1
|
Wicaksana AL, Hertanti NS. A scoping review of Islamic pilgrimage to Mecca: Mapping the health concerns and proposed solutions. Public Health Nurs 2024; 41:487-502. [PMID: 38468445 DOI: 10.1111/phn.13299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 12/15/2023] [Accepted: 02/22/2024] [Indexed: 03/13/2024]
Abstract
OBJECTIVES To map the current evidence about the health concerns and the potential solutions related to the Islamic pilgrimage to Mecca. DESIGN A scoping review was applied. Papers published in English between 2012 and 2023 were included but non-human research and sources without any related data were excluded. Data charting and extraction were used to map the current evidence. RESULTS The total of 36 papers were included with the total number of pilgrims of 17,075,887. The majority of studies were published in the Asia Pacific region (36.11%) as original articles (88.89%). The health concerns were grouped into five main aspects. There were 7603 deaths recorded or about 44 incidences of deaths per 100,000 pilgrims during the pilgrimage. There were recorded 11,018; 6178; 3393; and 17,810 cases for communicable diseases; non-communicable diseases; injuries and trauma; and health services (i.e., cardiac catheterization) and vaccination, respectively. CONCLUSION Relating to the five health concerns, this study identified the top seven issues in each category (i.e., hypertension, influenza vaccination), except for the death record. Moreover, there were three solutions (for general health, non- and communicable-diseases) presented. Stakeholders could use this evidence to improve healthcare quality particularly related to the annual Islamic pilgrimage to Mecca.
Collapse
Affiliation(s)
- Anggi Lukman Wicaksana
- Department of Medical Surgical Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- The Sleman Health and Demographic Surveillance System, Universitas Gadjah Mada, Yogyakarta, Indonesia
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
| | - Nuzul Sri Hertanti
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
- Center for Tropical Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| |
Collapse
|
2
|
Suraifi M, Delpisheh A, Karami M, Mehrabi Y, Jahangiri K, Lami F. Enhancing Public Health Surveillance: Outbreak Detection Algorithms Deployed for Syndromic Surveillance During Arbaeenia Mass Gatherings in Iraq. Cureus 2024; 16:e60134. [PMID: 38736767 PMCID: PMC11088799 DOI: 10.7759/cureus.60134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2024] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND Large gatherings often involve extended and intimate contact among individuals, creating environments conducive to the spread of infectious diseases. Despite this, there is limited research utilizing outbreak detection algorithms to analyze real syndrome data from such events. This study sought to address this gap by examining the implementation and efficacy of outbreak detection algorithms for syndromic surveillance during mass gatherings in Iraq. METHODS For the study, 10 data collectors conducted field data collection over 10 days from August 25, 2023, to September 3, 2023. Data were gathered from 10 healthcare clinics situated along Ya Hussein Road, a major route from Najaf to Karbala in Iraq. Various outbreak detection algorithms, such as moving average, cumulative sum, and exponentially weighted moving average, were applied to analyze the reported syndromes. RESULTS During the 10 days from August 25, 2023, to September 3, 2023, 12202 pilgrims visited 10 health clinics along a route in Iraq. Most pilgrims were between 20 and 59 years old (77.4%, n=9444), with more than half being foreigners (58.1%, n=7092). Among the pilgrims, 40.5% (n=4938) exhibited syndromes, with influenza-like illness (ILI) being the most common (48.8%, n=2411). Other prevalent syndromes included food poisoning (21.2%, n=1048), heatstroke (17.7%, n=875), febrile rash (9.0%, n=446), and gastroenteritis (3.2%, n=158). The cumulative sum (CUSUM) algorithm was more effective than exponentially weighted moving average (EWMA) and moving average (MA) algorithms for detecting small shifts. CONCLUSION Effective public health surveillance systems are crucial during mass gatherings to swiftly identify and address emerging health risks. Utilizing advanced algorithms and real-time data analysis can empower authorities to improve their readiness and response capacity, thereby ensuring the protection of public health during these gatherings.
Collapse
Affiliation(s)
- Mustafa Suraifi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IRN
| | - Ali Delpisheh
- Department of Epidemiology, Safety Promotion and Injury Prevention Research Center, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IRN
| | - Manoochehr Karami
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IRN
| | - Yadollah Mehrabi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IRN
| | - Katayoun Jahangiri
- Department of Health in Disaster and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IRN
| | - Faris Lami
- Department of Community and Family Medicine, College of Medicine, Baghdad University, Baghdad, IRQ
| |
Collapse
|
3
|
Alahmari AA, Khan AA, Alamri FA, Almuzaini YS, Habash AK, Jokhdar H. Healthcare policies, precautionary measures and outcomes of mass gathering events in the era of COVID-19 pandemic: Expedited review. J Infect Public Health 2024; 17 Suppl 1:27-33. [PMID: 37059635 PMCID: PMC10049799 DOI: 10.1016/j.jiph.2023.03.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/14/2023] [Accepted: 03/23/2023] [Indexed: 03/30/2023] Open
Abstract
With the onset of the COVID-19 pandemic in early 2020, several countries suspended or restricted mass gathering (MG) events to mitigate the risk of superspreading events. Prohibiting MGs aimed to lessen the likelihood of highly infectious persons coming into close contact with many others. Now that the world has opened its doors wide and removed most of precautionary measures, many questions arise. In this review, we aimed to summarize the current evidence regarding the policies and regulations that were implemented for the safe return of MG events. Besides, we highlighted the impact of the return of MG events during 2021 on the trajectory of COVID-19 spread. Canceling MG events can carry religious, societal, economic, and public negative consequences necessitating the safe return of these events. The experience with the COVID-19 pandemic was the foundation for the recommendations for the safe conduction of MG events during the pandemic by international public health bodies. When policymakers adequately applied precautionary measures and strategic approaches, we witnessed the safe holding of huge MG events without aggravating the COVID-19 situation or increasing the number of new cases beyond the capacity and readiness of the national healthcare system.
Collapse
Affiliation(s)
- Ahmed A Alahmari
- Global Centre for Mass Gatherings Medicine, Ministry of Health, Saudi Arabia
| | - Anas A Khan
- Department of Emergency Medicine, College of Medicine, King Saud University, Saudi Arabia
| | - Fahad A Alamri
- Global Centre of Mass Gatherings Medicine, Family Medicine, Primary Health Centre, Ministry of Health, Riyadh, Saudi Arabia.
| | - Yasir S Almuzaini
- Global Centre for Mass Gatherings Medicine, Ministry of Health, Saudi Arabia
| | - Alia K Habash
- Global Centre for Mass Gatherings Medicine, Ministry of Health, Saudi Arabia
| | - Hani Jokhdar
- Deputyship of Public Health, Ministry of Health, Riyadh, Saudi Arabia
| |
Collapse
|
4
|
Li N, Hou S, Zhang Y, Yao L, Li T. COVID-19 prevention and control measures and experiences during the 14th National Games of China: a qualitative interview study. Front Public Health 2024; 11:1271615. [PMID: 38317684 PMCID: PMC10840134 DOI: 10.3389/fpubh.2023.1271615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/22/2023] [Indexed: 02/07/2024] Open
Abstract
Background The 14th National Games was the first sporting mass gathering to be held in China in the context of the COVID-19 pandemic. It may increase the risk of severe acute respiratory syndrome coronavirus 2 transmission. In order to reduce the spread of the virus during the 14th National Games, the Chinese government took a series of public health measures, and ultimately no confirmed cases were found in the 14th National Games venues. Objective This study aimed to discuss preventive and control measures used to respond to the COVID-19 pandemic during the 14th National Games. Methods Five experts were selected for this study using a snowball sampling method, and semistructured and in-depth interviews were conducted. Based on grounded theory, the transcriptions were analysed and coded using Nvivo 12 software. Results A theoretical model of the COVID-19 prevention and control measures at the 14th National Games of China was constructed. The model contains seven main components: the health risks of mass gatherings, crowd management, emergency medical care, allocation of emergency medical resources, pandemic emergency drills, the pandemic prevention and control management platform (Quanyuntong app), and emergency response plans. Conclusion The study showed that the deployment of emergency medical resources was the most important for mass gatherings. This study not only expanded the applications of grounded theory but also serves as a reference for future scholars when conducting more in-depth empirical studies on public health countermeasures for mass gatherings and can inform organizers when holding mass gatherings.
Collapse
Affiliation(s)
- Nan Li
- College of Management and Economics, Tianjin University, Tianjin, China
| | - Shike Hou
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China
| | - Yongzhong Zhang
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China
| | - Lulu Yao
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China
| | - Tiantian Li
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China
| |
Collapse
|
5
|
Alrashdi MM, Al Thobaity A. Exploring the experiences, motivations, and skillsets of nurse volunteers during Hajj: implications for enhancing volunteer programs. BMC Nurs 2024; 23:44. [PMID: 38225578 PMCID: PMC10790463 DOI: 10.1186/s12912-024-01712-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 01/03/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND The annual Islamic pilgrimage of Hajj attracts millions of pilgrims from around the world, necessitating the involvement of healthcare professionals, including nurse volunteers, to ensure the safety and well-being of attendees. This study aims to explore the experiences, motivations, and skillsets of nurse volunteers during the Hajj pilgrimage, focusing on the personal, professional, and spiritual dimensions of volunteering, and providing insights to enhance volunteer programs. METHODS The demographic data shows that the majority of nurse volunteers during Hajj 2022 fell in the 30-39 age group and were predominantly women. The study provides insights into the interest, experience, and motives for volunteering, with spiritual motives cited as a primary driver. An overview of volunteer hours, perceived benefits, and pre-existing skills reveals diverse commitments and skillsets among the volunteers. RESULTS Nurse volunteers during Hajj 2022 show diverse age and gender composition, strong commitment, spiritual motives, varied engagement, and professional skills. Team dynamics, skills development, and positive experiences are crucial. A potential gap exists in preparatory education. Significant associations are found between age, volunteer hours, training, skill practice, and gender. CONCLUSION This study highlights the multifaceted benefits of volunteering during Hajj and underscores the need for decision-makers to devise strategies that cater to diverse needs, foster collaboration, and enhance the preparedness of nurse volunteers. Further research is suggested to examine the long-term impact of volunteering during Hajj on nurses' professional development and personal well-being and to evaluate the effectiveness of various recruitment strategies, training programs, and support initiatives.
Collapse
Affiliation(s)
- Mashael Mohammed Alrashdi
- Ministry of Health, Riyadh First Health Complex Al Kharj Zone, 8295 Ibn Taqi, Al-Hamra district, Riyadh Region, Al-Kharj Governorate, Saudi Arabia
| | - Abdulellah Al Thobaity
- Medical Surgical Nursing Department, College of Nursing, Taif University, 3966, 26516, Taif, Saudi Arabia.
| |
Collapse
|
6
|
Alrufaidi KM, Nouh RM, Alkhalaf AA, AlGhamdi NM, Alshehri HZ, Alotaibi AM, Almashaykhi AO, AlGhamdi OM, Makhrashi HM, AlGhamdi SA, AlZahrani AG, Mujib SA, Abd-Ellatif EE. Prevalence of emergency cases among pilgrims presenting at King Abdulaziz International Airport Health Care Center at Hajj Terminal, Jeddah, Saudi Arabia during Hajj Season, 1440 H - 2019. DIALOGUES IN HEALTH 2023; 2:100099. [PMID: 38515476 PMCID: PMC10954003 DOI: 10.1016/j.dialog.2023.100099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 12/23/2022] [Accepted: 01/05/2023] [Indexed: 09/02/2023]
Abstract
Introduction About 2-3 million pilgrims come to Makkah, Saudi Arabia from all countries to perform Hajj. During the Hajj season of 2019 (1440 H), the total number of pilgrims was 2,489,406, of whom 1,855,027 came from foreign countries. This study aims to investigate the prevalence, pattern, and findings of emergency health problems among pilgrims travelling through King Abdul Aziz International Airport Health Care Center (KAIA-HC) at Hajj Terminal in Jeddah during hajj season of 1440-H. Methodology A cross-sectional study was conducted by reviewing the medical records of pilgrims coming for treatment at KAIA-HC, before and after Hajj between 1 Dhul Qi'dah to 29 Dhul Hijjah 1440 AH (Corresponding to 4 July to 31 August 2019 AD). The collected data included demographics, medical history, diagnoses of the emergency health problems, infections, and their findings. Data were analyzed using Epi Info 7 and SPSS 25. Results About 296 (3.87%) of 7,643 pilgrims treated at KAIA-HC were emergency cases. Their average age was 43 years (Standard Deviation (SD) ±7.5); 51.3% were females; the highest (45.3%) was between 30 - 59 years age group, both males and females; the highest two nationalities were Indonesian (14.2%) and Egyptian (12.5%). Diagnoses included hypertension 59(19.9%), bronchial asthma 53 (17.9%), and 23 cases (10.5%) were suffering from hypotension. 16 (5.4%) of patients had a myocardial infarction and 10 (3.4%) had cerebrovascular accidents. In 13 cases (4.4%), a chest infection was reported. Diabetes complications (hyperglycemia, hypoglycemia, and diabetic ketoacidosis) were reported in 28 (9.4%) of the cases. There were 28 (9.5%) surgical diagnoses, 13 (4.4%) were cut wounds, 11 (3.7%) were bone fracture and dislocation, and 4 (1.4%) were head trauma. With regard to the findings, 82 (27.7%) were referred to hospitals; 10 (3.3%) cases required Cardio-Pulmonary Resuscitation, seven of whom survived. The most common referral causes were myocardial Infarction amounting 12(4.05%), followed by cerebrovascular accident 10(3.3%) and chest infection in 8 (2.7%). 13 (4.4%) of the total cases died. The most common causes of death were myocardial infarction, asthma, hypertension and hyperglycemia. Conclusion Our study emphasizes that emergency cases presented at KAIA-HC were few. Cardiovascular diseases represented the main reason for emergency cases, followed by respiratory diseases. 51% of patients were discharged without the need for a higher level of medical care.
