Hajj Period Research Articles

The Beneficial Aspects of Implementing Ifrad Pilgrimage for Indonesian Pilgrims

<em>Ifrad pilgrimage is a form of Hajj where an individual intends only for Hajj upon entering the state of Ihram. The pilgrim declares Labbaik Bahaj and performs Tawaf Qudum after entering Mecca, remaining in the state of Ihram until the designated Hajj period. Subsequently, the pilgrim follows all the Hajj rituals, including the standing at Arafah, staying at Muzdalifah, casting stones at Jamarat Al-Aqabah, performing Tawaf Ifadhah, Sa'i between Safa and Marwa, and spending the night at Mina for stone throwing on the days of Tashriq. After completing all the Hajj rituals, the pilgrim performs the second Tahallul, exits Mecca, and begins the second Ihram with the intention of Umrah if planning to undertake Umrah rituals. Tamattu' pilgrimage involves initially intending to perform Umrah upon entering the Miqat by saying Labbaik in Umrah. Upon entering Mecca, the pilgrim completes all Umrah rituals such as Tawaf and Sa'i, then shaves or trims the hair, concluding the state of Ihram. On the 8th of Dhu al-Hijjah, the pilgrim enters into the Hajj Ihram, performs Hajj rituals like standing at Arafah, Tawaf, Sa'i, and others comprehensively. Qiran pilgrimage is when an individual intends to perform both Hajj and Umrah simultaneously upon entering Ihram by uttering specific words. The individual remains in the state of Ihram until completing the Hajj rituals. During the Hajj, there is no need for additional Tawaf and Sa'i for Umrah; performing the Tawaf and Sa'i for Hajj is sufficient. Among these three types of pilgrimage, the Ifrad model is considered the least burdensome for pilgrims. This model does not incur penalties, and the greater benefit in performing the Hajj pilgrimage is achieved through the Ifrad model.</em>

Characteristics and Distribution of Heat-Related Illnesses during Hajj 2022

Background: Heat-related illnesses (HRI) are defined as elevated body core temperatures when exposed to an intense high temperature. HRIs include but are not limited to heat exhaustion (HE) and heat stroke (HS). HE and HS are among the leading causes of morbidity and mortality among pilgrims when the Hajj season occurs during the hot cycle of the year in Makkah. Methods: A retrospective cross-sectional data analysis was conducted on HRI cases during Hajj 2022/1443 Hijri. The data were extracted from the Hajj electronic health records system software immediately at the end of the Hajj period. Results: A total of 200 patients presented with HRI symptoms during the study period. Over half of the HRI patients were male (n=116, 58%). The mean age was 44 ± 14.6 years. One hundred forty-three patients (71.5%) were diagnosed with HE, while 57 (28.5%) were diagnosed with HS. A statistically significant association between age and HRIs was observed. Conclusion: More HRIs are expected due to the gradual elevation of ambient temperature and the global warming phenomenon. This study emphasizes the importance of education and awareness regarding preventive measures in the general population, especially among the most vulnerable subpopulations.

Characteristics and Distribution of Heat-Related Illnesses during Hajj 2022

Background: Heat-related illnesses (HRI) are defined as elevated body core temperatures when exposed to an intense high temperature. HRIs include but are not limited to heat exhaustion (HE) and heat stroke (HS). HE and HS are among the leading causes of morbidity and mortality among pilgrims when the Hajj season occurs during the hot cycle of the year in Makkah. Methods: A retrospective cross-sectional data analysis was conducted on HRI cases during Hajj 2022/1443 Hijri. The data were extracted from the Hajj electronic health records system software immediately at the end of the Hajj period. Results: A total of 200 patients presented with HRI symptoms during the study period. Over half of the HRI patients were male (n=116, 58%). The mean age was 44 ± 14.6 years. One hundred forty-three patients (71.5%) were diagnosed with HE, while 57 (28.5%) were diagnosed with HS. A statistically significant association between age and HRIs was observed. Conclusion: More HRIs are expected due to the gradual elevation of ambient temperature and the global warming phenomenon. This study emphasizes the importance of education and awareness regarding preventive measures in the general population, especially among the most vulnerable subpopulations.

