North African Populations Research Articles

Distinct Clinical and Prognostic Features of Myelodysplastic Syndrome in Patients from the Middle East, North Africa, and Beyond: A Systemic Review.

Myelodysplastic syndrome (MDS) describes a group of bone marrow malignancies with variable morphologies and heterogeneous clinical features. The aim of this study was to systematically appraise the published clinical, laboratory, and pathologic characteristics and identify distinct clinical features of MDS in the Middle East and North Africa (MENA) region. We conducted a comprehensive search of the PubMed, Web of Science, EMBASE, and Cochrane Library databases from 2000 to 2021 to identify population-based studies of MDS epidemiology in MENA countries. Of 1935 studies, 13 independent studies published between 2000 and 2021 representing 1306 patients with MDS in the MENA region were included. There was a median of 85 (range 20 to 243) patients per study. Seven studies were performed in Asian MENA countries (732 patients, 56%) and six in North African MENA countries (574 patients, 44%). The pooled mean age was 58.4 years (SD 13.14; 12 studies), and the male-to-female ratio was 1.4. The distribution of WHO MDS subtypes was significantly different between MENA, Western, and Far East populations (n = 978 patients, p < 0.001). More patients from MENA countries were at high/very high IPSS risk than in Western and Far East populations (730 patients, p < 0.001). There were 562 patients (62.2%) with normal karyotypes and 341 (37.8%) with abnormal karyotypes. Our findings establish that MDS is prevalent within the MENA region and is more severe than in Western populations. MDS appears to be more severe with an unfavorable prognosis in the Asian MENA population than the North African MENA population.

Development and testing of microsatellite loci for the study of population genetics of Ixodes ricinus Linnaeus, 1758 and Ixodes inopinatus Estrada-Peña, Nava and Petney, 2014 (Acari: Ixodidae) in the western Mediterranean region

Ixodes ricinus is an important vector of several human and veterinary infectious agents. Its wide geographical distribution and permissive feeding behaviour have prompted earlier studies on its population genetics. Results were, nevertheless, not conclusive. Furthermore, no research has fully focused on the south-western distribution range of I. ricinus, where exchanges between European and North African populations are more likely to occur. The presence of an additional species, Ixodes inopinatus, in the area further confuses the topic, as the two species are hard to differentiate morphologically. The present work describes the testing of microsatellite markers previously described for I. ricinus using Portuguese and Tunisian tick populations of both species. In addition, new microsatellite loci were developed to complement the available marker toolbox. Loci showed different amplification successes across subpopulations, with Tunisian DNA less readily amplified. Altogether, 15 loci were considered suitable for genetic analyses of Portuguese subpopulations, 10 for Tunisian samples, and seven, common to both populations, were considered to be informative at the inter-continental level. A preliminary analysis of both datasets revealed two isolated populations, which can correspond to two different species. Furthermore, Tunisian specimens identified by sequencing of 16S rDNA as having I. ricinus or I. inopinatus sequence profiles all clustered together in one single population using the proposed microsatellites. This confirms that taxonomic decisions based only on 16S rRNA gene sequencing can be misleading. The application of the proposed set of microsatellite markers to a larger sample, representative of the south-western Ixodes’ distribution range, will be crucial to clarify the distribution of both species.

Identification a novel pathogenic LRTOMT mutation in Mauritanian families with nonsyndromic deafness.

Although recessive mutations in GJB2 are the common genetic etiology of sensorineural hearing impairment (SNHI), variants in LRTOMT gene were also identified, mostly in Middle East and North African populations. Using Sanger sequencing we screened the exon 7 of LRTOMT in a cohort of 128 unrelated Mauritanian children with congenital deafness. Only one biallelic missense mutation, predicted as pathogenic (c.179T > C;p.Leu60Pro) was found at homozygous state in four families. This variant, not reported before, showed a deleterious effect by SIFT (score: 0.01) and a disease-causing effect by Mutation Taster (prob: 1). Exploration of the encoded protein 3D structure revealed a disruption from an organized α helix (in the normal protein structure) into a random conformation. Early fitting of a cochlear implant seemed to improve the audition ability of the mutation carrier. Further screening using a panel of deafness genes may expose other variants underlying hearing impairment in our population.