Collapse
Affiliation(s)
| | - Randa Mohammed Nouh
- Consultant of Public Health, Field Epidemiology Training Program, MOH, Saudi Arabia
| | | | | | | | | | | | | | | | - Saeed Abdulaziz AlGhamdi
- Department of Nursing, Health Control Center at King Abdulaziz International Airport, Jeddah, Saudi Arabia
| | | | | | - Eman Elsayed Abd-Ellatif
- Department of Public Health and Community Medicine, Faculty of Medicine, Mansoura University, 35511, Egypt
| |
Collapse
|
7
|
Haseeb A, Saleem Z, Faidah HS, Saati AA, AlQarni A, Iqbal MS, Alghamdi S, Elrggal ME, AlGethamy M, Radwan RM, Mahrous AJ, Abuhussain SSA, Khayyat SM, Ibrahim K, Godman B, Sheikh A. Threat of Antimicrobial Resistance among Pilgrims with Infectious Diseases during Hajj: Lessons Learnt from COVID-19 Pandemic. Antibiotics (Basel) 2023; 12:1299. [PMID: 37627718 PMCID: PMC10451798 DOI: 10.3390/antibiotics12081299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/19/2023] [Accepted: 07/19/2023] [Indexed: 08/27/2023] Open
Abstract
Hajj pilgrimage is a large mass gathering global event that may facilitate the spread and emergence of various infectious diseases as well as antimicrobial resistance (AMR) in a local and global scenario. Planning and preparing for these public health issues is a challenging and complex process for the Kingdom of Saudi Arabia (KSA) health authorities. Despite multiple efforts for the prevention and treatment of infectious diseases through longtime funding in education and medical care, the prevalence of infectious disease is still high among Hajj pilgrims. The commonly observed infectious diseases during Hajj include respiratory tract infections (influenza and pneumonia), urinary tract infections and skin infections that may necessitate the use of antimicrobials. Beta-lactams are used as a first-line treatment for hospital acquired infections as well as community acquired infections due to their broad-spectrum activity. However, most of the bacterial isolates such as Staphylococcus spp., Pseudomonas spp. and E. coli are resistant to beta-lactams. Irrational use of antimicrobials, lack of infection prevention practices and suboptimal healthcare access further exacerbate the risk of spreading AMR among Hajj pilgrims. Enhanced collaboration between countries, sharing of best practices and international cooperation are crucial in addressing AMR threats among pilgrims. Consequently, robust surveillance systems for early detection and monitoring of AMR, collaboration with national as well as international healthcare agencies, effective infection prevention and control measures, public awareness and rational use of antimicrobials via antimicrobial stewardship programs are required to mitigate the risk of AMR and ensure the health and well-being of pilgrims during Hajj.
Collapse
Affiliation(s)
- Abdul Haseeb
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia
| | - Zikria Saleem
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan
| | - Hani Saleh Faidah
- Department of Microbiology, Faculty of Medicine, Umm Al-Qura University, Makkah 24382, Saudi Arabia
| | - Abdullah A. Saati
- Department of Community Medicine & Pilgrims Healthcare, Faculty of Medicine, Umm Al-Qura University, Makkah 24382, Saudi Arabia
| | - Abdullmoin AlQarni
- Department of Infectious Diseases, Alnoor Specialist Hospital Makkah, Makkah 24382, Saudi Arabia
| | - Muhammad Shahid Iqbal
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia
| | - Saleh Alghamdi
- Department of Clinical Pharmacy, Faculty of Clinical Pharmacy, Al Baha University, Al Baha 57911, Saudi Arabia
| | - Mahmoud E. Elrggal
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia
| | - Manal AlGethamy
- Department of Infection Prevention & Control Program, Alnoor Specialist Hospital Makkah, Makkah 24382, Saudi Arabia
| | - Rozan Mohammad Radwan
- Pharmaceutical Care Department, Alnoor Specialist Hospital, Makkah 24382, Saudi Arabia
| | - Ahmad Jamal Mahrous
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia
| | | | - Sarah M. Khayyat
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia
| | - Kiran Ibrahim
- Department of Epidemiology and Public Health, University of Nottingham, Nottingham NG7 2QL, UK
| | - Brian Godman
- School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria 0208, South Africa;
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow G4 0RE, UK
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman 346, United Arab Emirates
| | - Aziz Sheikh
- Usher Institute, The University of Edinburgh, Teviot Place, Edinburgh EH16 4UX, UK
| |
Collapse
|
8
|
Taheri M, Eshrati B, Bahadorimonfared A, Sohrabi MR. The Association of Acute Watery Diarrhea in Iranian Pilgrims of Iraq with Cholera Cases in Iranians. Med J Islam Repub Iran 2023; 37:52. [PMID: 37426475 PMCID: PMC10329509 DOI: 10.47176/mjiri.37.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Indexed: 07/11/2023] Open
Abstract
Background Despite the advances in the control of infectious diseases like cholera, they can potentially cause epidemics, especially in mass gathering events. One of the most important countries on the walking way of the Arbaeen religious event is Iran, which requires health system preparedness. The aim of this study was to predict the cholera epidemic in Iran by using the syndromic surveillance system of Iranian pilgrims in Iraq. Methods The data of the Iranian pilgrims with acute watery diarrhea in Iraq during the Arbaeen religious event and the confirmed cholera cases of pilgrims after returning to Iran were analyzed. We used the Poisson regression model of the relationship between the numbers of cases to evaluate acute watery diarrhea and cholera. Spatial statistics and hot spot analysis were used to identify the provinces with the highest incidence. SPSS software Version 24 was used for statistical analysis. Results The frequency of acute watery diarrhea cases was 2232 and the frequency of cholera in pilgrims after returning to Iran was 641. The results of spatial analysis for acute watery diarrhea cases showed a high number of acute watery diarrhea cases in the Khuzestan and Isfahan provinces, located in hot spots. Using Poisson regression, the relationship between the number of acute watery diarrhea reported in the syndromic surveillance system and the number of cholera cases was confirmed. Conclusion The syndromic surveillance system is useful to predict the outbreak of infectious diseases in large religious mass gatherings.
Collapse
Affiliation(s)
- Mahbobeh Taheri
- Department of Community Medicine, School of Medicine, Shahid Beheshti University
of Medical Sciences, Tehran, Iran
| | - Babak Eshrati
- Preventive Medicine and Public Health Research Center, Iran University of
Medical Sciences, Tehran, Iran
| | - Ayad Bahadorimonfared
- Department of Community Medicine, School of Medicine, Shahid Beheshti University
of Medical Sciences, Tehran, Iran
| | - Mohammad-Reza Sohrabi
- Department of Community Medicine, School of Medicine, Shahid Beheshti University
of Medical Sciences, Tehran, Iran
- Social Determinants of Health Research Centre, Shahid Beheshti University of
Medical Science, Tehran, Iran
| |
Collapse
|
9
|
Diwan V, Sharma U, Ganeshkumar P, Thangaraj JWV, Muthappan S, Venkatasamy V, Parashar V, Soni P, Garg A, Pawar NS, Pathak A, Purohit MR, Madhanraj K, Hulth A, Ponnaiah M. Syndromic surveillance system during mass gathering of Panchkroshi Yatra festival, Ujjain, Madhya Pradesh, India. New Microbes New Infect 2023; 52:101097. [PMID: 36864894 PMCID: PMC9971318 DOI: 10.1016/j.nmni.2023.101097] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 01/29/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023] Open
Abstract
Background The health implications surrounding a mass gathering pose significant challenges to public health officials. The use of syndromic surveillance provides an ideal method for achieving the public health goals and objectives at such events. In the absence of published reports of systematic documentation of public health preparedness in mass gatherings in the local context, we describe the public health preparedness and demonstrate the operational feasibility of a tablet-based participatory syndromic surveillance among pilgrims during the annual ritual circumambulation- Panchkroshi Yatra. Methods A real-time surveillance system was established from 2017-2019 to capture all the health consultations done at the designated points (medical camps) in the Panchkroshi yatra area of the city Ujjain in Madhya Pradesh. We also surveyed a subset of pilgrims in 2017 to gauge satisfaction with the public health measures such as sanitation, water, safety, food, and cleanliness. Results In 2019, injuries were reported in the highest proportion (16.7%; 794/4744); most numbers of fever cases (10.6%; 598/5600) were reported in 2018, while 2017 saw the highest number of patient presentations of abdominal pain (7.73%; 498/6435). Conclusion Public health and safety measures were satisfactory except for the need for setting up urinals along the fixed route of the circumambulation. A systematic data collection of selected symptoms among yatris and their surveillance through tablet could be established during the panchkroshi yatra, which can complement the existing surveillance for detecting early warning signals. We recommend the implementation of such tablet-based surveillance during such mass gathering events.
Collapse
Affiliation(s)
- Vishal Diwan
- ICMR- National Institute for Research in Environmental Health, Bhopal, India,Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden,Corresponding author. ICMR- National Institute for Research in Environmental Health, Bhopal, India.
| | - Upasana Sharma
- ICMR- National Institute of Epidemiology, Chennai, India
| | | | | | | | | | | | | | - Ankit Garg
- R.D Gardi Medical College, Ujjain, India
| | | | | | | | | | | | | |
Collapse
|
10
|
Rathbone JA, Stevens M, Cruwys T, Ferris LJ. COVID-safe behaviour before, during and after a youth mass gathering event: a longitudinal cohort study. BMJ Open 2022; 12:e058239. [PMID: 35820769 PMCID: PMC9274022 DOI: 10.1136/bmjopen-2021-058239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE As mass gathering events resume in the wake of the COVID-19 pandemic, there is a pressing need to understand (a) engagement in COVID-safe behaviour at these events and (b) how attending a mass gathering impacts subsequent behaviours. This study examined anticipated COVID-safe behaviour before, during, and after a youth mass gathering event. DESIGN Longitudinal cohort study. SETTING Self-report data were collected online at five timepoints from secondary-school graduates participating in celebrations linked to an annual week-long youth mass gathering event in Australia. PARTICIPANTS Australian secondary-school graduates completed surveys before the event (N=397), on days 1 (N=183), 3 (N=158) and 5 (N=163) of the event, and 3 weeks after the event (N=140). Of those who completed the first survey, 72 indicated they would attend a primary mass gathering site where the largest mass gathering of graduates in Australia occurs in a typical (non-pandemic) year; 325 indicated they would be celebrating at other locations (ie, secondary sites). PRIMARY OUTCOME MEASURES Anticipated COVID-safe behaviour: physical distancing from friends and strangers and additional protective behaviours (hand hygiene and mask wearing). RESULTS At all timepoints, participants anticipated maintaining appropriate (>1.5 m) physical distance from strangers, but not from friends (<0.5 m). Attendees at the primary site reported less physical distancing from friends over time throughout the mass gathering, χ2(4)=16.89, p=0.002. Physical distancing from strangers, χ2(4)=26.93, p<0.001, and additional protective behaviours, χ2(4)=221.23, p<0.001, also declined across the mass gathering among both groups. These reductions in COVID-safe behaviour were significant and enduring, with all declines persisting at follow-up. CONCLUSION It is critical that public health messaging and interventions emphasise the risks of disease transmission arising from other attendees who are known to us during mass gathering events, and that such messaging is sustained during and following the event to combat reductions in COVID-safe behaviour.
Collapse
Affiliation(s)
- Joanne A Rathbone
- Research School of Psychology, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Mark Stevens
- Research School of Psychology, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Tegan Cruwys
- Research School of Psychology, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Laura J Ferris
- School of Business, The University of Queensland, Saint Lucia, Queensland, Australia
| |
Collapse
|
11
|
Madu Emeka P, Ineta Badg L, Estrella E, Belgira An G, Ezzat Khal H. Investigation of Colistin and Polymyxin B on Clinical Extreme Resistant Enterobacteriaceae Isolates for Surveillance Purposes. INT J PHARMACOL 2022. [DOI: 10.3923/ijp.2022.699.713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
12
|
Nurhayati N, Purnama TB. Funeral Processes During the COVID-19 Pandemic: Perceptions Among Islamic Religious Leaders in Indonesia. JOURNAL OF RELIGION AND HEALTH 2021; 60:3418-3433. [PMID: 34472008 PMCID: PMC8409696 DOI: 10.1007/s10943-021-01418-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/27/2021] [Indexed: 06/13/2023]
Abstract
Controversies surrounding the handling of corpses have been amplified during the present COVID-19 pandemic. According to Indonesian scholars, certain perspectives driving these controversies inhibit the implementation of health protocols issued by the government. This study comprehensively explores the diverse perceptions and responses of religious leaders regarding COVID-19 funeral management. Participants comprised six scholars from major Islamic religious organizations, two community leaders, and two families representing COVID-19 patients. Furthermore, content analysis was used to analyze the data. The results showed that the religious leaders, all men aged over 50 years, supported the health directives designed to reduce high transmission risk. However, there were substantial disparities in corpse preparation processes, potentially due to organizational beliefs around burial rites. Some religious leaders aligned their protocols with their religious beliefs. Conversely, families of the deceased insisted that the approved protocol for handling corpses went against their religious and cultural values. Therefore, promotion of protocols and coordination among the government, religious leaders, and the community are needed to decrease the misperceptions and misinformation surrounding the new COVID-19 funeral protocols.