Health Issues of Nigerian Muslim Pilgrims in The Immediate Post-Covid-19 Era Hajj Year 2022– Part II (Non-Communicable Diseases)

Background: Hajj is an important rite in the life of devout Muslims, requiring the devolvement of physical and material resources in its execution. Limitations posed by COVID-19 on the performance of Hajj make the year 2022 hajj to be an atypical one compared to other years' international hajj. Nigerian pilgrims are peculiar as a low-and middle-income country (LAMIC) with the highest number of Muslim pilgrims from Africa. The objective of this article is to review the health implications of Hajj and peculiarities of the post- COVID 19 era, regarding non-communicable diseases in Nigerian pilgrims based on literature, the interaction of authors with pilgrims, and the experiences of an author as a pilgrim. Results: Commonly encountered non-communicable respiratory, cardiovascular, nutritional, gastrointestinal, endocrine, reproductive, neurological, and musculoskeletal health issues in Nigerian pilgrims were explored. Preventive health strategies by individual pilgrims, the national medical team of National Hajj Commission of Nigeria (NAHCON), the Ministry of Health (MOH) of the Kingdom of Saudi Arabia (KSA) and other stakeholders involved directly or indirectly in conducting Hajj rites were appraised. This includes but not limited to illness screening, chronic illness management, life style modification, medication adherence, and accident prevention. Conclusions: It was concluded that the efforts of the Kingdom of Saudi Arabia, as well as Nigeria authorities on Hajj health services, are commendable, though there are still a lot of areas that need to be improved upon. Significant importance should be given to pre-hajj and post-hajj screening of pilgrims for communicable health issues in pilgrims to enable optimal execution of hajj task and maintenance of pilgrims’ health beyond hajj period.

Lower 6-minutes walk test result and presence of cardiovascular risk factors linked to healthcare facility visits of pilgrims: the importance of fitness in hajj pilgrimage

Abstract Background Hajj pilgrimage, a mandatory religious practice for the Muslims, is a physical rite attributed heavily on the fitness of the participants due to increased workload in performing its activities. The 6-minutes walk test is a simple assessment to predict candidates’ fitness level. Objective We sought to determine the association between pilgrim candidate fitness level, determined by 6-minutes walk test result during predeparture preparation, as well as pre-existing potential risk factors of hajj pilgrim participants. Method In this retrospective cohort, we obtained the data of 2022 pilgrimage participants from Indonesian Ministry of Religious Affairs, consisting of demographic characteristics, anthropometric indexes, medical history, physical examination, and functional exercise capacity predicted by 6-minute walk test conducted during pre-departure preparation. Baseline demographic, bivariate tests for each variable, and multivariate test were analyzed by IBM SPSS 26. Result There was significant correlation between age of ≥60 (p < 0.001), hypertension (p < 0.001), diabetes mellitus (p < 0.001), 6-minutes walk test (p < 0.001), smoker status (p = 0.008), high LDL-C (p = 0.026), obesity (p =0.033), female sex (p = 0.043) and healthcare visit episode of pilgrims. The risk ratio value for low result group of 6-minutes walk test (< 500 meters) against outpatient incidence during hajj period was 1.08 (95% CI; 1.04 -1.12). It indicated that the inability of reaching >500 meters in 6-minutes walk test is related to outpatient incidence by 1.08 times. Conclusion There is a slight increase in healthcare visit incidence in pilgrims with low result of 6-minutes walk test. The 6-minutes walk test, a simple and reproducible assessment of fitness level, may provide useful information to improve preparation of pilgrimage.

Impact of implementing a stroke code on the door to needle time during Hajj at a tertiary center in Makkah, Saudi Arabia.