Genetic characterization of the Berber-speaking population of Souss (Morocco) based on autosomal STRs.

The Souss, located in southern Morocco, is one of the oldest areas of human settlement in North Africa. Despite this historical relevance, the Souss has not received sufficient attention in terms of population genetic studies. In this study, we utilized the AmpFlSTR Identifiler PCR amplification system to establish the allelic frequencies and statistical parameters of 15 autosomal STRs (Short Tandem Repeats) in 150 healthy unrelated Berber-speaking individuals from the Souss. We explored the genetic relationships between Souss and other reference populations based on our dataset as well as previously published population data. A total of 210 alleles were detected with corresponding allele frequencies ranging from 0.003 to 0.367. The most polymorphic locus was D18S51 with 23 alleles which was also the most discriminating locus as expected. The phylogenetic analysis clustered the Souss closer to the Azrou and southern Moroccan populations. The population comparison showed affinity between the Souss and most North African populations, as well as with Middle Easterners and Europeans. Historical events and geographical proximity have contributed to the affinity between the Souss and surrounding North African, Southern European, and Middle Eastern populations. Overall, this study highlights the reliability of the 15 STRs for identifying individuals and assessing paternity in the Souss population.

First genetic characterization of Xeroderma pigmentosum in Libya: High frequency of XP-C founder mutation.

Xeroderma pigmentosum is an autosomal recessive disease characterized by a high sensitivity to UV radiations. The disease is clinically and genetically heterogeneous, thus making accurate early clinical diagnosis difficult. Although the disease is considered rare worldwide, previous studies have shown that it is more frequent in Maghreb countries. So far, no genetic study has been published on Libyan patients, except three reports limited to clinical descriptions. Our study, which represents the first genetic characterization of XP in Libya, was conducted on 14 unrelated families including 23 Libyan XP patients with a consanguinity rate of 93%. Blood samples were collected from 201 individuals including patients and their relatives. Patients were screened for founder mutations already described in Tunisia. The two founder Maghreb XP mutations, XPA p.Arg228* associated with the neurological form and XPC p.Val548Alafs*25 in patients with only cutaneous manifestations, were homozygously identified. The latter was predominant (19 of 23 patients). In addition, another XPC homozygous mutation (p.Arg220*) has been identified in only one patient. For the remaining patient, the absence of founder XPA, XPC, XPD, and XPG mutations suggests mutational heterogeneity of XP in Libya. Identification of common mutations with other Maghreb populations is in favor of a common ancestor in North-African populations.

Genetic Polymorphisms in ERCC1 Gene and Their Association with Response to Radiotherapy in Moroccan Patients with Nasopharyngeal Carcinoma.

Nasopharyngeal carcinoma (NPC) is a severe malignant disease. Despite its low frequency, NPC is very common in North African population. Radiotherapy is the standard therapeutic treatment of NPC. However, radioresistance hampers the success of treatment. At the molecular scale, radioresistance is due to genetic variations involved in DNA repair pathways in NPC patients. Several studies reported that single nucleotide polymorphisms (SNPs) in excision repair cross complementing group 1 (ERCC1) could be associated with radioresistance. In this optic, the present study aimed to evaluate the association between DNA repair gene polymorphisms ERCC1 C8092A and ERCC1 C118T and radiotherapy response of patients with NPC. A total of 95 patients with confirmed NPC were recruited at the Mohammed VI Center for Cancer Treatment, Casablanca - Morocco between 2016 and 2018. Two single nucleotide polymorphisms in ERCC1 gene were genotyped. Multiple analysis software was used to assess the correlation between these SNPs and radio-therapeutic response. Sequencing of ERCC1 C8092A polymorphism revealed that CC and CA genotypes were found in 51.6% and 45.3% of cases, respectively, whereas the homozygote AA genotype was reported in only 3.1% of cases. For ERCC1 C118T polymorphism, the heterozygote CT genotype was identified in 49.5% of cases. Homozygotes genotypes CC and TT were detected in 17.9% and 32.6% respectively of NPC cases. Of note, no significant association was found between the ERCC1 C8092A polymorphism and response to radiation therapy (p=0.81). Similarly, there was no significant association between the response to radiotherapy and allelic distribution (p=0.56). Likewise, no correlation was observed neither with genotypes (p=0.07) nor with alleles (p=0.09) of ERCC1 C118T polymorphism and response to radiation therapy. Our results clearly showed that ERCC1 C8092A and ERCC1 C118T polymorphisms were not associated with response to radiotherapy in Moroccan NPC patients. Large studies are warranted to confirm the role of these SNPs in therapeutic response of NPC patients.