Collapse
Affiliation(s)
- Nurhayati Nurhayati
- Faculty of Public Health, Universitas Islam Negeri Sumatera Utara, Jl IAIN, Gaharu, Medan, Indonesia.
| | - Tri Bayu Purnama
- Faculty of Public Health, Universitas Islam Negeri Sumatera Utara, Jl IAIN, Gaharu, Medan, Indonesia
- Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition/Pusat Kajian Gizi Regional UI, East Jakarta, Indonesia
| |
Collapse
|
13
|
Easy Access to Antibiotics; Spread of Antimicrobial Resistance and Implementation of One Health Approach in India. J Epidemiol Glob Health 2021; 11:444-452. [PMID: 34734384 PMCID: PMC8477994 DOI: 10.1007/s44197-021-00008-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 09/14/2021] [Indexed: 11/01/2022] Open
Abstract
Antimicrobial resistance (AMR) is a global public health concern because of its fast spread. India, one of the world's top consumer of antibiotics and second most populated country has its unique constraints of social, cultural and economic strata. The continual self-medication, use of antibiotics for the growth promotion in animals, and accumulation of residual antibiotics in the environment challenge the implementation of AMR containment policy. Hence, the present review attempts to delineate the influence of antibiotics abuse on the human, animal and environmental health under the realm of one health. It was based on the literature search using public databases to highlight the rapid surge in the burden of AMR in India affecting various sectors and/or ecosystems in India. It was found that the irrational and overuse of antibiotics in different sectors have led to the emergence of extended antimicrobial resistance wherein the environment acts as a reservoir of antibiotic resistance genes (ARGs); completing the cycle of contamination and recontamination. There are efforts by government policy makers to reduce the burden of AMR in the country to reduce the health risks, through the One Health approach. Parallel efforts in educating healthcare professionals, strict legislation for pharmacies and pharmaceutical companies should be prioritize. At the same time surveillance of newly emerged AMR pathogens, prioritising research focusing on AMR, and awareness camps or programs among the local population is critical while addressing the consequences of spared of AMR in India.
Collapse
|
14
|
Khan AA, Sabbagh AY, Ranse J, Molloy MS, Ciottone GR. Mass Gathering Medicine in Soccer Leagues: A Review and Creation of the SALEM Tool. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18199973. [PMID: 34639274 PMCID: PMC8508246 DOI: 10.3390/ijerph18199973] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 12/05/2022]
Abstract
Potential risks for public health incidents, outbreaks, and casualties are inferred at association football events, especially if event organizers have not taken appropriate preventative measures. This review explores the potential risks imposed by mass gathering (MG) football events, with particular emphasis on tools and methodologies to manage the risks of football MG events. Effective planning and implementation of MGs along with the mitigation of risks related to people’s health require special attention to all potential threats, especially in frequent and recurring MG events such as football leagues. The well-being of all participants can be compromised by ignoring a single risk. Healthcare systems should cooperate with all stakeholders and organizations who are involved in MG management and response. Provision of services during MG or a disaster must be performed by trained personnel or entities that have full access to available resources in accessible publicly known locations at the MG event site. Several MG assessment tools were developed worldwide; however, to adapt to the Saudi context, SALEM tool was developed to provide a guide for MG planning and assessment. SALEM assesses the risks of MG events with scores that help to categorize the risk of MG events by offering recommendations for required resources.
Collapse
Affiliation(s)
- Anas A. Khan
- Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh 12372, Saudi Arabia
- The Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh 12372, Saudi Arabia
- Correspondence: ; Tel.: +966-11-806-6590
| | | | - Jamie Ranse
- Menzies Health Institute Queensland, Griffith University, Gold Coast 4215, Australia;
- Department of Emergency Medicine, Gold Coast Health, Gold Coast 4215, Australia
| | - Michael S. Molloy
- University College Dublin School of Medicine and Medical Science, D04 V1W8 Dublin, Ireland;
- Faculty Sports and Exercise Medicine, Royal College of Surgeons in Ireland, RCSI House 121 St. Stephen’s Green, D02 H903 Dublin, Ireland
- Disaster Medicine Fellowship, Beth Israel Deaconess Medical Center, 457 Brookline Ave., Boston, MA 02215, USA
- Wexford General Hospital, Ireland East Hospital Group, Carricklawn, Y35 Y17D Wexford, Ireland
| | | |
Collapse
|
15
|
Medicine in Unplanned Mass Gatherings: A Qualitative Study of Health-Care Providers' Response and Recommendations to Beirut's Protests. Disaster Med Public Health Prep 2021; 16:1532-1536. [PMID: 34284849 DOI: 10.1017/dmp.2021.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study aims at exploring the dynamics of health-care provision during recent unplanned public mass gatherings in Beirut, and how the health-care system adapts to mass movements in protests. METHODS A qualitative study was conducted using semi-structured interviews with 12 health-care providers who volunteered at medical tents set during protests in Beirut, Lebanon. Responses were transcribed and coded. RESULTS Three themes were noted: preparedness and logistics, encountered cases, and participants' proposed recommendations. In terms of preparedness and logistics, participants lacked knowledge of field medicine protocols and an organizational structure. They faced difficulties in securing equipment and advertising their services. Most encountered cases were physical injuries rather than mental health problems. The participants proposed both short-term recommendations, including advice on how to boost care provided, and long-term recommendations on structuring the health-care system to be better prepared. CONCLUSIONS On-site health-care provision during unplanned mass gatherings is a vital need. We recommend forming a task force of health-care workers from various fields led by the Ministry of Public Health in every respective country to plan protocols, train personnel, and secure resources beforehand.
Collapse
|
16
|
Sharaf F, El-Samongy M, Bouqellah N, Al-Madani A, Abu-Alruhaylah M, Ashour Y, Dar-Odeh N, Abu Hammad O. Ethnicity is a major determinant of the pattern of dermatological diseases among pilgrims during the Hajj in 2019. Dermatol Reports 2021; 13:8934. [PMID: 33824707 PMCID: PMC8018253 DOI: 10.4081/dr.2021.8934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 01/21/2021] [Indexed: 11/23/2022] Open
Abstract
The authors aim to explore the pattern and demographics of dermatological disorders occurring during Hajj 2019. Clinical records from three major public healthcare facilities in Al-Madinah Al-Munawara were retrieved for the period July-August, 2019. Collected data included age, gender, nationality, and dermatological complaints. 550 records were retrieved. Patients were 282 (51.3%) males and 268 (48.7%) females with a mean age of 58.3±12.6 years. Most patients were Asians (n=320, 58.2%), and Africans (n=183, 33.3%). Accidents (n=226, 41.1%), and infections (148, 26.9%) were the most common complaints. Asians and Africans had significantly: more accidents and less infections (P=0.002, P=0.027 respectively). They were the only category affected by exacerbations of auto immune diseases. Asian and African pilgrims are mainly affected by traumatic dermatologic conditions. Preventive awareness programs should target these ethnicities to reduce their higher rates of accidents. Other ethnicities need programs that promote hygienic practices and target infections.
Collapse
Affiliation(s)
- Futoun Sharaf
- College of Medicine, Al-Rayan Colleges, Al Madina Al Munawara, Saudi Arabia
| | | | - Nahla Bouqellah
- College of Science, Taibah University, Al Madina Al Munawara, Saudi Arabia
| | | | | | - Yasir Ashour
- Al Madinah General Hospital, Al Madina Al Munawara, Saudi Arabia
| | - Najla Dar-Odeh
- College of Dentistry, Taibah University, Al Madina Al Munawara, Saudi Arabia.,School of Dentistry, University of Jordan, Amman, Jordan
| | - Osama Abu Hammad
- College of Dentistry, Taibah University, Al Madina Al Munawara, Saudi Arabia.,School of Dentistry, University of Jordan, Amman, Jordan
| |
Collapse
|
17
|
Elias HI, Chicanequisso EM, Nhantumbo B, Braga JM, Gurjal L, Luis M, Dimas T, Baltazar CS, Rossetto EV. Profile of people seeking health services during Pope Francis' visit to Mozambique, 2019. Pan Afr Med J 2020; 35:95. [PMID: 32636993 PMCID: PMC7320787 DOI: 10.11604/pamj.2020.35.95.21611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 03/04/2020] [Indexed: 11/23/2022] Open
Abstract
Pope Francis visited Mozambique from September 4-6, 2019. During the visit, a real-time surveillance system for mass gathering events was implemented in all places where people gathered in Maputo City for early detection of possible outbreaks and other health-related events. The system was implemented at four sites were mass gathering events occurred over the three-day visit. Data were collected by administering a simple questionnaire on a tablet, which collected information about sociodemographics, syndromic diagnoses, and outcomes of the patients that sought medical care. Additionally, a descriptive epidemiological assessment was performed during the event. A total of 150 individuals were attended at the designated places during the event. Of these, 56.7% were female and 90.7% aged > 15 years. The majority of the patients (74.7%) sought care on the third day of the event, which was held at the Zimpeto National Stadium. The most common diagnoses were hypertension (20.7%), hypothermia (15.3%), and headache (11.3%). Almost all cases (95.0%) were discharged, (4.0%) cases were transferred and (1.0%) case resulted in death on the way to the health facility. The surveillance system strategy developed to detect real-time public health events during the Pope?s visit was successfully implemented. No outbreak was identified during the event.
Collapse
Affiliation(s)
- Hélio Inácio Elias
- Mozambique Field Epidemiology Training Program, Instituto Nacional de Sade, Maputo, Mozambique
| | | | - Beatriz Nhantumbo
- Mozambique Field Epidemiology Training Program, Instituto Nacional de Sade, Maputo, Mozambique
| | - Judite Monteiro Braga
- Mozambique Field Epidemiology Training Program, Instituto Nacional de Sade, Maputo, Mozambique.,Instituto Nacional de Saúde, Maputo, Mozambique
| | - Lorna Gurjal
- Epidemiology Department, National Public Health Directorate, Ministry of Health, Maputo, Mozambique
| | - Maiumuna Luis
- Epidemiology Department, National Public Health Directorate, Ministry of Health, Maputo, Mozambique
| | - Tomas Dimas
- Instituto Nacional de Saúde, Maputo, Mozambique
| | | | - Erika Valeska Rossetto
- MassGenics assigned to Mozambique Centers for Disease Control and Prevention, Maputo, Mozambique
| |
Collapse
|
18
|
Alasmari AK, Edwards PJ, Assiri AM, Behrens RH, Bustinduy AL. Use of face masks and other personal preventive measures by Hajj pilgrims and their impact on health problems during the Hajj. J Travel Med 2020; 27:5903249. [PMID: 32901805 DOI: 10.1093/jtm/taaa155] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/25/2020] [Accepted: 08/24/2020] [Indexed: 11/13/2022]
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 face mask 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') was used to gather survey data in regards to health problems and preventive measures during the Hajj. RESULTS A total of 2973 Hajj pilgrims were surveyed. In all, 38.7% reported symptoms of upper respiratory tract infections (URTIs) and 5.4% reported symptoms of travel diarrhoea. Compliance with face mask use was 50.2%. Changing a face mask every 4 h was found to be significantly associated with lower prevalence of URTIs [adjusted odds ratio 0.56 (95% confidence interval 0.34-0.92), P = 0.02]. There was no statistical difference between overall face mask use and URTI acquisition. The main sources of food, eating raw vegetables/food, frequency of hand washing or use of hand sanitizers 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 reused by other pilgrims. CONCLUSION Preventive measures are the most effective way to prevent infections. Pilgrims can benefit from face masks by changing them frequently. There is still limited information on the effect of the use of face mask in decreasing the risk of URTI in mass gatherings.
Collapse
Affiliation(s)
- Abrar K Alasmari
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Phil J Edwards
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Abdullah M Assiri
- Preventive Health, Ministry of Health, Riyadh, Kingdom of Saudi Arabia
| | - Ronald H Behrens
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Amaya L Bustinduy
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
19
|
AL-Eitan LN, Tarkhan AH, Alghamdi MA, Marston DA, Wu G, McElhinney LM, Brown IH, Fooks AR. Bat-Borne Coronaviruses in Jordan and Saudi Arabia: A Threat to Public Health? Viruses 2020; 12:E1413. [PMID: 33316899 PMCID: PMC7764733 DOI: 10.3390/v12121413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/30/2020] [Accepted: 12/03/2020] [Indexed: 11/22/2022] Open
Abstract
Emerging infectious diseases are of great concern to public health, as highlighted by the ongoing coronavirus disease 2019 (COVID-19) pandemic. Such diseases are of particular danger during mass gathering and mass influx events, as large crowds of people in close proximity to each other creates optimal opportunities for disease transmission. The Hashemite Kingdom of Jordan and the Kingdom of Saudi Arabia are two countries that have witnessed mass gatherings due to the arrival of Syrian refugees and the annual Hajj season. The mass migration of people not only brings exotic diseases to these regions but also brings new diseases back to their own countries, e.g., the outbreak of MERS in South Korea. Many emerging pathogens originate in bats, and more than 30 bat species have been identified in these two countries. Some of those bat species are known to carry viruses that cause deadly diseases in other parts of the world, such as the rabies virus and coronaviruses. However, little is known about bats and the pathogens they carry in Jordan and Saudi Arabia. Here, the importance of enhanced surveillance of bat-borne infections in Jordan and Saudi Arabia is emphasized, promoting the awareness of bat-borne diseases among the general public and building up infrastructure and capability to fill the gaps in public health preparedness to prevent future pandemics.
