Assessment of Preventative Measures Practice among Umrah Pilgrims in Saudi Arabia, 1440H-2019

  1. Mansour Tobaiqy
  2. Ahmed H. Alhasan
  3. Manal M. Shams
  4. Samar A. Amer
  5. Katie MacLure
  6. Mohammed F. Alcattan
  7. Sami S. Almudarra

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Abstract

Background: Annually, approximately 10 million pilgrims travel to the Kingdom of Saudi Arabia (KSA) for Umrah from more than 180 countries. This event presents major challenges for the Kingdom’s public health sector, which strives to decrease the burden of infectious diseases and to adequately control their spread both in KSA and pilgrims home nations. The aims of the study were to assess preventative measures practice, including vaccination history and health education, among Umrah pilgrims in Saudi Arabia. Methods: A cross sectional survey was administered to pilgrims from February to April 2019 at the departure lounge at King Abdul Aziz International airport, Jeddah city. The questionnaire comprised questions on sociodemographic information (age, gender, marital status, level of education, history of vaccinations and chronic illnesses), whether the pilgrim had received any health education and orientation prior to coming to Saudi Arabia or on their arrival, and their experiences with preventative practices. Results: Pilgrims (n = 1012) of 41 nationalities completed the survey. Chronic diseases were reported among pilgrims (n = 387, 38.2%) with cardiovascular diseases being the most reported morbidity (n = 164, 42.3%). The majority of pilgrims had been immunized prior to travel to Saudi Arabia (n = 770, 76%). The most commonly reported immunizations were influenza (n = 514, 51%), meningitis (n = 418, 41%), and Hepatitis B virus vaccinations (n = 310, 31%). However, 242 (24%) had not received any vaccinations prior to travel, including meningitis vaccine and poliomyelitis vaccine, which are mandatory by Saudi Arabian health authorities for pilgrims coming from polio active countries. Nearly a third of pilgrims (n = 305; 30.1%) never wore a face mask in crowded areas during Umrah in 2019. In contrast, similar numbers said they always wore a face mask (n = 351, 34.6%) in crowded areas, while 63.2% reported lack of availability of face masks during Umrah. The majority of participants had received some form of health education on preventative measures, including hygiene aspects (n = 799, 78.9%), mostly in their home countries (n = 450, 44.4%). A positive association was found between receiving health education and practicing of preventative measures, such as wearing face masks in crowded areas (p = 0.04), and other health practice scores (p = 0.02). Conclusion: Although the experiences of the preventative measures among pilgrims in terms of health education, vaccinations, and hygienic practices were at times positive, this study identified several issues. These included the following preventative measures: immunizations, particularly meningitis and poliomyelitis vaccine, and using face masks in crowded areas. The recent COVID-19 pandemic highlights the need for further studies that focus on development of accessible health education in a form that engages pilgrims to promote comprehensive preventative measures during Umrah and Hajj and other religious pilgrimages.

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  1. Version published to 10.3390/ijerph18010257
  2. ScreenIT

    SciScore for 10.1101/2020.06.09.20126581: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIACUC: Ethics Approval: The study obtained permission from the Health Directorate Affairs in Jeddah Ministry of Health, reviewed by the College of Applied Medical Sciences Ethics & Scientific Committee at the University of Jeddah, and also received permission from the King Abdul Aziz Airport, Islamic Port in Jeddah.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Analysis: Statistical analysis was undertaken using SPSS (SPSS Ic, Cart, NC version 22), The data was summarized and analyzed using suitable methods and tests.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations of the study: There are a number of biases that are present in this study, including recruitment by the Al Hamla company members to participate in this study and the responses (the number of refusals to participate was not recorded). Although the sample size is reasonable and provided detailed and crucial data on the preventive measures, including vaccination history and health education, considering the millions of Umrah pilgrims arrived at the holy cities in Saudi Arabia yearly, low participation and other factors may limit the generalizability of the findings. Time constraints and language barriers were also limiting factors since the recruitment took place at the airport. Despite these limitations, this study has provided several crucial insights that were consistent with other studies on the Hajj and Umrah in Saudi Arabia. Conclusions: This study reported the experiences of 1012 Umrah pilgrims concerning the preventive measures that have been adopted prior and during their religious trip to Saudi Arabia in 2019. The majority had reported taking immunization prior to travel; however, almost a quarter of the respondents reported not having received any vaccinations, including the mandatory meningitis vaccine. The majority of pilgrims had received health education on preventive measures, including hygienic practices, mostly in their home countries. Of note is that almost half of the respondents 485 (47.9%) had reported using face masks “always or often,” however...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.06.09.20126581 on medRxiv