Morpho-Biometric Characterization of the North African (Tunisian) Local Chicken Populations

Morpho-Biometric Characterization of the North African (Tunisian) Local Chicken Populations

Effects of the COVID-19 pandemic on sleep health among Middle Eastern and North African (MENA) populations: a systematic review of the literature

ObjectivesThis study sought to conduct a systematic review of the literature on the impact of the COVID-19 pandemic on sleep health among Middle Eastern and North African (MENA) populations, understudied...

The genomic analysis of current-day North African populations reveals the existence of trans-Saharan migrations with different origins and dates

The Sahara Desert has acted as a barrier to human gene-flow between the northern and central parts of Africa since its aridification. Nonetheless, some contacts between both sides of the desert have occurred throughout history, mainly driven by commercial activity. Part of this was the infamous trans-Saharan slave trade, which forcedly brought peoples from south of the Sahara to North Africa from Roman times until the nineteenth century. Although historical records exist, the genetic aspects of these trans-Saharan migrations have not been deeply studied. In the present study, we assess the genetic influence of trans-Saharan migrations in current-day North Africa and characterize its amount, geographical origin, and dates. We confirm the heterogeneous and generally low-frequency presence of genomic segments of sub-Saharan origin in present-day North Africans acquired in recent historical times, and we show evidence of at least two admixture events: one dated around the thirteenth–fourteenth centuries CE between North Africans and a Western-sub-Saharan-like source similar to current-day Senegambian populations, and another one dated around the seventeenth century CE involving Tunisians and an Eastern-sub-Saharan-like source related to current-day south-Sudan and Kenyan populations. Time and location coincide with the peak of trans-Saharan slave-trade activity between Western African empires and North African powers, and are also concordant with the possibility of continuous recent south-to-north gene-flow. These findings confirm the trans-Saharan human genetic contacts, providing new and precise evidence about its possible dates and geographical origins, which are pivotal to understanding the genomic composition of an underrepresented region such as North Africa.

High density and successful breeding of Turtle doves Streptopelia turtur in Moroccan olive groves.

