Annual Hajj Pilgrimage Research Articles

Unveiling Sentiments: A Comprehensive Analysis of Arabic Hajj-Related Tweets from 2017–2022 Utilizing Advanced AI Models

Sentiment analysis plays a crucial role in understanding public opinion and social media trends. It involves analyzing the emotional tone and polarity of a given text. When applied to Arabic text, this task becomes particularly challenging due to the language’s complex morphology, right-to-left script, and intricate nuances in expressing emotions. Social media has emerged as a powerful platform for individuals to express their sentiments, especially regarding religious and cultural events. Consequently, studying sentiment analysis in the context of Hajj has become a captivating subject. This research paper presents a comprehensive sentiment analysis of tweets discussing the annual Hajj pilgrimage over a six-year period. By employing a combination of machine learning and deep learning models, this study successfully conducted sentiment analysis on a sizable dataset consisting of Arabic tweets. The process involves pre-processing, feature extraction, and sentiment classification. The objective was to uncover the prevailing sentiments associated with Hajj over different years, before, during, and after each Hajj event. Importantly, the results presented in this study highlight that BERT, an advanced transformer-based model, outperformed other models in accurately classifying sentiment. This underscores its effectiveness in capturing the complexities inherent in Arabic text.

Heat Stroke in Emergency Department: Diagnosis and Management

Background: Heat stroke is a severe health concern with the potential for multi-organ failure, necessitating rapid and effective management. With rising global temperatures, there is increasing concern regarding the vulnerability of populations in high-heat areas, notably in Saudi Arabia, especially during the annual Hajj pilgrimage. Objective: This paper aims to review the epidemiology, evaluation and management techniques of heat stroke, emphasizing the situation during Hajj pilgrimages in Saudi Arabia, and to outline the best practices for emergency management. Methodology: A comprehensive review of literature and studies related to heat stroke, both globally and specific to Saudi Arabia, was undertaken. An in-depth analysis of emergency management, including initial assessment, cooling methods, organ support, medication, and prevention strategies, was conducted. Results: Heat stroke remains a significant cause of emergency department visits, with specific groups, such as men and the elderly, being more susceptible. During the Hajj in 2016, 267 patients were diagnosed with heat-related illnesses, with heatstroke accounting for 29% of these cases. With the threat of global warming, studies indicate a potential tenfold increase in heat stroke risk with a 2°C rise in temperatures. Swift and comprehensive cooling is pivotal for recovery. Management emphasizes rapid recognition, assessment, and varied cooling methods, along with targeted treatments for organ dysfunctions. Prevention strategies play a vital role, given the higher efficacy and practicality over treating organ dysfunctions. Conclusion: Heat stroke is a pressing health challenge, particularly in high-risk environments like Saudi Arabia during the Hajj pilgrimage. While effective emergency management protocols exist, an emphasis on prevention is crucial. It is imperative to incorporate a comprehensive approach to address both the immediate threat and long-term risks of heat stroke, especially with the looming challenge of global warming.

Intravenous Critical Care Medications Preparation during Hajj Mass Gathering

The annual Hajj pilgrimage in Mecca, Saudi Arabia, attracts millions of Muslims from around the world, creating a unique mass gathering (MG). The World Health Organization has expressed concerns regarding unsafe pharmaceutical practices and medication errors, emphasizing the importance of addressing medication safety in high-risk environments. During the Hajj, nurses are responsible for preparing intravenous (IV) medications, which may increase the potential for medication preparation errors. This review seeks to underscore the critical measures necessary for ensuring medication safety when handling IV medications in critical care settings during Hajj MGs. Furthermore, the review proposes a streamlined guide for the preparation and dosage of IV critical care medications, including antidotes, to support healthcare providers in maintaining medication safety throughout the Hajj. By adopting these recommendations, healthcare professionals can significantly improve the safety and overall well-being of pilgrims participating in the Hajj pilgrimage.

