Skip to main content
Top
Published in: Archives of Public Health 1/2015

Open Access 01-12-2015 | Research

Knowledge gaps on paediatric respiratory infections in Morocco, Northern Africa

Authors: Imane Jroundi, Chafiq Mahraoui, Rachid Benmessaoud, Cinta Moraleda, BadrSououd Benjelloun, Quique Bassat

Published in: Archives of Public Health | Issue 1/2015

Login to get access

Abstract

Background

The burden of acute respiratory infections (ARI) among Moroccan children remains significant. However, scarce information is available regarding trends in its epidemiology and etiology, or regarding its associated prognostic factors.
The purpose of this work was to review available data on the burden of ARI among children under five years of age in Morocco.

Methods

A systematic review was conducted for the period 1997–2014 using the PRISMA proposed methodology. Various online databases were screened, in addition to physical libraries of Moroccan medical schools, and official reports of the Moroccan Ministry of Health. Search queries in English and French languages included: Respiratory Tract Infections, pneumonia, epidemiology, etiology, microbiology, mortality and Morocco. The documents were included for analysis when they reported original data on the incidence, distribution, or a clinical description of the diseases or their etiology or described clinical management or national preventive strategies.

Results

Thirty-two documents were included in the final analysis. 21 of which had been published. In 2012, ARI caused 13% of paediatric deaths, half of the consultations at health facilities and third of the paediatric admissions. The microorganisms more frequently identified among hospitalized children were Streptococcus pneumoniae (38%) and Haemophilus influenza type b (Hib) (15%). The MOH introduced Hib vaccines into the national immunization program (PNI) in 2007and the 13-valent vaccine against pneumococcus in 2010. The national first line antibiotics recommended for non-severe ambulatory treatment is Amoxicillin. Studies of antibiotic resistance showed from 1998 to 2008 a 22% increase in the rate of penicillin non-susceptibility among Streptococcus pneumoniae isolates. Viral respiratory infections and the role attributed to air pollution in the incidence of ARI have been poorly characterized.

