To date, no culture-specific food frequency questionnaires (FFQ) are available in North Africa. The aim of this study was to adapt and examine the reproducibility and validity of an FFQ or use in the Moroccan population. The European Global Asthma and Allergy Network (GA2LEN) FFQ was used to assess its applicability in Morocco. The GA2LEN FFQ is comprised of 32 food sections and 200 food items. Using scientific published literature, as well as local resources, we identified and added foods that were representative of the Moroccan diet. Translation of the FFQ into Moroccan Arabic was carried out following the World Health Organization (WHO) standard operational procedure. To test the validity and the reproducibility of the FFQ, 105 healthy adults working at Hassan II University Hospital Center of Fez were invited to answer the adapted FFQ in two occasions, 1 month apart, and to complete three 24-h dietary recall questionnaires during this period. Pearson correlation, and Bland-Altman plots were used to assess validity of nutrient intakes. The reproducibility between nutrient intakes as reported from the first and second FFQ were calculated using intra-class correlation coefficient (ICC). All nutrients were log-transformed to improve normality and were adjusted using the residual method. The adapted FFQ was comprised of 255 items that included traditional Moroccan foods. Eighty-seven adults (mean age 27.3 ± 5.7 years) completed all the questionnaires. For energy and nutrients, the intakes reported in the FFQ1 were higher than the mean intakes reported by the 24-h recall questionnaires. The Pearson correlation coefficients between the first FFQ and the mean of three 24-h recall questionnaires were statistically significant. For validity, de-attenuated correlations were all positive, statistically significant and ranging from 0.24 (fiber) to 0.93 (total MUFA). For reproducibility, the ICCs were statistically significant and ranged between 0.69 for fat and 0.84 for Vitamin A. This adapted FFQ is an acceptable tool to assess usual dietary intake in Moroccan adults. Given its representativeness of local food intake, it can be used as an instrument to investigate the role of diet on health and disease outcomes.

Objective: In Morocco, the association between obesity/overweight and socio-demographic 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/m²) or overweight (25·0 ≤ BMI < 29·9 kg/m²) 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 = 3·02, 95 % CI 2·06, 4·44) compared to individuals <35 years old. Married women were more prone to obesity and overweight (OR = 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 = 2·62, 95 % CI 1·40, 4·87 for family income ≥5000 MAD/month compared to <2000 MAD/month) and in married persons (OR = 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.

Background: Dietary habits in Morocco are changing and the causes are not well understood. This study aimed to analyse socio-demographic factors associated with adherence to the Mediterranean diet (MeDi) in a national random sample of the adult Moroccan population. Methods: The data collected in this cross-sectional survey included socio-demographic factors and a food frequency questionnaire. MeDi adherence was assessed in 2214 individuals with complete dietary data. MeDi adherence was measured according to a simplified MeDi score based on the weekly frequency of intake of eight food groups (vegetables, legumes, fruits, cereal or potatoes, fish, red meat, dairy products and olive oil) with the use of the sex specific medians of the sample as cut-offs. A value of 0 or 1 was assigned to consumption of each component according to its presumed detrimental or beneficial effect on health. Logistic regression was used to estimate the association between MeDi adherence (low score 1-4 vs. high 5-8) and other factors. Results: Mean age of the sample was 41.4 (standard deviation 15.3) years, 45.4% were men and 29.9% had a low MeDi adherence. Married subjects (adjusted odds ratio ORa=0.68, 95% CI 0.55-0.84) were less likely to have a low MeDi adherence compared to single, divorced or widowed persons. Persons from rural areas (ORa=1.46, 95% CI: 1.02-2.08), were more often low MeDi adherents compared to those from urban areas. Obese persons (ORa=1.56, 95% CI: 1.16-2.11) were more prone to low MeDi adherence than normal weight individuals. Conclusion: MeDi is far from being a universal pattern in the Moroccan population. Intervention strategies should be implemented in target groups to maintain the traditional MeDi pattern considered as the original diet in Morocco.