To assess the impact of a stroke code on the door to needle time during Hajj at a tertiary center in Makkah, Saudi Arabia. Stroke is one of the most common medical problems globally. Tissue plasminogen activator is an effective treatment in patients with acute ischemic stroke. However, its efficacy is time-dependent. We conducted a retrospective study on acute ischemic stroke patients who presented within the study window and were eligible for intravenous thrombolysis therapy at King Abdullah Medical City in Makkah between September 1, 2015 and July 2020. Sixty-nine patients received intravenous tissue plasminogen activator and enrolled in this study, 28 patients of which presented during the Hajj period. We found a statistically significant reduction in both the door to needle time and the door to computed tomography time during the Hajj period. In addition, the length of hospital stay reduced significantly in the same period CONCLUSION: We observed a 44% reduction in the door to needle time during the implementation of the stroke code. However, we did not observe a significant difference in clinical outcomes. This study is limited by its small sample size and it lacks a long follow-up for clinical conditions.

Viral aetiology of severe acute respiratory illness among patients admitted during the 2022 peri-Hajj period

Severe acute respiratory illness (SARI) among pilgrims continues to be an important healthcare issue. The aim of this study was to describe the viral aetiology of patients admitted to hospitals in the holy cities of Makkah and Madinah during the 2022 peri-Hajj period. This is a retrospective analysis of patients admitted to hospitals with SARI. Patients were tested with multiplex polymerase chain reaction for the most common viral aetiologies. In total, 179 cases of SARI were identified during the study period. Of these, 101 (56.4%) were males, 78 (43.6%) were females, and 78 (43.6%) were Saudi. The mean age was 58.60 years (standard deviation 20.5) years. The most common age group was ≥65 years (n=68, 36%), followed by 55-59 years (n=37, 19%). The most common comorbidities were diabetes mellitus (n=67, 36%), hypertension (n=65, 35%) and chronic lung disease (n=34, 18%). Eighty-five (47.5%) patients tested negative and 94 (42.5%) tested positive for various viral aetiologies. The most frequently detected viruses were severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) (n=28, 15%) and influenza (n=22, 12%); of the influenza cases, 16 were influenza A (6 (43%) were H3N2), and six were influenza B. The only case of Middle East respiratory syndrome coronavirus (MERS-CoV) was in a citizen, and none of the visitors or residents had MERS-CoV. Of the total cases, 27 (14%) died during the follow-up period. In a binary regression analysis, only age was associated with mortality (P=0.002). The most commonly detected viruses among patients admitted to hospital with SARI were SARS-CoV-2 and influenza. It is important to continue surveillance of admitted and non-admitted patients in different Hajj periods to identify any shift in the aetiologic agents.

The Impact of Classical Cardiovascular Risk Factors on Hospitalization and Mortality among Hajj Pilgrims.

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality during Hajj. The objective of the present study was to examine the effect of classical cardiovascular disease risk factors on mortality and hospitalization among Hajj pilgrims from East Java, Indonesia, during 2017, 2018, and 2019. This study was a retrospective cohort of Hajj pilgrims from East Java, Indonesia, from 2017 to 2019. The data on risk factors were obtained from the pre-embarkation Hajj screening records. The diagnosis of hospitalization and cause of death during the Hajj period were obtained from the medical report and hospital/flight doctor death certificate. A total of 72078 eligible subjects were included in this study. 33807 (46.9%) were men, and 38271 (53.1%) were women, and the majority (35%) were aged between 50 and 59 years. A total of 42446 pilgrims (58.9%) were classified as high risk due to underlying health conditions such as hypertension, diabetes, or if they were aged 60 years or older. The overall hospitalization rate is 971 per 100,000 pilgrims and the overall death rate is 240 deaths per 100,000 pilgrims. Multivariate analysis using logistic regression showed that male gender, age > 50 years, hypertension grade II-III, diabetes, overweight, and obesity were associated with a higher risk of hospitalization. Moreover, male gender, diabetes, and overweight were associated with a higher risk of mortality. Of all hospitalized patients, 92 patients (13.1%) had an initial diagnosis of CVD, and CVD is the main cause of mortality (38.2%) of pilgrims. Pilgrims with classical cardiovascular risk factors were associated with increased hospitalization and mortality.