Conclusions

Further efforts should be made towards the development of adequate surveillance programs to better clarify the epidemiology, etiology, antimicrobial susceptibility patterns and the effectiveness of the preventives and curatives strategies in place against paediatric ARIs in Morocco. Additionally, a holistical approach should be used to identify the heath determinants of ARIs among children.
Literature
1.
go back to reference Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, et al. Global, regional, and national causes of child mortality in 2000–13, with a projections to inform post 2015 priorities: an updated systematic analysis. Lancet. 2014;375:1969–87. Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, et al. Global, regional, and national causes of child mortality in 2000–13, with a projections to inform post 2015 priorities: an updated systematic analysis. Lancet. 2014;375:1969–87.
3.
go back to reference Adegbola R. A Rationale and expectations of the Pneumonia Etiology Research for Child Health (PERCH) study. Expert Rev Respir Med. 2011;5(6):731–3.CrossRefPubMed Adegbola R. A Rationale and expectations of the Pneumonia Etiology Research for Child Health (PERCH) study. Expert Rev Respir Med. 2011;5(6):731–3.CrossRefPubMed
5.
go back to reference Zar HJ, Ferkol T W. The global burden of respiratory disease Impact on child health. Pediatr Pulmonol. 2014;49(5):430–4.CrossRefPubMed Zar HJ, Ferkol T W. The global burden of respiratory disease Impact on child health. Pediatr Pulmonol. 2014;49(5):430–4.CrossRefPubMed
6.
go back to reference Nair H, Simões Eric AF, Rudan I, Gessner BD, Azziz-Baumgartner E, Shayne F Zhang J, et al. Global and regional burden of hospital admissions for severe acute lower respiratory infections in young children in 2010: a systematic analysi. Lancet. 2013;381:1380–90.CrossRefPubMedPubMedCentral Nair H, Simões Eric AF, Rudan I, Gessner BD, Azziz-Baumgartner E, Shayne F Zhang J, et al. Global and regional burden of hospital admissions for severe acute lower respiratory infections in young children in 2010: a systematic analysi. Lancet. 2013;381:1380–90.CrossRefPubMedPubMedCentral
10.
go back to reference Direction de l’Epidémiologie et de Lutte contre les Maladies, Ministère de la Santé, Maroc. La lutte nationale contre les infections respiratoires aigues. Esperance Médicale. 2000;7(66):532–4. Direction de l’Epidémiologie et de Lutte contre les Maladies, Ministère de la Santé, Maroc. La lutte nationale contre les infections respiratoires aigues. Esperance Médicale. 2000;7(66):532–4.
11.
go back to reference Joseph F. Effect of the integrated management of childhood illness strategy on health care quality in Morocco. Int J Qual Health Care. 2006;18(2):134–44. Joseph F. Effect of the integrated management of childhood illness strategy on health care quality in Morocco. Int J Qual Health Care. 2006;18(2):134–44.
12.
go back to reference Bircher J, Kuruvilla S. Defining health by addressing individual, social, and environmental determinants: new opportunities for health care and public health. J Public Health Policy. 2014;35(3):363–86.CrossRefPubMedPubMedCentral Bircher J, Kuruvilla S. Defining health by addressing individual, social, and environmental determinants: new opportunities for health care and public health. J Public Health Policy. 2014;35(3):363–86.CrossRefPubMedPubMedCentral
13.
go back to reference Bland CJ, Meurer LN, Maldonado G. A systematic approach to conducting a non-statistical meta-analysis of research literature. Acad Med. 1995;70(7):642–53.CrossRefPubMed Bland CJ, Meurer LN, Maldonado G. A systematic approach to conducting a non-statistical meta-analysis of research literature. Acad Med. 1995;70(7):642–53.CrossRefPubMed
14.
go back to reference Lahrach J, Abourazzak S, Atmani S, Bouharrou A, Hida M. Pleurésie purulente chez l’enfant. A propos de 35 cas. Arch Pediatr. 2010;17(6S1):168.CrossRef Lahrach J, Abourazzak S, Atmani S, Bouharrou A, Hida M. Pleurésie purulente chez l’enfant. A propos de 35 cas. Arch Pediatr. 2010;17(6S1):168.CrossRef
15.
go back to reference Jroundi I, Benmessaoud R, Moraleda C, Tligui H, Seffar M, et al. The epidemiology and aetiology of infections in children admitted with clinical severe pneumonia to a university hospital in Rabat, Morocco. J Trop Paediatr. 2014;60(4):270–8.CrossRef Jroundi I, Benmessaoud R, Moraleda C, Tligui H, Seffar M, et al. The epidemiology and aetiology of infections in children admitted with clinical severe pneumonia to a university hospital in Rabat, Morocco. J Trop Paediatr. 2014;60(4):270–8.CrossRef
16.
