Evaluation of Provider Skills in Performing Visual Inspection with Acetic Acid in the Cervical Cancer Screening Program in the Meknes-Tafilalet Region of Morocco

Selmouni, Farida,Sauvaget, Catherine,Zidouh, Ahmed,Plaza, Consuelo Alvarez,Muwonge, Richard,Rhazi, Karima El,Basu, Partha,Sankaranarayanan, Rengaswamy Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.9

Background: This study documented the performance of providers of visual inspection with acetic acid (VIA) at primary health centers, assessing their compliance with the VIA skills checklist and determinants of non-compliance, and exploring their perceptions of VIA training sessions. Materials and Methods: A cross-sectional study was conducted among VIA providers in the $Mekn\grave{e}s$-Tafilalet region of Morocco. Structured observation of their performance was conducted through supervisory visits and multiple focus group discussions (FGDs). Results: Performance of all the recommended steps for effective communication was observed in a low proportion of procedures (36.4%). Midwives/nurses had higher compliance than general practitioners (GPs) (p<0.001). All recommended steps for VIA examination were performed for a high proportion of procedures (82.5%). Compliance was higher among midwives/nurses than among GPs (p<0.001) and among providers in rural areas than those in urban areas (p<0.001). For pre-VIA counselling, all recommended steps were performed for only 36.8% of procedures. For post-VIA counseling, all recommended steps were performed in a high proportion (85.5% for VIA-negative and 85.1% for VIA-positive women). Midwives/nurses had higher compliance than GPs when advising VIA-positive women (p=0.009). All infection prevention practices were followed for only 14.2% of procedures, and compliance was higher among providers in rural areas than those in urban areas (p<0.001). Most FGD participants were satisfied with the content of VIA training sessions. However, they suggested periodic refresher training and supportive supervision. Conclusions: Quality assurance of a cervical cancer screening program is a key element to ensure that the providers perform VIA correctly and confidently.

Calculation of X-ray spectra characteristics and kerma to personal dose equivalent Hp(10) conversion coefficients: Experimental approach and Monte Carlo modeling

A. Arectout,I. Zidouh,Y. Sadeq,M. Azougagh,B. Maroufi,E. Chakir,H. Boukhal 한국원자력학회 2022 Nuclear Engineering and Technology Vol.54 No.1

This work aims to establish some X-ray qualities recommended by the International Standard Organization(ISO) using the half-value layer (HVL) and Hp(10) dosimetry approaches. The HVL values of thefollowing qualities N-60, N-80, N-100, N-150 and N-250 were determined using various attenuationlayers. The obtained results were compared to those of reference X-ray beam qualities and a goodagreement was found (difference less than 5% for all qualities). The GAMOS (Geant4-based Architecturefor Medicine-Oriented Simulations) radiation transport Monte Carlo toolkit was employed to simulatethe production of X-ray spectra. The characteristics HVLs, mean energy and the spectral resolution ofsimulated spectra have been calculated and turned out to be conform to the ISO reference ones (differenceless than the limit allowed by ISO). Furthermore, the conversion coefficients from air kerma topersonal dose equivalent for simulated and measured spectra were fairly similar (the maximum differenceless than 4.2%)

Cervical Cancer in Morocco: Epidemiological Profile from Two Main Oncological Centers

Berraho, Mohamed,Bendahhou, Karima,Obtel, Majdouline,Zidouh, Ahmed,Benider, Abdellatif,Errihani, Hassan,Nejjari, Chakib Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.7

Background: In Morocco, the epidemiological profile of cervical cancer is not well established. The focus of the present study was both epidemiological and pathological characteristics. Methods: For all cases of cervical cancer treated between 2003 and 2007 in the National Institute of Oncology and the Oncology Department of the IbnRochd hospital (Casablanca), 900 cases were randomly selected. Results: The mean age was $52.1{\pm}11.8$ years. The most (90.5%) represented histological type was squamous cell carcinoma. For more than 57.0% cases the mean distance between patient's origin and center of treatment was greater than 100km. According to the FIGO classification, only 17.2% of patients were identified as being in early stages (0 and I). For 72.2% patients the follow-up did not exceed 2 years. At 1 year of following-up 55.8% of patients were alive and 43.4% were lost to following-up. Conclusion: Our study addressed the issue of the burden of cervical cancer in Morocco. The result provides a basis for decision-makers for the development of strategic measures to implement the fight against cervical cancer in Morocco.

