A Longitudinal Study Regarding the Health Profile of the 2017 South African Hajj Pilgrims

Experiences of Indonesian nurses as Hajj health personnel in caring for Hajj pilgrims: A qualitative study

Background

Investigating the experiences and roles of nurses during Hajj is vital due to the unique public health challenges posed by the mass gathering of diverse pilgrims. Nurses play a crucial role in disease surveillance, infection control, and managing emergencies like heat stroke and injuries. Their insights can improve emergency preparedness and public health management.

Objective

This study aimed to explore the experiences of Indonesian nurses as Hajj health personnel caring for Hajj pilgrims during the 2023 Hajj season.

Methods

This study employed a qualitative descriptive design and selected participants through purposive sampling from hospitals, public healthcare centers, and clinics in Yogyakarta, Indonesia. Nine nurses participated in the research, and data were collected through a focus group discussion in December 2023. Thematic analysis was used to analyze the data.

Results

Six themes emerged, including practicing ethical principles in providing health care during the hajj process, competency qualifications as a health worker, the health care process during Hajj, legal Requirements for Hajj, the importance of therapeutic communication skills to establish cooperation with various parties, and recognizing the role of duties and responsibilities during the hajj process.

Conclusion

The study emphasizes the importance of competencies, ethics, communication, and strategic planning in Hajj healthcare. Effective online communication, especially via WhatsApp, was crucial for coordination. The findings emphasize the need for strategic workforce planning, resource allocation, and continuous training to enhance care quality for pilgrims, informing better planning and policy development for future Hajj seasons.

Patterns of diabetes mellitus by age, sex, and province among Iranian Hajj pilgrims and health care delivery during 2012-2022: A retrospective study of 469,581 participants

OBJECTIVE

Hajj is among the oldest pilgrimages in the world, there is a limited study that evaluates the epidemiological pattern of Diabetes Mellitus [1] and the medical care required and provided to pilgrims. The present study assessed the prevalence and pattern of DM in Iranian pilgrims from 2012-22.

METHOD

All demographic information, risk factors, and the prevalence of DM were extracted from the database and medical records of the Hajj Pilgrimage Medical Centre, Iranian Red Crescent Society through file reading. Also, to investigate the effect of the risk factors considered in the study, the multiple logistic regression model was used.

RESULTS

The present study included data from 469,581 Hajj pilgrims. Most pilgrims were in the age group of 45 to 70 years (73.25%). The prevalence of diabetes in patients over 70 years old was the highest (16.73%). The prevalence of DM was estimated at 14.64% in women and 12.51% in men. The lowest DM prevalence was in Lorestan (7.81%), North Khorasan (9.07%), Sistan and Baluchistan (9.29%), and Hamedan (9.41), respectively. The highest prevalence rate was in Khuzestan (20.12%), Yazd (19.14), and Mazandaran (17.55), respectively. Our analysis reveals that, for instance, with each yearly increase in the age of the pilgrims (assuming other variables remain constant), the odds of having DM increase by 0.04. For the gender, the odds of having DM among women is 0.33 higher than among men, when the other variable is constant.

CONCLUSIONS

The study results show a significant difference in the prevalence of diabetes in age, gender, and distribution in different provinces. Therefore, appropriate screening, diagnosis, and management by primary care physicians are necessary to prevent adverse health outcomes and reduce the economic burden of mortality and morbidity.

Morbidity amongst South African Hajj pilgrims in 2023-a retrospective cohort study

South Africans are not accustomed to the dry arid climate and sweltering heat in Saudi Arabia. We conducted a retrospective cohort study to identify the common health conditions pre-Hajj, during the 5 days of Hajj and on return to South Africa from Hajj amongst the 2023 pilgrims. A QR code and a mobile link to a self-administered questionnaire was sent to all 3500 South African pilgrims. Five hundred and seventy-seven pilgrims returned the completed surveys. Mean age of the participants was 48 years (SD 12) with a higher female representation (3:2). Forty eight percent (279) had pre-existing chronic conditions. Forty five percent (259) reported being ill during their stay in the Kingdom, 20% (115) reported having an illness during the main 5 days, whilst 51% (293) reported having an illness within 7 days of returning to South Africa. Only six pilgrims were admitted to hospital after their return home. Respiratory tract linked symptoms were the most frequently reported (95% pre Hajj and 99% post Hajj). Participants who reported having a chronic condition (AOR 1.52 95% CI 1.09-2.11) and engaging in independent exercising prior to Hajj (AOR 1.52-1.07-2.10) were at an increased likelihood of developing an illness within 7 days of returning home. Post travel surveillance swabs to identify potential pathogens that the returning pilgrims are incubating should be explored to guide further interventions.

