analysis of Reported Data from Primary Healthcare Centers in Agadir city, Morocco (2013 - 2019)

“…The estimated prevalence from 2013 to 2019 is between 0.02% and 0.11%, which is much lower than that recorded at the regional level (about 2.4%) [19], and at the national level and compared to other cities [11,12,14,15,20,21].…”

“…Cases by gender are similar in proportion to the AIRMAG study [15]. The most affected age group depends on each PHC, where the average age is 43 year, which it is similar to the regional average age [19] and higher compared to the national average age [23]. Among all recorded cases, the first visit to the PHCs was in the first trimester (45.36%), which may generally be explained by meteorological conditions, climate change and pollen exposure [4,24].…”

“…In this study, we identify some characteristics of asthma cases and its control in the population of Agadir city. The results indicate a spatial and temporal variation of the reported cases during the period from 2013 to 2019, which may be due, at first glance, to an increase in cases, whereas it seems to be a problem of reporting, traceability, geographical accessibility, and availability of medication [19]. At the national level, this variability was observed by region and by zone [19].…”

“…It can be stated that these asthmatics only come to the PHCs in case of complications and to get free drugs. Asthma control by PHCs physicians is therefore not optimal [19]. Probably attributed to insufficient therapeutic education, which is an important factor in ensuring optimal control [27], or the caregivers' level of knowledge [28].…”

Asthma in Morocco: Retrospective Analysis of Case Characteristics reported by Hospital Units

“…In both urban and rural Morocco, there has been a steady increase in prevalence rates. Depending on the region and area, the highest-prevalence age group fluctuated Sadeq et al, (2015). In 2012, the adjusted prevalence of asthma consultations in children aged less than five years in the Souss-Massa-Draa region was between 1 and 5 per 1000.…”