K. El Rhazi

Centre Hospitalier Universitaire Hassan II, Fez, Fès-Boulemane, Morocco

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Publications (67)75.78 Total impact

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    ABSTRACT: Background This study aims to explore the perception and satisfaction of cervical cancer screening by Visual Inspection with Acetic acid (VIA) in Meknes-Tafilalet Region among target women. Methods A cross-sectional study was conducted using face-to-face interviews with women, routinely attending health centers, who met the inclusion criteria. Descriptive analysis was undertaken to report data. Results A total of 324 women were included in the study. Results revealed low awareness about cervical cancer (19.6 %) and a very high acceptability of VIA screening (94.5 %). Of the 306 women screened, 99 % stated that they would recommend the VIA testing to their friends and female relatives. All those women who were screened negative expressed their intent to repeat the test every three years. Those found VIA positive affirmed they would perform confirmatory explorations. The majority (96.3 %) of the women believed that screening by VIA could save their lives; cervical cancer was a concern for 98.6 %; and only 11.6 % felt anxious about repeating the VIA test. The majority of women (98.6 %) were satisfied with the service received at the health center. Conclusions This study showed that the participants had a strong perception about cervical cancer screening and were willing to have further confirmation or future retests. Electronic supplementary material The online version of this article (doi:10.1186/s12905-015-0268-0) contains supplementary material, which is available to authorized users.
    BMC Women's Health 12/2015; 15(1). DOI:10.1186/s12905-015-0268-0 · 1.50 Impact Factor
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    ABSTRACT: Background: 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. Methods: 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. Results: 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. Conclusions: 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.
    BMC Psychiatry 12/2015; 15(1). DOI:10.1186/s12888-015-0680-x · 2.21 Impact Factor
  • Z Selihi · M Berraho · K El Rhazi · Y El Achhab · B Lyoussi · C Nejjari ·
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    ABSTRACT: Degenerative complications as a result of diabetes impose a heavy disease burden and increase mortality. This study presents epidemiological and clinical profiles of diabetic patients in the EpiDiaM cohort study, which include 1196 diabetic cases recruited from the basic health care network in the city of Fez. The mean age of the participants was 57.5 (SD 10.4) years with 47.1% aged between 50 and 60 years. The majority (77.7%) were women. The mean duration of diabetes was 8 (SD 6.6) years. Hypertension was found in 49.3% of the cohort, 77.9% were overweight or obese and 63.8% had one or more complications. Among those with complications, retinopathy was the most common (69.4%), followed by heart conditions (50.8%), neuropathy (45.6%) and renal disease (4.8 %). The high prevalence of complications emphasizes the need to address the avoidable risk factors and prevent complications.
    Eastern Mediterranean health journal = La revue de santé de la Méditerranée orientale = al-Majallah al-ṣiḥḥīyah li-sharq al-mutawassiṭ 09/2015; 21(6):448-50.

  • The International Journal of Tuberculosis and Lung Disease 07/2015; · 2.32 Impact Factor
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    ABSTRACT: Colorectal Cancers (CRC) are one of the most common malignancies in the world. Their incidence in Morocco, between 2005 and 2007, was 5.6 for 100000 inhabitants, which is very low compared to what found in developed countries. In addition, CRCs show a high frequency of rectal localizations, and occurs in a younger population in Morocco compared to what found in developed countries. The purpose of this study is to confirm these CRC peculiarities in Morocco and try to explain them by exploring the microsatellite instability molecular pathway. This is a prospective observational study conducted since January 2010, including 385 patients admitted in Hassan II University Hospital of Fez. We collected clinical, radiological and pathological data. We investigated the expression of mismatch repair (MMR) proteins in 214 patients and BRAF gene mutations in 159 patients. Mean age was 55.08 +/- 15.16 years. 36.5 % of patients were less than 50 years old and 49.3 % of tumors were localized in the rectum. Loss of MMR protein expression was observed in 11.2 % of cases. It was independently associated with individual or family history of cancer belonging to Hereditary Non-Polyposis Colorectal Cancer (HNPCC) spectrum (p = 0.01) and proximal localization (p = 0.02). No BRAF mutation was detected in all cases. These results confirm the high occurrence of CRCs to young patients and the high frequency of rectal localizations in Moroccan population. They mostly show an absence of BRAF mutation, supposing a rarity of MLH1 promoter hypermethylation pathway, which may even partially explain the CRC peculiarities in our context. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/5868184711716884.
    Diagnostic Pathology 06/2015; 10(1):77. DOI:10.1186/s13000-015-0326-9 · 2.60 Impact Factor
  • M. Khalis · H. Charaka · F. Abbass · N. Tachfouti · K. El Rhazi · C. Nejjari ·