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

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.

Community pharmacists' knowledge, prospective and practice towards health related illness at Hajj and Umrah: A cross sectional study

Objectives

To assess the community pharmacists' (CPs) knowledge, attitude, and perception of health-related illness among pilgrims, and to investigate the common diseases and the pattern of medications dispensed by CPs during Hajj and Umrah seasons.

Method

A cross-sectional study was carried out in Riyadh, Saudi Arabia over two months in 2022, through electronic platform using prevalidated questionnaires adopted from the literature. The questionnaires were divided into 4 sections assessing the CP's knowledge, attitude, and perception about health-related illness, common dispensed agents, and required vaccination during Hajj and Umrah.

Results

A total of 544 CPs, mostly between the age of 31-40 (69.9%), participated in this research. About 87.9% of the CPs received a pilgrim after performing their rituals coming to the pharmacy complaining of infection or health problem. In this study, 99.8%(n = 544), 99.6%(n = 543), and 92.7% (n = 505) of the CPs identified influenza, food poisoning, and diarrhea/gastroenteritis as the most common issues during the Hajj & Umrah season respectively. As results, anti-diarrheal agents (96.3%), painkillers (87.3%), inhalers (89.4%), and sunscreens (88.3%) were the most requested pharmaceutical agents. Additionally, 96.7%(n = 527) of the CPs agreed that vaccination is safe to be given to Hajj and Umrah pilgrims particularly for those aged ≥ 65 years, and 89.4%(n = 487) of them reported awareness of vaccines that are required by Saudi Ministry of Health. Both Influenza and meningococcal meningitis vaccines were identified by 99.8% of the CPs, but polio vaccine was identified by 33.9%.

Conclusion

Community pharmacists provided pharmaceutical care services for Hajj and Umrah pilgrims. The majority of CPs had adequate knowledge about viral diseases during Hajj and Umrah and their requirement for vaccination.

Travel-related respiratory symptoms and infections in travellers (2000-22): a systematic review and meta-analysis

BACKGROUND

Respiratory tract infections (RTIs) are common in travellers due to the year-round or seasonal presence of respiratory pathogen and exposure to crowded environments during the itinerary. No study has systematically examined the burden of RTI infections among travellers. The aim of this systematic review and meta-analysis is to evaluate the prevalence of RTIs and symptoms suggestive of RTIs among travellers according to risk groups and/or geographic region, and to describe the spectrum of RTIs.

METHODS

The systematic review and meta-analysis was registered in PROSPERO (CRD42022311261). We searched Medline, Embase, Scopus, Cochrane Central, Web of Science, Science Direct and preprint servers MedRxiv, BioRxiv, SSRN and IEEE Xplore on 1 February 2022. Studies reporting RTIs or symptoms suggestive of RTIs in international travellers after 1 January 2000 were eligible. Data appraisal and extraction were performed by two authors, and proportional meta-analyses were used to obtain estimates of the prevalence of respiratory symptoms and RTIs in travellers and predefined risk groups.

FINDINGS

A total of 429 articles on travellers' illness were included. Included studies reported 86 841 symptoms suggestive of RTIs and 807 632 confirmed RTIs. Seventy-eight percent of reported respiratory symptoms and 60% of RTIs with available location data were acquired at mass gatherings events. Cough was the most common symptom suggestive of respiratory infections, and the upper respiratory tract was the most common site for RTIs in travellers. The prevalence of RTIs and respiratory symptoms suggestive of RTIs were 10% [8%; 14%] and 37% [27%; 48%], respectively, among travellers. Reporting of RTIs in travellers denoted by publication output was found to correlate with global waves of new respiratory infections.

INTERPRETATION

This study demonstrates a high burden of RTIs among travellers and indicates that travellers' RTIs reflect respiratory infection outbreaks. These findings have important implications for understanding and managing RTIs among travellers.