go back to reference Hassani A. Respiratory infection in morocco: past, present and future. Pediatr Pulmonol. 2001;S23:153–4.CrossRef Hassani A. Respiratory infection in morocco: past, present and future. Pediatr Pulmonol. 2001;S23:153–4.CrossRef
17.
go back to reference Louriz and al. Clinical features of the initial cases of 2009 pandemic influenza A (H1N1) virus infection in a university hospital of Morocco. Int Arch Med. 2010;3:26.CrossRef Louriz and al. Clinical features of the initial cases of 2009 pandemic influenza A (H1N1) virus infection in a university hospital of Morocco. Int Arch Med. 2010;3:26.CrossRef
18.
go back to reference Lahlou A, Bajjou T, El Rhaffouli H, Laraqui A, Hilali F, Menouar K, et al. Pandemic influenza 2009 in Morocco: experience of M. V military teaching hospital, Rabat. Euro Surveill. 2011;16(23):15–21. Lahlou A, Bajjou T, El Rhaffouli H, Laraqui A, Hilali F, Menouar K, et al. Pandemic influenza 2009 in Morocco: experience of M. V military teaching hospital, Rabat. Euro Surveill. 2011;16(23):15–21.
19.
go back to reference Barakat A, Hassan I, Samira B, Imad C, Abderahman B, Mohammed Y, et al. Influenza surveillance among outpatients and inpatients in Morocco, 1996–2009. PloS One. 2011;6(9):e24579.CrossRefPubMedPubMedCentral Barakat A, Hassan I, Samira B, Imad C, Abderahman B, Mohammed Y, et al. Influenza surveillance among outpatients and inpatients in Morocco, 1996–2009. PloS One. 2011;6(9):e24579.CrossRefPubMedPubMedCentral
20.
go back to reference Belabbes H, El Mdaghri M, Redouani A, Benbachir M. Serotypes and antimicrobial susceptibilities of streptococcus pneumonia isolated in Casablanca between 1994 and 1997. Maroc Med. 2000;22(4):265–70. Belabbes H, El Mdaghri M, Redouani A, Benbachir M. Serotypes and antimicrobial susceptibilities of streptococcus pneumonia isolated in Casablanca between 1994 and 1997. Maroc Med. 2000;22(4):265–70.
21.
go back to reference Benbachir M, Benredjeb S, Boye CS, Dosso M, Belabbes H, Kamoun A, et al. Two-year surveillance of antibiotic resistance in Streptococcus pneumoniae in four African cities. Antimicrob Agents Chemother. 2001;45(2):627–9.CrossRefPubMedPubMedCentral Benbachir M, Benredjeb S, Boye CS, Dosso M, Belabbes H, Kamoun A, et al. Two-year surveillance of antibiotic resistance in Streptococcus pneumoniae in four African cities. Antimicrob Agents Chemother. 2001;45(2):627–9.CrossRefPubMedPubMedCentral
22.
go back to reference El Mdaghri N, Belabbes H, Najib J, Zerouali K, Benbachir M. Changing epidemiology of streptococcus pneumoniae in Morocco, 2006–2008. Implications for National Immunization Program. Clin Microbiol Infect. 2010;16(S2):468–9. El Mdaghri N, Belabbes H, Najib J, Zerouali K, Benbachir M. Changing epidemiology of streptococcus pneumoniae in Morocco, 2006–2008. Implications for National Immunization Program. Clin Microbiol Infect. 2010;16(S2):468–9.
23.
go back to reference El Mdaghri M, Benbachir M, Najib M, Belabbes H. Les infections invasives à pneumocoque chez l’enfant au Maroc : résistance aux antibiotiques et fluctuations des sérotypes responsables avant introduction des vaccins conjugés. RFL. 2009;S416:32–3. El Mdaghri M, Benbachir M, Najib M, Belabbes H. Les infections invasives à pneumocoque chez l’enfant au Maroc : résistance aux antibiotiques et fluctuations des sérotypes responsables avant introduction des vaccins conjugés. RFL. 2009;S416:32–3.
24.
go back to reference Borg MA and al. Prevalence of penicillin and erythromycin resistance among invasive Streptococcus pneumoniae isolates reported by laboratories in the southern and eastern Mediterranean region. Clin Microbiol Infect. 2009;15(3):232–7.CrossRef Borg MA and al. Prevalence of penicillin and erythromycin resistance among invasive Streptococcus pneumoniae isolates reported by laboratories in the southern and eastern Mediterranean region. Clin Microbiol Infect. 2009;15(3):232–7.CrossRef
25.
go back to reference Seffar M, Benouda A, Hajjam Z, Alaoui MA. Sensibilité aux antibiotiques des souches de pneumocoques isolées au CHU de Rabat. Méd et mal infect. 2002;32:525–32.CrossRef Seffar M, Benouda A, Hajjam Z, Alaoui MA. Sensibilité aux antibiotiques des souches de pneumocoques isolées au CHU de Rabat. Méd et mal infect. 2002;32:525–32.CrossRef
26.
go back to reference Benouda A, Ben Redjeb S, Hammami A, Sibille S, Tazir M, Ramdani BN. Antimicrobial resistance of respiratory pathogens in North African countries. J Chemother. 2009;21(6):627–32.CrossRefPubMed Benouda A, Ben Redjeb S, Hammami A, Sibille S, Tazir M, Ramdani BN. Antimicrobial resistance of respiratory pathogens in North African countries. J Chemother. 2009;21(6):627–32.CrossRefPubMed
27.
