BackgroundSnakebites cause considerable death and injury throughout the globe, particularly in tropical regions, and pose an important yet neglected threat to public health. In 2008, the Centre Anti Poison et de Parmacovigilance du Maroc (CAPM) started to set up a specific strategy for the control of snakebites that was formalized in 2012. The aim of the present study is to describe and update the epidemiological characteristics of snakebites notified to CAPM between 2009 and 2013.MethodsThis retrospective five-year study included all cases of snakebites notified to CAPM by mail or phone.ResultsDuring the study period, 873 snakebite cases were reported to CAPM, an average incidence of 2.65 cases per 100,000 inhabitants with 218 cases each year. The highest incidence was found in Tangier-Tetouan region with 357 cases (40.9 %) followed by Souss Massa Draa region with 128 cases (14.6 %). The average age of patients was 26.8 ± 17.2 years. The male to female sex ratio was 1.67:1 and 77 % of cases occurred in rural areas. The bites occurred mainly in spring (44 %) followed by summer (42 %). Snake species was identified in 54 cases (6.2 %): colubrids represented 31 % (n = 18) and vipers 67 % (n = 36), mainly Daboia mauritanica, Bitis arietans and Cerastes cerastes. In 311 cases (35.6 %), the patients showed viper syndrome. Thrombocytopenia was observed in 23.5 % of viper syndrome cases, whereas, compartment syndrome was observed in 7.6 % patients. FAV-Afrique® was administered in 41 patients (5 %). In patients treated with antivenom, 38 patients recovered and three died. Twenty-seven deaths were reported (3.9 %).ConclusionDespite specific efforts to better understand the epidemiology of snakebites in Morocco (incidence, severity, snake species involved), it remains underestimated. Therefore, further work is still necessary to ensure accessibility of appropriate antivenom against venomous species and to improve the management of envenomation in Morocco.

Acute pesticide poisoning among children is a reality in Morocco. Preventive measures may be needed.

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Résumé -Objectif : Déterminer les facteurs prédictifs de gravité des intoxications aiguës aux pesticides reçues au Centre Antipoison du Maroc (CAPM).Méthodes : Une étude rétrospective des cas d'intoxication reçus par téléphone au niveau du CAPM a été réalisée entre janvier 1992 et décembre 2007. L'évaluation de la gravité s'est faite par le poisoning score severity (PSS). L'analyse descriptive a porté sur l'âge, le sexe, les circonstances, le délai post intoxication, le type d'usage et la classe chimique du pesticide. Une analyse univariée a été effectuée afin d'identifier les facteurs de risque. Résultats : Au total, 2609 appels concernant des cas d'intoxication par pesticide ont été reçus au CAPM, soit 11,3 % de l'ensemble des cas d'intoxication. L'âge moyen était de 19,1 ± 14,5 ans. L'étiologie accidentelle était la plus fréquente (50,1 %) suivie de l'autolyse (42,2 %). Le sex ratio était de 0,93. La voie orale était la plus incriminée (81,9 %). Les patients se présentaient en grade 2 ou en grade 3 dans 45,1 % des cas. La mortalité était de 4,8 %. Les insecticides étaient impliqués dans 54,3 % des cas suivis par les raticides (34 %). Les organophosphorés étaient la classe chimique la plus retrouvée (30 %). Les raticides minéraux représentaient la cause la plus fréquente de décès. Plusieurs facteurs ont été considérés comme facteurs prédictifs du décès à savoir le poisoning score severity (PSS) (P < 10 −4 ), l'âge (P = 0,0108), la voie orale (P = 0,0336), la circonstance volontaire (P = 0,95×10 −4 ), le type d'usage (P = 0,016), et la classe chimique du pesticide (P < 10 −4 ). Conclusion : Les intoxications aiguës par pesticides sont une réalité au Maroc. Les parents et les professionnels de santé doivent être conscients du danger potentiel de ces intoxications afin de les prévenir ou de prévenir leurs conséquences. Mots clés : Intoxication, pesticide, organophosphorés, phosphure d'aluminium, centre antipoisonAbstract -Objective: The purpose of our study is to evaluate risk factors for acute pesticide poisoning received in Poison Control Centre of Morocco. Patients and Methods: This is a retrospective study. We collected all cases related to pesticide poisoning received by telephone to the poison control centre of Morocco from January 1992 to December 2007. Patients were classified according to the poisoning score severity (PSS). We analyzed demographic features, circumstances, outcome, type of pesticide and compounds. To detect the possible relationship between two variables; correlations were used. Results: 2609 cases were collected, representing 11.3% of all of poisonings. The mean age was 19.1 ± 14.5 years; range 1 day to 84 years. The female sex is more prevalent; sex ratio was 0.93. 50.1% of cases were accidental exposures and 42.2% were suicide attempts. Oral route was involved in 81.9% of cases and inhalation in 9.27%. Patients were classified in grade 2 (PSS) or grade 3 in 45.1%. The mortality was 4.8%. Insecticides were implicated in 54.3% and included organophosphates (30%). Mineral rodenticides wer...

In Morocco, acute Atractylis gummifera L. poisoning represents the leading cause of death by plant poisoning especially for children. All cases received in the Moroccan poison control centre from January 1981 to December 2009 (n = 467) were included in a retrospective study of the characteristics and risk factors of A. gummifera L. poisoning The most vulnerable age group was children (63.4% of cases). Most cases were due to accidental exposure (75.5%), but some were from therapeutic use (18.1%) or attempted abortion (7.4%). Patients presented with moderate poison severity signs (grade 2) in 22.3% of cases or severe signs (grade 3) in 21.0%. The mortality rate was 39.2%. The majority of deaths (81.1%) occurred in children aged < 15 years following accidental exposure. Multivariate logistic regression analysis revealed that risk factors for mortality were coma (OR = 20.5); hepatitis (OR = 52.7) and rural residence (OR = 7.26), while gastric decontamination was a protector factor (OR = 0.26). Medicine and Pharmacy of Fez, Fez, Morocco (Correspondence to S. Achour: achoursanae@gmail.com 1 Laboratory of Toxicology, University Hospital and Faculty of