Analysis of public transportation system in makkah: Evaluation of efficiency, efficacity and safety operation of Almashaaer Al Mugaddassah Metro (MMMSL)

The pilgrim passenger service was designed to support traffic capacities of 72,000 pphpd (during Hajj), the line length is approximate 18 Km, double track, and standard gauge. This study proposes to evaluate efficiency, efficacity and safety operation of the metro system build in Makkah, Almashaaer Al Mugaddassah Metro (MMMSL). It is a special 18 Km of Metro line dedicated to support pilgrim service, especially during Hajj period. This line connects Arafat, Muzdalifah, Mina and Jamarat in Makkah area. This line was constructed in 2 years, during 2009 to 2011 time period, and entering in full service before Hajj, November 2011. This paper intends to suggest a further development(s) study concerning safety operation, and efficiency of the MMMSL metro line, and suggest potential infrastructure upgrades fit traffic capacities. Therefore, researchers present to the concerned reader(s) a paper structured to cater information for: introduction, line operation, dysfunctionalities, scheme development principles, identification of potential errors in scheme design, and recommendation for improvement. A qualitative research method was used, with both, literature review and five semi-structured interviews with industry experts. Research results indicated that more sample analysis and evaluation should be carried out, with a balance between a four-line metro system and upgrade the existing line to Maglev transport technology, software simulation of traffic capacities with verified software tools, analyse of station accommodation and loading / off-loading capacities, issues caused by signaling systems operating with OOP (Object Orientated Programming), etc. It was clearly outlined that existing metro system capacity cannot cope with 72,000 pphpd, and for existing forecasted figures of 2.5 million Hajj Pilgrims, a system with nearly 100,000 pphpd would satisfy requirements.

Effect of a Supervised Exercise-Training Programme on Morbidity and Wellness of South African Hajj Pilgrims in 2018: A Pilot Study

Introduction: Ill health and poor physical and mental conditioning adversely affects pilgrims’ ability to optimally perform the arduous physical rituals of Hajj. We postulate that a supervised, pre-departure exercise programme improves their health status and may reduce morbidity. Methods: Ninety-three accredited pilgrims completed a 6-12 weeks graduated, supervised walking programme designed to get the participants fit to do a 10 km walk. Assessments including a morbidity survey, a six-minute walk test, and a POMS (Profile of Mood States) were conducted before and immediately after the exercise programme. A morbidity questionnaire, the six-minute walk test, and POMS were completed post-Hajj (n=88). A group of 200 non-matched pilgrims who were not part of the exercise programme, were approached post-Hajj to fill in the morbidity questionnaire, with eight-two responding. Results: Results for 88 participants were available with 13.7% reporting medical events during the Hajj period, significantly less than the non-participants (62.2% of 82 respondents), and less when compared to other studies (up to 91%). The mean distance recorded in the six-minute walk test increased by 5% after the exercise programme (481.3 meters before to 506.3 m after) and 3% after Hajj (520.7 m). Similar positive changes in the POMS were noted across the three time periods. The resting heart rate did not show significant changes. Conclusion: This study shows that a supervised exercise programme for Hajj pilgrims has a positive effect on their physical and mental conditioning, which may reduce morbidity. Larger controlled trials are warranted to determine the optimum dose of exercise.

