Cross-sectional Survey Of Doctors Research Articles

Determinants of COVID-19 vaccine acceptance amongst doctors practising in Cross River State, Nigeria

Background: COVID-19 vaccine is one of the most effective public health intervention approaches for prevention of COVID-19. Despite its well-known efficacy and safety, significant proportion of frontline COVID-19 healthcare workers remain hesitant about accepting the vaccine for whatever reasons. This study aimed to determine acceptance rate and determinants of vaccine refusal among doctors in Cross River State, Nigeria.
 Methodology: This was a cross-sectional survey of doctors using structured online questionnaire administered via the WhatsApp platform of the medical doctors’ association, in order to assess their rate of acceptance of COVID-19 vaccines, and reasons for vaccine refusal. The predictors of vaccine acceptance were analysed by univariate and multivariate logistic regression analyses.
 Results: Of the 443 medical doctors targeted on the WhatsApp platform, 164 responded to the questionnaire survey, giving a response rate of 37.0% (164/443). The mean age of the respondents is 38 ±6.28 years, 91 (55.5%) are 38 years old and above, 97 (59.1%) are males and 67 (40.9%) are females, giving a male-to-female ratio of 1.4:1. The greater proportion of the respondents are physicians (70/148, 47.3%) and about three-quarter of the participants (127/164, 77.4%) had received COVID-19 vaccine. The proportion of physicians who had received COVID-19 vaccine (57/70, 81.4%) was more than the proportion of general practitioners (31/42, 73.8%) and surgeons (24/35, 68.6%). Low perceived benefit of vaccination was the main reason given for COVID-19 vaccine refusal (45.9%, 17/37). No significant association was found between vaccine refusal and suspected predictors (p>0.05).
 Conclusion: Our study revealed high rate of COVID-19 vaccine acceptance among medical doctors especially among the physicians, with the surgeons showing lowest acceptance rate. A significant proportion would not take vaccine because they perceived it lacks much benefits. To raise vaccine acceptance among doctors, more efforts on vaccine literacy that would target doctors from all sub-specialties especially surgeons and incorporate vaccine benefits should be made.

A cross-sectional survey of doctors' views on flexible postgraduate physician training in Ireland.

Recruitment and retention of doctors is a priority for the Irish healthcare service, with many leaving to work in regions with more favourable conditions. Aligning flexible training options with other jurisdictions may be an effective means of improving working conditions. We sought to assess possible improvements to the existing system and to review barriers to flexible training. We carried out a survey using 'Survey Monkey' and disseminated it to 1557 basic specialist (BST) and higher specialist trainee (HST) doctors of the Institute of Medicine, 3500 members of the Irish Medical Organisation (IMO), and across social media. There were 854 respondents; 303 (35.5%) BST, 352 (41.2%) HST, 125 (14.6%) non-training doctors, unknown, n = 74. The response rate was approximately 15-23%. Non-consultant doctors identified a preference for access to flexible training (n = 849, 99.4%), with 82.2 of doctors reporting that they would consider applying (n = 702). Most (92.4%) considered the current provision of 16 whole-time equivalent positions as inadequate (n = 789). Of doctors who would not apply for flexible training, themes identified included a perceived negative impact on their career, not meeting eligibility criteria, prolonged training, and salary implications. Suggestions for improving the system included expanding the number of places available, removing eligibility criteria, job sharing options, and the provision of regional training schemes. Access to flexible training should be a priority for the healthcare service, which may enhance recruitment and retention. A majority of our sample of non-consultant doctors identified a preference for access to flexible training options.

Use of the Theoretical Domains Framework to explore factors influencing paediatric fever management practices and antipyretic use in New Zealand emergency departments.

To explore factors influencing fever management practices and antipyretic use among New Zealand Emergency Department (ED) doctors and nurses using the Theoretical Domains Framework (TDF). Cross-sectional survey of doctors and nurses across 11 New Zealand EDs. The questionnaire examined eight of 12 TDF domains, based on a generic questionnaire validated to assess TDF-based determinants of health-care professional behaviour. Relevant domains were identified by the frequency of beliefs; the presence of conflicting beliefs within a domain; and the likely strength of impact of a belief on paediatric fever management in the ED. About 602 participants (243 doctors, 353 nurses and 6 unknown) completed the survey (response rate 47.5%). Over half (351/591, 59.6%, 95% confidence interval (CI) 55.5-63.5%) knew the content of clinical practice guidelines regarding antipyretic use in febrile children (TDF Domain Knowledge), or had been trained to ensure antipyretics are given to febrile children only if they appear distressed (347/592, 58.6%, 95% CI 54.5-62.6%) (Skills). Over 40% (246/590, 95% CI 37.7-45.8%) aim to reduce the fever before discharge (Goals). Most (444/591, 75.1%, 95% CI 71.4-78.6%) participants felt capable of explaining appropriate antipyretic use to parents/care givers (Beliefs about Capabilities). Only a minority (155/584, 26.5%, 95% CI 23.0-30.3%) thought that they can ensure antipyretics are given to febrile children only if they appear distressed when the ED is busy (Environmental Context and Resources). Using the TDF, we identified factors influencing fever management practices and antipyretic use in the ED. These factors can guide the design of targeted, theory-informed knowledge translation strategies.

