Ziad A Memish1, Jaffar A Al-Tawfiq2, Malak Almasri3, Nadia Akkad3, Saber Yezli3, Abdulhafeez Turkestani4, Mark van der Linden5, Abdullah Assiri3. 1. Ministry of Health, Riyadh, Saudi Arabia; Alfaisal University, College of Medicine, Riyadh, Saudi Arabia. Electronic address: Zmemish@yahoo.com. 2. Johns Hopkins Aramco Healthcare, Dharan, Saudi Arabia; Indiana University School of Medicine, Indianapolis, IN, USA. 3. Ministry of Health, Riyadh, Saudi Arabia. 4. Makkah Regional Health Directorate, Makkah, Ministry of Health, Riyadh, Saudi Arabia. 5. German National Reference Center for Streptococci, Aachen, Germany.
Abstract
BACKGROUND: The annual Muslim pilgrimage attracts over two million pilgrims who gather in a limited time and space. The pilgrimage carries the potential risk of increase risk of the acquisition of Streptococcus pneumonia. In this cohort study, we evaluate the effect of the Hajj on the prevalence of pneumococcal serotype nasopharyngeal carriage in the Hajj pilgrim population. The secondary objective is to evaluate the effects of the mass gathering on carriage of invasive pneumococcal serotypes. METHODS: This is a prospective cohort study with two data collection periods: at the beginning and at the end of the Hajj. Nasopharyngeal samples were taken via a standardized swabbing method. RESULTS: A total of 1175 pilgrims were enrolled at the beginning of the study and 1155 (98.3%) were included at the second part of the study. The pre-Hajj samples were obtained at a mean of 0 days and the post-Hajj sampling occurred at a mean of 15 days after arrival to Saudi Arabia. The overall carriage rate of Streptococcus pneumoniae in the pre- and post-Hajj was 1.8% and 7.1% (P = 0.0016). The potential coverage of the 7-valent pneumococcal conjugate vaccine (PCV7), PCV10 and PCV13 were 15.5%, 19.1%; and 35.5%, respectively. The coverage for the 23-valent pneumococcal polysaccharide vaccine (PPV23) was 40%. CONCLUSION: Although there was an increase in the acquisition of S. pneumoniae, its magnitude is low which does not support public health recommendations for general pneumococcal vaccination of pilgrims except those at risk.
BACKGROUND: The annual Muslim pilgrimage attracts over two million pilgrims who gather in a limited time and space. The pilgrimage carries the potential risk of increase risk of the acquisition of Streptococcus pneumonia. In this cohort study, we evaluate the effect of the Hajj on the prevalence of pneumococcal serotype nasopharyngeal carriage in the Hajj pilgrim population. The secondary objective is to evaluate the effects of the mass gathering on carriage of invasive pneumococcal serotypes. METHODS: This is a prospective cohort study with two data collection periods: at the beginning and at the end of the Hajj. Nasopharyngeal samples were taken via a standardized swabbing method. RESULTS: A total of 1175 pilgrims were enrolled at the beginning of the study and 1155 (98.3%) were included at the second part of the study. The pre-Hajj samples were obtained at a mean of 0 days and the post-Hajj sampling occurred at a mean of 15 days after arrival to Saudi Arabia. The overall carriage rate of Streptococcus pneumoniae in the pre- and post-Hajj was 1.8% and 7.1% (P = 0.0016). The potential coverage of the 7-valent pneumococcal conjugate vaccine (PCV7), PCV10 and PCV13 were 15.5%, 19.1%; and 35.5%, respectively. The coverage for the 23-valent pneumococcal polysaccharide vaccine (PPV23) was 40%. CONCLUSION: Although there was an increase in the acquisition of S. pneumoniae, its magnitude is low which does not support public health recommendations for general pneumococcal vaccination of pilgrims except those at risk.
Authors: Mohammad Irfan Azeem; Mohamed Tashani; Al-Mamoon Badahdah; Leon Heron; Kristen Pedersen; Neisha Jeoffreys; Jen Kok; Elizabeth Haworth; Dominic E Dwyer; Grant Hill-Cawthorne; Harunor Rashid; Robert Booy Journal: World J Clin Cases Date: 2017-03-16 Impact factor: 1.337