Collapse
Affiliation(s)
- Laith N. AL-Eitan
- Department of Biotechnology and Genetic Engineering, Jordan University of Science and Technology, Irbid 22110, Jordan;
| | - Amneh H. Tarkhan
- Department of Biotechnology and Genetic Engineering, Jordan University of Science and Technology, Irbid 22110, Jordan;
| | - Mansour A. Alghamdi
- Department of Anatomy, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia;
- Genomics and Personalized Medicine Unit, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
| | - Denise A. Marston
- Department of Virology, Animal and Plant Health Agency (APHA, Weybridge), Surrey KT15 3NB, UK; (D.A.M.); (G.W.); (L.M.M.); (I.H.B.); (A.R.F.)
| | - Guanghui Wu
- Department of Virology, Animal and Plant Health Agency (APHA, Weybridge), Surrey KT15 3NB, UK; (D.A.M.); (G.W.); (L.M.M.); (I.H.B.); (A.R.F.)
| | - Lorraine M. McElhinney
- Department of Virology, Animal and Plant Health Agency (APHA, Weybridge), Surrey KT15 3NB, UK; (D.A.M.); (G.W.); (L.M.M.); (I.H.B.); (A.R.F.)
| | - Ian H. Brown
- Department of Virology, Animal and Plant Health Agency (APHA, Weybridge), Surrey KT15 3NB, UK; (D.A.M.); (G.W.); (L.M.M.); (I.H.B.); (A.R.F.)
| | - Anthony R. Fooks
- Department of Virology, Animal and Plant Health Agency (APHA, Weybridge), Surrey KT15 3NB, UK; (D.A.M.); (G.W.); (L.M.M.); (I.H.B.); (A.R.F.)
| |
Collapse
|
20
|
Youssouf BM, Alfalati B, Alqthmi R, Alqthmi R, Alsehly LM. Causes of Upper Gastrointestinal Bleeding Among Pilgrims During the Hajj Period in the Islamic Years 1437-1439 (2016-2018). Cureus 2020; 12:e10873. [PMID: 33178526 PMCID: PMC7652364 DOI: 10.7759/cureus.10873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Approximately 3.5 million pilgrims perform Hajj every year. Planning for their healthcare requires knowledge of the pattern of diseases and risk factors of pilgrims who require hospitalization during the Hajj period. The aim of the current study was to evaluate common causes and risk factors of upper gastrointestinal bleeding (UGIB) among pilgrims during the Hajj season. Method We conducted a retrospective cross-sectional study using a data collection checklist to collect data from medical records. We included all patients who had UGIB and attended the endoscopy department of the King Abdulaziz Hospital, Mecca, in the AL-Hajj season of the Islamic years 1437-1439 (2016-2018). Results A total of 93 patients were included in the current study; of those, 65.59% were males. The mean age of the patients was 63.37 ± 12.83 years, and about one-third (29.03%) of them were Indonesian. Overall, melena with or without anemia was the most common presentation (44.09%), followed by hematemesis (34.78%), melena with hematemesis (15.05%), hematemesis with ascites (9.68%), and abdominal/epigastric pain (3.23%). The most common cause of UGIB was the presence of gastric origin (erosive gastritis/gastric ulcer/gastric tumor) with 22.58% of the patients presenting with the same. The most common factors were medications, especially non-steroidal anti-inflammatory drugs (NSAIDs) (37.63%) and blood thinners (22.58%). Hypertension (31.18%), diabetes mellitus (DM) (29.03%), and chronic liver disease/failure (27.96%) were the most common chronic conditions in the studied population. Conclusion Medical orientation towards high-risk pilgrims prone to developing UGIB who intend to travel may help reduce the risk of developing the condition, by taking proper measurements of those groups by the medical teams, especially in those with preventable factors.
Collapse
Affiliation(s)
| | | | - Reem Alqthmi
- Internal Medicine, Umm Al-Qura University, Makkah, SAU
| | - Rahma Alqthmi
- Internal Medicine, Umm Al-Qura University, Makkah, SAU
| | | |
Collapse
|
21
|
Yadav R, Rajput V, Gohil K, Khairnar K, Dharne M. Comprehensive metagenomic insights into a unique mass gathering and bathing event reveals transient influence on a riverine ecosystem. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2020; 202:110938. [PMID: 32800221 DOI: 10.1016/j.ecoenv.2020.110938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/21/2020] [Accepted: 06/23/2020] [Indexed: 05/04/2023]
Abstract
The religious mass gathering and bathing can pose a multitude of significant public health challenges and lead to severe alterations in the river microbial ecology. The Pandharpur Wari is an annual pilgrimage of Maharashtra, India, where millions of devotees carry the footprints of the saint-poets and pay their obeisance to Lord Vitthal on the 11th day of moon's waxing phase (Ashadi Ekadashi). As a part of the ritual, the engrossed devotees, walk over 250 km, take a first holy dip in a sacred river Indrayani at Alandi and secondly in Bhima River at Pandharpur. The MinION-based shotgun metagenomic approach was employed to examine the impact of spiritual mass bathing on environmental changes (concerning the river microbial community structure and functions); and public health aspects (in terms of changes in the pathogenic potential and antibiotic resistance). The analysis of bathing and post-bathing samples of both the rivers revealed alterations in the alpha and beta diversity, indicating significant spatiotemporal variations in the overall microbial structure and function. Furthermore, the analysis revealed up to 80% of differences in the abundance of virulence genes between the bathing and post bathing samples. We observed parallel increase of priority skin and enteric pathogens (ranging from 11% to 80%) such as Acinetobacter baumannii, Staphylococcus aureus, Streptococcus pyogenes, Mycobacterium tuberculosis, and Pseudomonas aeruginosa during the bathing event. Moreover, we observed a significant increase in the antibiotic resistance in the bathing samples of Bhima and Indrayani rivers respectively. Altogether, this is the first comprehensive metagenomic study unravelling the influence of religious mass-bathing on the riverine ecosystem.
Collapse
Affiliation(s)
- Rakeshkumar Yadav
- National Collection of Industrial Microorganisms (NCIM), CSIR-National Chemical Laboratory (CSIR-NCL), Pune, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India.
| | - Vinay Rajput
- National Collection of Industrial Microorganisms (NCIM), CSIR-National Chemical Laboratory (CSIR-NCL), Pune, India.
| | - Kushal Gohil
- National Collection of Industrial Microorganisms (NCIM), CSIR-National Chemical Laboratory (CSIR-NCL), Pune, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India.
| | - Krishna Khairnar
- Environmental Virology Cell (EVC), CSIR- National Environmental Engineering Research Institute (CSIR-NEERI), Nagpur, India.
| | - Mahesh Dharne
- National Collection of Industrial Microorganisms (NCIM), CSIR-National Chemical Laboratory (CSIR-NCL), Pune, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India. http://
| |
Collapse
|
22
|
Knowledge regarding Zika Virus Infection among Healthcare Providers in an Academic Tertiary Care Center in Riyadh, Saudi Arabia: A Cross-Sectional Survey Study. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2020; 2020:8145219. [PMID: 32256906 PMCID: PMC7086415 DOI: 10.1155/2020/8145219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 11/25/2019] [Accepted: 02/12/2020] [Indexed: 11/23/2022]
Abstract
Background Zika virus (ZIKV) has become a major concern across the world. It is highly necessary for healthcare providers (HCPs) to have sufficient knowledge about such a disease. The purpose of this study is to assess the knowledge regarding ZIKV among HCPs in Riyadh, Saudi Arabia. Materials and Methods. A cross-sectional survey study was conducted at a tertiary care center in Riyadh, KSA, during a two-month period from September 19, 2016 to November 19, 2016. Descriptive statistics were performed on data collected. For continuous variables, data were expressed as means ± standard deviations (SDs), medians, and ranges. Proportions were used to describe categorical variables. Knowledge scores were evaluated and compared by demographic characteristics including age, designation, years of practice, and gender, using the t-test/Mann–Whitney U test or the Kruskal–Wallis test, as appropriate. Results A total of 336 HCPs from different specialties (physicians, dentists, nurses, pharmacists, and nutritionists) completed the questionnaire. Significant differences in knowledge about ZIKV were observed by participant's age. Significantly higher knowledge levels were observed among older participants (45 years or more; p=0.011). A substantial difference in the knowledge level was observed by department, with pairwise comparisons showing significant differences in knowledge scores between all departments except for Pharmacy vs. Nutrition and Nursing vs. Internal Medicine. Knowledge scores were not significantly different by years of practice. Conclusion Our study showed inadequate knowledge of HCPs from different specialties about ZIKV infection which needs to be improved in terms of infection prevention and control. Awareness about ZIKV infection should be ensured and maintained among HCPs to face any possible emergence in the region.
Collapse
|
23
|
Leal Neto O, Cruz O, Albuquerque J, Nacarato de Sousa M, Smolinski M, Pessoa Cesse EÂ, Libel M, Vieira de Souza W. Participatory Surveillance Based on Crowdsourcing During the Rio 2016 Olympic Games Using the Guardians of Health Platform: Descriptive Study. JMIR Public Health Surveill 2020; 6:e16119. [PMID: 32254042 PMCID: PMC7175192 DOI: 10.2196/16119] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/06/2019] [Accepted: 01/27/2020] [Indexed: 12/01/2022] Open
Abstract
Background With the evolution of digital media, areas such as public health are adding new platforms to complement traditional systems of epidemiological surveillance. Participatory surveillance and digital epidemiology have become innovative tools for the construction of epidemiological landscapes with citizens’ participation, improving traditional sources of information. Strategies such as these promote the timely detection of warning signs for outbreaks and epidemics in the region. Objective This study aims to describe the participatory surveillance platform Guardians of Health, which was used in a project conducted during the 2016 Olympic and Paralympic Games in Rio de Janeiro, Brazil, and officially used by the Brazilian Ministry of Health for the monitoring of outbreaks and epidemics. Methods This is a descriptive study carried out using secondary data from Guardians of Health available in a public digital repository. Based on syndromic signals, the information subsidy for decision making by policy makers and health managers becomes more dynamic and assertive. This type of information source can be used as an early route to understand the epidemiological scenario. Results The main result of this research was demonstrating the use of the participatory surveillance platform as an additional source of information for the epidemiological surveillance performed in Brazil during a mass gathering. The platform Guardians of Health had 7848 users who generated 12,746 reports about their health status. Among these reports, the following were identified: 161 users with diarrheal syndrome, 68 users with respiratory syndrome, and 145 users with rash syndrome. Conclusions It is hoped that epidemiological surveillance professionals, researchers, managers, and workers become aware of, and allow themselves to use, new tools that improve information management for decision making and knowledge production. This way, we may follow the path for a more intelligent, efficient, and pragmatic disease control system.
Collapse
Affiliation(s)
- Onicio Leal Neto
- University of Zurich, Zurich, Switzerland.,Epitrack, Recife, Brazil
| | - Oswaldo Cruz
- Scientific Computation Program, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Jones Albuquerque
- Epitrack, Recife, Brazil.,Immunopathology Lab Keizo Asami, Recife, Brazil
| | | | | | | | - Marlo Libel
- Ending Pandemics, San Francisco, CA, United States
| | | |
Collapse
|
24
|
Ebrahim SH, Memish ZA. COVID-19 - the role of mass gatherings. Travel Med Infect Dis 2020; 34:101617. [PMID: 32165283 PMCID: PMC7102534 DOI: 10.1016/j.tmaid.2020.101617] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 03/04/2020] [Indexed: 12/21/2022]
Abstract
Mass gathering (MG) medicine emerged against the backdrop of the 2009 pandemic H1N1 Public Health Emergency of International Concern (PHEIC) when the Kingdom of Saudi Arabia (KSA) hosted the largest annual mass gathering of over 3 million pilgrims from 180 plus countries. However, the events surrounding the latest threat to global health, the PHEIC COVID-19, may be sufficient to highlight the role of mass gatherings, mass migration, and other forms of dense gatherings of people on the emergence, sustenance, and transmission of novel pathogens. The COVID-19 spread illustrates the role of MGs in exacerbation of the scope of pandemics. Cancellation or suspension of MGs would be critical to pandemic mitigation. It is unlikely that medical countermeasures are available during the early phase of pandemics. Therefore, mitigation of its impact, rather than containment and control becomes a priority during pandemics. As the most systematically studied MG-related respiratory disease data come from KSA, the cancellation of Umrah by the KSA authorities, prior to emergence of cases, provide the best opportunity to develop mathematical models to quantify event cancellations related mitigation of COVID-19 transmission in KSA and to the home countries of pilgrims. COVID-19 has already provided examples of both clearly planned event cancellations such as the Umrah suspension in KSA, and where outbreaks and events were continued.