The turtle dove is a migratory species that has suffered a rapid decline principally across its Northern ranges, despite pronounced conservation measures. Consequently, it has been categorized as 'Near Threatened' in Europe. Degradation of breeding habitats and a decrease in food resources are listed as principal causes of this decline. Despite its importance, the productivity of the North African population is widely unknown. Here we present the first estimation of the density of the breeding population and the superior reproductively of Streptopelia turtur arenicola in Morocco and entire North Africa. This study was carried out for two seasons 2018-2019 in the Saïss plain, central Morocco. Based on previous data, doves were monitored weekly, from early March to late August, in aquatic ecosystems (two dams and one river) and farmlands (cereals and orchards). The breeding population was censused using the "point-count" method, following a walked transect of 5 km in orchards, 7 km in cereal fields, and 3 km along the river. Equally, nests were searched in natural habitats counting riparian trees, forests, and ornamental trees, and in orchards based on the Common Birds Census (CBC) methodology, in which the singing doves, mating pairs, nesting, and/or feeding behavior were the most monitored signs to discover nests. In orchards, nests were searched line-by-line based on the rows of fruit trees. For each recorded nest, we note the breeding chronology, clutch size and incubation period, success and failure factors, dimensions, and vertical placement on trees. To evaluate the predictors of doves' occurrence, we noted at each site the presence of cereals, water, human disturbance, presence of nesting trees, and predators. In total, 3,580 turtle doves (22.37 birds/ha), including 240 breeding pairs, were documented. Nesting occurred mainly in olive groves, cereals were used for forage, and aquatic ecosystems for water sources. The nesting period lasted from late April to July (last fledglings). All nests were located on olive trees at a height of 225.30 ± 48.87 cm. The clutch size was 1.98 ± 0.13 (laid eggs/built nests), the incubation period lasted 14.16 ± 1.32 days, and the rearing period lasted 16.54 ± 1.76 days. The breeding success among the 240 monitored nests accounted for 73.84% during the nesting phase and 87.42% during the incubation phase; 71.5%% of nestlings have fledged, which is the highest success rate for turtle doves in Europe and Northwest Africa. Clutches were aborted mostly due to predation from snakes (7.5% of nests, 16.12% of eggs, and 5.63% of chicks), nest desertion (9.16% of nests and 5.37% of eggs), and marginally by the destruction of nests through farming activities. These findings are important for conservation plans, to restore turtle doves' habitats in Europe, where the species is widely declining.

Developing CIRdb as a catalog of natural genetic variation in the Canary Islanders

The current inhabitants of the Canary Islands have a unique genetic makeup in the European diversity landscape due to the existence of African footprints from recent admixture events, especially of North African components (> 20%). The underrepresentation of non-Europeans in genetic studies and the sizable North African ancestry, which is nearly absent from all existing catalogs of worldwide genetic diversity, justify the need to develop CIRdb, a population-specific reference catalog of natural genetic variation in the Canary Islanders. Based on array genotyping of the selected unrelated donors and comparisons against available datasets from European, sub-Saharan, and North African populations, we illustrate the intermediate genetic differentiation of Canary Islanders between Europeans and North Africans and the existence of within-population differences that are likely driven by genetic isolation. Here we describe the overall design and the methods that are being implemented to further develop CIRdb. This resource will help to strengthen the implementation of Precision Medicine in this population by contributing to increase the diversity in genetic studies. Among others, this will translate into improved ability to fine map disease genes and simplify the identification of causal variants and estimate the prevalence of unattended Mendelian diseases.

Variations anatomiques du sinus ethmoïdal des patients opérés de dacryocystorhinostomie au centre hospitalier Hassan II de FES (étude de 215 patients)

Although several studies have tried to identify the causes of failure of dacryocystorhinostomy (DCR) surgery, the ethmoid sinus remains an underestimated and little described source of failure. To study anatomical relationship between the ethmoidal sinus, particularly the "Agger nasi" cell, with the lacrimal fossa in the North African population, little described in the literature. This study is based on the results of preoperative analysis of dacryo-computed tomography. Analysis of preoperative computed tomography images of patients undergoing dacryocystorhinostomy over a 7-year period from January 2011 to December 2017. Anatomical relationships were studied according to the following classification: type I: No ethmoid cells located anteriorly to the posterior lacrimal crest on transverse images; type II: ethmoidal cells extending anteriorly to the posterior lacrimal crest, but not reaching the anterior edge of the lacrimal bone; Type III: ethmoidal cells located anterior to the lacrimal bone suture. Two hundred and fifteen preoperative computed tomography images were analyzed. The morphology of the ethmoid sinus was classified as type 1 in 33.5%, type 2 in 42.32% and type 3 in 24.18%. Computed tomography analysis was symmetrical in 87.5% and asymmetrical in 12.5%. During dacryocystorhinostomy, the surgeon must take into consideration type III, which can be present in 25% of cases. In the case of surgical failure, a dacryo-CT must be performed to rule out such anterior positioning of the ethmoid cells.

Association between epidemiological and clinico-pathological features of breast cancer with prognosis, family history, Ki-67 proliferation index and survival in Tunisian breast cancer patients.

