Cutaneous leishmaniasis (CL) is a major public health problem in Morocco. Three distinct parasites are involved; Leishmania tropica, Leishmania major and Leishmania infantum. The objective of this study is to investigate the epidemiological and the clinical features of endemic foci of CL in Sidi Kacem and Ouazzane provinces in the north of Morocco including molecular identification of parasites. We studied the evolution and the distribution of 1,656 CL cases coming from 39 sectors in these provinces between 1997 and 2012. The causative agents of CL in these areas were identified by using the ITS1-PCR-RFLP method. A tendency of seasonality in incidence was observed, showing a peak in April. Most infected patients were from Ouazzane province. The patients' ages ranged from 6 months to 85 years; 54% of them were females. The highest rate lesions were found in the age group of 9 years or less and most lesions were localized in the face (79.6%). The movement of populations from neighboring endemic areas and establishment of habitation in areas where housing conditions are unfavorable favored the emergence of the disease.

Chronic metabolic acidosis (CMA) is a major cause of growth defect, implying disturbances of protein metabolism. Previously, in vivo studies performed in the fasting state showed enhanced whole body protein turnover, whereas in vitro studies showed unchanged muscle protein synthesis. The present study is the first to determine the effects of CMA on muscle protein synthesis and degradation in vivo. Two studies were performed in 60 g male rats fed a 30% casein diet. In study I, one group was sham-operated (C rats), and two groups underwent subtotal nephrectomy. One of them developed acidosis (UA rats) which was corrected in the other by NaHCO3 in the diet (UNA rats). Study II compared sham-operated rats rendered acidotic by NH4Cl in the drinking water (CA rats) and normal pair-fed (CNA) rats. Fractional protein synthesis rate (FSR) was determined in gastrocnemius muscle after injection of 3H-phenylalanine. Fractional protein degradation rate (FDR) was calculated as FSR minus fractional rate of muscle growth (FGR). In study I, UA rats had lower growth and N balance (163 +/- 12 vs. 216 +/- 11 mg N/day; P < 0.001) than UNA rats, despite identical food intake (11 g/day). This was associated with identical FSR (10.4 +/- 0.5 vs. 10.9 +/- 0.5%/day), but enhanced protein degradation (6.30 +/- 0.99 vs. 5.10 +/- 0.71%/day; P < 0.05). Plasma insulin, C peptide, PTH and corticosterone did not differ in UA and UNA rats, whereas plasma IGF-I was markedly reduced (147 +/- 21 vs. 283 +/- 27 ng/ml; P < 0.01) in UA rats.(ABSTRACT TRUNCATED AT 250 WORDS)

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