A Cross-Sectional Survey of Doctors in Nigeria Regarding Local Infection Prevention and Control Procedures for Coronavirus Disease 2019 (COVID-19).

Worldwide COVID-19-related mortalities have included healthcare workers in the frontline caring for COVID-19 infected patients. This necessitates the practice of infection prevention and control procedures to protect health professionals from contracting the virus at the workplace. We investigated the knowledge and practice of doctors working in Nigeria regarding infection prevention and control procedures in the workplace. This is a cross-sectional study of doctors and dentists working in Nigeria using a semi-structured self-administered questionnaire adapted from the World Health Organization "Perception of health workers regarding local infection prevention and control procedures for the Coronavirus Disease 2019" tool. Data were analyzed using SPSS version 25. 302 doctors participated in this survey. Most were female 195 (64.6%); 80.50% provided direct care to patients; 267 (88.4%) worked in hospitals with suspected or confirmed cases of COVID-19 while 179 (59.3) directly cared for patients with suspected or confirmed cases of COVID-19 infection. 137 (70.6%) had close contact with confirmed cases of COVID-19. Hand hygiene and gloves were the most common procedure/material available for the prevention of infections for the respondents in the healthcare settings, followed by other types of medical facemasks, N95 respirator masks, eye protection like goggles and disposable aprons. In 2020, during the period of the COVID-19 pandemic, doctors in Nigeria were knowledgeable about infection prevention procedures but do not have access to personal protective equipment.

136. Attitudes and Practices of Antimicrobial Resistance and Antimicrobial Stewardship at the Uganda Cancer Institute

BackgroundAs access to cancer treatment has increased in sub-Saharan Africa (sSA), infection-related complications are a growing concern. Little is known about infection management practices in this setting. Understanding the unique challenges to diagnosing and treating infections can inform the development of targeted strategies to improve infection management for cancer treatment programs throughout sSA. MethodsWe conducted a cross-sectional survey of doctors, nurses, and pharmacists at the Uganda Cancer Institute (UCI), a national cancer referral hospital in Kampala, Uganda. The 25-item survey was designed to assess staff knowledge of antimicrobial resistance and antimicrobial stewardship, investigate antibiotic decision-making practices, and identify barriers to diagnosing and treating infections. ResultsOf the 61 respondents, 25 (41%) were doctors, 7 (11%) were pharmacists, and 29 (48%) were nurses. In total, 98% (60/61) had heard of the term “antimicrobial resistance” and 84% (51/61) agreed that antimicrobial resistance is an important problem at UCI. Multiple factors were felt to contribute to antimicrobial resistance including the use of too many antibiotics, patient insistence on antibiotics, and poor patient adherence (Fig 1). While 72% (44/61) had heard of the term “antimicrobial stewardship”, only 25% (15/61) knew a lot about what it meant. Numerous factors were considered important to antibiotic decision-making including patient white blood cell count and severity of illness (Fig 2). Perceived barriers to infection diagnosis included the inability to obtain blood cultures and to regularly measure patient temperatures; perceived barriers to obtaining blood cultures included patient cost and availability of supplies (Fig 3). Figure 1. Factors that doctors, pharmacists, and nurses working at the Uganda Cancer Institute (UCI) perceive as contributing to antimicrobial resistance at the UCI. Percentages shown next to bars represent the combined total percentage of respondents reporting that the factor does not or usually does not contribute (left of bars, main chart), occasionally or frequently contributes (right of bars, main chart), or neither contributes nor does not contribute (right of neutral chart).Figure 2. Factors that doctors, pharmacists, and nurses working at the Uganda Cancer Institute consider to be important when choosing antibiotics to treat infections. Percentages shown next to bars represent the combined total percentage of respondents reporting that the factor is somewhat or very unimportant (left of bars, main chart), somewhat or very important (right of bars, main chart), or neither important nor unimportant (right of neutral chart).Figure 3. Factors that doctors, pharmacists, and nurses working at the Uganda Cancer Institute perceive as limiting the ability to diagnose infections and obtain blood cultures. ConclusionWhile most staff recognized the term “antimicrobial resistance” and identified this as a major local problem, fewer were familiar with the term “antimicrobial stewardship”. We identified numerous perceived barriers to infection diagnosis and treatment, including the ability to consistently measure temperatures and the cost of blood cultures. A multipronged approach is needed to improve staff knowledge of antimicrobial stewardship and to address the systematic barriers to infection management at UCI. Disclosures All Authors: No reported disclosures