BACKGROUND: The association between smoking and tuberculosis (TB) treatment failure has not yet been assessed in Morocco. OBJECTIVE: To evaluate the impact of smoking on the failure rate of patients with TB. METHODS: A cohort of 727 new TB cases was followed between 2004 and 2009. Socio-demographic measurements and smoking status were collected by questionnaire. Treatment failure was defined according to international guidelines. Univariate analyses were used to assess associations of treatment failure with smoking status and demographic characteristics. Multivariate logistic regression was used to adjust for potential confounding. RESULTS: The patients' mean age was 35.0 ± 13.2 years. The monthly household income was <€180 for 71.4% of the patients. The rate of treatment failure was 6.9%. Failure was significantly higher among smokers (9.1% vs. 4.5%; P < 0.01), alcohol drinkers (18.5% vs. 4.9%; P < 0.01), and those with a monthly income of <€180 (8.4% vs. 3.3%; P < 0.01). After adjusting for confounding variables, smoking and low income remained significantly associated with treatment failure (adjusted OR 2.25, 95%CI 1.06–4.76, and 3.23, 95%CI 1.12–9.32). CONCLUSION: Smoking is associated with TB treatment failure in Morocco. Anti-smoking interventions should be incorporated into current TB case management.

Data on psychoactive substance (PAS) consumption among adolescents in the North Center of Morocco are not at all available. Therefore, the current study aimed at investigating the prevalence and the determinants of psychoactive substances use among middle and high school students in this region. A cross-sectional study was conducted from April 2012 to November 2013 in public middle and high schools in the North Central Region of Morocco. An anonymous self-administered questionnaire was used to assess psychoactive substances use among a representative sample of school students from the 7th to the 12th grade, aged 11–23 years, selected by stratified cluster random sampling. Factors associated with psychoactive substance use were identified using multivariate stepwise logistic regression analyses. A total of 3020 school students completed the questionnaires, 53.0 % of which were males. The overall lifetime smoking prevalence was 16.1 %. The lifetime, annual and past month rates of any psychoactive substance use among the study subjects were 9.3, 7.5, and 6.3 % respectively. Cannabis recorded the highest lifetime prevalence of 8.1 %, followed by alcohol 4.3 %, inhalants 1.7 %, psychotropic substances without medical prescription 1.0, cocaine 0.7, heroine 0.3, and amphetamine with only 0.2 %. Psychoactive substance use was associated with males more than females. The risk factors identified by multivariate stepwise logistic regression analyses were being male, studying in secondary school level, smoking tobacco, living with a family member who uses tobacco, and feeling insecure within the family. The prevalence among all school students reported by the current study was comparable to the national prevalence. Efforts to initiate psychoactive substance prevention programs among school students should be made by designing such programs based on the significant factors associated with psychoactive substance use identified in this study.

Suicidal behavior is a major cause of injury and death worldwide, especially among adolescents and young adults. Few studies have tackled this issue in the Arab world. The present study investigated the prevalence and the risk factors of suicidal behaviors among Moroccan school students. From April 2012 to November 2013, a cross-sectional study was conducted in the North-Centre region of Morocco among students in public secondary schools selected using stratified cluster random sampling. The data were collected via anonymous self-administered questionnaires. The Mini International Neuropsychiatric Interview was used in its Moroccan Colloquial Arabic version to assess suicidality according to the DSM-IV criteria. A total of 3020 students (53 % boys) aged 11–23 years (average age = 16 ± 2.1 years) were included in the study. The prevalence of suicide ideation, suicide planning and suicide attempts during the last month were 15.7, 6.3, and 6.5 % respectively. Univariate analyses demonstrated that suicidal behaviors followed different epidemiological patterns. According to the multivariate analyses, the risk factors for all suicidal behaviors among Moroccan school students were the female gender, middle school level, urban locations, low family income, parents’ divorce, tobacco consumption and psychoactive substances (alcohol and cannabis) use. The intervention of preventive programs has become an emergency to overcome the issue of suicidality in Morocco. Further researches on adolescents’ suicidal behaviors are suggested to update temporal data and assess the effectiveness of potential interventions.