Microbial surveillance of Hajj tents: Bioaerosol sampling coupled with real-time multiplex PCR

Respiratory tract infections are common among pilgrims attending annual Hajj in Mecca, Saudi Arabia. Pilgrims typically spend most of the Hajj period inside ventilated tents, where microorganisms may be transmitted through bioaerosols and droplets. To perform microorganism surveillance inside Hajj tents and assess the similarities between microorganisms isolated from tent bioaerosol samples and nasopharyngeal swabs (NP) of tent occupants. Respiratory microorganisms in bioaerosols collected from Hajj tents over a 4-day period were compared with NP of tent occupants using real-time multiplex polymerase chain reaction analysis. A total of 152 samples were collected: 120 tent bioaerosol samples collected on days 9, 10, 11, and 12 of Dhu al-Hijjah, and 32 NP collected on day 12 of Dhu al-Hijjah (corresponding to 23/08/2018). Eighty-three (69.2%) bioaerosol samples tested positive for at least 1 microorganism, with the number of pathogens increasing over the 4 days of sampling. Twenty-seven (84.38%) NP swabs from tent occupants also tested positive. Microorganisms identified in pilgrim nasal carriage and tent bioaerosol samples were similar, and included K. pneumonia, S. aureus, S. pneumonia, human adenovirus, Moraxella, influenza A, and H. influenza. The data suggest that the Hajj tent environment may contribute to the spread of airborne infections during Hajj. This can have important ramifications for novel pathogens with pandemic potential.

Innovative education training program of hajj healthcare workers improves the outcomes of Indonesian elderly hajj pilgrims

The ability of the Muslim community in Indonesia to perform the hajj pilgrimage, which fulfills Islam’s fifth pillar, is increasing. With the rise in life expectancy, the number of Indonesian elderly hajj pilgrims (EHP) is consequently growing. However, chronic conditions such as impairments, illnesses, and diseases cause an increase in morbidity and mortality among EHP. Thus, an innovative training program with practical tips for a healthy hajj experience is needed to improve the healthcare service to the EHP. This study aims to investigate the effects of an innovative training on the performance of Hajj Healthcare Workers of Indonesia (HHWI) and on the clinical outcomes of EHP. It was a quasi-experimental study. The population was all HHWI from the Surakarta embarkation in 2014. Meanwhile, the sample of this study was all 21 HHWI from Yogyakarta who received innovative training consisting of EHP special care training (theory and practice) in addition to basic national training. Twenty-one HHWI from Surakarta were randomly chosen as a control group and only received basic national training. Pre and post tests were used to assess knowledge of HHWI after training. The average pretest scores of the intervention and control groups were 48.50 and 48.07, respectively (p= 0.337), while the posttest score of the intervention group was 86.83 (p = 0.033). The measured parameters were the performance of HHWI, which is reflected by the EHP mortality rate, the number of outpatients, and the number of patients referred to the outpatients. We included the EHP under the supervision of HHWI, which has acquired training. EHP morbidity was evaluated as the number of outpatients and referred patients. There were 2216 outpatients from the intervention group as compared with 2144 in the control group, with most of them being 60-70 years old (p= 0,075). The number of referred EHP in the intervention and control groups was 10 and 30 patients, respectively (OR 2.94; p= 0.002). As for the mortality cases, we observed 7 EPH deaths during the hajj period (2 EPH from the intervention group vs 5 EPH from the control group; OR 0.263; p=0.207). Innovative training could reduce referral morbidity and mortality among elderly hajj pilgrims

Spatial Analysis of Traffic Accidents in the City of Medina Using GIS

The general objective of this research is to determine how to use the spatial analysis of traffic accidents in Medina Menorah City through geographic information systems. This research aimed to identify, locate and define the sites where traffic accidents are concentrated and determine the need to apply specific safety standards to reduce accidents and identify their causes thereof. This current research applied the analytical descriptive approach for its relevance with this specific research. This research collected traffic accidents data from the Ministry of the Interior, Department of General Traffic. That data captured the hotspots accidents in Medina Menorah City. Some of the most important results of the study are as follows: many roads were selected as High Accident Location HAL, such as Central Ring Roads, King Faisal bin Abdul-Aziz Road, Prince Abdul Majid bin Abdul-Aziz Road, and King Abdulla bin Abdel-Aziz Road. The high-speed roads are heavily linked to the massive increase of traffic accident rates, and the increase in the street section length led to the soaring number of total accidents. The study recommended performing more studies and different highway safety studies to identify and locate accident patterns on road networks. Due to the fact that the accidents concentration is intensely focused on Medina City center and Prophet’s Mosque, it is a must to increase the number of public transportations to and from Prophet’s Mosque, particularly during the Hajj period, because of the fact that the visitors of Prophet’s Mosque is on the increase during the said period. This study can be applied in other cities because knowing the locations of traffic crash hotspots can provide us with valuable insights into the causes of accidents and this knowledge helps decision-makers to better assess the risk associated with accidents.