P55 FutureCOVID: Exploring the perspectives of doctors & nurses of student response during the COVID-19 pandemic

IntroductionThe training medical students receive means they can be used as auxiliary healthcare staff during pandemics and disasters. During COVID-10, many medical students volunteered in healthcare settings in clinical and non-clinical capacities. While there has been research into students’ perceptions of the pandemic and their role within the NHS, the perceptions of healthcare staff perceive this student response has not been explored.MethodsCOVIDAssist is a survey based cross sectional observational study of medical student volunteering during COVID-19. The study consists of a cross sectional survey of doctors & nurses who worked alongside medical students in the NHS during the pandemic. We will use qualitative and quantitative methods to analyze responses.ResultsThe primary objective of the study is to assess how effective student response was in reducing the burden on healthcare teams during the pandemic. Secondary objectives are: to identify the broad specialty (e.g. medicine, surgery, primary care) and healthcare roles medical students were most beneficial) ; the GMC outcome-based skills students exhibited; the training provided to students before volunteering and what additional training could have been provided to students.ConclusionThe outcomes of this study will help inform current and future guidance on effective student deployment during pandemics and disasters. The results are also expected to provide insight into necessary training adaptations.

Perceived organizational support and emotional stability modify the effect of depression tendency on burnout in doctors

Objective: To explore and analyze the relationship between burnout, depression, perceived organizational support and emotional stability, as well as their interaction on burnout, so as to provide reference for improving the situation of burnout on doctors. Methods: By cluster random sampling, a cross-sectional survey of doctors in a municipal hospitals of Zhengzhou in June to August, 2015, Henan Province was conducted. The questionnaires of Maslach Burnout Inventory-General Survey (MBI-GS) , Perceived organizational support, Eysenck Personality Questionnair-Revission Short Scale of China (EPQ-RSC) and Center for Epidemiological Studies Depression Scale (CES-D) were used for questionnaire survey and analysis. Multiple regression analysis was used to explore the interaction of organizational support and emotional stability on depressive tendency and occupational burnout. Results: Among the 389 doctors, 147 were males and 242 were females. Age M (P(25), P(75)) was 33.0 (29.0, 40.0) years, and length of work M (P(25), P(75)) was 7.0 (4.0, 16.0) years. Burnout was positively correlated with depression tendency and emotional stability (r=0.571, 0.453, P<0.01) , while burnout was negatively correlated with perceived organizational support (r=-0.260, P<0.01) . The interaction among depression tendency, perceived organizational support and emotional stability was statistically significant (β=-0.002, P<0.05) , the independent effect on burnout is 1.0% (ΔR(2)=0.010) , the positive effect of emotional stability was the largest (β=0.550) , followed by the positive effect of depression tendency (β=0.494) . When the tendency of depression increased, the burnout of doctors with high perceived organizational support and emotional stability was higher than those with high perceived organizational support and emotional instability and those with low perceived organizational support (P<0.01) . Conclusion: Emotional stability is the main factor affecting the effect of depression tendency on doctors' burnout. Doctors with stable emotion and high perceived organizational support showed obvious changes in burnout when depression tendency increased, and showed stronger burnout.

Physician, heal thyself: a cross-sectional survey of doctors’ personal prescribing habits

BackgroundSelf-prescribing and prescribing to personal contacts is explicitly discouraged by General Medical Council guidelines.AimsThis study examines how widespread the practice of self-prescribing and prescribing to personal contacts is.MethodsA 16-item questionnaire...

Osteoporotic Fracture Guidelines and Medical Education Related to the Clinical Practices: A Nationwide Survey in China.