Diagnostic detection of intended bacteria associated with respiratory tract infections among Kelantanese Malaysian Hajj pilgrims by a ready-to-use, thermostable multiplex PCR assay

Bacterial respiratory tract infections (RTIs) are prone to be associated with serious health problems during the annual Hajj pilgrimage and are a public health concern due to the potential of pathogens transmission across continents. This study aimed to perform a diagnostic screening of intended bacteria associated with RTIs among Malaysian Hajj pilgrims by using a newly developed PCR assay. Expectorated sputum specimens (n = 202) and sociodemographic characteristics of the returning Hajj pilgrims were collected upon arrival in Kelantan, Malaysia. Diagnostic screening of bacterial respiratory pathogens was performed using a thermostabilized multiplex PCR assay in parallel with the sputum culture. Of the six intended bacteria: Haemophilus influenzae, Klebsiella pneumoniae, Mycobacterium tuberculosis, Pseudomonas aeruginosa, Staphylococcus aureus and Streptococcus pneumoniae, the sputum specimens were found positive for H. influenzae (n = 139), K. pneumoniae (n = 20), and S. pneumoniae (n = 19) by the multiplex PCR assay. The sensitivity, specificity, positive- and negative predictive values (PPV and NPV) of this assay were 100% (95% confidence interval (CI): 97.85% to 100.00%), 92.23% (95% CI: 85.27% to 96.59%), 95.51% (95% CI: 91.61% to 97.64%) and 100.00%, respectively. The accuracy of this assay was 97.07% (95% CI: 94.31% to 98.73%). Overall, H. influenzae was found to be the predominant organism in the pilgrims’ sputa by both molecular and microbial culture methods. The multiplex PCR assay would enable a simple, faster and reliable means for the massive screening of intended bacteria compared to the sputum culture, especially during the Hajj pilgrimage.

High genetic diversity of human rhinovirus among pilgrims with acute respiratory tract infections during the 2019 Hajj pilgrimage season

ObjectivesAcute respiratory tract infections (ARIs) due to human rhinoviruses (HRVs) are common in pilgrims during the annual Hajj pilgrimage. The objective of this study was to investigate the genetic diversity of HRV among pilgrims with respiratory symptoms during Hajj 2019. MethodsHRV infection was detected using multiplex real-time reverse transcription polymerase chain reaction. Cycle sequencing was performed on positive samples and the sequences were subjected to phylogenetic analysis. ResultsA total of 19 HRV-positive respiratory samples were sequenced. All three serotypes of HRV were identified: HRV-A (13; 68.42%) was more common than HRV-B (2; 10.53%) and HRV-C (4; 21.05%). HRV-A species were found to be of genotypes A101, A21, A30, A57, A23, A60, and A11. HRV-B species belonged to genotypes B4 and B84, and HRV-C species were of genotypes C15, C3, and C56. ConclusionSequencing studies of respiratory tract viruses in pilgrims are important. We provide preliminary evidence of high diversity of HRV genotypes circulating in pilgrims in a restricted area during Hajj. This requires further clinical and sequencing studies of viral pathogens in larger cohorts of overseas and local pilgrims.

Antibiotic resistance, genotype and clinical significance of Acinetobacter Baumannii in Saudi Arabia

