Gastrointestinal symptoms and knowledge and practice of pilgrims regarding food and water safety during the 2019 Hajj mass gathering

Evaluation of community pharmacists' knowledge and attitude about Hajj and Umrah-related health conditions in the western region, Saudi Arabia: A cross-sectional study

BACKGROUND

During the Hajj and Umrah seasons in Saudi Arabia, pilgrims tend to experience a higher frequency of various health conditions. Respiratory infections, gastrointestinal infections, and food poisoning are among the most prevalent ailments. To address these health concerns, community pharmacists (CPs) have developed standardized treatment protocols. Pharmacists' skills in medication dispensing, health consultations, and preventive care enhance pilgrims' well-being in challenging pilgrimage settings.

AIMS

The objective of this study was to investigate the knowledge and attitude of CPs towards health conditions related to Hajj and Umrah in the Western Region of Saudi Arabia where the Hajj and Umrah are taking place.

METHODS

Between March and April 2023, an online cross-sectional study using Google form was carried out among CPs who work in the western region of Saudi Arabia. The study made use of a self-administered questionnaire consisting of four sections that aimed to obtain information about the CPs' knowledge and attitudes towards health conditions related to Hajj and Umrah. Data analysis was conducted using the Statistical Package for the Social Sciences version 26 (SPSS).

RESULT

A total of 496 CPs completed and returned the questionnaire, by giving a response rate of 99.2% (n = 500). Among them, 55.1% were aware of the necessary vaccines for Hajj and Umrah. Approximately 46.6% of CPs provided health-related advice to pilgrims. The most common health conditions experienced by pilgrims were diarrhea (59.5%), followed by flu and cough (58%), gastrointestinal diseases (39.4%), food poisoning (33.6%), viral fever, and heat stroke (24.4%). Regarding attitudes towards vaccination, 55.3% of CPs agreed that vaccination is safe for pilgrims aged 65 years and above, and 65.7% agreed that vaccination can help reduce medical costs during Hajj and Umrah seasons. Additionally, 61.1% of CPs recommended updating immunization against vaccine-preventable diseases for all travelers to ensure a safe Hajj and Umrah. The overall mean knowledge of CPs regarding vaccination during Hajj and Umrah was 4.739(2.49) (median = 5; Range = 0-9). However, 56.7% of CPs demonstrated good knowledge, while 43.3% reported poor knowledge regarding vaccination during Hajj and Umrah.

CONCLUSION

The community pharmacists (CPs) in the Mecca region were found to have good knowledge, with more than half of them having positive attitudes about vaccination for Hajj and Umrah-related health conditions. It is crucial to enhance the knowledge and attitudes of CPs to provide better care and participate in reliable and supportive healthcare and counseling sessions for managing various health infections.

Gastrointestinal illness among attendees of the FIFA Football World Cup 2022 in Qatar

Objectives

Mass gathering events may facilitate the transmission of foodborne diseases. We determined the presentations and causative organisms of gastrointestinal illness among the attendees of the Fédération Internationale de Football Association Football World Cup 2022 (FIFA 2022).

Methods

The study was conducted at Hamad Medical Corporation in Qatar, which served as the national reference laboratory for all microbiology testing. We retrieved all stool testing data from the attendees of FIFA 2022 from October 1 to December 31, 2022. Stool microscopy for ova and parasite and cultures were performed on all samples. Polymerase chain reaction testing was performed for cases of suspected foodborne outbreaks or when a rapid result was required for public health response.

Results

Among 2179 samples tested, one or more organisms were identified in 424 cases. The most common reasons for testing were acute diarrhea/gastroenteritis (51.4%), abdominal pain (11.5%), screening/surveillance of contacts (10.6%), and fever (7.6%). Bacteria were identified in 92.5% (Salmonella spp. 40%, Escherichia coli 25.7%, and Shigella spp. 8.8%), viruses in 7.8%, and parasites in 2.8% of the samples.

Conclusions

The number of individuals who underwent stool testing during the FIFA 2022 was low. The yield of stool testing was higher for those with acute diarrhea/gastroenteritis and fever but not for those with abdominal pain or for surveillance/screening.

Assessment and Association of the World Health Organization's Five Keys to Food Safety Among Selected Food Truck Operators Demographic in Jeddah City

The World Health Organization (WHO) reports that food handlers play a significant role in the maintenance of food safety from food production to storage. This study aims to assess the implementation of WHO five keys to safer food in the food trucks in Jeddah city. This study was an observational study. A total of 103 registered and licensed food trucks in Jeddah were selected using the opportunity sampling method. The WHO's five keys to safer food questionnaire was used by the researchers to inspect and evaluate the hygiene status of food trucks. A chi-square test was used to assess the association between the demographic characteristics of food truck handlers and the implementation of the variables used to evaluate WHO's five keys to safer food in their food trucks. P value < 0.05 was considered significant. The participation rate was 64.4% (103/160). Most food truck handlers were older than 30 years (55.3%), were men (81.6%), had secondary-level education (40.8%), and were Saudi nationals (69.9%). More than 50% of food truck handlers had less than three years of experience in business, and 67% of food truck handlers had undergone training in food handling. The researchers found good implementation of Key 5c. - "Water from cans/bottles used for cooking" (93.2%), followed by Key 1a. "Cleaning and disinfecting done periodically" (78.6%), and poor implementation for Key 3a. - "Calibrated thermometers are used to check temperatures" (30.1%) in the food trucks. The overall implementation score of WHO's five keys to safer food was found to be good (score ≥ 8) in 57.3% of food trucks. Food handlers' age, gender, and training in food handling indicated a significant association with the implementation of WHO's five keys to safer food. The exposure of food handlers to food handling training indicated a significant association with good implementation of all five keys to safer food.