ObjectivesTo investigate the knowledge and practices of Chinese doctors in the management of osteoporotic fractures after the Chinese osteoporotic fracture guidelines update and aseries of medical education in 2017.MethodsThis was a cross‐sectional survey of doctors in 71 cities across Mainland China. Based on the 2017 Chinese guidelines for the diagnosis and treatment of osteoporotic fractures, a questionnaire was designed and pre‐tested for reliability and validity. Doctors were surveyed with the questionnaire after scientific meetings during February 2017 to January 2018 through WeChat or conference digital platforms or in paper form. Descriptive statistics was used to analyze the responses to the questionnaire.ResultsOverall, 314 valid questionnaires were confirmed. Regarding diagnosis, 77% agreed that osteoporosis could be diagnosed once an osteoporotic fracture occurred; 83% believed that the bone mineral density criteria for osteoporosis diagnosis would be T ≤ −2.5 SD. For treatment, almost all (99.7%) agreed with anti‐osteoporosis treatment being one of the basic principles of osteoporotic fracture treatment; 71.6% considered bisphosphonates as the most commonly used anti‐osteoporosis drug; 97% believed that patients who have used anti‐osteoporosis drugs should reassess osteoporosis after osteoporotic fractures instead of discontinue; 95% thought that the patients who did not use anti‐osteoporosis medications before osteoporotic fracture should be treated with anti‐osteoporosis drugs after fracture treatment as early as possible; 89% agreed that the standard use of bisphosphonates after osteoporotic fracture would not affect bone healing adversely; 59% believed the course of bisphosphonates treatment for osteoporosis would be 3–5 years, and 27% considered it to be 1–3 years. The patient follow‐up rate was poor: 46% selected follow‐up rate <30%; only 20% selected follow‐up rate >50%. Only 31% of the hospitals had long‐term management programs for osteoporotic fractures.ConclusionsDoctors generally adhered to the updated Chinese guidelines for osteoporotic fractures; frequent participation in medical education can help doctors to increase their awareness of osteoporosis as well as their acceptance and practice of the guidelines.

Incident reporting behaviours following the Francis report: A cross-sectional survey.

Previous studies have shown a lack of engagement in the reporting process. There is limited evidence about whether attitudes and behaviours of doctors in the UK towards incident reporting have changed following the events at Mid Staffordshire National Health Service Foundation Trust and the recommendations that followed. We conducted a relatively large survey of doctors, aiming to assess whether doctors recognised incidents and reported them accordingly, along with their behaviours towards reporting and their suggestions of how incident reporting may be improved. A cross-sectional survey of doctors was undertaken in 11 hospitals in the north of England. The participants (n=581) were invited to take part in an electronic questionnaire. Demographics were obtained, and engagement with the incident reporting process was assessed, including an estimate of the number of incidents which were witnessed but not actually reported. Factors which influenced reporting behaviours were recorded. Free-text comments were encouraged. A mixed method analysis of the responses was performed. Doctors do not appear to be engaging with the incident reporting process-in particular, junior doctors. The main reason given for not completing forms was not having enough time (38.2% of respondents), primarily due to the length and complexity of forms. Many doctors, 43.7%, witnessed more than 5 incidents, but only 13.3% of doctors submitted more than 5 reports. Free text comments revealed 4 themes which impact upon reporting behaviours: organisational issues, form structure, a culture of blame, and a lack of feedback. Several suggestions for improvement were made. Little has changed in the attitudes and behaviours of doctors. Improving incident reporting form structure to make it more user-friendly and improving feedback may engage doctors and lead to an improved safety culture. The way the medical profession reports serious and other incidents still needs to be improved.

Use of the partogram by doctors and midwives at Odi District Hospital, Gauteng, South Africa

Background: There is scientific evidence that using the partogram reduces maternal and foetal morbidity and mortality. The use of partograms by doctors and midwives at Odi District Hospital has been reported as inadequate by external audits. The level of knowledge of and use of partograms amongst doctors and midwives at Odi District Hospital was investigated.&#x0D; &#x0D; Methods: A cross-sectional survey of doctors and midwives was undertaken using a self-administered questionnaire. A mixed-methods research approach was used to elicit information on the knowledge and use of the partogram.&#x0D; &#x0D; Results: Despite 57 (83.8%) participants having had some form of training on the partogram, only 54 (79.4%) routinely used it. All but one participant had heard of the partogram. Reasons for not using the partogram included being unsure how to use it (13%), partogram charts not available (8.7%), partogram takes too long (21.7%), being too busy (26.1%), and a feeling that the partogram was not the doctor’s responsibility (26.1%). Overall knowledge of partograms was insufficient, resulting in inadequate use of partograms. In-service training is required to improve the skills of doctors and midwives in the correct knowledge and use of partograms.&#x0D; &#x0D; Conclusion: Partograms are not used as required by doctors and midwives, and further training is needed.&#x0D; &#x0D; (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp)&#x0D; &#x0D; S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.1280899