Breast cancer has different epidemio-clinical characteristics in Middle East and North-African populations compared to those reported in the Western countries. The aim of this study is to analyze the epidemiological and clinico-pathological features of breast cancer in Tunisia and to determine prognostic factors with special interest to family history, Ki-67 proliferation index and comorbidity. We retrospectively reviewed epidemiological and clinico-pathological data from patients' medical records, treated in the Medical Oncology Department at Abderrahmane Mami Hospital, in the period 2011-2015. Data has been collected on 602 breast cancer patients and analyzed using SPSS software V.23.0. Our study showed high fractions of young breast cancer patients and cases with dense breasts. The most prevalent comorbidities observed in the studied cohort were cardiovascular diseases and diabetes. Familial breast cancer was found in 23.3% of cases and was associated with younger age at diagnosis (p<0.001) and advanced stage (p = 0.015). Ki-67 index >20% was significantly associated with early age at diagnosis, lymph node involvement (p = 0.002), advanced tumor grade (p<0.001) and high risk of relapse (p = 0.007). Ki-67 cut-off 30% predicted survival in luminal cases. Survival was worse in patients with triple negative breast cancer compared to non-triple negative breast cancer, inflammatory breast cancer compared to non-inflammatory breast cancer, moderately to poorly differentiated tumors compared to well-differentiated tumors and with positive lymph nodes compared to pN0 (p<0.05). Our study showed new insights into epidemiological and clinico-pathological characteristics of breast cancer that are not well explored in Tunisian population. Considering our findings along with the implementation of electronic health record system may improve patient health care quality and disease management.

Genetic Differentiation and Molecular Phylogenetics of North African Catfish from Three Distinct Waterbodies

Abstract The population structure and genetic variability of North African catfish Clarias gariepinus (Burchell 1822) were investigated using partial mitochondrial DNA cytochrome b region sequences. Fifty-four (54) samples were investigated from three geographically isolated rivers in Nigeria. The analysis of 53 haplotypes revealed greater haplotype diversity (0.99930) and nucleotide diversity (p) (0.07270). According to an analysis of molecular variance (AMOVA), the genetic diversity of North African catfish within populations is significantly higher than the genetic diversity across populations. The FST scores (0.75000, 0.94792 and 0.95699) indicated that North African catfish populations in three Nigerian freshwater bodies had a strong genetic structure. The phylogenetic reconstruction of unique haplotypes revealed the placement of a haplotype (Ogbese) linked by others from all three groups with a point mutation ranging from 1 to 24 nucleotides. North African catfish populations in the Asejire and Ureje are genetically diverse, as evidenced by a high level of haplotype diversity of 1.0000, low nucleotide diversity spanning from 0.05101 to 0.07889, and high FST values (within-population genetic variation). The common haplotypes between some populations and mixes of haplotypes from different populations within the same genetic cluster demonstrate that the population genetic structure is not distinct.

Identifying the winter grounds of the recently described Barbary Reed Warbler (Acrocephalus baeticatus ambiguus)

The Iberian and North African populations of reed warblers have been described recently as a separate taxon, ambiguus, forming a sister clade to the Sahelian subspecies minor of African Reed Warbler Acrocephalus baeticatus. Although the breeding range of ambiguus has been identified, the migration strategy of its populations remained unknown. We deployed geolocators and sampled the innermost primary from breeding adults in Spain for stable hydrogen (δ2H) analyses and also analysed stable carbon (δ13C) and nitrogen (δ15N) isotopes in feathers collected in two reed warbler taxa (Acrocephalus scirpaceus and Acrocephalus baeticatus ambiguus) in Morocco, to identify the moulting and wintering sites of these populations. Ring recoveries, geolocator tracks and probabilistic assignments to origin from δ2H values indicate that Spanish ambiguus are likely to moult south of the Sahara and winter in West Africa, probably from Mauretania to southern Mali and Ivory Coast. Moroccan ambiguus, however, undergo post‐breeding moult north of the Sahara, and possibly then migrate to West Africa. With other populations of ambiguus breeding from Algeria to Libya and probably wintering further east in the Sahelian belt, the Barbary Reed Warbler can therefore be considered a trans‐Saharan migrant, with a post‐breeding moult strategy that varies between populations, and probably structured according to breeding latitude.