Collapse
Affiliation(s)
| | - Ziad A Memish
- Research & Innovation Center, King Saud Medical City, Ministry of Health and; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia. Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| |
Collapse
|
25
|
Hult Khazaie D, Khan SS. Shared social identification in mass gatherings lowers health risk perceptions via lowered disgust. BRITISH JOURNAL OF SOCIAL PSYCHOLOGY 2019; 59:839-856. [PMID: 31872907 PMCID: PMC7586968 DOI: 10.1111/bjso.12362] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 12/06/2019] [Indexed: 11/28/2022]
Abstract
Previous research concerning mass gathering‐associated health risks has focused on physical factors while largely neglecting the role of psychological factors. The present research examined the effect of experiencing shared social identification on perceptions of susceptibility to health risks in mass gatherings. Participants in Study 1 were asked to either recall a crowd in which they shared a social identity with other crowd members or a crowd in which they did not. Participants subsequently completed measures assessing shared social identity, disgust, and health risk perceptions. Study 2 involved administering the same measures as part of a survey to participants who had recently attended a music festival. The results from both studies indicated that sharing a social identity lowered health risk perceptions; this effect was indirect and mediated via disgust. This highlights the importance of considering social identity processes in the design of health communication aimed at reducing mass gathering‐associated health risks.
Collapse
Affiliation(s)
| | - Sammyh S Khan
- School of Psychology, Keele University, Staffordshire, UK
| |
Collapse
|
26
|
Tavan A, Tafti AD, Nekoie-Moghadam M, Ehrampoush M, Vafaei Nasab MR, Tavangar H, Fallahzadeh H. Risks threatening the health of people participating in mass gatherings: A systematic review. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2019; 8:209. [PMID: 31807599 PMCID: PMC6852309 DOI: 10.4103/jehp.jehp_214_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Accepted: 05/14/2019] [Indexed: 06/10/2023]
Abstract
CONTEXT Mass gatherings (MGs) are established for different religious, social, political, cultural, and sport motivations. Many risks threaten the participants' health in MGs for different reasons. One duty of health-care system is to identify the risks and manage them to reduce the participants' injuries in MGs. This study aimed to identify and classify the risks threatening the health of participants in MGs and review related articles systematically. SUBJECTS AND METHODS In this study, we investigated electronic databases including Science Direct, PubMed, Ovid, ProQuest, Web of Science, Scopus, and Google Scholar. This systematic review investigated those health articles which studied MGs published after 2000. Keywords that were searched included (Mass gathering OR Crowd) AND (Assessment OR Evaluation) AND (Disaster OR Emergencies) AND (Injuries OR Stamped). The final full text articles were assessed qualitatively by STROBE article assessment checklist, and then the data extracted from the results of the articles were analyzed and reported. RESULTS Initially, a total of 1874 articles were found, qualitative exclusion and inclusion criteria were applied, and finally 29 full-text articles were selected for the analysis. More than forty health-related risks were recognized. In order to better understand the risks and use of the results more efficiently, the risks were classified and reported into the following five domains: environmental risks, individual risks, psychological risks, public health risks, and management risks. CONCLUSION Many risks threaten the health of participants in MGs. Recognizing and managing the risks are considered the primary and basic essentials of health sector for the better management of MGs.
Collapse
Affiliation(s)
- Asghar Tavan
- Department of Health in Disasters and Emergencies, International Campus, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Abbasali Dehghani Tafti
- Department of Health in Disasters and Emergencies, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahmood Nekoie-Moghadam
- Department of Health Services Management, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohmmadhasan Ehrampoush
- Department of Environmental Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Reza Vafaei Nasab
- Department of Physical Medicine and Rehabilitation, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossein Tavangar
- Department of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossein Fallahzadeh
- Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| |
Collapse
|
27
|
Xygalatas D, Khan S, Lang M, Kundt R, Kundtová-Klocová E, Krátký J, Shaver J. Effects of Extreme Ritual Practices on Psychophysiological Well-Being. CURRENT ANTHROPOLOGY 2019. [DOI: 10.1086/705665] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
28
|
Lami F, Jewad AW, Hassan A, Kadhim H, Alharis S. Noncommunicable Disease Emergencies During Arbaeenia Mass Gathering at Public Hospitals in Karbala, Najaf, and Babel Governorates, Iraq, 2014: Cross-Sectional Study. JMIR Public Health Surveill 2019; 5:e10890. [PMID: 31573917 PMCID: PMC6792027 DOI: 10.2196/10890] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 11/25/2018] [Accepted: 12/03/2018] [Indexed: 12/19/2022] Open
Abstract
Background Arbaeenia is the largest religious mass gathering (MG) in Iraq where millions of people from Iraq and many other countries visit Karbala city, south Iraq. MGs are associated with high rates of morbidity and mortality from different noncommunicable diseases (NCDs) such as cardiovascular diseases, diabetes mellitus, and asthma. There is a scarcity of publications that address MGs in Iraq. Objective This study aimed to explore the NCD emergencies in public hospitals in Karbala, Najaf, and Babel governorates in Iraq, during the Arbaeenia MG and assess predisposing factors for NCD emergencies. Methods The study was conducted from November 27 to December 16, 2014. Data were collected in the pre-event and during MG event from 7 selected hospitals. The pre-event data were collected from emergency room (ER) registers and logbooks, and the data on the MG event were collected daily through direct interview with patients and treating physicians using a structured questionnaire. Results In total, 4425 NCD emergencies were recorded. Of these, 80.13% (3546/4425) were collected during the MG event. The NCD emergencies attended at ER hospitals during MG were severe hypertension (HT), diabetes (hyperglycemia), ischemic heart disease (IHD), asthma, and pulmonary edema. The load of NCD emergencies and the daily average emergencies increased 4-fold and 2-fold during the MG event, respectively. Most of the NCD emergencies were treated at ER departments, and a few were hospitalized. Intense physical activities and poor adherence to diet and medication were risk factors for IHD, severe HT, and hyperglycemic diabetes emergencies. Exposure to noxious gases or fumes and recent respiratory infections were risk factors for asthma emergencies. Conclusions As the pilgrims approached Karbala city during the Arbaeenia MG, the hospitals on the roads leading to the city experienced an increased load of patients because of different NCD emergencies. Although hospitals should be equipped with the necessary supplies, health education for pilgrims is mandatory, particularly on the factors that can exacerbate their diseases.
Collapse
Affiliation(s)
- Faris Lami
- Department of Community and Family Medicine, College of Medicine, University of Baghdad, Baghdad, , Iraq
| | | | - Abulameer Hassan
- Najaf Directorate of Health, Iraq Ministry of Health, Najaf, , Iraq
| | - Hadeel Kadhim
- Najaf Directorate of Health, Iraq Ministry of Health, Najaf, , Iraq
| | - Sura Alharis
- Najaf Directorate of Health, Iraq Ministry of Health, Najaf, , Iraq
| |
Collapse
|
29
|
Alnabulsi H, Drury J, Vignoles VL, Oogink S. Understanding the impact of the Hajj: Explaining experiences of self‐change at a religious mass gathering. EUROPEAN JOURNAL OF SOCIAL PSYCHOLOGY 2019. [DOI: 10.1002/ejsp.2623] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Hani Alnabulsi
- School of Psychology University of Sussex Brighton UK
- Department of Urban Design Custodian of the Two Holy Mosques Institute for Hajj Research Umm Al‐Qura University Mecca Saudi Arabia
| | - John Drury
- School of Psychology University of Sussex Brighton UK
| | | | - Sander Oogink
- School of Psychology University of Sussex Brighton UK
- Faculty of Psychology and Neuroscience Maastricht University Maastricht The Netherlands
| |
Collapse
|
30
|
Zhang Y, Shi F, Yu Z, Yang A, Zeng M, Wang J, Yin H, Zhang B, Ma X. A cross-sectional study on factors associated with hypertension and genetic polymorphisms of renin-angiotensin-aldosterone system in Chinese hui pilgrims to hajj. BMC Public Health 2019; 19:1223. [PMID: 31484569 PMCID: PMC6727391 DOI: 10.1186/s12889-019-7357-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 07/22/2019] [Indexed: 01/11/2023] Open
Abstract
Background Hypertension is the leading risk factor for cardiovascular disease (CVD), however, the studies on lifestyle and genetic risks in Chinese pilgrims to Hajj was limited. The aim of this study is to examine the prevalence and associated lifestyle and genetic risks for hypertension among Hui Hajj pilgrims in China. Methods We performed a cross-sectional analysis of data in 1,465 participants aged 30–70 years who participated in a medical examination for Hui Hajj pilgrims from Gansu province, China in 2017. Multiple logistic regression was used to evaluate the association of potential risk factors with hypertension. Deoxyribonucleic acid (DNA) polymorphism was examined at sites in the renin-angiotensin-aldosterone system (RAAS). Results The prevalence of hypertension was 47% among this population. Lifestyle factors such as fried food preference (like vs. dislike: odds ratio [OR]: =1.53, 95% confidence interval [CI]: 1.13–2.09) and barbecued food preference (like vs. dislike: OR = 1.45, 95% CI: 1.06–1.97) were associated with elevated risk of hypertension among Hui pilgrims. Comparing with Angiotensin converting enzyme (ACE) rs4425 AA genotype, TT genotype was associated with hypertension risk (OR = 2.16, 95% CI: 1.17–4.00). Similar results were also observed for ACE rs4437 CC genotype (OR = 1.95, 95% CI: 1.07–3.55), Angiotensin II receptor (ATR) rs129876 AA genotype (OR = 4.10, 95% CI: 2.30–7.32) and Aldosterone synthase (CYP11B2) rs1912 TT genotype (OR = 2.82, 95% CI: 1.57–5.06) genotypes. Conclusions Unhealthy lifestyle and genetic factors were associated with the prevalence of hypertension in Chinese Hui pilgrims and their interactions were also observed. Electronic supplementary material The online version of this article (10.1186/s12889-019-7357-1) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Yinxia Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610000, China.,Northwest Minzu University, Lanzhou, 730030, China
| | - Fangfang Shi
- Center for Disease Control and Prevention, Kongtong District, Pingliang, Gansu, China
| | - Zhanbiao Yu
- Qingyang People's Hospital, Qingyang, 745000, China
| | - Aimin Yang
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Kowloon, Hong Kong SAR
| | - Maolan Zeng
- Northwest Minzu University, Lanzhou, 730030, China
| | - Jiaoyue Wang
- Gansu International Travel Healthcare Center, Lanzhou, 730000, China
| | - Haiping Yin
- Gansu International Travel Healthcare Center, Lanzhou, 730000, China
| | - Benzhong Zhang
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Xiao Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610000, China.
| |
Collapse
|
31
|
Meo SA, Iqbal M, Usmani AM, Almana AA, Alrashed AH, Al-Regaiey KA. Effect of wearing cotton towel Ihram and plain Ihram on lung function among Hajj Pilgrims. Pak J Med Sci 2019; 35:893-898. [PMID: 31372113 PMCID: PMC6659059 DOI: 10.12669/pjms.35.4.727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives: Hajj is the world’s largest gathering to Makkah, Saudi Arabia. Wearing cotton made Ihram is a basic and an essential component of Hajj. The aim of this study was to investigate the lung functions among Hajj pilgrims who were wearing cotton towel ihram (ihram with fibers) compared to those who were wearing plain cotton ihram (ihram without fibers). Methods: Ninety male, non-smoker, Hajj pilgrim volunteers with age ranged 20-60 years were selected. Forty five of them wore cotton towel ihram and 45 wore plain ihram. A day before leaving for Hajj and wearing ihram (6th Dhu-al-Hijjah) lung function base line parameters of Hajj pilgrims were determined. Hajj Pilgrims continuously wear ihram from 7-10th Dhu-al-Hijjah. In the afternoon of 10th Dhu-al-Hijjah, after removal of ihram, all parameters were repeated and at the completion of Hajj when all pilgrims return to their homes at Riyadh, all parameters were recorded again. Results: Before wearing Ihram, anthropometric and lung function baseline parameters were recorded, no significant difference was found between the study population. After wearing Ihram on the 7th Dhu-al-Hijjah and its removal on the 10th Dhu-al-Hijjah significant decline in the lung function test parameters was observed among Hajj pilgrims who were wearing cotton towel ihram. Forced Vital Capacity (FVC) 4.30±1.18 vs. 5.03±1.41 (p=0.01); Forced Expiratory Flow 25% (FEF-25%) 4.39±1.94 vs. 5.69±2.84 (p=0.03); Forced Expiratory Flow-50% (FEF-50%) 2.93±1.65 vs. 4.07±2.08 (p=0.01); Forced Expiratory Flow-75% (FEF-75%) 1.02±0.70 vs. 1.66±0.94 (p=0.002) compared to those who were wearing plain ihram. Conclusions: Lung function test parameters were decreased among the Hajj pilgrims who were wearing cotton towel ihram compared to those who were wearing plain cotton ihram. The pattern of impairment of lung function shows an obstructive peripheral airway lung involvement. It is suggested to conduct further large sample size studies to confirm the present study observations and reach at better conclusions.
