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Türkün C, Gölgeli M, Atay FM. A mathematical interpretation for outbreaks of bacterial meningitis under the effect of time-dependent transmission parameters. NONLINEAR DYNAMICS 2023; 111:1-18. [PMID: 37361004 PMCID: PMC10235855 DOI: 10.1007/s11071-023-08577-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/08/2023] [Indexed: 06/28/2023]
Abstract
We consider a SIR-type compartmental model divided into two age classes to explain the seasonal exacerbations of bacterial meningitis, especially among children outside of the meningitis belt. We describe the seasonal forcing through time-dependent transmission parameters that may represent the outbreak of the meningitis cases after the annual pilgrimage period (Hajj) or uncontrolled inflows of irregular immigrants. We present and analyse a mathematical model with time-dependent transmission. We consider not only periodic functions in the analysis but also general non-periodic transmission processes. We show that the long-time average values of transmission functions can be used as a stability marker of the equilibrium. Furthermore, we interpret the basic reproduction number in case of time-dependent transmission functions. Numerical simulations support and help visualize the theoretical results.
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Affiliation(s)
- Can Türkün
- Department of Mathematics, TOBB University of Economics and Technology, Ankara, Turkey
- Present Address: Department of Industrial Engineering, Altınbaş University, Istanbul, Turkey
| | - Meltem Gölgeli
- Department of Mathematics, TOBB University of Economics and Technology, Ankara, Turkey
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A Longitudinal Study Regarding the Health Profile of the 2017 South African Hajj Pilgrims. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073607. [PMID: 33807142 PMCID: PMC8036399 DOI: 10.3390/ijerph18073607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 11/17/2022]
Abstract
The Hajj mass gathering annually attracts over two million Muslim pilgrims worldwide to the Kingdom of Saudi Arabia (KSA). We aimed to establish demographics and health profiles for the South African pilgrims performing the 2017 Hajj. Methods: This is a longitudinal survey-based study conducted on 1138 adult South African pilgrims in two phases (during and post-Hajj). Data on demographics, vaccination status, underlying health conditions, pre-Hajj training, health promotion, travel history, and health issues during and post-Hajj were collected using pre-designed questionnaires. Results: Participants had a mean age of 49.2 years (SD = 13.3; range 18–81), with a male: female ratio of 1.2:1. The majority of pilgrims were married (88.2%), of Indian/Asian background (73%), and literate (>99%). Nearly all pilgrims were vaccinated against meningococcal disease and yellow fever, but only 23.7% were vaccinated against Influenza. Hypertension, diabetes, and elevated cholesterol levels were the most common underlying health conditions reported by 22.6%, 13.2%, and 11.5% of pilgrims, respectively. One month after return to South Africa, nearly 65% of pilgrims reported illness during Hajj, while 40% reported falling ill post event upon return to South Africa. Nevertheless, only a few were admitted to hospitals (12 during Hajj and 15 post-Hajj). Among ill pilgrims, respiratory symptoms were the most commonly experienced symptoms during (70.2%) and post-Hajj (82.2%). Other symptoms such as walking-related symptoms include symptoms directly related or mainly caused by walking (e.g., leg pain, sore feet, blisters on the feet), dehydration, and gastrointestinal tract symptoms reported during Hajj. Medication to treat respiratory symptoms and antibiotics were the most commonly used medications during and post-Hajj. Having an underlying health condition was an independent predictor of falling ill during or post Hajj. Conclusion: Our study indicates that a sizable proportion of South African pilgrims are elderly with underlying health conditions and most contract respiratory tract infections during and post Hajj. Our study highlights the need for systematic collection of prospective pilgrims’ demographics and health data and more attention to post-Hajj health follow-ups of pilgrims.
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Al-Tawfiq JA, Memish ZA. The Emergence, Persistence, and Dissemination of Antimicrobial-Resistant Bacteria in Environmental Hajj Settings and Implications for Public Health. Trop Med Infect Dis 2021; 6:33. [PMID: 33802167 PMCID: PMC8005974 DOI: 10.3390/tropicalmed6010033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 11/21/2022] Open
Abstract
The emergence of antimicrobial resistance is causing the loss of what was once considered the miracle cure. The transmission of antimicrobial resistance during mass gathering is a potential threat in addition to other infectious diseases. Here, we review the English language literature on the rate and the acquisition of antimicrobial resistance during the Hajj. There is a variable incidence of methicillin-resistant Staphylococcus aureus, Escherichia coli, and Enterobacteriaceae. There had been no report of multi-drug-resistant Mycobacterium tuberculosis. Continued surveillance of antimicrobial resistance coupled with public health measures are needed to decrease the rate of emergence of resistance.