Health-Related Quality of Life among Breast Cancer Patients and Influencing Factors in Morocco

El Fakir, Samira,El Rhazi, Karima,Zidouh, Ahmed,Bennani, Maria,Benider, Abdelatif,Errihani, Hassan,Mellass, Nawfel,Bekkali, Rachid,Nejjari, Chakib Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.12

Background: Breast cancer is the most common cancer among women in most countries of the world. It is ranked first in females in Morocco (accounting for 33.4% of the total cancer burden) and more than 60% of cases are diagnosed at stage III or IV. During the last decade, health-related quality of life (HRQOL) has become an important aspect of breast cancer treatment. The objective of this study was to describe self-reported HRQOL in patients with breast cancer and to investigate its associations with sociodemographic and clinical variables. Methods: A prospective study was carried out in the main oncology centers in Morocco. Quality of life was measured using the Moroccan Arabic versions of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C 30 (EORTC QLQ C30) and the Breast Cancer-Specific Quality of Life Questionnaire (EORTC QLQ-BR23). Statistical analyses were performed using descriptive statistics and multivariate analyses. Results: A total of 1463 subjects were included in the study, with a mean age of 55.6 (SD. 11.2) years, 70% being married. The majority had stage II (45.9%) and a few cases stage IV (12.9%) lesions. The participants' global health mean score was 68.5 and in "functional scales", social functioning scored the highest (Mean 86.2 (SD=22.7)). The most distressing symptom on the symptom scale was financial difficulties (Mean 63.2 (SD=38.2)). Using the disease specific tool, it was found that future perspective scored the lowest (Mean 40.5 (SD=37.3)). On the symptom scale, arm symptoms scored the highest (Mean 23.6 (SD=21.6)). Significant mean differences were noted for many functional and symptom scales. Conclusion: Our results emphasized that the general HRQOL for our study population is lower than for corresponding populations in other countries. This study provided baseline information on the quality of life for a large sample of Moroccan women diagnosed with breast cancer.

Organization and Evaluation of Performance Indicators of a Breast Cancer Screening Program in Meknes-Tafilalt Region, Morocco

Charaka, Hafida,Khalis, Mohamed,Elfakir, Samira,Khazraji, Youssef Chami,Zidouh, Ahmed,Abousselham, Loubna,El Rhazi, Karima,Lyoussi, Badiaa,Nejjari, Chakib Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.12

Objective: The benefits of screening and early detection of breast cancer, including reduced morbidity and mortality, have been well-reported in the literature. In 2011, a breast cancer screening program was launched in Meknes-Tafilalt region of Morocco. The aim of this study was to evaluate the early performance indicators of this program. Materials and Methods: This retrospective evaluative study was conducted between April 2012 and December 2014, in Meknes-Tafilalt region of Morocco. Several performance indicators of the breast cancer screening program were calculated: the compliance rate, the positivity rate, the referral rate, the cancer detection rate and the organizational indicators. Results: During 2012-2014, a total of 184,951 women participated in the breast cancer screening program. The compliance rate was 26%, the positive rate was 3.3%, the referral rate was 36.7%, and the cancer detection rate was 1.2 per 1,000 women. The median time between the date of clinical breast examination and the date of biopsy (or cyto-puncture) was 36 days. The median time between the date of positive mammography and the date of biopsy (or cyto-puncture) was 6 days. The median time between the date of clinical breast examination and the date of the first received treatment was 61 days. Conclusions: The program needs better monitoring, as well as implementation of quality assurance tools to improve performance in our country.