Air Quality Over Major Cities of Saudi Arabia During Hajj Periods of 2019 and 2020

Mecca and Madinah are two holy cities where millions of people in general, visit throughout the years, during Hajj (Muslim's pilgrimage) time number of people visit these holy cities from different parts of the world is very high. However, the Government of Saudi Arabia only allowed 1000 pilgrims during the 2020 Hajj especially when the world is suffering from COVID-19. In the present paper, a detailed analysis of air quality parameters available from ground measurements have been carried over major cities of Saudi Arabia, Mecca, Madinah, and Jeddah from June to September 2019 and 2020. At Mecca and Jeddah, PM10, NO2 and CO concentrations are found to be higher in comparison to stations located close to Madinah. In addition, meteorological parameters, temperature, relative humidity, and wind directions are also analysed to understand changes associated with the meteorological parameters. Our detailed analysis shows a reduction in concentrations of pollutants during the 2020 Hajj, when the lockdown was observed in Saudi Arabia due to COVID-19. During June–August 2020 lockdown period, no major changes in PM10 concentration was observed since there were frequent dust events were observed. In contrast, our results show 44% reduction in NO2 (8.77 ppbv in 2019 to 4.97 ppbv in 2020) and 16% reduction in CO (0.85 ppm in 2019 to 0.72 ppm in 2020) concentrations during COVID-19 restrictions. The concentrations of NO2 and CO do not cause any issue for the air quality as NO2 and CO Indices lie within the green band (Air quality index 0–50). In Mecca, Madinah and Jeddah, the air quality is generally affected during Hajj, but during 2020, the concentration of particulate matter was influenced by local weather conditions.

The Role of Ambient Temperature and Plasma Osmolarity on Clinical Outcomes of Acute Myocardial Infarction Patients during Hajj

Background: Performance of Hajj is physically very demanding, especially if performed during the summer season. The aim of this study is to evaluate the importance of ambient temperature and dehydration, indicated by plasma osmolarity on the clinical outcomes of cardiac patients during Hajj season in 2017. Methods: We included all patients referred to tertiary center with acute coronary syndrome during Hajj period of 2017. Plasma osmolarity was calculated using concentrations of sodium, plasma glucose, and blood urea nitrogen at admission. Patients were stratified by groups (G) of admission osmolarity, clinical outcome was compared. The primary endpoints were in-hospital mortality, length of stay, Cardiac complications (heart failure, re-infarction, arrhythmia, shock and thrombus formation), left ventricular function and readmission rate. Result: Total of 300 patients were identified with mean age 56.2 ±12.1, 84% males and 97(32%) were pilgrims. They were exposed to average heat index 61.9 ±10.6° C. Significantly longer admissions were found in the group of higher osmolarity (G2) (≥295 mos/L) as compared to patients with normal osmolarity in G1 [6.7 ±14.9 VS 4.0 ±4.5, P=0.045]. Total in-hospital death rate was 4.3% (13). Using Binary regression analysis; osmolarity Group [p=0.009], Pilrgrim [P=0.005], Heat index [ P=0.005], were independent predictor of inhospital mortality, while Heat index is the only independent predictor for MACE [P=0.001]. Conclusion: Plasma osmolarity and heat index significantly affect cardiac patient’s outcome. These finding underscore the importance of health awareness of protection from dehydration for pilgrims during summer season.

Causes of Upper Gastrointestinal Bleeding Among Pilgrims During the Hajj Period in the Islamic Years 1437-1439 (2016-2018).