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Affiliation(s)
- Jaffar A. Al-Tawfiq
- Specialty Internal Medicine and Quality Division, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia;
- Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21093, USA
| | - Ziad A. Memish
- Director Research and Innovation Center, King Saud Medical City, Ministry of Health, Riyadh 12746, Saudi Arabia
- Al-Faisal University, Riyadh 11533, Saudi Arabia
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
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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.
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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
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Alqahtani AS, Tashani M, Heywood AE, Booy R, Rashid H, Wiley KE. Exploring Australian Hajj Tour Operators' Knowledge and Practices Regarding Pilgrims' Health Risks: A Qualitative Study. JMIR Public Health Surveill 2019; 5:e10960. [PMID: 31124464 PMCID: PMC6552451 DOI: 10.2196/10960] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 02/02/2019] [Accepted: 02/07/2019] [Indexed: 01/15/2023] Open
Abstract
Background Travel agents are known to be one of the main sources of health information for pilgrims, and their advice is associated with positive health behaviors. Objective This study aimed to investigate travel agents’ health knowledge, what health advice they provide to the pilgrims, and their sources of health information. Methods In-depth interviews were conducted among specialist Hajj travel agents in Sydney, Australia. Thematic analysis was undertaken. Results Of the 13 accredited Hajj travel agents, 9 (69%) were interviewed. A high level of awareness regarding gastrointestinal infections, standard hygiene methods, and the risk of injury was noted among the participants and was included in advice provided to pilgrims. However, very limited knowledge and provision of advice about the risk of respiratory infections was identified. Knowledge of the compulsory meningococcal vaccine was high, and all participated travel agents reported influenza vaccine (a recommended vaccine) as a second “compulsory” vaccine for Hajj visas. Conversely, participants reported very limited knowledge about other recommended vaccines for Hajj. The Ministry of Hajj website and personal Hajj experience were the main sources of information. Conclusions This study identifies a potential path for novel health promotion strategies to improve health knowledge among Hajj travel agents and subsequently among Hajj pilgrims.
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Affiliation(s)
| | - Mohamed Tashani
- Child and Adolescent Health, Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, Australia
| | | | - Robert Booy
- Child and Adolescent Health, Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, Australia
| | - Harunor Rashid
- Child and Adolescent Health, Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, Australia
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Alqahtani AS, Althimiri NA, BinDhim NF. Saudi Hajj pilgrims' preparation and uptake of health preventive measures during Hajj 2017. J Infect Public Health 2019; 12:772-776. [PMID: 31023600 DOI: 10.1016/j.jiph.2019.04.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 04/03/2019] [Accepted: 04/07/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Few studies have reported the uptake of health preventive measures among Hajj pilgrims from Saudi Arabia. Yet, none of these studies have explored their perceptions of health risks at Hajj or pretravel health-advice-seeking behavior. METHODS A cross-sectional survey conducted among Hajj pilgrims from Saudi Arabia. RESULTS Of 344 pilgrims who completed the survey, 44% sought some form of pretravel health information; among them, 38% from non-medical sources. About 67% of participants received an influenza vaccine, and 8.7% received a pneumococcal vaccine. Lack of aware of vaccine availability was the main reason for nonreceipt (26%). Being employed and having a high level of education were significant factors in vaccine uptake. Two thirds of pilgrims carried some medications to use during Hajj; analgesics, antipyretics and antibiotics were the most reported drugs. Various methods of hand hygiene were the most used preventive measures (≈65%) followed by facemask use (53%). Those who concerned about food poisoning at Hajj were more likely to cleaned their hands with hand sanitizers (aOR = 2.5, 95% CI = 1.1-5.4, p = 0.01) and avoid eating food from street vendors (aOR = 2.9, 95% CI = 1.1-7.5, p = 0.02). CONCLUSION Pretravel health-advice-seeking behavior and the use of preventive measures during Hajj were suboptimal among Saudi Hajj pilgrims.