go back to reference Moustaoui N, Aitmhand R, Elmdaghri N, Benbachir M. Serotypes, biotypes and antimicrobial susceptibilities of Haemophilus influenzae isolated from invasive disease in children in Casablanca. Clin Microbiol Infect. 2000;6(1):48–9.CrossRefPubMed Moustaoui N, Aitmhand R, Elmdaghri N, Benbachir M. Serotypes, biotypes and antimicrobial susceptibilities of Haemophilus influenzae isolated from invasive disease in children in Casablanca. Clin Microbiol Infect. 2000;6(1):48–9.CrossRefPubMed
28.
go back to reference Jroundi I, Mahraoui C, Benmessaoud R, Moraleda C, Tligui H, Seffar M, et al. Antibiotic usage prior and during hospitalization for clinical severe pneumonia in children under five years of age in Rabat, Morocco. Antibiotic. 2013;2:450–64.CrossRef Jroundi I, Mahraoui C, Benmessaoud R, Moraleda C, Tligui H, Seffar M, et al. Antibiotic usage prior and during hospitalization for clinical severe pneumonia in children under five years of age in Rabat, Morocco. Antibiotic. 2013;2:450–64.CrossRef
29.
go back to reference Warda K, Oufdou K, Zahlane K, Bouskraoui M. Antibiotic resistance and serotype distribution of nasopharyngeal isolates of Streptococcus pneumoniae from children in Marrakech region (Morocco). J Infect Public Health. 2013;6(6):473–81.CrossRefPubMed Warda K, Oufdou K, Zahlane K, Bouskraoui M. Antibiotic resistance and serotype distribution of nasopharyngeal isolates of Streptococcus pneumoniae from children in Marrakech region (Morocco). J Infect Public Health. 2013;6(6):473–81.CrossRefPubMed
30.
go back to reference Jroundi I, Mahraoui C, Benmessaoud R, Moraleda C, Tligui H, Seffar M, et al. Risk factors for a poor outcome among children admitted with clinically severe pneumonia to a university hospital in Rabat, Morocco. Int J Infect Dis. 2014;14:S1201–9712. 01612-9. Jroundi I, Mahraoui C, Benmessaoud R, Moraleda C, Tligui H, Seffar M, et al. Risk factors for a poor outcome among children admitted with clinically severe pneumonia to a university hospital in Rabat, Morocco. Int J Infect Dis. 2014;14:S1201–9712. 01612-9.
31.
go back to reference El Idrissi-Raja L, Draïss G, Bourrous M, Amine M, Bouskraoui M. Survey on passive smoking in children in Agadir. Rev Pneumol Clin. 2011;67(5):289–97.CrossRefPubMed El Idrissi-Raja L, Draïss G, Bourrous M, Amine M, Bouskraoui M. Survey on passive smoking in children in Agadir. Rev Pneumol Clin. 2011;67(5):289–97.CrossRefPubMed
32.
go back to reference Houssaini AS, Messaouri H, Nasri I, Roth MP, Nejjari C, Benchekroun MN. Air pollution as a determinant of asthma among schoolchildren in Mohammedia Morocco. Int J Environ Health Res. 2007;17(4):243–57.CrossRefPubMed Houssaini AS, Messaouri H, Nasri I, Roth MP, Nejjari C, Benchekroun MN. Air pollution as a determinant of asthma among schoolchildren in Mohammedia Morocco. Int J Environ Health Res. 2007;17(4):243–57.CrossRefPubMed
33.
go back to reference Maynard-Tucker G. Parents’management of ARI in the Region of Marrakech. J Trop Paediatr. 1998;44(1):59–62.CrossRef Maynard-Tucker G. Parents’management of ARI in the Region of Marrakech. J Trop Paediatr. 1998;44(1):59–62.CrossRef
34.
go back to reference Center for Diseases Control and Prevention. Prevention of pneumococcal disease among infants and children — use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 2010;59:RR-11. Center for Diseases Control and Prevention. Prevention of pneumococcal disease among infants and children — use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 2010;59:RR-11.
35.
go back to reference Jackson S, Mathews KH, Pulanić D, Falconer R, Rudan I, Campbell H, et al. Risk factors for severe acute lower respiratory infections in children – a systematic review and meta-analysis. Croat Med J. 2013;54:110–21.CrossRefPubMedPubMedCentral Jackson S, Mathews KH, Pulanić D, Falconer R, Rudan I, Campbell H, et al. Risk factors for severe acute lower respiratory infections in children – a systematic review and meta-analysis. Croat Med J. 2013;54:110–21.CrossRefPubMedPubMedCentral
36.
go back to reference World Health Organization. WHO Report on the Global Tobacco Epidemic, 2013, Country profile, Morocco. World Health Organization. WHO Report on the Global Tobacco Epidemic, 2013, Country profile, Morocco.
Metadata
Title
Knowledge gaps on paediatric respiratory infections in Morocco, Northern Africa
Authors
Imane Jroundi
Chafiq Mahraoui
Rachid Benmessaoud
Cinta Moraleda
BadrSououd Benjelloun
Quique Bassat
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Archives of Public Health / Issue 1/2015
Electronic ISSN: 2049-3258
DOI
https://doi.org/10.1186/s13690-015-0076-x

Other articles of this Issue 1/2015

Archives of Public Health 1/2015 Go to the issue