    Revue d Épidémiologie et de Santé Publique 05/2015; 63:S81. DOI:10.1016/j.respe.2015.03.100 · 0.59 Impact Factor
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    ABSTRACT: BACKGROUND: Increasing access to essential respiratory medicines and influenza vaccination has been a priority for over three decades. Their use remains low in low- and middle-income countries (LMICs), where little is known about factors influencing use, or about the use of influenza vaccination for preventing respiratory exacerbations.
    The International Journal of Tuberculosis and Lung Disease 01/2015; 19(1):21-30. DOI:10.5588/ijtld.14.0263 · 2.32 Impact Factor
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    ABSTRACT: Abstract Objective: To carry out an inventory on the availability, challenges and needs of Dietary Assessment (DA) methods in Africa as a pre-requisite to provide evidence, and set directions (strategies) for implementing common dietary methods and support web-research infrastructure across countries. Methods: The inventory was performed within the framework of the "Africa's Study on Physical Activity and Dietary Assessment Methods" (AS-PADAM) project. It involves International Institutional and African networks. An inventory questionnaire was developed and disseminated through the networks. Eighteen countries responded to the dietary inventory questionnaire. Results: Various DA tools were reported in Africa, 24-Hour Dietary Recall and Food Frequency Questionnaire were the most commonly used. Few tools were validated and tested for reliability. Face-to-face interview was the common method of administration. No computerised software or other new (web) technologies were reported. No tools were standardised across countries. Conclusions: The lack of comparable DA methods across represented countries is a major obstacle to implement comprehensive and joint nutrition-related programmes for surveillance, programme evaluation, research and prevention. There is a need to develop new or adapt existing DA methods across countries by employing related research infrastructure that have been validated and standardised in other settings, with the view to standardizing methods for wider use.
    Critical Reviews in Food Science and Nutrition 12/2014; DOI:10.1080/10408398.2014.981630 · 5.18 Impact Factor
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    ABSTRACT: Background In Morocco, knowledge of cancer risk factors, a crucial element in the process of behavioral change, has never been evaluated. This study aims to provide information on the level of awareness of cancer risk factors among the Moroccan general population. Methods A cross sectional survey was carried out in May 2008, using a stratified sampling method in a representative sample of the Moroccan adult population. The used questionnaire included social and demographic data as well as questions about 14 cancer related factors regarding passive or active smoking, alcoholic beverages, obesity, physical inactivity, food coloring, red meat, fat, salt, fruit, vegetables, olive oil, green tea, coffee, breast-feeding. Subjects had to choose between 3 propositions for each proposed factor (risk factor/Protective factor/Don’t Know). The knowledge score was calculated by summing the correct answer for each proposed factor except coffee and food coloring. The answer was assigned 1 if it’s correct or 0 if it was incorrect or the participant responded ‘don’t know. The maximum knowledge score was 12. Multivariate linear regression model was used to evaluate the determinants of knowledge score. Results Among 2891 subjects who participated to the survey, 49.5% were men and 42% were from a rural area. The mean age was 41.6 ± 15.2 years. The mean knowledge score of cancer related factors was 8.45 ± 3.10 points. Knowledge score increased with educational level (β = −0.65 if school year ≤6 versus >6) and housing category (β = 1.80 in high standing housing vs rural housing). It was also higher in urban area, among never smokers and among people never consuming alcohol compared to others groups. Conclusion These results provide valuable information necessary to establish relevant cancer prevention strategies in Morocco aiming to enhance and improve people’s knowledge about risk factors especially in some target groups.
    BMC Cancer 09/2014; 14(1):695. DOI:10.1186/1471-2407-14-695 · 3.36 Impact Factor
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    ABSTRACT: Background Diet and lifestyle may modulate lung function and COPD but most evidence comes from richer countries. We have systematically investigated the evidence on the association between diet and lung function in Africa and the Middle East, where the burden of COPD is increasing. Methods Protocol-driven strategies were used to search the Cochrane library, MEDLINE, and Web of Science for all studies published up to September 2013 on any dietary or related lifestyle exposures and lung function (LF) or COPD. We used the PRISMA (Preferred Reporting Items for Systematic Reviews (SR) and Meta-Analyses) guidelines for data extraction. Quality of eligible papers was assessed using the Critical Appraisal Skills Programme (CASP). Results 782 potentially relevant studies were identified. 631 titles and abstracts were examined for eligibility after eliminating 151 duplicate studies. 22 studies met the inclusion criteria: 16 cross-sectional, 3 case-control, and 3 interventions. 18 were on lung function and 4 on COPD. Exposures were limited to vitamins A, C and E, omega 3 fatty acids, use of nutrient supplements, obesity, body fat, and prolonged periods of fasting (Ramadan). The samples studied were mostly unrepresentative of the general population. Most studies shown a positive association between antioxidant nutrients and LF but data were too heterogeneous to carry out meta-analyses. Conclusion This first systematic review on diet and related risk factors for lung function and COPD in Africa and the Middle East highlights the need for improved studies in the general population of this region. ERS fellowshipSTRTF - 2013-3077 supported Dr El-Rhazi http://erj.ersjournals.com/content/44/Suppl_58/P4964
    The European Respiratory Society (ERS) Annual Congress, Munich, Germany; 09/2014
  • Z. Selihi · M. Berraho · K. El Rhazi · S. Keita · C. Nejjari ·