Background: In Saudi Arabia, due to its dynamic population and annual hajj pilgrimage, there is influx and efflux of millions of visitors every year, especially to Makkah dan Madinah, providing an international hub for the exchange of microbes. It is rather a common interest to understand the molecular epidemiology and clinical significance of multidrug resistant organisms in this country. Acinetobacter baumannii in particular, is one of the most common Gram negative bacteria isolated in the Kingdom. This organism is responsible for ventilator associated pneumonia, blood stream infections, urinary tract infections and skin infections. Objective: In this manuscript we aim to review the literature available on the antimicrobial resistance, genotypes and clinical significance ofA. baumannii acquisitions in Saudi Arabia. Methodology: The literature was reviewed systematically using PubMed with a combination of the terms ‘Acinetobacter’ AND ‘Saudi Arabia’. Reference lists of relevant articles were searched to identify further material. We only included studies with plausible data. Main observations: In Makkah itself, there are significant increase in carbapenem resistant Acinetobacter from 14% in 2004-2005, 46% in 2005-2006, 63% in 2011 to 90% in 2015. Recent publication from Madinah indicated, beside resistant to carbapenem approaching 90%, an alarming resistant rate to the last resort antibiotic, polymyxin is also observed at 24% of 379 tested strains. In a study in Makkah, the most predominant sequence types being ST 195 and ST557, which in the worldwide clonal complex 2. Conclusion: These resistant rate and sequences type indicated intermingling of the resistant superbugs occurred. With limited treatment option, effective infective control measures and antibiotic stewardship programs are the key element to contain these resistant isolates from spread. Bangladesh Journal of Medical Science Vol. 21 No. 02 April’22 Page : 233-242

A Mathematical Modeling Study: Assessing Impact of Mismatch Between Influenza Vaccine Strains and Circulating Strains in Hajj.

The influenza virus causes severe respiratory illnesses and deaths worldwide every year. It spreads quickly in an overcrowded area like the annual Hajj pilgrimage in Saudi Arabia. Vaccination is the primary strategy for protection against influenza. Due to the occurrence of antigenic shift and drift of the influenza virus, a mismatch between vaccine strains and circulating strains of influenza may occur. The objective of this study is to assess the impact of mismatch between vaccine strains and circulating strains during Hajj, which brings together individuals from all over the globe. To this end, we develop deterministic mathematical models of influenza with different populations and strains from the northern and southern hemispheres. Our results show that the existence and duration of an influenza outbreak during Hajj depend on vaccine efficacy. In this concern, we discuss four scenarios: vaccine strains for both groups match/mismatch circulating strains, and vaccine strains match their target strains and mismatch the other strains. Further, there is a scenario where a novel pandemic strain arises. Our results show that as long as the influenza vaccines match their target strains, there will be no outbreak of strain H1N1 and only a small outbreak of strain H3N2. Mismatching for non-target strains causes about 10,000 new H3N2 cases, and mismatching for both strains causes about 2,000 more new H1N1 cases and 6,000 additional H3N2 cases during Hajj. Complete mismatch in a pandemic scenario may infect over 342,000 additional pilgrims (13.75%) and cause more cases in their home countries.

Airborne LiDAR Assisted Obstacle Recognition and Intrusion Detection Towards Unmanned Aerial Vehicle: Architecture, Modeling and Evaluation

With the rapid development of wireless communication and flight control technologies, the unmanned aerial vehicles (UAVs) have been widely used in multiple application scenarios. A typical scenario is massive crowd management of the multi-millions annual Hajj Pilgrimage to Mecca where UAVs are widely utilized to conduct crowd monitoring by carrying sensory devices. The safe flight of a UAV is crucial for ensuring the successful execution of missions. With the aim to overcome the disadvantage caused by the ground station intrusion detection, the combination of UAV and airborne LiDAR has been widely studied in the field of UAV obstacle recognition. This article studies the UAV network architecture under a common scenario and proposes an obstacle recognition and intrusion detection algorithm for UAV based on an airborne LiDAR (ALORID). First, the preprocessing of the data obtained by a LiDAR, i.e., the coordinate conversion of LiDAR data in combination with UAV motion parameters, is completed. Then, the LiDAR data graph at the current moment is generated by the image noisy point filtering algorithm. After that, the improved density-based spatial clustering of applications with noise (DBSCAN) algorithm is used for image clustering of intrusions to obtain the LiDAR time-domain cumulative graph in a certain detection time. Finally, the motion recognition and location detection of each cluster are completed. The experiment results verify the effectiveness of the proposed algorithm in identifying the moving state of the intrusions.