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Altassan KK, Morin C, Shocket MS, Ebi K, Hess J. Dengue fever in Saudi Arabia: A review of environmental and population factors impacting emergence and spread. Travel Med Infect Dis 2019; 30:46-53. [PMID: 30978417 DOI: 10.1016/j.tmaid.2019.04.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 11/09/2018] [Accepted: 04/07/2019] [Indexed: 12/31/2022]
Abstract
Dengue fever (DF) is the most important mosquito-transmitted viral disease causing a large economic and disease burden in many parts of the world. Most DF research focuses on Latin America and Asia, where burdens are highest. There is a critical need for studies in other regions where DF is an important public health problem but less well-characterized and can differ, such as the Middle East. The first documented case of DF in Saudi Arabia occurred in 1993. After a decade of sporadic outbreaks, the disease was declared endemic in 2004 and this designation persists. Climate, sociodemographic factors, and increasing urbanization impact the spread of DF in Saudi Arabia, as in other areas. However, DF transmission in Saudi Arabia is also affected by several unique factors, including large numbers of migrant workers and religious pilgrims from other dengue endemic areas across the Middle East, North Africa, and Asia. Important knowledge gaps relate to the role of climatic factors as drivers of DF in Saudi Arabia and the role of foreign workers and pilgrims in the original and continuous importation of dengue virus. Filling these gaps would improve health system preparedness.
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Affiliation(s)
- Kholood K Altassan
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, 98195, USA.
| | - Cory Morin
- Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, 98105, USA.
| | - Marta S Shocket
- Department of Biology, Stanford University, 371 Serra Mall Stanford, CA, 94305, USA.
| | - Kris Ebi
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, 98195, USA; Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, 98105, USA.
| | - Jeremy Hess
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, 98195, USA; Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, 98105, USA; Department of Environmental and Occupational Health Sciences, University of Washington, Box 357234 1959 NE Pacific Street, Seattle, WA, 98195, USA; Department of Emergency Medicine, School of Medicine, University of Washington, Seattle, WA, 98195, USA.
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Leangapichart T, Rolain JM, Memish ZA, Al-Tawfiq JA, Gautret P. Emergence of drug resistant bacteria at the Hajj: A systematic review. Travel Med Infect Dis 2017; 18:3-17. [PMID: 28652197 DOI: 10.1016/j.tmaid.2017.06.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 06/15/2017] [Accepted: 06/22/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Hajj is the annual mass gathering of Muslims, and is a reservoir and potential source of bacterial transmission. The emergence of bacterial transmission, including multi-drug resistance (MDR) bacteria, during Hajj has not been systematically assessed. METHODS Articles in Pubmed, Scopus, and Google scholar were identified using controlled words relating to antibiotic resistance (AR) at the Hajj from January 2002 to January 2017. Eligible studies were identified by two researchers. AR patterns of bacteria were obtained for each study. RESULTS We included 31 publications involving pilgrims, Hajj workers or local patients attending hospitals in Mecca, Mina, and the Medina area. Most of these publications provided antibiotic susceptibility results. Ten of them used the PCR approach to identify AR genes. MRSA carriage was reported in pilgrims and food handlers at a rate of 20%. Low rates of vancomycin-resistant gram-positive bacteria were reported in pilgrims and patients. The prevalence of third-generation cephalosporin-resistant bacteria was common in the Hajj region. Across all studies, carbapenem-resistant bacteria were detected in fewer than 10% of E.coli isolates tested but up to 100% in K. pneumoniae and A. baumannii. Colistin-resistant Salmonella enterica, including mcr-1 colistin-resistant E.coli and K.pneumoniae were only detected in the pilgrim cohorts. CONCLUSION This study provides an overview of the prevalence of MDR bacteria at the Hajj. Pilgrims are at high risk of AR bacterial transmission and may carry and transfer these bacteria when returning to their home countries. Thus, pilgrims should be instructed by health care practitioners about hygiene practices aiming at reducing traveler's diarrhea and limited use of antibiotics during travel in order to reduce the risk of MDR bacterial transmission.
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Affiliation(s)
- Thongpan Leangapichart
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes (URMITE) CNRS-IRD UMR 6236, Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France
| | - Jean-Marc Rolain
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes (URMITE) CNRS-IRD UMR 6236, Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France
| | - Ziad A Memish
- Ministry of Health, Riyadh, Saudi Arabia; Alfaisal University, College of Medicine, Riyadh, Saudi Arabia; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Jaffar A Al-Tawfiq
- Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Indiana University School of Medicine, Indianapolis, IN, USA
| | - Philippe Gautret
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes (URMITE) CNRS-IRD UMR 6236, Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France.
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