Collapse
Affiliation(s)
- Sultan Ayoub Meo
- Sultan Ayoub Meo, Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Muhammad Iqbal
- Muhammad Iqbal, Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Adnan Mahmood Usmani
- Adnan Mahmood Usmani, University Diabetes Centre, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman Abdulaziz Almana
- Abdulrahman Abdulaziz Almana, Department of Armed Forces Medical Services, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Abdulrahman Hamad Alrashed
- Abdulrahman Hamad Alrashed, Department of Family Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Khalid Abdullah Al-Regaiey
- Khalid Abdullah Al-Regaiey, Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
32
|
Alnabulsi H, Drury J, Templeton A. Predicting collective behaviour at the Hajj: place, space and the process of cooperation. Philos Trans R Soc Lond B Biol Sci 2019; 373:rstb.2017.0240. [PMID: 29967304 DOI: 10.1098/rstb.2017.0240] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2018] [Indexed: 11/12/2022] Open
Abstract
Around 2 million pilgrims attend the annual Hajj to Mecca and the holy places, which are subject to dense crowding. Both architecture and psychology can be part of disaster risk reduction in relation to crowding, since both can affect the nature of collective behaviour-particularly cooperation-among pilgrims. To date, collective behaviour at the Hajj has not been systematically investigated from a psychological perspective. We examined determinants of cooperation in the Grand Mosque and plaza during the pilgrimage. A questionnaire survey of 1194 pilgrims found that the Mosque was perceived by pilgrims as one of the most crowded ritual locations. Being in the plaza (compared with the Mosque) predicted the extent of cooperation, though crowd density did not. Shared social identity with the crowd explained more of the variance than both location and density. We examined some of the process underlying cooperation. The link between shared social identity and giving support to others was stronger in the plaza than in the Mosque, and suggests the role of place and space in modulating processes of cooperation in crowds. These findings have implications for disaster risk reduction and for applications such as computer simulations of crowds in pilgrimage locations.This article is part of the theme issue 'Interdisciplinary approaches for uncovering the impacts of architecture on collective behaviour'.
Collapse
Affiliation(s)
- Hani Alnabulsi
- School of Psychology, University of Sussex, Falmer, Brighton BN1 9QH, UK.,Department of Urban Design, Custodian of the Two Holy Mosques Institute for Hajj Research, Umm Al-Qura University, Mecca, Kingdom of Saudi Arabia
| | - John Drury
- School of Psychology, University of Sussex, Falmer, Brighton BN1 9QH, UK
| | - Anne Templeton
- School of Psychology, University of Sussex, Falmer, Brighton BN1 9QH, UK.,School of Psychology, Keynes College, University of Kent, Canterbury, Kent CT2 7NP, UK
| |
Collapse
|
33
|
Sharma U, Desikachari BR, Sarma S. Protocol for development of a risk assessment tool for planning and management of religious mass-gathering events of India-a health system-strengthening initiative. Pilot Feasibility Stud 2019; 5:83. [PMID: 31293791 PMCID: PMC6591856 DOI: 10.1186/s40814-019-0464-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 06/05/2019] [Indexed: 12/02/2022] Open
Abstract
Background Religious mass gatherings (MGs) have always been an integral part of our society. At the outset, mass-gathering events provide challenging settings to plan a suitable emergency public health response. Published studies basically talk about retrospective reviews, case studies of the public health preparedness, or health care provided at individual events. Developing an understanding of the variables associated with MGs is the first step for public health managers. Risk assessment (RA) is a crucial part of pre-event planning as it helps foresee potential risks. Based on RA, one can develop preventive measures and ensure that the infrastructure to control the potential problems is in place. This study is an attempt to systemize RA process during MG events in a country that is culturally rich but with poor resources to handle such events. A RA tool will be developed for planning and management of religious MG events of India. Methods/design Various strategies will be used to develop the risk assessment tool (RA tool). Extensive review of literature clubbed with key informant interviews will be done in order to identify the risk variables and decide the domains and items of the tool. Further, this tool will be developed as a mobile-based application. The feasibility of the mobile-based RA tool will be tested in real-time MG event in one part of the country. Concurrently in the same event, a community survey of residents and visitors will be done in order to assess public perceptions of public health and environmental risks associated with MG events. Discussion The findings of this study will provide insights into the public health and environmental concerns that need to be considered if preventive strategies and intervention programs are to be designed for MG events. A “RA Tool,” which can be used in the planning and management of MG events by the public health managers will strengthen the existing health systems preparedness plans for MGs.
Collapse
Affiliation(s)
- Upasana Sharma
- 1Achutha Menon Centre for Health Science Studies (AMCHSS), Sree Chitra Tirunal Institute for Medical Sciences & Technology (SCTIMST), Trivandrum, 695011 Kerala India
| | - B R Desikachari
- 2Senior Public Health Consultant, Formerly with Department of Public Health and Preventive Medicine, Government of Tamil Nadu, Chennai, India
| | - Sankara Sarma
- 1Achutha Menon Centre for Health Science Studies (AMCHSS), Sree Chitra Tirunal Institute for Medical Sciences & Technology (SCTIMST), Trivandrum, 695011 Kerala India
| |
Collapse
|
34
|
Tashani M, Badahdah AM, Alfelali M, Barasheed O, Alqahtani AS, Heron L, Wong M, Louth J, Rashid H, Borrow R, Booy R. Effect on meningococcal serogroup W immunogenicity when Tdap was administered prior, concurrent or subsequent to the quadrivalent (ACWY) meningococcal CRM 197-conjugate vaccine in adult Hajj pilgrims: A randomised controlled trial. Vaccine 2019; 37:3562-3567. [PMID: 31128875 DOI: 10.1016/j.vaccine.2019.05.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/07/2019] [Accepted: 05/08/2019] [Indexed: 01/07/2023]
Abstract
Immune responses to the capsular polysaccharide administered in the polysaccharide-protein conjugate vaccines can be either improved or suppressed by the pre-existence of immunity to the carrier protein. Receiving multiple vaccinations is essential for travellers such as Hajj pilgrims, and the use of conjugated vaccines is recommended. We studied the immune response to meningococcal serogroup W upon prior, concurrent and sequential administration of a quadrivalent meningococcal conjugate vaccine (MCV4) conjugated to CRM197 (coadministered with 13 valent pneumococcal vaccine conjugate CRM197 [PCV13]), and tetanus-diphtheria-acellular pertussis (Tdap) vaccine in Australian adults before attending the Hajj pilgrimage in 2014. Participants were randomly assigned, by computer-generated numbers, to three study arms by 1:1:1 ratio. Group A received Tdap followed by MCV4-CRM197 (+PCV13) 3-4 weeks later. Group B received all three vaccines in a single visit. Group C received MCV4-CRM197 (+PCV13) followed by Tdap 3-4 weeks later. Blood samples obtained prior to and 3-4 weeks after immunisation with MCV4-CRM197 were tested for meningococcal serogroup W-specific serum bactericidal antibody responses using baby rabbit complement (rSBA). One hundred and seven participants aged between 18 and 64 (median 40) years completed the study. No significant difference in meningococcal serogroup W rSBA geometric mean titre (GMT) was observed between the study arms post vaccination with MCV-CRM197 but Group A tended to have a slightly lower GMT (A = 404, B = 984 and C = 1235, p = 0.15). No statistical difference was noticed between the groups in proportions of subjects achieving a ≥4-fold rise in rSBA titres or achieving rSBA titre ≥8 post vaccination. In conclusion, receipt of MCV4-CRM197 vaccine prior, concurrent or subsequent to Tdap has similar immunologic response, and hence concurrent administration is both immunogenic and practical. However, further investigation into whether carrier induced suppression is a public health issue is suggested. Clinical trial registration: ANZCTR no. ACTRN12613000536763.
Collapse
Affiliation(s)
- Mohamed Tashani
- The Discipline of Child and Adolescent Health, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Faculty of Medicine, University of Tripoli, Ain Zara, Tripoli, Libya
| | - Al-Mamoon Badahdah
- The Discipline of Child and Adolescent Health, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; National Centre for Immunisation Research and Surveillance (NCIRS), The Children's Hospital at Westmead, NSW, Australia; Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Mohammad Alfelali
- The Discipline of Child and Adolescent Health, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; National Centre for Immunisation Research and Surveillance (NCIRS), The Children's Hospital at Westmead, NSW, Australia; Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Osamah Barasheed
- The Executive Administration of Research and Innovation, King Abdullah Medical City in Holy Capital (KAMC-HC), Makkah 24246, Saudi Arabia
| | | | - Leon Heron
- National Centre for Immunisation Research and Surveillance (NCIRS), The Children's Hospital at Westmead, NSW, Australia
| | - Melanie Wong
- Immunology Department, The Children's Hospital at Westmead, Westmead 2145, NSW, Australia
| | - Jennifer Louth
- Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, UK
| | - Harunor Rashid
- The Discipline of Child and Adolescent Health, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; National Centre for Immunisation Research and Surveillance (NCIRS), The Children's Hospital at Westmead, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, University of Sydney, Sydney, NSW 2145, Australia
| | - Ray Borrow
- Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, UK
| | - Robert Booy
- The Discipline of Child and Adolescent Health, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; National Centre for Immunisation Research and Surveillance (NCIRS), The Children's Hospital at Westmead, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, University of Sydney, Sydney, NSW 2145, Australia; WHO Collaborating Centre for Mass Gatherings and High Consequence/High Visibility Events, Flinders University, Adelaide 5001, Australia
| |
Collapse
|
35
|
Karampourian A, Ghomian Z, Khorasani-Zavareh D. Qualitative study of health system preparedness for traumatic incidents in a religious mass gathering. Injury 2019; 50:1097-1104. [PMID: 30595410 DOI: 10.1016/j.injury.2018.12.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 12/08/2018] [Accepted: 12/12/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND OBJECTIVES Traumatic incidents may occur during religious mass gatherings. A lack of preparedness by the health system to respond to traumatic incidents may increase the mortality rate. This study investigated the factors that affect the preparedness of a health system to respond to traumatic incidents, and we provide appropriate suggestions for improving the response to such incidents during religious mass gatherings. METHODS A qualitative research method was used with a conventional content analysis approach. In total, 22 semi-structured interviews were conducted employing the content analysis method. The data were analyzed based on the means of the meaning units, condensed meaning units, sub-themes, themes, and codes. RESULTS Four main categories and nine sub-categories emerged from the data: factors that increased or decreased the occurrence of incidents (with three sub-categories comprising risk perception and fatalism, pilgrims' responses to incidents, and health system response to traumatic events); medical infrastructure (with two sub-categories comprising medical infrastructure in the host country and medical structures in border cities); organizational resource category (with two sub-categories comprising manpower, and equipment and facilities); and coordination of responsible organizations (with two sub-categories comprising inter-organizational coordination and inter-agency collaboration). All of the data were extracted from the experiences of the participants. CONCLUSION Similar to other mass gatherings, Arbaeen requires multi-sectoral and international planning, organizing, and management. The key factors that could improve the preparedness to respond to traumatic events in Arbaeen include training, increasing the perception of risk, changing the attitudes and behavior of pilgrims, developing a national strategic plan of the health system preparedness for policymakers, and implementing scenario-based exercises for executives.
Collapse
Affiliation(s)
- Arezou Karampourian
- Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Zohreh Ghomian
- Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Davoud Khorasani-Zavareh
- Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Neurobiology, Care Sciences and Society (NVS), H1, Division of Family Medicine and Primary Care, Alfred Nobels Allé 23 141 83 Huddinge, Sweden.
| |
Collapse
|
36
|
Almasri M, Ahmed QA, Turkestani A, Memish ZA. Hajj abattoirs in Makkah: risk of zoonotic infections among occupational workers. Vet Med Sci 2019; 5:428-434. [PMID: 31016884 PMCID: PMC6682789 DOI: 10.1002/vms3.169] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
At completion of Hajj, the Islamic pilgrimage to Makkah, pilgrims give thanks for the blessing, and acceptance, of Hajj, marking the end of the pilgrimage by sacrificing an animal and distributing the sacrificial meat to the poor. With over two million Muslims making Hajj, each Hajj, more than 1.2 million heads of cattle: sheep, goats and camels are slaughtered. Over 16 000 abattoir workers work around the clock to sacrifice and process the cattle in keeping with Islamic law and public health guidelines. Because of their proximity to high densities of cattle and cattle meat, Makkah's abattoir workers are at risk of zoonosis. This was a longitudinal study aimed at determining the risk of some zoonotic diseases among male permanent abattoir workers during Hajj. Specifically, seroprevalence of antigens for Brucella, Crimean–Congo haemorrhagic fever (CCHF), Alkhurma haemorrhagic fever (AHF) and Rift Valley Fever (RVF) were determined, among the study participants. An enrolment questionnaire, and a follow‐up questionnaire, with provision of 10 mL blood for testing 2 days before intense Hajj animal exposure, up to 20 days after intense animal exposure and between 30 and 42 days after Hajj butchering exposures. While working with livestock, study participants were interrogated on hand hygiene and personal protection. Eighty male permanent abattoir workers participated in the study. Majority, 96.25% (n = 77) declared washing their hands with soap and water, most 98.75% (n = 79) never used eye protection, few occupational workers dressed in personal protective clothing or footwear. All workers tested negative for CCHF and RVF, one was positive for AHF and six for Brucella. The risk of some zoonotic infections like Brucella and AHF is low among permanent occupational workers in the slaughtering house in Makkah during Hajj 2013. No serological evidence for CCHF and RVF viruses, even though workers showed low compliance with use of personnel protective equipment.