Mass Gathering Medicine (Hajj Pilgrimage in Saudi Arabia): The Outcome of Cardiopulmonary Resuscitation during Hajj

The annual Hajj (pilgrimage) to the Islamic holy shrines at the city of Makkah in the Kingdom of Saudi Arabia is one of the largest yearly recurring mass gatherings worldwide. We aim to evaluate the outcome of outside and inside the hospital cardiopulmonary resuscitation to resuscitate cardiopulmonary arrest among pilgrims. In a prospective cohort study of cardiac arrest patients during Hajj period (January 2004–December 2007 and January 2010–December 2011), 426 patients were resuscitated. The mean age was 64.0 ± 12.0 years. A total of 252 (52.2%) patients had an outside the hospital cardiac arrest, whereas 174 (40.8%) patients had an inside the hospital cardiac arrest. The survival rate of outside the hospital was 5%, whereas inside the hospital was 30%. The overall survival rate was 15.5%. During Hajj, cardiopulmonary resuscitation inside the hospital was associated with better clinical outcomes than outside the hospital. Patients with cardiac arrest outside of the hospital are much less likely to survive due to the lack of immediately trained help and the delay of arrival of aid due to overcrowding. Sudden cardiac arrest leading to death could be minimized if cardiopulmonary resuscitation and defibrillation are delivered before the arrival of emergency medical services.

High frequency of Haemophilus influenzae associated with respiratory tract infections among Malaysian Hajj pilgrims.

Overcrowding during the annual Hajj pilgrimage has been known to increase the risk of infectious diseases transmission. Despite the high prevalence of respiratory illness among Malaysian Hajj pilgrims, knowledge about the etiologic pathogens is yet very limited. Thus, this study aimed to determine the spectrum of bacterial respiratory pathogens among the Hajj pilgrims returning to Malaysia in year 2016. Expectorated sputum specimens were collected from the Hajj pilgrims with symptomatic respiratory tract infections (RTIs). Subsequently, the bacterial pathogens were identified using the standard bacteriological culture method and Vitek II system. This study indicated that 255 (87.33%) out of 292 cultured sputa were positive with at least one potential pathogenic bacteria. Out of 345 total bacterial isolates, 60% (n=207) were Haemophilus influenzae, which was associated with both single bacterium infection (132/173, 76.3%) and multiple bacterial infections (75/82, 91.5%). The other bacterial isolates included; Klebsiella pneumoniae (n=37, 10.7%), Moraxella catarrhalis (n=27, 7.8%), Haemophilus parainfluenzae (n=25, 7.2%), Streptococcus group G (n=18, 5.2%), Klebsiella spesies (n=16, 4.6%), Streptococcus pneumoniae (n=11, 3.2%) and few other organisms. High frequency of H. influenzae was isolated from Malaysian Hajj pilgrims, especially those with respiratory symptoms. Further study should evaluate the actual pathogenicity of the organism and the interactions between the respiratory microbiota towards developing effective prevention strategies of RTIs among the local pilgrims.

Patterns of Inpatient Admissions during Hajj: Clinical conditions, length of stay and patient outcomes at an advanced care centre in Makkah, Saudi Arabia.

