Abstract
BackgroundThe majority of pilgrims seeking healthcare during Hajj are seen at primary healthcare centers (PHCCs). Data on the utilization of these facilities during Hajj can aid in directing optimal health services delivery and allocation of resources during the pilgrimage.MethodWe investigated the pattern of disease presentation, caseload, and medication prescribing and dispensing at 51 PHCCs during the 2019 Hajj. Data on patients’ demographics, diagnoses, and prescribed medications were retrieved from each PHCC’s electronic records and analyzed. Data were also used to calculate six of the World Health Organization (WHO) indicators for drug use at these facilities.ResultsData were captured for 99,367 patients who were mostly Hajj pilgrims (95.4%), male (69.1%) from the Eastern Mediterranean (60.8%) and had a mean age of 46.6 years (SD = 14.9). Most patients (85.2%) were seen in Mina and towards the end of Hajj. The majority of patients (96.0%) had a single diagnosis; most commonly, respiratory (45.0%), musculoskeletal (17.2%), and skin (10.5%) diseases. Patients were prescribed 223,964 medications, mostly analgesics (25.1%), antibacterials for systemic use (16.5%), anti-inflammatory and antirheumatic products (16.4%), and cough and cold preparations (11.9%). On average, 2.25 (SD = 0.94) medications were prescribed per consultation, with low (1.3%) prevalence of polypharmacy. An antibiotic and an injectable were prescribed in 43.6 and 2.67% of patient encounters, respectively. Most (92.7%) of the prescribed drugs were actually dispensed, in an average time of 8.06 min (SD = 41.4). All PHCCs had a copy of the essential drugs list available, on which all the prescribed drugs appeared.ConclusionRespiratory illnesses are the main reason for PHCCs visits during Hajj, and analgesics and antibiotics are the most common medications prescribed to pilgrims. Our results, including the calculated WHO drug use indicators, contribute to evidence-based optimization of primary healthcare services during Hajj.
Highlights
The Hajj pilgrimage to Makkah, Kingdom of Saudi Arabia (KSA), is one of the five pillars of Islam and is a religious duty for every Muslim who is physically and financially able to perform it [1]
Respiratory illnesses are the main reason for primary healthcare centers (PHCCs) visits during Hajj, and analgesics and antibiotics are the most common medications prescribed to pilgrims
This study aims to determine the pattern of disease presentation, caseload, and medication prescribing and dispensing at seasonal PHCCs in Mina, Arafat, and Muzdalifah, during Hajj
Summary
The Hajj pilgrimage to Makkah, Kingdom of Saudi Arabia (KSA), is one of the five pillars of Islam and is a religious duty for every Muslim who is physically and financially able to perform it [1]. During the Hajj ritual days, pilgrims move to the holy site of Mina where they spend a few days, including 1 day (9th DulHija) in the desert plain of Arafat and a short stay at Muzdalifah area [1]. Saudi authorities use a well-coordinated and inter-sectoral approach to orchestrate the public health planning and management of Hajj, which includes addressing the increased demand for health services during the event. Free healthcare is provided for Hajj pilgrims through numerous permanent and seasonal (only operational during the Hajj season) hospitals and primary healthcare centers (PHCCs) in Makkah and Medina. In 2018, 21 permanent and eight seasonal hospitals were available, in addition to 33 permanent and 106 seasonal PHCCs [2] Of the latter, 93 were located in the holy sites of Mina, Arafat and Muzdalifah. Data on the utilization of these facilities during Hajj can aid in directing optimal health services delivery and allocation of resources during the pilgrimage
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