Use of face masks and other personal preventive measures by Hajj pilgrims and their impact on health problems during the Hajj

Abstract

Background The Hajj is one of the world’s largest pilgrimage and gathers millions of Muslims from different nationalities every year. Communicable diseases have been reported frequently, during and following the Hajj and these have been linked to individual behavioural measures. This study aimed to measure the effect of personal preventive measures, such as facemask use, hand hygiene and others, adopted by pilgrims in reducing the acquisition of infectious diseases. Methods We conducted a cross-sectional study at the Hajj terminal in King Abdulaziz International Airport in Jeddah, Saudi Arabia. Pilgrims were approached in the airport lounges after the 2017 Hajj season and prior to the departure of their flights from Jeddah to their home countries. An electronic data collection tool (‘Open Data Kit’ (ODK)), was used to gather survey data in regards to health problems and preventive measures during the Hajj. Results 2973 Hajj pilgrims were surveyed. 38.7% reported symptoms of upper respiratory tract infections (URTI) and 5.4% reported symptoms of travel diarrhoea. Compliance with facemask use was 50.2%. Changing a facemask every 4 hours was found to be significantly associated with lower prevalence of URTIs (adjusted OR 0.56; (95% CI; 0.34–0.92), P = 0.02). There was no statistical difference between overall facemask use and URTI acquisition. The main sources of food, eating raw vegetables/food, frequency of hand washing or use of hand sanitisers were not found to be significantly associated with reported travellers’ diarrhoea. Unlicensed barbers were used by 12% of pilgrims and 9.2% of pilgrims reported using blades that were re-used by other pilgrims. Conclusion Preventive measures are the most effective way to prevent infections Pilgrims can benefit from facemasks by changing them frequently. There is still limited information on the effect of the use of facemask in decreasing the risk of URTI in mass gatherings.

A scoping review of Islamic pilgrimage to Mecca: Mapping the health concerns and proposed solutions

“…These advices were applicable for either healthy pilgrims or vulnerable people living with specific diseases. Personal hygiene and facemasks were universal precautions as preventive measures in communicable diseases and have been proven to be effective in preventing disease transmission (Alasmari et al., 2020; Sahin et al., 2015). All pilgrims should make sure they are fully vaccinated prior to making the Hajj and should be ready with their vaccination cards (Alasmari et al., 2020; Memish et al., 2017).…”

“…A few studies reported the incidence of death as only 13.89% in this review. There was an incidence rate of about 44 deaths The most common communicable disease during the Islamic pilgrimage to Mecca was respiratory tract infection (Alasmari et al, 2020;Farahmand et al, 2022;Mushi et al, 2021). This was followed by several ambiguous infectious symptoms such as cough, fever, and sore throat.…”

Facemask against viral respiratory infections among Hajj pilgrims: A challenging cluster-randomized trial

“…Several previous observational studies at Hajj have failed to show the effectiveness of facemasks in preventing respiratory infections [50][51][52], possibly due also to poor adherence to instructions, although a recent study showed that changing facemask every four hourly reduced the chance of upper respiratory tract infections among Hajj pilgrims (adjusted OR 0.56; 95% CI 0.34 to 0.92; p = 0.02) [55]. In our cRCT, though pilgrims in both intervention and control groups were close to each other day and night, none wore a mask for 24 hours as advised.…”

Travel‐related gastrointestinal diseases: Assessment and management

“…Although the incidence of TD has decreased in recent years, particularly in regions with growing economies [11], it remains a significant problem for international travellers. The reported incidence varies from 5.4% to 85% [12, 13] of travellers. It is intriguing to consider how COVID‐19 public health measures such as greater use of hand sanitisers may influence the incidence of TD, but an epidemiologic surveillance study from Spain did report a decrease in food and waterborne infections during year 1 of the pandemic [14].…”