Objectives:This study aimed to describe inpatient clinical conditions at an advanced care facility in Saudi Arabia during the annual Hajj pilgrimage and to determine factors correlating with length of stay (LOS).Methods:This retrospective study was conducted at the King Abdullah Medical City (KAMC), Makkah, Saudi Arabia, and included all inpatients admitted during the annual Hajj pilgrimage between August and October 2015. Demographic, administrative and clinical data were collected from patient charts and analysed.Results:A total of 296 inpatients were included in the study, of which the majority were male (73.6%) and ≥55 years old (77%). Walk-in admissions occurred less frequently than referrals (38.9% versus 61.1%). Most patients (41.6%) were admitted during the peak Hajj period (the 8-13th days of Dhu al-Hijjah). Acute coronary syndrome was the most prevalent provisional diagnosis (65.2%). In terms of outcomes, 89.2% of the inpatients were discharged in a stable condition, with 37.5% discharged within ≤24 hours of admission. However, 39.9% required admission to the Intensive Care Unit (ICU). Overall, LOS was significantly associated with various factors, including the mode of admission, admission period, admitting department, number of comorbidities and ICU admission (P <0.050 each).Conclusion:Most of admissions were referrals, and the main Hajj period witnessed the majority of admissions. The vast majority of inpatients eventually discharged in a stable condition. Determinants of the length of hospital stay were the mode of admission, admission period, admitting department, number of comorbidities and ICU admission.

Undiagnosed Active Pulmonary Tuberculosis among Pilgrims during the 2015 Hajj Mass Gathering: A Prospective Cross-sectional Study.

Mass gatherings pose a risk for tuberculosis (TB) transmission and reactivation of latent TB infection. The annual Hajj pilgrimage attracts 2 million pilgrims many from high TB-endemic countries. We evaluated the burden of undiagnosed active pulmonary TB in pilgrims attending the 2015 Hajj mass gathering. We conducted a prospective cross-sectional study in Mecca, Kingdom of Saudi Arabia, for nonhospitalized adult pilgrims from five high TB-endemic countries. Enrollment criteria were the presence of a cough and the ability to produce a sputum sample. Sputum samples were processed using the Xpert MTB-RIF assay. Data were analyzed for drug-resistant TB, risk factors, and comorbidities by the country of origin. Of 1,164 consenting pilgrims enrolled from five countries: Afghanistan (316), Bangladesh (222), Nigeria (176), Pakistan (302), and South Africa (148), laboratory results were available for 1,063 (91.3%). The mean age of pilgrims was 54.5 (range = 18-94 years) with a male to female ratio of 2.6:1; 27.7% had an underlying comorbidity, with hypertension and diabetes being the most common, 20% were smokers, and 2.8% gave a history of previous TB treatment. Fifteen pilgrims (1.4%) had active previously undiagnosed drug-sensitive pulmonary TB (Afghanistan [12; 80%], Pakistan [2; 13.3%], and Nigeria [1; 6.7%]). No multidrug-resistant TB cases were detected. Pilgrims from high TB-endemic Asian and African countries with undiagnosed active pulmonary TB pose a risk to other pilgrims from over 180 countries. Further studies are required to define the scale of the TB problem during the Hajj mass gathering and the development of proactive screening, treatment and prevention guidelines.

The challenges of cholera at the 2017 Hajj pilgrimage

The challenges of cholera at the 2017 Hajj pilgrimage

Exploring the Significance of Mecca Sacred Mosque Global Location

&lt;span lang="EN-US"&gt;In traditional Islamic cities, the great mosque lies in the middle as the main landmark of the city. It is stated in the Qur'an that the Ka’ba (Mecca sacred mosque) was the first house that was built in Mecca city for humanity to worship Allah. Therefore, Mecca is the holiest city of Islam, and the goal of the annual Muslim hajj (pilgrimage). The objective of the present study is to explore the significance of sacred mosque of Mecca global location on dry land by using accurate measurements and Satellite programs.&lt;/span&gt;&lt;span lang="EN-US"&gt;The results of the study illustrate that the sacred mosque of&lt;span&gt; &lt;/span&gt;Mecca equally distances away from the following locations:&lt;/span&gt;&lt;span&gt;1) &lt;/span&gt;&lt;span lang="EN-US"&gt;The farthest borders edges of Africa and Europe as well,&lt;/span&gt;&lt;span&gt; 2) &lt;/span&gt;&lt;span lang="EN-US"&gt;The nearest borders of the new world continents along with a part of Asia which meeting the Northern borders of North America at the Bering Sea,&lt;/span&gt;&lt;span&gt; 3) &lt;/span&gt;&lt;span lang="EN-US"&gt;The farthest borders of the new world continents that represent the outer edges of the dry land&lt;/span&gt;&lt;span&gt;, 4) &lt;/span&gt;&lt;span lang="EN-US"&gt;Finally, the Ka’ba is equally distant from the geographical centers of the new world continents.&lt;/span&gt;

Zika in Singapore: implications for Saudi Arabia.