Use of the partogram by doctors and midwives at Odi District Hospital, Gauteng, South Africa

Background: There is scientific evidence that using the partogram reduces maternal and foetal morbidity and mortality. The use of partograms by doctors and midwives at Odi District Hospital has been reported as inadequate by external audits. The level of knowledge of and use of partograms amongst doctors and midwives at Odi District Hospital was investigated.Methods: A cross-sectional survey of doctors and midwives was undertaken using a self-administered questionnaire. A mixed-methods research approach was used to elicit information on the knowledge and use of the partogram.Results: Despite 57 (83.8%) participants having had some form of training on the partogram, only 54 (79.4%) routinely used it. All but one participant had heard of the partogram. Reasons for not using the partogram included being unsure how to use it (13%), partogram charts not available (8.7%), partogram takes too long (21.7%), being too busy (26.1%), and a feeling that the partogram was not the doctor’s responsibility (26.1%). Overa...

Antibiotic therapy and staphylococcal skin infections in a tropical malarial zone (Guyana). Practices in conventional and exceptional situations.

A problem of community-acquired Staphylococcus aureus skin infections emerged in the French armed forces in 2004, in a malaria-endemic areas. The high incidence rate led us to evaluate military staff practices. This was a cross-sectional survey of doctors and nurses deployed as officers in French Guyana since 2006. The definition of skin and soft-tissue infection came from the criteria for epidemiological surveillance of the armed forces. We studied the management of antibiotic therapy and its related difficulties. In all, 47 officers responded. At the Military Medical Center (MMC), 23.4% of respondents routinely prescribed antibiotics, compared with 36.2% when stationed in the jungle (p<0.05%). Complication led 68.1 of staff to prescribe antibiotic prescriptions at the MMC, compared with 46.8% in the jungle (p<0.05%). Finally, 22.5% of those at MMC prescribed antibiotic coverage of surgical drainage, compared with 14.8% in the jungle (p<0.05%). Pristinamycin and fusidic acid were the preferred antibiotics. Two-thirds of the staff reported difficulties in jungle management. This first study indicates the need for an update of military medical recommendations. Personnel training must continue to enable them to provide appropriate aggressive management in the current endemic context.

Medical barriers to emergency contraception: a cross-sectional survey of doctors in North India.

Some medical doctors in India have publicly expressed opposition to making emergency contraceptive pills (ECPs) easily accessible, even though ECPs are included in the method mix of the Ministry of Health and Family Welfare program and as an over-the-counter (OTC) product. Such opposition affects access to ECPs by influencing policy, procurement, and distribution, besides stigmatizing the ECP user. This study was conducted to assess ECP knowledge, attitudes, and practices of doctors in North India. A cross-sectional survey of 83 doctors who provide ECPs, randomly selected from 3 cities in the state of Uttar Pradesh, was conducted in 2011. The quantitative data were complemented by 19 in-depth interviews with purposively selected senior gynecologists and other opinion leaders. All surveyed physicians cited the correct dose and regimen for ECPs. However, the large majority of those surveyed believed that ECPs work by preventing implantation. (The best evidence currently indicates that ECPs do not work by preventing implantation.) Most doctors also believed incorrectly that ECPs have several contraindications and side effects. They also had strong reservations against OTC provision of ECPs by pharmacists and community health workers (CHWs) and negative attitudes toward ECP users, which serve as serious medical barriers to mainstreaming use of ECPs. Physicians and their professional associations exert a strong influence on the operationalization of national contraceptive policies. Evidence-based advocacy and educational campaigns targeting doctors are needed to address and resolve their reservations about ECPs, particularly about its provision as an OTC product and its distribution by CHWs. Partnerships with medical associations can help reduce doctors' negative attitudes and create a conducive environment for influencing clinical practices. Such changes are needed to increase the availability and use of ECPs as part of a package of a full range of contraceptive method options to prevent unwanted pregnancy among the most vulnerable populations.

Mental health of doctors in a tertiary hospital in Nigeria.