Collapse
Affiliation(s)
- Malak Almasri
- Public Health Directorate, Ministry of Health, Riyadh, Kingdom of Saudi Arabia
| | - Qanta A Ahmed
- Division of Pulmonary Disease and Critical Care Medicine, Department of Medicine, Winthrop University Hospital, Mineola, New York, USA
| | | | - Ziad A Memish
- Infectious Diseases Division, Department of Medicine & Department of Research, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia.,Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| |
Collapse
|
37
|
Health care workers' awareness and infection control practices about Ebola virus disease in Hajj 2015. J Infect Public Health 2019; 12:720-725. [PMID: 30981653 DOI: 10.1016/j.jiph.2019.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 03/24/2019] [Accepted: 03/25/2019] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Saudi Arabia being a major pilgrimage center with an annual turnover of millions of pilgrims from all over the world has a high risk for transmission of infections; Ebola virus disease (EVD) being one of them. Health care workers (HCWs) are particularly vulnerable to these infections. The objectives of this research were to assess the overall knowledge and infection control practices of HCWs about EVD, and to evaluate and compare the role of pre deployment Hajj training of HCWs assigned Hajj duties with those HCWs who did not receive this training. METHODS Through a comparative cross sectional study design a randomly selected representative sample of HCWs who performed Hajj duties in 2015 were compared with those who were not part of Hajj. Participants were taken from different Makkah and Jeddah region hospitals. A validated self-administered questionnaire was used to assess EVD awareness of 1216 HCWs. Chi square test was applied to check the association between the two groups using SPSS 22. RESULTS Overall, medical practitioners had a higher level of knowledge (76.5%) about EVD (in-terms of average correct answers) compared to nurses (59.6%) and other HCWs (56.7%). There was relatively poor knowledge about the EVD management, the Ebola cases fatality rate and the risk of the health care workers from this infectious disease. However, it was obvious that the HCWs who performed Hajj duties and underwent pre-deployment training had more knowledge and better practices about EVD compared to the Non Hajj HCWs and the difference was statistically significant (p < 0.001). CONCLUSION This study concludes that even though the HCWs were well aware about EVD but there was a lack of practice. As infection control routine trainings are limited, gaps have been identified in knowledge and practice of infection control.
Collapse
|
38
|
|
39
|
Khan S, Khan ID. Obstetric and Neonatal Outcomes of Pregnant Indian Pilgrims: A three-year experience at the Indian Hajj Medical Mission. Sultan Qaboos Univ Med J 2018; 18:e355-e361. [PMID: 30607278 DOI: 10.18295/squmj.2018.18.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 02/28/2018] [Accepted: 04/12/2018] [Indexed: 11/16/2022] Open
Abstract
Objectives The Hajj, an annual mass gathering of Muslim pilgrims, is known for its high morbidity and mortality rates. However, pregnant women sometimes participate in this pilgrimage, despite guidelines that discourage such an undertaking due to potential fetomaternal complications. This study aimed to evaluate fetomaternal outcomes among pregnant Indian Hajj pilgrims. Methods This prospective cross-sectional study was conducted at two Indian Hajj Medical Mission (IHMM)-affiliated secondary care hospitals in Saudi Arabia during the Hajj periods of August-October 2015 and 2016 and July-September 2017. All female Indian pilgrims of reproductive age who underwent pregnancy screening at secondary care IHMM hospitals during this period were included in the study. Definitive obstetric care was provided at the Makkah Maternity & Child Hospital. Data regarding the pilgrims' obstetric characteristics, antenatal complications, management and fetomaternal outcomes were evaluated. Results A total of 114 pregnant Indian pilgrims were identified during the study period. The most common antenatal complications were respiratory tract infections (51.75%), followed by iron deficiency anaemia (17.54%), hyperemesis gravidarum (14.04%), hypothyroidism (9.65%) and gestational diabetes mellitus (5.26%). There were 20 vaginal deliveries (17.54%), two Caesarean sections (1.75%) and 32 abortions (28.07%). The cumulative three-year birth rate was 24.60 per 1,000 females. Conclusion During Hajj, pregnant pilgrims have a high risk of abortion, respiratory tract infections and various antenatal, perinatal and neonatal complications which may go unreported or untreated. Women should therefore be educated regarding the risk of adverse fetomaternal outcomes which may occur while undertaking a Hajj pilgrimage during pregnancy.
Collapse
Affiliation(s)
- Shazia Khan
- Department of Obstetrics & Gynaecology, Indian Naval Hospital Ship Asvini, Mumbai, India
| | - Inam D Khan
- Department of Clinical Microbiology & Infectious Diseases, Army College of Medical Sciences & Base Hospital, New Delhi, India
| |
Collapse
|
40
|
Jani K, Dhotre D, Bandal J, Shouche Y, Suryavanshi M, Rale V, Sharma A. World's Largest Mass Bathing Event Influences the Bacterial Communities of Godavari, a Holy River of India. MICROBIAL ECOLOGY 2018. [PMID: 29536131 DOI: 10.1007/s00248-018-1169-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Kumbh Mela is one of the largest religious mass gathering events (MGE) involving bathing in rivers. The exponential rise in the number of devotees, from around 0.4 million in 1903 to 120 million in 2013, bathing in small specified sites can have a dramatic impact on the river ecosystem. Here, we present the spatiotemporal profiling of bacterial communities in Godavari River, Nashik, India, comprising five sites during the Kumbh Mela, held in 2015. Assessment of environmental parameters indicated deterioration of water quality. Targeted amplicon sequencing demonstrates approximately 37.5% loss in microbial diversity because of anthropogenic activity during MGE. A significant decrease in phyla viz. Actinobacteria, Chloroflexi, Proteobacteria, and Bacteroidetes was observed, while we noted substantial increase in prevalence of the phylum Firmicutes (94.6%) during MGE. qPCR estimations suggested nearly 130-fold increase in bacterial load during the event. Bayesian mixing model accounted the source of enormous incorporation of bacterial load of human origin. Further, metagenomic imputations depicted increase in virulence and antibiotic resistance genes during the MGE. These observations suggest the striking impact of the mass bathing on river ecosystem. The subsequent increase in infectious diseases and drug-resistant microbes pose a critical public health concern.
Collapse
Affiliation(s)
- Kunal Jani
- National Centre for Microbial Resource, National Centre for Cell Science, Sutarwadi, Pashan, Pune, Maharashtra, 411021, India
- Symbiosis School of Biological Sciences, Symbiosis International University, Pune, 412115, India
| | - Dhiraj Dhotre
- National Centre for Microbial Resource, National Centre for Cell Science, Sutarwadi, Pashan, Pune, Maharashtra, 411021, India
| | - Jayashree Bandal
- Department of Microbiology, KTHM College, Nashik, Maharashtra, 422002, India
| | - Yogesh Shouche
- National Centre for Microbial Resource, National Centre for Cell Science, Sutarwadi, Pashan, Pune, Maharashtra, 411021, India
| | - Mangesh Suryavanshi
- National Centre for Microbial Resource, National Centre for Cell Science, Sutarwadi, Pashan, Pune, Maharashtra, 411021, India
| | - Vinay Rale
- Symbiosis School of Biological Sciences, Symbiosis International University, Pune, 412115, India
| | - Avinash Sharma
- National Centre for Microbial Resource, National Centre for Cell Science, Sutarwadi, Pashan, Pune, Maharashtra, 411021, India.
| |
Collapse
|
41
|
Yanagisawa N, Wada K, Spengler JD, Sanchez-Pina R. Health preparedness plan for dengue detection during the 2020 summer Olympic and Paralympic games in Tokyo. PLoS Negl Trop Dis 2018; 12:e0006755. [PMID: 30235211 PMCID: PMC6147396 DOI: 10.1371/journal.pntd.0006755] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 08/14/2018] [Indexed: 11/29/2022] Open
Abstract
Background Participants in mass gathering events are at risk of acquiring imported and locally endemic infectious diseases. The 2014 dengue outbreak in Tokyo gathered attention since it was the first time in 70 years for Japan to experience an autochthonous transmission. Preparation for emerging infectious threats is essential even in places where these outbreaks have been largely unknown. The aim of this study is to identify strategies for early detection and prevention of dengue infection during the 2020 summer Olympics and Paralympics in Tokyo. Methodology/Principal findings We modified and adapted the failure mode and effect analysis (FMEA) methodology, generally used in industrial manufacturing, to examine the current controls for dengue detection and assessment. Information on existing controls were obtained from publicly available resources. Our analysis revealed that the national infectious disease control system to detect dengue in Japan is robust. However, in the case of large assemblies of international visitors for special events when the spread of communicable and vector-borne diseases increases, there are three main gaps that could be reinforced. First, cyclical training or a certification program on tropical disease management is warranted for physicians, especially those working in non-infectious disease-designated hospitals or clinics. Second, multi-language communication methods need to be strengthened especially in the health and hospitality sector. Third, owners of accommodations should consider incorporating a formal tropical disease-training program for their staff members and have a contingency plan for infectious disease-suspected travelers. Conclusions/Significance Our findings may facilitate physicians and public health officials where new controls would be beneficial for the 2020 summer Olympics and Paralympics. The FMEA framework has the potential to be applied to other infectious diseases, not just dengue. Dengue is a mosquito-borne disease that is most prevalent among the emerging arboviruses. Most patients recover from dengue without complications, but a small portion of cases may progress to severe dengue which carries a high mortality rate if left untreated. In 2014, a dengue outbreak unexpectedly occurred in Tokyo, which was the first time in 70 years for Japan to experience an autochthonous transmission. Thus, preparation for dengue and other emerging infectious threats is essential even in places where these outbreaks have been largely unknown. Tokyo will be hosting the Olympic and Paralympic games in 2020, and interventions are warranted to mitigate the risks. We modified and adapted the failure mode effect analysis (FMEA) methodology to test the vulnerability and resiliency of the current controls. Although the FMEA methodology is generally used in industrial manufacturing, it has the potential to be utilized for health preparedness for other infectious diseases as well. Our analysis identifies three strategies to reinforce early detection of dengue infection and prevent further transmission during the Olympic and Paralympic Games.
Collapse
Affiliation(s)
- Naoki Yanagisawa
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
- * E-mail:
| | - Koji Wada
- Graduate School of Public Health, International University of Health and Welfare, Tokyo, Japan
| | - John D. Spengler
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Ramon Sanchez-Pina
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| |
Collapse
|
42
|
Karampourian A, Ghomian Z, Khorasani-Zavareh D. Exploring challenges of health system preparedness for communicable diseases in Arbaeen mass gathering: a qualitative study. F1000Res 2018; 7:1448. [PMID: 30473777 PMCID: PMC6234742 DOI: 10.12688/f1000research.15290.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/22/2018] [Indexed: 11/20/2022] Open
Abstract
Background: Infectious diseases are common problems in mass gatherings, especially when there is a lack of health system preparedness. Since Iran is one of the most important countries on the walking path of Arbaeen and has a vital role in providing health services to pilgrims, the experiences of health challenges by participants is of key importance. The aim of this study is to explore stakeholders' experiences on the health system's preparedness and challenges, and to provide suggestions for preventing infectious diseases during the Arbaeen mass gathering. Methods: A qualitative research method was used with a conventional content analysis approach. The number of participants was 17, including 13 executive managers and 4 health policymakers who entered the study among participants. Semi-structured interviews were used to generate the data. Interviews were analyzed by means of content analysis after face-to-face interviews. Results: Data analysis resulted in the extraction of four main themes and 11 sub-themes. Health infrastructure defects in Iraq has three sub-themes (health abandonment in Iraq, the weaknesses in health culture and problems related to the health system); poor control of the causative factors of infectious diseases has three sub-themes (the underlying factors of the prevalence of contagious diseases, health system response to communicable diseases and ignoring the risks of the Arbaeen ceremony); the low perception of risk in pilgrims has three sub-themes (lack of awareness in pilgrims, fatalism in pilgrims and unhygienic belief in pilgrims); and the ineffectiveness of health education has two sub-themes (training shortage in the targeted group and educational content problems) that shows participant's experiences of the health system's challenges for coping with infectious diseases during the Arbaeen ceremony. Conclusion: Pilgrim-based training, planning and controlling other challenges may change these threats to opportunities and improve the health of participants of the mass gathering of Arbaeen in the region.
Collapse
Affiliation(s)
- Arezou Karampourian
- Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, 198353-5511, Iran
| | - Zohreh Ghomian
- Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, 198353-5511, Iran
| | - Davoud Khorasani-Zavareh
- Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, 198353-5511, Iran
- Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, 198353-5511, Iran
- Department of Clinical Sciences and Education, Karolinska Institute, Stockholm, 202100-2973, Sweden
| |
Collapse
|
43
|
Alharbi I, Alyoubi B, Hoque MR, Almazmomi N. Big Data Based m-Health Application to Prevent Health Hazards: A Design Science Framework. Telemed J E Health 2018; 25:326-331. [PMID: 30192202 DOI: 10.1089/tmj.2018.0063] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Every year about three million Muslims visit the Holy City of Makkah in Saudi Arabia to perform the Hajj. Because of the large number of people present during this period, pilgrims can be subjected to many health hazards. An adequate system to minimize these health hazards is needed to support the pilgrims who attend the Hajj. This study justifies the need for developing a large data-based m-Health application to identify the health hazards encountered during the Hajj. MATERIALS AND METHODS In developing a big data-based m-Health application, this study follows the framework suggested by Hevner. The design of the science framework allows the development of a technological solution (i.e., design artifact) of the problem through a series of actions. The design involves rigorous knowledge of the environmental factors, including knowledge of the construction and evaluation of technological solutions, that are important and relevant to an existing problem. RESULTS Based on the design science framework, the process of artifact development can be classified into Artifact Design, Artifact Implementation, and Artifact Evaluation. This paper presents the Artifact Design step for the design of the big data-based m-Health application, which has an Environmental Relevance Cycle, a Knowledge-based rigor Cycle, and an Artifice development and design cycle. The big data-based m-Health application is a prototype and must be evaluated using the evaluation-and-feedback loop process until the optimum artifact is completely built and integrated into the system. CONCLUSION Development of a big data-based m-Health application using a design science framework can support the effective and comprehensive plan of the government of Saudi Arabia for preventing and managing Hajj-related health issues. Our proposed model for developing and designing a big data-based m-Health application could provide direction for developing the most advanced solution for dealing with the Hajj-related health issues in the future.
