Mass Gatherings and Public Health: Case Studies from the Hajj to
                        Mecca

Rahman, Juma; Thu, Min; Arshad, Neelam; Putten, Marc Van der

doi:10.1016/j.aogh.2016.12.001

Cited by 36 publications

(35 citation statements)

References 29 publications

(45 reference statements)

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“…Compliance among overseas pilgrims ranged from 96% to 98% between 2006 and 2010 [13], and two recent studies conducted at King Abdul Aziz International Airport, among 796 and 5235 arriving overseas pilgrims in 2013 and 2014, revealed uptake rates of 98.2% and 100%, respectively [10,11]. However, assessing compliance to other measures of the vaccination policy among overseas pilgrims, such as type and timing of vaccination, is recommended [11,16].…”

Section: Discussionmentioning

confidence: 99%

“…Monitoring the annual number of Hajj visas and mandating the vaccine as a prerequisite for the visa application both limited the numbers of overseas pilgrims and improved vaccination rates. For instance, reports on vaccine uptake among overseas pilgrims since 2006 showed a compliance of no less than 96% and reaching up to 100% [10][11][12][13][14]; however, concerns remain among this group of pilgrims, including the receipt of inappropriate vaccines and, due to the limited access to vaccines (including cost), the use of fraudulent vaccination certificates [11,15,16].…”

Section: Introductionmentioning

confidence: 99%

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Meningococcal Vaccine for Hajj Pilgrims: Compliance, Predictors, and Barriers

et al. 2019

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Background: Major intercontinental outbreaks of invasive meningococcal disease associated with the Hajj occurred in 1987, 2000, and 2001. Mandatory meningococcal vaccination for all pilgrims against serogroups A and C and, subsequently, A, C, W, and Y controlled the epidemics. Overseas pilgrims show excellent adherence to the policy; however, vaccine uptake among domestic pilgrims is suboptimal. This survey aimed to evaluate meningococcal vaccine uptake among Hajj pilgrims and to identify key factors affecting this. Methods: An anonymous cross-sectional survey was conducted among pilgrims in Greater Makkah during the Hajj in 2017-2018. Data on socio-demographic characteristics, vaccination status, cost of vaccination, and reasons behind non-receipt of the vaccine were collected. Results: A total of 509 respondents aged 13 to 82 (median 33.8) years participated in the survey: 86% male, 85% domestic pilgrims. Only 389/476 (81.7%) confirmed their meningococcal vaccination status; 64 individuals (13.4%), all domestic pilgrims, did not receive the vaccine, and 23 (4.8%) were unsure. Among overseas pilgrims, 93.5% certainly received the vaccine (6.5% were unsure) compared to 80.9% of domestic pilgrims (p < 0.01). Being employed and having a tertiary qualification were significant predictors of vaccination adherence (odds ratio (OR) = 2.2, 95% confidence interval (CI) = 1.3-3.8, p < 0.01; and OR = 1.7, CI = 1-2.5, p < 0.05, respectively). Those who obtained pre-Hajj health advice were more than three times as likely to be vaccinated than those who did not (OR = 3.3, CI = 1.9-5.9, p < 0.001). Lack of awareness (63.2%, 36/57) and lack of time (15.8%, 9/57) were the most common reasons reported for non-receipt of vaccine. Conclusion: Many domestic pilgrims missed the compulsory meningococcal vaccine; in this regard, lack of awareness is a key barrier. Being an overseas pilgrim (or living at a distance from Makkah), receipt of pre-Hajj health advice, and employment were predictors of greater compliance with the vaccination policy. Opportunities remain to reduce the policy-practice gap among domestic pilgrims. Author Contributions: Conceptualization, G.R.B., T.A., H.A., and H.R.; data curation, A.-M.B.; formal analysis, A.-M.B. and H.R.; project administration, H.R.; supervision, A.K., R.B., and H.R.; validation, A.-M.B., F.A., W.F., Trop. Med. Infect. Dis. 2019, 4, 127 11 of 13 and A.A.; visualization, A.-M.B.; writing-original draft, A.-M.B., F.A., W.F., A.A., and A.K.; writing-review and editing

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Meningococcal Vaccine for Hajj Pilgrims: Compliance, Predictors, and Barriers

et al. 2019

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“…There are also several risk factors associated with Hajj in Saudi Arabia that can contribute to the severity of respiratory disease, such as a lack of rest and dehydration. Pilgrims with pre-existing respiratory diseases like asthma or COPD may experience asthma attacks or difficulty breathing, which if not dealt with immediately can cause respiratory failure and death (Ihaji, Gerald, Helen, & Ogwuche, 2014;Pane et al, 2019;Rahman, Thu, Arshad, & Van der Putten, 2017;Rudini, 2016).…”

Section: Relationship Between Genetic Risk Factors and Death Caused Bmentioning

confidence: 99%

Risk Factors for Respiratory Death Among Indonesian Pilgrims in 2018

Liani

Machmud

2020

JBE

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Background: In 2018, respiratory disease was the leading cause of death in Hajj pilgrims, accounting for 37% of total deaths. Purpose: This study analyzes the most influential risk factors for death caused by respiratory disease among Indonesian pilgrims in 2018. Methods: This study uses a cross sectional design. Secondary data was obtained from the 2018 Integrated Hajj Computerized System for Health (Siskohatkes) and sourced from the Hajj Health Center (Puskeshaji), Ministry of Health of the Republic of Indonesia which is also recorded about the first to third Hajj medical examination records. The sample was all pilgrims who died while performing the Hajj in Saudi Arabia, 361 pilgrims. The variables included age, gender, pre-existing respiratory disease, education level, type of work, BMI, smoking status, and influenza vaccination status. The data was analyzed using chi square and multiple logistic regression. Results: The majority of pilgrims who died during the Hajj pilgrimage in Saudi Arabia in 2018 were aged ≥60 years (75.30%), male (58.40%), did not have a pre-existing respiratory disease (85.60%), had a low education level (46.00%), worked indoors (73.10%), had a normal BMI (48.20%), did not smoke (88.60%), and had had the influenza vaccine (56.20%). The most influential risk factors were pre-existing respiratory disease with PR = 1.55 (95% CI = 1.16 – 2.90) and influenza vaccination status with PR = 1.39 (95% CI = 1.07 – 1.81). Conclusion: Having a pre-existing respiratory disease and not being vaccinated against influenza increase the likelihood of respiratory disease death among Indonesian pilgrims in 2018.

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“…Heat, sun exposure, thirst, crowding, traffic congestions, steep inclines, rough terrain, and cultural diversity present extensive stressors.’ Infection may spread. Extensive local medical support is provided …”

Section: Feetmentioning

confidence: 99%

Fasting, feasting, feet: religious festivals and diabetes

Hillson¹

2019

Practical Diabetes

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Mass Gatherings and Public Health: Case Studies from the Hajj to Mecca

Cited by 36 publications

References 29 publications

Meningococcal Vaccine for Hajj Pilgrims: Compliance, Predictors, and Barriers

Meningococcal Vaccine for Hajj Pilgrims: Compliance, Predictors, and Barriers

Risk Factors for Respiratory Death Among Indonesian Pilgrims in 2018

Fasting, feasting, feet: religious festivals and diabetes

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