    Revue d Épidémiologie et de Santé Publique 09/2014; 62:S229-S230. DOI:10.1016/j.respe.2014.06.188 · 0.59 Impact Factor
  • B. Zarrouq · K. Bendaou · I. Rammouz · A. Najdi · C. Nejjari · K. El Rhazi ·

    Revue d Épidémiologie et de Santé Publique 09/2014; 62:S198-S199. DOI:10.1016/j.respe.2014.06.089 · 0.59 Impact Factor
  • B. Zarrouq · K. Bendaou · I. Rammouz · B. Lyoussi · C. Nejjari · K. El Rhazi ·
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    ABSTRACT: Introduction Au Maroc, le suicide des adolescents est un phénomène rarement étudié. L’objectif de cette étude était d’évaluer les déterminants et la prévalence du risque suicidaire et des tentatives de suicide chez les élèves de la région Centre Nord du Maroc. Méthodes Une enquête transversale a été réalisée entre avril 2012 et novembre 2013, au sein des collèges et lycées publiques. Un questionnaire anonyme auto-administré explorant le risque suicidaire selon les critères du MINI DSM-IV a été utilisé. Résultats Au total, 2885 élèves (52,7 % garçons) âgés de 11 à 23 ans ont rempli le questionnaire. Le risque suicidaire global était de 35,3 % (n = 1017) avec des différences significatives entre les garçons et les filles (27 % versus 44,5 % ; p < 0,001). La prévalence du risque suicidaire léger était de 16,9 % (IC-95 % : 15,6–18,4), celle du risque moyen était de 8,1 % (IC-95 % : 7,1–9,1), et celle du risque élevé était de 10,1 % (IC-95 % : 9–11,3). Les tentatives de suicide au cours de la vie ont été déclarées par 10,6 % d’élèves (IC-95 % : 9,4–11,7). L’analyse multivariée a montré que le risque suicidaire est hautement associé au sexe féminin (OR = 2,9 ; IC-95 % [2,4–3,4]), au tabagisme (OR = 2,1 ; IC-95 % : [1,6–2,8]), et à l’usage de toxiques (OR = 2 ; IC-95 % : [1,4–2,8]). Discussion Une telle prévalence élevée du risque suicidaire au milieu scolaire est choquante et inattendue. D’où la nécessité urgente de l’élaboration d’une stratégie nationale de prévention contre le suicide chez les adolescents.
    Revue d Épidémiologie et de Santé Publique 09/2014; 62:S182–S183. DOI:10.1016/j.respe.2014.06.038 · 0.59 Impact Factor
  • Z. Selihi · M. Berraho · K. El Rhazi · Y. El Achhab · C. Nejjari ·