BackgroundApproximately 3.5 million pilgrims perform Hajj every year. Planning for their healthcare requires knowledge of the pattern of diseases and risk factors of pilgrims who require hospitalization during the Hajj period. The aim of the current study was to evaluate common causes and risk factors of upper gastrointestinal bleeding (UGIB) among pilgrims during the Hajj season.MethodWe conducted a retrospective cross-sectional study using a data collection checklist to collect data from medical records. We included all patients who had UGIB and attended the endoscopy department of the King Abdulaziz Hospital, Mecca, in the AL-Hajj season of the Islamic years 1437-1439 (2016-2018).ResultsA total of 93 patients were included in the current study; of those, 65.59% were males. The mean age of the patients was 63.37 ± 12.83 years, and about one-third (29.03%) of them were Indonesian. Overall, melena with or without anemia was the most common presentation (44.09%), followed by hematemesis (34.78%), melena with hematemesis (15.05%), hematemesis with ascites (9.68%), and abdominal/epigastric pain (3.23%). The most common cause of UGIB was the presence of gastric origin (erosive gastritis/gastric ulcer/gastric tumor) with 22.58% of the patients presenting with the same. The most common factors were medications, especially non-steroidal anti-inflammatory drugs (NSAIDs) (37.63%) and blood thinners (22.58%). Hypertension (31.18%), diabetes mellitus (DM) (29.03%), and chronic liver disease/failure (27.96%) were the most common chronic conditions in the studied population.ConclusionMedical orientation towards high-risk pilgrims prone to developing UGIB who intend to travel may help reduce the risk of developing the condition, by taking proper measurements of those groups by the medical teams, especially in those with preventable factors.

Scenario of pathogenesis and socioeconomic burden of human brucellosis in Saudi Arabia.

Brucellosis is considered a prevailing endemic infectious disease in the Kingdom of Saudi Arabia and represents a health problem with socio-economic burden. There are two main Brucella species that cause human brucellosis; Brucella abortus, and Brucella melitensis. The clinical features range from asymptomatic to the acute symptoms of fever, joint pain, muscle pain, headache, nausea/vomiting, anorexia and malaise in addition to the subsequent complications that might occur. The endemicity of brucellosis might be explained due to obstacles in controlling the importation of animals for slaughtering during Hajj periods and for several other predisposing factors. The distribution of the disease is all over the country and the most prevalent part is the south followed by north and then the east and central parts. However, in the complexity of brucellosis control measures, there are several activities which have been implemented to tackle the disease such as mass vaccination of animals, regulating importation of slaughter animals, and improving public awareness. This review provides a detailed description of the status of brucellosis in Saudi Arabia, which includes epidemiology, clinical characteristics, virulence and pathophysiology, and prevention of the disease.