Background On 31 August 2016, the Singapore Ministry of Health and the National Environment Agency confirmed a cluster of new infections related to the Zika virus. As of 11 October 2016, 404 cases of Zika virus infections, including 8 cases among pregnant women, were confirmed by the Singapore authorities (1,2). Further, the first pregnant woman in Singapore to be infected with Zika has been identified, living in the south-east part of the state, where other Zika cases had already been identified. Malaysia documented its first Zika infection the next day, Thursday 1 September 2016, indicating the virus had already crossed the border. The Malaysian woman infected had recently visited her daughter, a resident in Singapore, who also tested positive for Zika infection. As Zika is surging at this key international hub, the wider region of Asia is on high alert for potential transmission of the virus to the Arabian Peninsula. Certainly Singapore, a tropical island, is well acquainted with mosquito-borne infections, most notably dengue fever, which shares the same vectors as Zika, Aedes aegypti and Aedes albopictus (3). Recognition is growing that dengue-affected areas can expect and indeed should plan for unfolding Zika outbreaks. Particularly worrisome for Singapore is that over the first 9 months of 2016 a cumulative total of 12 032 cases of dengue fever were notified to the Ministry of Health, suggesting Zika numbers could be equally high, both adding to morbidity and mortality, but also confounding the diagnosis of both conditions. Zika virus and Saudi Arabia In Saudi Arabia the situation is being very closely watched. Global travel of an infected person is a likely mechanism for spreading the pathogen to new territories. In Saudi Arabia dengue virus (DEN-1, DEN-2, DEN-3) was first detected in Jeddah in 1994 and Aedes aegypti was implicated (4,5). After a large outbreak of dengue in Mecca in 2009 the disease became endemic in the city (6). Saudi Arabia is host to tens of millions of Muslims for religious tourism at Mecca, and 6 weeks ago, with the completion of the 2016 annual Hajj pilgrimage, the country had received a total of 1 325 372 international travellers, including from Singapore, Malaysia and neighbouring Indonesia, the most populous Muslim-majority nation in the world. Should Zika impact Indonesia, Saudi Arabia will be particularly threatened. Certainly the numbers of pilgrims traveling to Saudi Arabia from these countries are sobering: while only 100 pilgrims travel from Singapore to Hajj, over 15 000 arrive from Malaysia, and Indonesia sends almost 200 000 to every Hajj, where approximately 2-3 million Muslims gather. A further 6 million Muslims attend Umrah, the minor pilgrimage, most often performed in the months leading up to Hajj (the Hajj season), among whom many tens of thousands of Indonesians can also be expected. For these reasons, should Zika make the leap to Indonesia, the world's fourth most populated country (247 million), Saudi Arabia can expect significant outbreaks of Zika virus infection within a short time frame. In some ways, although the Hajj Healthcare and Emergency Management System is seasoned at managing epidemics, outbreaks and even national effects of global pandemics which coincide with Hajj season, we are certainly fortunate that this year Hajj was a huge success. Next year we may not be so lucky. Zika poses particular challenges to Indonesia: first the assumed lack of population immunity among Indonesians can be expected to lead to significant widespread acute infections among all ages groups. In Indonesia, other arboviral infections (e.g. dengue and chikungunya) are commonly encountered, distinguishing Zika infection may be difficult or delayed and matters could be further complicated by co-infection. Similarities to these other pathogens could be one reason why Zika has not been so frequently reported in Asia in the past when Zika expanded from equatorial Africa to Equatorial Asia between 1969 and 1983. …

"Your Health Essential for Your Hajj": Muslim pilgrims' knowledge, attitudes and practices regarding Middle East respiratory syndrome coronavirus (MERS-CoV) during Hajj season.