IntroductionDoctors are vulnerable to psychiatric morbidity as a result of their busy schedules and multiple role obligations. Yet, they often don't admit they have mental health problems nor are they readily subjected to mental health evaluation by their colleagues due to fear of labeling and general stigma.MethodsA cross-sectional survey of doctors in the service of University of Ilorin Teaching Hospital, Ilorin, Nigeria was done using a socio-demographic questionnaire and the twelve items General Health Questionnaire (GHQ-12) using a cut-off point of 3 to indicate possibility of psychiatric disorder (GHQ-12 positive). Non-parametric analysis and regression test of factors associated with psychiatric morbidity was done using SPSS. Level of significance was set at 0.05 p-value.ResultsTwo hundred and forty one doctors representing 68.9% of the doctors participated in the survey. The point prevalence of psychiatric morbidity among the doctors using the GHQ-12 was 14.9%. Being married, non-participation in social activities and perception of work load as being “heavy” were significantly associated with psychiatric morbidity (p-value < 0.05).ConclusionThe prevalence of psychiatric morbidity among doctors at the University of Ilorin Teaching Hospital was higher than the general population prevalence. Measures to lessen the negative effect of marriage and the perceived heavy work load on mental health of doctors, such as provision of recreational facilities within the hospital and encouragement of doctors’ participation in social activities are advanced.

Why UK-trained doctors leave the UK: cross-sectional survey of doctors in New Zealand

To investigate factors which influenced UK-trained doctors to emigrate to New Zealand and factors which might encourage them to return. Cross-sectional postal and Internet questionnaire survey. Participants in New Zealand; investigators in UK. Participants UK-trained doctors from 10 graduation-year cohorts who were registered with the New Zealand Medical Council in 2009. Reasons for emigration; job satisfaction; satisfaction with leisure time; intentions to stay in New Zealand; changes to the UK NHS which might increase the likelihood of return. Of 38,821 UK-trained doctors in the cohorts, 535 (1.4%) were registered to practise in New Zealand. We traced 419, of whom 282 (67%) replied to our questionnaire. Only 30% had originally intended to emigrate permanently, but 89% now intended to stay. Sixty-nine percent had moved to take up a medical job. Seventy percent gave additional reasons for relocating to New Zealand including better lifestyle, to be with family, travel/working holiday, or disillusionment with the NHS. Respondents' mean job satisfaction score was 8.1 (95% CI 7.9-8.2) on a scale from 1 (lowest satisfaction) to 10 (highest), compared with 7.1 (7.1-7.2) for contemporaries in the UK NHS. Scored similarly, mean satisfaction with the time available for leisure was 7.8 (7.6-8.0) for the doctors in New Zealand, compared with 5.7 (5.6-5.7) for the NHS doctors. Although few respondents wanted to return to the UK, some stated that the likelihood of doctors' returning would be increased by changes to NHS working conditions and by administrative changes to ease the process. Emigrant doctors in New Zealand had higher job satisfaction than their UK-based contemporaries, and few wanted to return. The predominant reason for staying in New Zealand was a preference for the lifestyle there.

Meningococcal, influenza virus, and hepatitis B virus vaccination coverage level among health care workers in Hajj.

BackgroundThe objective of this study was to assess the compliance of health care workers (HCWs) employed in Hajj in receiving the meningococcal, influenza, and hepatitis B vaccines.MethodsA cross-sectional survey of doctors and nurses working in all Mena and Arafat hospitals and primary health care centers who attended Hajj-medicine training programs immediately before the beginning of Hajj of the lunar Islamic year 1423 (2003) using self-administered structured questionnaire which included demographic data and data on vaccination history.ResultsA total of 392 HCWs were studied including 215 (54.8%) nurses and 177 (45.2%) doctors. One hundred and sixty four (41.8%) HCWs were from Makkah and the rest were recruited from other regions in Saudi Arabia. Three hundred and twenty three (82.4%) HCWs received the quadrivalent (ACYW135) meningococcal meningitis vaccine with 271 (83.9%) HCWs receiving it at least 2 weeks before coming to Hajj, whereas the remaining 52 (16.1%) HCWs received it within < 2 weeks. Only 23 (5.9%) HCWs received the current year's influenza virus vaccine. Two hundred and sixty (66.3%) of HCWs received the three-dose hepatitis B vaccine series, 19.3% received one or two doses, and 14.3% did not receive any dose. There was no statistically significant difference in compliance with the three vaccines between doctors and nurses.ConclusionThe meningococcal and hepatitis B vaccination coverage level among HCWs in Hajj was suboptimal and the influenza vaccination level was notably low. Strategies to improve vaccination coverage among HCWs should be adopted by all health care facilities in Saudi Arabia.