Collapse
Affiliation(s)
- Ibraheem Alharbi
- 1 Department of Management Information Systems, College of Business, University of Jeddah , Jeddah, Saudi Arabia
| | - Bader Alyoubi
- 1 Department of Management Information Systems, College of Business, University of Jeddah , Jeddah, Saudi Arabia
| | - Md Rakibul Hoque
- 2 Department of Management Information Systems, University of Dhaka , Dhaka, Bangladesh
| | - Najah Almazmomi
- 1 Department of Management Information Systems, College of Business, University of Jeddah , Jeddah, Saudi Arabia
| |
Collapse
|
44
|
Badahdah AM, Rashid H, Khatami A, Booy R. Meningococcal disease burden and transmission in crowded settings and mass gatherings other than Hajj/Umrah: A systematic review. Vaccine 2018; 36:4593-4602. [PMID: 29961604 DOI: 10.1016/j.vaccine.2018.06.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 06/11/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Mass gatherings (MGs) such as the Hajj and Umrah pilgrimages are known to amplify the risk of invasive meningococcal disease (IMD) due to enhanced transmission of the organism between attendees. The burden of IMD at MGs other than Hajj and Umrah has not previously been quantified through a systematic review. METHODS A systematic search for relevant articles in PubMed and Embase was conducted using MeSH terms; this was buttressed by hand searching. Following data abstraction, a narrative synthesis was conducted to quantify the burden of IMD at MGs and identify potential risk factors and mitigation measures. RESULTS Thirteen studies reporting occurrence of IMD at MGs or similar crowded settings were identified. Eight studies reported cases or outbreaks in MGs of ≥1000 people; five others reported IMD in other crowded settings; all occurred between 1991 and 2015. All age groups were involved in the identified studies; however the majority of cases (∼80%) were young people aged 15-24 years. The number of affected people ranged from one to 321 cases and the overall crude estimate of incidence was calculated as 66 per 100,000 individuals. Serogroups A, C, B and W were identified, with serogroups A and C being most common. Of 450 cases of IMD reported in non-Hajj/Umrah MGs, 67 (14.9%) had fatal outcomes. CONCLUSION IMD outbreaks at non-Hajj/Umrah MGs are generally much smaller than Hajj-related outbreaks and affect mainly young people. Health education and vaccination should be considered for attendees of high risk non-Hajj/Umrah MGs, especially those involving adolescents and young adults.
Collapse
Affiliation(s)
- Al-Mamoon Badahdah
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), The Children's Hospital at Westmead, The University of Sydney, NSW, Australia; Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, NSW, Australia; Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Harunor Rashid
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), The Children's Hospital at Westmead, The University of Sydney, NSW, Australia; Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, University of Sydney, NSW, Australia
| | - Ameneh Khatami
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, NSW, Australia; Departments of Paediatric Infectious Diseases and Microbiology, School of Medicine, NYU Langone Medical Centre, NY, USA
| | - Robert Booy
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), The Children's Hospital at Westmead, The University of Sydney, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, University of Sydney, NSW, Australia; WHO Collaborating Centre for Mass Gatherings and High Consequence/High Visibility Events, Flinders University, Adelaide 5001, Australia; NHMRC Centre for Research Excellence - Immunisation in Understudied and Special Risk Populations: Closing the Gap in Knowledge Through a Multidisciplinary Approach, School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, Australia
| |
Collapse
|
45
|
Kazi DS, Greenough PG, Madhok R, Heerboth A, Shaikh A, Leaning J, Balsari S. Using mobile technology to optimize disease surveillance and healthcare delivery at mass gatherings: a case study from India's Kumbh Mela. J Public Health (Oxf) 2018; 39:616-624. [PMID: 27694349 PMCID: PMC5939834 DOI: 10.1093/pubmed/fdw091] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 07/25/2016] [Indexed: 11/18/2022] Open
Abstract
Background Planning for mass gatherings often includes temporary healthcare systems to address the needs of attendees. However, paper-based record keeping has traditionally precluded the timely application of collected clinical data for epidemic surveillance or optimization of healthcare delivery. We evaluated the feasibility of harnessing ubiquitous mobile technologies for conducting disease surveillance and monitoring resource utilization at the Allahabad Kumbh Mela in India, a 55-day festival attended by over 70 million people. Methods We developed an inexpensive, tablet-based customized disease surveillance system with real-time analytic capabilities, and piloted it at five field hospitals. Results The system captured 49 131 outpatient encounters over the 3-week study period. The most common presenting complaints were musculoskeletal pain (19%), fever (17%), cough (17%), coryza (16%) and diarrhoea (5%). The majority of patients received at least one prescription. The most common prescriptions were for antimicrobials, acetaminophen and non-steroidal anti-inflammatory drugs. There was great inter-site variability in caseload with the busiest hospital seeing 650% more patients than the least busy hospital, despite identical staffing. Conclusions Mobile-based health information solutions developed with a focus on user-centred design can be successfully deployed at mass gatherings in resource-scarce settings to optimize care delivery by providing real-time access to field data.
Collapse
Affiliation(s)
- Dhruv S Kazi
- Department of Medicine, Department of Epidemiology and Biostatistics, and Center for Vulnerable Populations, University of California, San Francisco, CA 94158, USA.,Division of Cardiology, Zuckerberg San Francisco General Hospital, San Francisco, CA 94110, USA
| | - P Gregg Greenough
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA02115, USA
| | | | - Aaron Heerboth
- Department of Emergency Medicine, University of California, San Diego, CA92103, USA
| | - Ahmed Shaikh
- Maharashtra Government Ministry of Health, Mumbai, Maharashtra400102, India
| | - Jennifer Leaning
- Harvard TH Chan School of Public Health, Boston, MA 02115, USA.,FXB Center for Health and Human Rights, Harvard University, Cambridge, MA 02138, USA
| | - Satchit Balsari
- Harvard TH Chan School of Public Health, Boston, MA 02115, USA.,FXB Center for Health and Human Rights, Harvard University, Cambridge, MA 02138, USA.,Weill Cornell Global Emergency Medicine Division, Weill Cornell Medicine, New York, NY 10065, USA
| |
Collapse
|
46
|
Abd El Ghany M, Alsomali M, Almasri M, Regalado EP, Naeem R, Tukestani A, Asiri A, Hill-Cawthorne GA, Pain A, Memish ZA. Enteric Infections Circulating during Hajj Seasons, 2011-2013. Emerg Infect Dis 2018; 23. [PMID: 28930004 PMCID: PMC5621540 DOI: 10.3201/eid2310.161642] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Foodborne-associated bacteria with increased incidence of antimicrobial drug resistance were the most common cause. Hajj, the annual Muslim pilgrimage to Mecca, Saudi Arabia, is a unique mass gathering event that raises public health concerns in the host country and globally. Although gastroenteritis and diarrhea are common among Hajj pilgrims, the microbial etiologies of these infections are unknown. We collected 544 fecal samples from pilgrims with medically attended diarrheal illness from 40 countries during the 2011–2013 Hajj seasons and screened the samples for 16 pathogens commonly associated with diarrheal infections. Bacteria were the main agents detected, in 82.9% of the 228 positive samples, followed by viral (6.1%) and parasitic (5.3%) agents. Salmonella spp., Shigella/enteroinvasive Escherichia coli, and enterotoxigenic E. coli were the main pathogens associated with severe symptoms. We identified genes associated with resistance to third-generation cephalosporins ≈40% of Salmonella- and E. coli–positive samples. Hajj-associated foodborne infections pose a major public health risk through the emergence and transmission of antimicrobial drug–resistant bacteria.
Collapse
|
47
|
Analysis of Medical Responses in Mass Gatherings: The Commemoration Ceremonies for the 100th Anniversary of the Battle of Gallipoli. Prehosp Disaster Med 2018; 33:288-292. [DOI: 10.1017/s1049023x18000353] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractIntroductionMass crowds outside the routine population create a burden of disease on Emergency Medical Services (EMS). The need for EMS in various mass-crowd events may vary. It is especially important to determine the EMS requirement that emerges during the historic commemoration ceremonies in Çanakkale (Turkey).Hypothesis/ProblemThis study aims to determine the unique challenges in the planning of EMS responses provided for people from various countries at the commemoration ceremony for a 100-year-old war and to identify the medical provision of those services.MethodsThis descriptive study examined the patient applications in the Çanakkale EMS at the commemoration ceremonies for the 100th anniversary of Gallipoli Wars (Çanakkale Amphibious Wars – Turkey) on April 24-25, 2015.ResultsA total of 221 cases were handled by 112 EMS in the ceremony area. Of those, 87.3% of the cases applied to a mobile operating room (MOR) stationed in the ceremony area while 12.7% of them applied directly to the health care team in a large area in the ceremony area. Overall, 13.1% of the cases were transferred to the hospital for further evaluation and treatment. Patient presentation rate (PPR) of the patients who were treated during the two days was 4.42, and transfer to hospital rate (TTHR) of the cases transferred to the hospital was calculated to be 0.58.ConclusionFurther studies may create models in regard to the estimations on mass and needs based on the data of previous organizations.KoçakH, ÇalışkanC, SönmezlerMS, EliuzK, KüçükdurmazF. Analysis of medical responses in mass gatherings: the commemoration ceremonies for the 100th anniversary of the Battle of Gallipoli. Prehosp Disaster Med. 2018;33(3):288–292.
Collapse
|
48
|
Abstract
The mass gathering of people is a potential source for developing, propagating, and disseminating infectious diseases on a global scale. Of the illnesses associated with mass gatherings, respiratory tract infections are the most common, the most easily transmitted, and the most likely to be spread widely beyond the site of the meeting by attendees returning home. Many factors contribute to the spread of these infections during mass gatherings, including crowding, the health of the attendees, and the type and location of meetings. The annual Hajj in the Kingdom of Saudi Arabia is the largest recurring single mass gathering in the world. Every year more than 10 million pilgrims attend the annual Hajj and Umrah. Attendees assemble in confined areas for several days. People with a wide range of age, health, susceptibility to illness, and hygiene sophistication come in close contact, creating an enormous public health challenge. Controlling respiratory infections at the Hajj requires surveillance, rapid diagnostic testing, and containment strategies. Although the Hajj is without equal, other mass gatherings can generate similar hazards. The geographic colocalization of the Zika virus epidemic and the 2016 Summer Olympic Games in Brazil is a current example of great concern. The potential of international mass gatherings for local and global calamity calls for greater global attention and research.
Collapse
|
49
|
Alfelali M, Khandaker G, Booy R, Rashid H. Mismatching between circulating strains and vaccine strains of influenza: Effect on Hajj pilgrims from both hemispheres. Hum Vaccin Immunother 2017; 12:709-15. [PMID: 26317639 DOI: 10.1080/21645515.2015.1085144] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The trivalent seasonal influenza vaccine is expected to provide optimum protection if the vaccine strains match the circulating strains. The effect of worldwide mismatch between the vaccine strains and extant strains on travelers attending Hajj pilgrimage is not known. Annually 2-3 million Muslims coming from north and south hemispheres congregate at Hajj in Mecca, Saudi Arabia, where intense congestion amplifies the risk of respiratory infection up to eight fold. In order to estimate, to what extent mismatching increases the risk of vaccine failure in Hajj pilgrims, we have examined the global data on influenza epidemiology since 2003, in light of the available data from Hajj. These data demonstrate that globally mismatching between circulating and vaccine strains has occurred frequently over the last 12 years, and the mismatch seems to have affected the Hajj pilgrims, however, influenza virus characteristics were studied only in a limited number of Hajj seasons. When the vaccines are different, dual vaccination of travelers by vaccines for southern and northern hemispheres should be considered for Hajj pilgrims whenever logistically feasible. Consideration should also be given to the use of vaccines with broader coverage, i.e., quadrivalent, or higher immunogenicity. Continuous surveillance of influenza at Hajj is important.
Collapse
Affiliation(s)
- Mohammad Alfelali
- a National Center for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead and the University of Sydney ; Sydney , NSW , Australia.,b Department of Family and Community Medicine ; Faculty of Medicine in Rabigh, King Abdulaziz University ; Jeddah , Saudi Arabia
| | - Gulam Khandaker
- a National Center for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead and the University of Sydney ; Sydney , NSW , Australia.,c Centre for Perinatal Infection Research, The Children's Hospital at Westmead and the University of Sydney ; Sydney , NSW , Australia.,d Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, The University of Sydney ; Sydney , NSW , Australia
| | - Robert Booy
- a National Center for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead and the University of Sydney ; Sydney , NSW , Australia.,d Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, The University of Sydney ; Sydney , NSW , Australia
| | - Harunor Rashid
- a National Center for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead and the University of Sydney ; Sydney , NSW , Australia.,d Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, The University of Sydney ; Sydney , NSW , Australia
| |
Collapse
|
50
|
Hopkins N, Reicher SD. Social identity and health at mass gatherings. EUROPEAN JOURNAL OF SOCIAL PSYCHOLOGY 2017. [DOI: 10.1002/ejsp.2288] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Nick Hopkins
- School of Social Sciences; University of Dundee; Dundee UK
| | | |
Collapse
|