BackgroundUp to date, there have been no studies to evaluate pilgrims' knowledge, attitude and practices regarding MERS-CoV during the annual Hajj pilgrimage in order to see whether there is a need for these aspects to be improved.MethodsA cross-sectional survey study was conducted with a convenience sampling. Participants were pilgrims, aged over 18, and able to speak Arabic or English. A self-administered structured questionnaire was distributed during Hajj season in Mecca. Descriptive and multiple linear regression analysis were used in data analysis.ResultsTwo hundred and fifty-seven participants completed the study, 80% of whom were female, and the median (IQR) age was 35 (24.5–43.5) years. Pilgrims had moderately correct knowledge and accurate attitudes about MERS-CoV with median scores of 5 (IQR 4–7) and 6 (IQR: 5–7) respectively. Educational level and employment status were significantly associated with knowledge whereas gender and age were significantly associated with attitude and practices respectively (P < 0.05). The correlation between knowledge, attitude and practices was significant (correlation coefficient: 0.207; P < 0.05). Better knowledge was found to be a predictor for positive practice.ConclusionsThese findings will provide insight when designing future interventions to promote specific messages to enhance knowledge, change attitude and improve practice regarding MERS-CoV.

Cancer Risk of Inhalation Exposure to Cd, Cr, As, Be and Ni in Ambient Air

Particulate matter may comprise toxic trace elements with carcinogenic effects. Of these trace elements, Cadmium (Cd), Chromium (Cr), Arsenic (As), Beryllium (Be) and Nickel (Ni) are classified as probable human carcinogens. During the annual Hajj pilgrimage, 2.3 million pilgrims stay in Makkah, Saudi Arabia; the increased vehicle traffic contributes to elevated concentrations of particulate matter. We aimed to determine the excess cancer risk (ECR) associated with inhalation exposure in the Makkah population. This study was conducted in the Arafat area, which is a highly-crowded area during Hajj. Inductively coupled plasma-mass spectrometry (ICP-MS) was used for trace element analysis. ECR resulting from inhalation exposure to each metal was calculated in accordance with the unit risk suggested by the Integrated Risk Information System. In summer, including Hajj, mean Cd, Cr, As, Be, and Ni atmospheric concentrations were 0.098, 0.008, 0.26, 0.03, and 0.012 μg/m3, respectively; in autumn, values were 0.06, 0.006, 0.16, 0.002, and 0.01 μg/m3, respectively. ECRs were 1.08 × 10&#87224, 7.21 × 10&#87224, 4.0 × 10&#87226, 4.6 × 10&#87226, and 2.4 × 10&#87226, respectively, exceeding the acceptable inhalation risk level (1.0 × 10&#87226) set by the US Environmental Protection Agency for each element. Higher atmospheric trace element concentrations in summer were due to high temperatures that increased atmospheric turbulence, leading to a greater amount of re-suspended dust from roads and blowing sand particles. These findings can be used by relevant authorities while developing regulations and strategies for developing air quality management to improve the health of pilgrims; however, larger prospective studies are required to estimate ECR in different seasons.