Pharmacy Transition Care Services during Mass Gathering Hajj in Saudi Arabia

International Journal of Pharmacology and Clinical Sciences,2020,9,4,117-119.DOI:10.5530/ijpcs.2020.9.23Published:November 2020Type:Review Article Authors:Yousef Ahmed Alomi, Nezar Adnan Yahya Khayat, Yasir Abdulraheem Bamagaus, Naif Olaythah Alharbi, Fareed Ali Alharpi, Ahmad M. AlKharoby, and Wael H. Motair Author(s) affiliations:Yousef Ahmed Alomi*, Critical Care Clinical Pharmacists, TPN Clinical Pharmacist, Freelancer Business Planner, Content Editor and Data Analyst, Riyadh, Saudi Arabia. Nezar Adnan Yahya Khayat, Bsc. Pharm Medication Safety Officer, Pharmaceutical Care Administration, Makkah Medical Affairs Region, Makkah, Saudi Arabia. Yasir Abdulraheem Bamagaus, Bsc. Pharm Regional General Manager, Pharmaceutical Care Administration, Makkah Medical Affairs Region, Makkah, Saudi Arabia. Naif Olaythah Alharbi, Diploma. Pharm Staff Pharmacist, Pharmaceutical Care Administration, Makkah Medical Affairs Region, Makkah, Saudi Arabia. Fareed Ali Alharpi, Bsc. Nursing Nursing staff, Makkah Medical Affairs Region, Makkah, Saudi Arabia. Ahmad M. AlKharoby, MD Assistant General Manager for assistant medical affiars, Makkah Medical Affairs Region, Makkah, Saudi Arabia. Wael H. Motair, MD General Manager, Makkah Medical Affairs Region, Makkah, Saudi Arabia. Abstract:Objective: To declare the pharmacy transition care services during the mass gathering hajj period as new initiatives in the Kingdom of Saudi Arabia. Methods: It is a new initiative project drove by national mass gathering pharmaceutical programs. The projects drove the mass gathering medicine guidelines and the international business model, pharmacy project guidelines project management institution guidelines of a new project. The initiative project is written through project management professionals and consisted of several parts, including the initial phase, the planning phase, the execution phase and the monitoring and controlling phase. Results: The mass gathering pharmacy transition care services with a defined vision, mission and goals. The services had multiple benefits, including clinical and economical on pilgrims, as demonstrated in the review. The extension of the project assured by risk management elements description. In addition, the monitoring and controlling of the services as illustrated. The conversion of operation project, though closing project stage, demonstrated in the analysis. Conclusion: The pharmacy transition care services during the mass gathering is a new initiative, part of the mass gathering medicine. Various pharmacy transition care services can be started during mass gathering; it is highly recommended to implement in Saudi Arabia. Keywords:Hajj, Initiative, Mass Gathering, Pharmacy, Saudi Arabia, Services, Transition CareView:PDF (135.17 KB) PDFClick here to download the PDF file. Images Pharmacy Transition Care Services during Mass Gathering Hajj in Saudi Arabia

Health and Safety in Crowded Large Size Buildings: The Effect of Perceived Safety on User Behaviour in the Holy Mosque

Abstract Crowded large space buildings are today becoming highly desirable facilities for communities, towns, and cities. Due to stricter health, safety requirements, and environmental effects, such buildings are of greater interest for research. The buildings are used for a variety of functions, including sporting, entertainment, and religious events. The Holy Mosque in Makkah Saudi Arabia is an excellent example of a crowded large space building with a maximum capacity reaching up to 2 million users, especially at the Hajj and Ramadan periods. Quite often, designer and facility managers of crowded large space buildings pay keen attention to normative and substantive (objective) safety, but research shows that perceived (subjective) safety which should also be important, is clear overlooked. To prove the significance of perceived safety, a theory has been adopted, which states that a reduction in perceived safety (PS) will negatively affect the user behaviour (UB) resulting in the occurrence of a disaster in crowded large size buildings. Initial research undertaken by the authors have identified 10 key factors affecting subjective safety in crowded large space buildings, this stage of the study is an empirical study to aimed at establishing how significant each factor affects PS and the effect of perceived safety on the UB in such types of buildings. The Holy Mosque was used as a case study. The research adopted the quantitative research methodology by collecting primary data using a group-administered questionnaire in electronic devices such as iPad from more than 1,940 Hajj pilgrims coming from 62 countries. This was analysed by SPSS and AMOS 22 for confirmatory factor analysis (CFA) and structural equation modeling (SEM) to test the interrelationships between the 10 identified factors and PS or between PS and UB through several hypotheses. The research has demonstrated that there is a significant influence on PS by most of the established factors and that PS has a significant influence on the behaviour of pilgrims in the Holy Mosque.

Disaster Preparedness in the Kingdom of Saudi Arabia: Exploring and Evaluating the Policy, Legislative Organisational Arrangements Particularly During the Hajj Period

This paper examines the natural disasters that have historically taken place in the Kingdom of Saudi Arabia, particularly during Hajj (the largest mass gathering event in the world). A literature search of multiple databases was conducted to identify what is currently known about the effectiveness of disaster management arrangements, policies and plans in the KSA.