A meta-analysis on the susceptibility to the development of bladder cancer in the presence of DNMT3A, DNMT3B, and MTHFR gene polymorphisms

BackgroundThe etiology of bladder cancer is not yet well known. In this study, we want to evaluate the effect of polymorphisms of genes that have an epigenetic effect (MTHFR, DNMT3A/B) on the susceptibility to develop bladder cancer (BC).MethodsA systematic review was performed for MTHFR, DNMT3A, and DNMT3B, followed by a meta-analysis conducted for rs1801131, rs1801133, rs2274976, rs1550117, and rs1569686 SNPs. A sensitivity and a subgroup analysis were then used.Results20 studies were included, where no statistically significant association between any of the analyzed SNPs and the occurrence of BC was detected. Subgroup analysis revealed a statistically significant association in North African population with rs1801133: TT vs. TC + CC (P = 0.013; OR 95% CI = 0.52 [0.311–0.872]); TT vs.TC (P = 0.003; OR 95% CI = 0.448 [0.261–0.769]) and in North American population with rs1801131: CC vs. CA (P = 0.039; OR 95% CI = 0.71 [0.523–0.984]). A sensitivity analysis revealed that there is a statistically significant association between rs1801131 and the occurrence of BC (OR = 0.79, 95%CI [0.65–0.97]), (OR = 0.80, 95%CI [0.65–0.98]) and (OR = 0.78, 95%CI [0.63–0.96]) which correspond to CC vs. CA + AA; CC vs. CA; and CC vs. AA genetic models.ConclusionThis is the first study to assess the effect of DNMTs on bladder cancer risk. No statistically significant association was found between polymorphisms of MTHFR, DNMT3A/B genes and bladder cancer development, except for the North African and the North American populations with rs1801133 and rs1801131, respectively, with a protective effect of rs1801131 based on a sensitivity analysis.

Algerian Engineer Training at a Time of Major Environmental Challenges:

Environmental problems are having a brutal impact on the daily lives of the North African population. These countries have a young population, with significant numbers in higher education. Given this context, are future graduates being made aware of environmental issues? Since future engineers are the creators of tomorrow’s technological and socio-technical changes, an analysis of their training is of particular interest. This article explores the ways in which choices are made in program creation and what influences changes in three engineering graduate schools in Algeria. Through a curriculum sociology approach, we examine how curricular offers are discussed and implemented when major environmental constraints weigh heavily on Algeria. We analyse higher education policies on engineer training, as well as the creation of programs, via an analysis of the programs themselves and interviews with 24 stakeholders. The article shows that in the absence of instructions imposed by political decision-makers, teachers enjoy a remarkable amount of freedom when creating curricula. However, tensions arise since there is no authority to arbitrate disagreements. The results open avenues for further reflection for researchers interested in macrosociological reconfiguration in higher education.&#x0D; Key words: engineer training; environment; curriculum; Algeria; macrosociological reconfiguration

MiR-146a, miR-196a2, miR-499, and miR-149 linked with susceptibility to acute lymphoblastic leukemia: A case-control study in Tunisia