    Revue d Épidémiologie et de Santé Publique 09/2014; 62:S187. DOI:10.1016/j.respe.2014.06.052 · 0.59 Impact Factor
  • M. Atassi · C. Nejjari · A. Najdi · A. Zidouh · R. Bekkali · K. El Rhazi ·

    Revue d Épidémiologie et de Santé Publique 08/2014; 62:S157. DOI:10.1016/j.respe.2014.05.103 · 0.59 Impact Factor
  • M. Atassi · S. El Fakir · O. Sy · A. Boly · K. El Rhazi · C. Nejjari ·

    Revue d Épidémiologie et de Santé Publique 08/2014; 62:S156. DOI:10.1016/j.respe.2014.05.100 · 0.59 Impact Factor
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    ABSTRACT: Understanding the effects of cancer on the quality of life of affected patients is critical to clinical research as well as to optimal management and care. The aim of this study was to adapt the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) questionnaire into Moroccan Arabic and to determine its psychometric properties. After translation, back translation and pretesting of the pre-final version, the translated version was submitted to a committee of professionals composed by oncologists and epidemiologists. The psychometric properties were tested in patients with cancer. Internal consistency was tested using Cronbach's alpha and the test-retest reliability using interclass correlation coefficients. Construct validity was assessed by examining item-convergent and divergent validity. It was also tested using Spearman's correlation between QLQ-C30 scales and EQ-5D. The study was conducted in 125 patients. The Moroccan version was internally reliable, Cronbach's α was 0.87 for the total scale and ranged from 0.34 to 0.97 for the subscales. The intraclass correlation coefficient of the test-retest reliability ranged from 0.64 for "social functioning" to 0.89 for "physical activities" subscales. The instrument demonstrated a good construct and concomitant validity. We have developed a semantically equivalent translation with cultural adaptation of EORTC QLQ-C30 questionnaire. The assessment of its measurement properties showed that it is quite reliable and a valid measure of the effect of cancer on the quality of life in Moroccan patients.
    BMC Research Notes 04/2014; 7(1):228. DOI:10.1186/1756-0500-7-228
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    ABSTRACT: Objective: To determine the association between dyspnea at entry into the PAQUID cohort and 13-year mortality, taking into consideration BMI and other mortality-related factors. Methods: Design: Longitudinal study. Setting: In Dordogne and Gironde, South Western France. Subjects: A total of 3646 French community dwellers aged 65 years old and over from the PAQUID study were included. Main outcome measures: dyspnea measured on 5-grades scale, mortality measured over 13 years of follow-up. Adjustment variables: age, gender, BMI (kg/m²), antecedent of ischemic heart disease, antecedent of stroke, hypertension, smoking history and diabetes. Results: The study sample included 3646 subjects out of whom 54.11% died at 13 years of follow-up, 57.3% of participants were women and mean age was 75.3 (SD 6.8) years. Univariate analysis showed that dyspnea was associated with 13-year mortality. Death occurred in 45.6% of non-dyspneic subjects , 51.8% in those with level 1 of dyspnea, 65.6% in level 2 and 80.6% in level 3 and 4 (P<10⁻⁴). The median survival was at 13.26 (SD 0.20) years for level-0 of dyspnea, 12.33 (SD 0.31) years for level-1 of dyspnea, 9.28 (SD 0.44) years for level-2 and 6.43 (SD 0.45) years for level-3 and 4 (P=10⁻³). In the multivariate analysis, the risk of mortality for level1 compared to level-0 was HR=1.13 (CI95%=[1.01-1.26]); this risk increases to HR=1.42 (CI95%=[1.25-1.63]) for level-2 and to HR=1.90 (CI95%=[1.61-2.25]) for level-3 and 4. Conclusion: These findings suggest that the relationship between long-term mortality and dyspnea is strong, consistent and independent of other covariates in the elderly.
    The Journal of Nutrition Health and Aging 03/2014; 18(3):335-335. DOI:10.1007/s12603-014-0024-4 · 3.00 Impact Factor