Understanding the pattern of musculoskeletal pain and its contributing factors among Hajj pilgrims

BACKGROUND

Hajj is a series of rituals that are done in specific areas and periods in Mecca. Performing Hajj requires a great amount of physical demand which may result in musculoskeletal pain (MSP) in different age groups.

OBJECTIVE

To estimate the prevalence of MSP and understand its pattern via exploring the factors that could be associated with muscular pain among pilgrims in the 2022 Hajj.

METHODS

A web-based survey was distributed during the annual Hajj mass gathering. Pilgrims were recruited from Hajj ritual sites. The collected data included demographics, musculoskeletal pain at ten anatomical body sites, and physical activity (PA) level. Descriptive and inferential statistics were used to analyze the data at a 0.05 significance level.

RESULTS

A total of 248 pilgrims participated in the study. The mean age of the sample was 43.49±12.70 years. Of all pilgrims, 78.6% had reported MSP in at least one anatomical body site during performing Hajj. Results revealed that Pilgrims were more likely to have MSP in the lower limb while performing Hajj rituals where the most prevalent reported pain was in the legs (46%), followed by the lower back (45%), knees (37%), and ankles/feet (30%). Age, sex, and PA were not significantly associated with MSP except the BMI was found to be a significant factor related to MSP among pilgrims (p <0.05).

CONCLUSION

Many pilgrims exhibited pain in at least one body part. Although physical fitness recommendations are published in the Saudi Ministry of Health, MSP preventative measures need to be disseminated by organizations and interested parties worldwide.

Food Safety Practices during Hajj: On-Site Inspections of Food-Serving Establishments

The presence of crowds during Hajj increases the risk of foodborne infection. Yet, research on the practices of food handlers during Hajj is limited. This study aimed to assess compliance with food safety practices and its associated factors during Hajj 2022. An observational cross-sectional study was conducted in Mecca and Madinah before and during Hajj 2022 and involved 195 food-serving establishments (FSEs) contracted for Hajj catering. Collected data included visit time, establishment location, licensure, whether food handlers had food safety training (professional training), and whether FSEs were under supervision from a consulting office (professional supervision). The included FSEs were 168/195 (86.2%). Two-thirds of FSEs surveyed (113, 67.3%) were under professional supervision, and 91 (54.2%) hired trained food safety workers. Compliance rates varied between outcomes (72.67 ± 17.21% to 88.3 ± 18.8%). Compared to Mecca, Madinah FSEs were more adherent to cleanliness (80.5 ± 27.9% vs. 91.5 ± 19.9%, respectively, p = 0.006). FSEs with trained workers were more likely to comply with proper food safety practices compared to those with untrained workers: cleanliness (OR: 7.2, 95% CI [2.6-20.23], p < 0.001); workers' commitment to health requirements (OR: 2.8, 95% CI [1.1-6.9], p = 0.025); handling of refrigerated and frozen food (OR: 5.27, 95% CI [1.83-15.20], p = 0.004); and food storage practices (OR: 12.5, 95% CI [2.0-12.5], p < 0.001). The role of professional training in increasing food safety practices compliance was highlighted. FSEs in Madinah were more compliant with food safety practices than those in Mecca. Therefore, Mecca FSEs may need stringent safety measures.

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.

A population-based survey of the prevalence of self-reported acute gastrointestinal illness in Zhejiang Province, China

Acute gastrointestinal illness (AGI) is a prevalent public health concern worldwide. This study investigated the magnitude, distribution and burden of self-reported AGI among residents of Zhejiang Province, China. A face-to-face household survey was conducted using a multi-stage stratified random sampling method in 10 counties in Zhejiang Province between July 2018 and June 2019. In total, 12,021 participants were recruited. The prevalence of AGI 28 days after standardization was 1.8% (95% confidence interval (CI), 1.6–2.1), with an incidence rate of 0.24 episodes of AGI per person-year and an estimated 14 million cases of AGI in Zhejiang Province. Univariate and multivariable analyses showed a higher AGI prevalence among people who performed housework and were unemployed in summer and autumn among respondents living in western or northern cities (p < 0.05). More than 50% of AGI cases were attributed to the consumption of contaminated food. The disease burden caused by AGI in Zhejiang Province was approximately 975 million Chinses yuan (CNY). These results indicated that the disease burden of AGI in Zhejiang Province should be addressed and highlights the need for an improved active surveillance system of foodborne diseases to assess the impact of AGI on society and health.