BackgroundMicroRNAs (miRNAs) are promising biomarkers of hematological malignancies, including acute lymphoblastic leukaemia (ALL). Recent studies revealed that miRNA single nucleotide polymorphisms (miR-SNP) modulate cancer risk by regulating various signaling pathways. However, their association with altered risk of ALL yielded inconsistent results. ObjectiveThis study aims to investigate the association of four miR-SNPs with altered risk of ALL risk in Tunisian, the first on North African population. MethodsA retrospective case-control study exploring the association of miR-146a, miR-196a2, miR-499, and miR-149 SNPs in 126 ALL patients and 126 healthy controls. ResultsOf the tested variants, significantly lower minor allele frequencies (MAF) of miR-146a C-allele and higher MAF frequency of miR-149 T-allele (P = 0.006) were seen in ALL cases. The association of miR-149 rs2292832 (Pc = 0.02), but not miR-146a rs2910164 (Pc = 0.11) persisted after correcting for multiple comparisons. Significantly reduced prevalence of miR-146a G/C genotype and higher frequency of miR-149 C/T genotype were seen in ALL cases vs. control subjects, which translated into negative association of miR-146a (rs2910164) with ALL according to the codominant and dominant models. Similarly, miR-149 (rs2292832) was positively associated with ALL according to the codominant and dominant genetic models. Three combinations comprising miR-146a/miR-196a2 GG vs CT + TT genotype combination, miR-146a/miR-499 GG vs TC + CC genotype combination, and miR-146a/miR-149 GG vs CT + TT genotype combination, were less frequent in ALL patients than in controls, and were negatively associated with the presence of ALL. ConclusionOur study suggests that miR-146a and miR-149 polymorphisms constitute biomarkers for personalized diagnosis of ALL.

Variation in cognitive insight processes between schizophrenia and bipolar disorder in a Tunisian population

IntroductionCognitive insight is a relatively recent concept referring to the ability, not only to reassess unusual experiences objectively after corrective feedback but also to distance oneself from them and it seems to be specifically altered in schizophrenia. Yet, despite its importance in the understanding of psychotic symptoms, this process has never been studied in the North African population.ObjectivesTherefore, this paper aims to compare cognitive insight performances between two Tunisian psychiatric populations and to explore its relationship with other cognitive processes.MethodsThe study population comprised 17 participants with schizophrenia, 9 with bipolar disorder, and 30 healthy controls. The groups were paired for age, education level, and socioeconomic status. We assessed depression, global executive functioning, verbal episodic memory, metamemory (online and offline), and cognitive insight. The latter was evaluated by the Beck Cognitive Insight Scale.ResultsThe results showed that, compared to the other groups, participants with schizophrenia obtained a lower self-reflectiveness score and a higher self-certainty score, resulting in a significantly lower composite index. These findings seem to indicate the alteration of cognitive insight in schizophrenia. However, no significant differences were found between the other two groups. Moreover, correlational analyses showed that cognitive insight components were only associated with metamemory indices which proved to be the best predictors of this ability, along with the global executive score.ConclusionsIn conclusion, our data seems to corroborate the international literature reporting a cognitive insight deficit in schizophrenia. However, further research is needed in order to better understand the specific processes underlying this metacognitive function.DisclosureNo significant relationships.

Incidence of clozapine-induced hematological side effects in a Tunisian population

IntroductionClozapine is commonly associated with adverse hematological outcomes. However, incidence of blood dyscrasias in the north African population is scarce.ObjectivesThe aim of this study was to assess the incidence of hematological side effects in a Tunisian sample of clozapine treated patients.MethodsWe conducted a retrospective longitudinal chart review of 64 patients on clozapine enrolled in our clozapine consultation between January 1, 2000 and September 2020.ResultsOur sample consisted of 15 women (23.5%) and 49 men (76.5%), mean age was 41.34 ±9.32 years. Patients were diagnosed with schizophrenia in 70.3% of the cases, 7 (10.9%) had a bipolar disorder and 12 (18.8%) had a schizoaffective disorder.We found blood dyscrasias in 21 patients (32.8%). Hematological abnormalities were as follow: 2 cases of agranulocytosis, 8 cases of neutropenia, 13 cases of thrombocytopenia, 5 cases of leukocytosis, 5 cases of eosinophilia and 3 cases of anemia. The incidence rate of hematological side effects was 0.1 case/year- person. The mean clozapine dose at the time of onset of the hematological side effect was 309.52 mg/day(range 25-600 mg/day).The median duration of clozapine treatment prior to developing hematological side effects was 119.71±126.52 days.Clozapine discontinuation was decided in 11 cases due to hematological side effects and reintroduced in 9 cases after normalization of blood count.ConclusionsThis study emphasis on the importance of a regular long-term monitoring of blood count to ensure early detection of hematological side effects.DisclosureNo significant relationships.