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    ABSTRACT: H. pylori persistent infection induces chronic gastritis and is associated with peptic ulcer disease and gastric carcinoma development. The severity of these diseases is related to human's genetic diversity, H. pylori genetic variability and environmental factors. To identify the prevalence of histo-pathological damages caused by H. pylori infection in Moroccan population, and to determine their association to H. pylori genotypes, a prospective study has been conducted during 3 years on patients attending the gastroenterology department of Hassan II University Hospital (CHU) of Fez, Morocco. A total of 801 Moroccan adults' patients were recruited; H. pylori was diagnosed and genotyped by PCR in biopsy specimens and histological exam was performed. We found a high rate of glandular atrophy. Chronic inflammation, neutrophil activity and glandular atrophy showed statistically significant association with H. pylori infection. However, intestinal metaplasia was inversely associated to this infection and no association was observed with gastric cancer cases. A statistically significant association was found between intestinal metaplasia and vacAs1 and vac Am1 genotypes in patients aged 50 years and more but not in younger. This last genotype is also associated to gastric cancer. In this study, gastric cancer showed no significant association with H. pylori. Further studies are warranted to determine the role of other etiological agents such as Epstein-Barr virus, human papillomavirus and possibly environmental and dietetic factors in the occurrence of this pathology.
    PLoS ONE 12/2013; 8(12):e82646. DOI:10.1371/journal.pone.0082646 · 3.23 Impact Factor
  • E B Benjelloun · A Jarrar · K El Rhazi · T Souiki · A Ousadden · K Ait Taleb ·
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    ABSTRACT: Conventional treatment of anal abscess by a simple drainage continues to be routine in many centers despite retrospective and randomized data showing that primary fistulotomy at the time of abscess drainage is safe and efficient. The purpose of this study is to report the long-term results of fistulotomy in the treatment of anal abscesses. This is a prospective nonrandomized study of 165 consecutive patients treated for anal abscess in University Hospital Hassan II, Fez, Morocco, between January 2005 and December 2010. Altogether 102 patients were eligible to be included in the study. Among them, 52 were treated by a simple drainage and 50 by drainage with fistulotomy. The results were analyzed in terms of recurrence and incontinence after a median follow-up of 3.2 years (range 2-6 years). The groups were comparable in terms of age, gender distribution, type and size of abscess. The recurrence rate after surgery was significantly higher in the group treated by drainage alone (88 %) compared to other group treated by drainage and fistulotomy (4, 8 %) (p < 0.0001). However, there was a tendency to a higher risk of fecal incontinence in the fistulotomy group (5 % vs 1 %), although this difference was not significant (p = 0.27). In the group treated by drainage and fistulotomy, high fistula tract patients are more prone to develop incontinence and recurrence, mainly within the first year. A long-term follow-up seems not to influence the results of fistulotomy group. These findings confirm that fistulotomy is an efficient and safe treatment of anal abscess with good long-term results. An exception is a high fistula, where fistulotomy may be associated with a risk of recurrence and incontinence.
    06/2013; 65(3). DOI:10.1007/s13304-013-0218-z

Publication Stats

147 Citations
75.78 Total Impact Points


  • 2012-2015
    • Centre Hospitalier Universitaire Hassan II
      Fez, Fès-Boulemane, Morocco
  • 2009-2014
    • Université Sidi Mohamed Ben Abdellah
      Fezna, Meknès-Tafilalet, Morocco
  • 2006-2014
    • Faculté de Médecine et de Pharmacie de Fès
      Fez, Fès-Boulemane, Morocco