Strengthening community emergency preparedness and response in threats and epidemics disasters prevention and management in Saudi Arabia

Background: Increasing natural and man-made threats to communities and disaster vulnerabilities have been linked to globalisation, increasing urbanisation and climate changes. This review paper analyses the changing trend and pattern in natural and man-made evolving emergencies threats and disasters vulnerability, towards robust and effective emergency community-based preparedness, emergency response policy and programs in Saudi Arabia. Method: A systematic review was performed to assess community emergency readiness in man-made or natural threats and epidemics disasters in the Kingdom. Findings: Our results showed that man-made disasters were the most reported cause of fatality with over 3979 deaths from 1975 to April, 2016. Substantially, Saudi Arabia government commitment and investment efforts have been devoted to ensure adequate emergency management. However, the level of community emergency preparedness culture for all types of risk assessment and management still requires urgent attention in the context of emerging global health threats and epidemics. This paper provides a set of lessons learnt that are useful to foster and scale-up further policy-makers and emergency planners proactive emergency preparedness capacity, and communities resilience initiatives. Leveraging on aggregate annual Hajj and Umrah pilgrimage or mass gathering lessons learnt, global emergency response experiences and best practices are assets in scaling-up proactive and practical community/public and regional emergency security resilience. Conclusion: Strengthening evidence-based comprehensive sustained Saudi innovative community-based emergency partnerships, community surveillance and preparedness, resilient measures and best practices against threats and disasters is advocated.

Strengthening community emergency preparedness and response in threats and epidemics disasters prevention and management in Saudi Arabia

Background: Increasing natural and man-made threats to communities and disaster vulnerabilities have been linked to globalisation, increasing urbanisation and climate changes. This review paper analyses the changing trend and pattern in natural and man-made evolving emergencies threats and disasters vulnerability, towards robust and effective emergency community-based preparedness, emergency response policy and programs in Saudi Arabia. Method: A systematic review was performed to assess community emergency readiness in man-made or natural threats and epidemics disasters in the Kingdom. Findings: Our results showed that man-made disasters were the most reported cause of fatality with over 3979 deaths from 1975 to April, 2016. Substantially, Saudi Arabia government commitment and investment efforts have been devoted to ensure adequate emergency management. However, the level of community emergency preparedness culture for all types of risk assessment and management still requires urgent attention in the context of emerging global health threats and epidemics. This paper provides a set of lessons learnt that are useful to foster and scale-up further policy-makers and emergency planners proactive emergency preparedness capacity, and communities resilience initiatives. Leveraging on aggregate annual Hajj and Umrah pilgrimage or mass gathering lessons learnt, global emergency response experiences and best practices are assets in scaling-up proactive and practical community/public and regional emergency security resilience. Conclusion: Strengthening evidence-based comprehensive sustained Saudi innovative community-based emergency partnerships, community surveillance and preparedness, resilient measures and best practices against threats and disasters is advocated.

The annual Hajj pilgrimage-minimizing the risk of ill health in pilgrims from Europe and opportunity for driving the best prevention and health promotion guidelines.

Mass gatherings at religious events can pose major public health challenges, particularly the transmission of infectious diseases. Every year the Kingdom of Saudi Arabia (KSA) hosts the Hajj pilgrimage, the largest gathering held on an annual basis where over 2 million people come to KSA from over 180 countries. Living together in crowded conditions exposes the pilgrims and the local population to a range infectious diseases. Respiratory and gastrointestinal tract bacterial and viral infections can spread rapidly and affect attendees of mass gatherings. Lethal infectious disease outbreaks were common during Hajj in the 19th and 20th centuries although they have now been controlled to a great extent by the huge investments made by the KSA into public health prevention and surveillance programs. The KSA provides regular updated Hajj travel advice and health regulations through international public health agencies such as the WHO, Public Health England, the Centers for Disease Control and Prevention, and Hajj travel agencies. During the Hajj, an additional 25 000 health workers are deployed; there are eight hospitals in Makkah and Mina complete with state-of-the-art surgical wards and intensive care units made specifically available for pilgrims. All medical facilities offer high quality of care, and services are offered free to Hajj pilgrims to ensure the risks of ill health to all pilgrims and KSA residents are minimal. A summary of the key health issues that arise in pilgrims from Europe during Hajj and of the KSA Hajj guidelines, together with other factors that may play a role in reducing the risks to pilgrims and to wider global health security, is provided herein.