Molecular detection of selected zoonotic respiratory pathogens and the presence of virulence and antibiotic resistance genes via PCR among Kelantan Hajj pilgrims

Aims@#Respiratory tract infections (RTIs) among Malaysian pilgrims are caused by exposure to zoonotic-potential respiratory pathogens, symptomatically and asymptomatically affected by rigorous pilgrimage rituals, overcrowding and other stressors. This study aimed to determine the prevalence, virulence and antibiotic resistance genes of selected zoonotic respiratory pathogens using polymerase chain reaction (PCR) assays among Hajj pilgrims from Kelantan state, Malaysia.@*Methodology and results@#Throat swab specimens were obtained from 189 Kelantan Hajj pilgrims in 2016 and examined by PCR for the identification of respiratory pathogens. Thirteen samples (6.88%) were positive for Streptococcus pneumoniae and four (2.11%) were positive for Klebsiella pneumoniae. All the samples were negative for Influenza A virus, MERS-CoV and Mycobacterium bovis. One sample was positive for S. pneumoniae virulence lytA gene. One sample was positive for K. pneumoniae virulence magA and K2A genes respectively, and three samples were positive for K. pneumoniae rmpA genes. Ten and seven samples were positive for S. pneumoniae mefA and pbpA antibiotic resistance genes respectively. Two samples were positive for K. pneumoniae blaKPC and blaOXA-48 antibiotic resistance genes. @*Conclusion, significance and impact of study@#This work provided insight into the existence of zoonotic respiratory pathogens inducing Hajj RTIs in Kelantan pilgrims. It showed promising findings for zoonotic studies in Hajj settings. The findings could be relevant in potential control measures for the management of zoonotic infections among Hajj pilgrims.

Mass Gathering (Hajj) Community Pharmacies Services: New Initiative in Saudi Arabia

Objective: To illustrate the pharmacy indicators during the mass gathering hajj as a new initiative 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 community pharmacy services with a defined vision, mission and goals. The services had various advantages, including clinical and economic on patients and healthcare services as demonstrated in the review. The continuation of the project assured by risk management elements description. Furthermore, the monitoring and controlling of the services as illustrated. The transition to operation project, though closing project stage declared in the analysis. Conclusion: The mass gathering medication safety is a new initiative project is part of the mass gathering medicine. There are various part of medication safety services can be started during mass gathering; it is highly recommended in Saudi Arabia.

Mass Gathering Hajj Emergency Pharmacy: New Initiative Project in Saudi Arabia

Objectives: To explore the mass gathering hajj emergency pharmacy 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 emergency pharmacy services with a defined vision, mission and goals. The services had various benefits, including clinical and economical on pilgrims, as described in the review. The continuity of the project assured by the risk management model description. Moreover, the monitoring and controlling of the services as demonstrated. The transition to operation project though closing project stage exemplified in the analysis. Conclusion: The mass gathering emergency pharmacy is a new initiative project in the mass gathering medicine. There are various emergency pharmacy services can be started during the mass gathering with clinical emergency pharmacy; it is highly suggested in Saudi Arabia.

Mass Gathering (Hajj) Clinical Pharmacy Services: New Initiative in Saudi Arabia

Objective: To declare the clinical pharmacy services during the mass gathering hajj period as a new initiative 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 clinical pharmacy services with a defined vision, mission and goals. The services had multiple benefits, including clinical and economical on the healthcare system, as described in the review. The continuation of the services assured by risk management elements description. Moreover, the monitoring and controlling of the projects as illustrated. The transition to operation project, though closing project stage illustrated in the analysis. Conclusion: The clinical pharmacy services during the mass gathering hajj period is a new initiative project in the mass gathering medicine. Multiple clinical pharmacy services can be started during a mass gathering with an emphasison decrease morbidity and mortality; it is highly recommended in the Kingdom of Saudi Arabia.

Mass Gathering (Hajj) Medication Safety Services: New Initiative in Saudi Arabia

Objective: To demonstrate the mass gathering hajj medication safety 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 medication safety services during the mass gathering with a defined vision, mission and goals. The services had multiple benefits, including clinical and economical on patients and healthcare services, as described in the review. The extension of the project assured by risk management elements description. Besides, the monitoring and controlling of the services as illustrated. The conversion of operation project, though closing project stage illustrated in the analysis. Conclusion: The mass gathering medication safety is a new initiative project that is part of the mass gathering medicine. There is various part of medication safety services can be started during the mass gathering; it is highly recommended in Saudi Arabia.

Management, Medication Use and Economic Burden of Asthma among Hajj and Umrah Pilgrims

Introduction:During Hajj and Umrah season, asthma-related acute admissions produce the enormous burden on healthcare facilities and causes delay in admissions for more severe cases, e.g. myocardial infarction,cardiac failureand severe trauma cases. Therefore, the snapshot of asthma-related admissions during the Hajj and Umrah season was determined by asthma-related admissions and medication use and economic burden during Hajj and Umrah pilgrimage season. Methodology:All asthma-related admissions during the month of Ramadan (fasting month) and Hajj pilgrimage were assessed from patients’data retrospectively. The convenience sampling strategy was used to retrievestudy variables. Statistical Package for Social Science (SPSS) Version 22.0 was used to analyze the data.Results:A total of 271 patients were selected as per inclusion criteria, the majority of them were males 153 (56.5%), while most of them were Saudi 70 (35.8%) and Egyptians 86 (31.7%). During hospitalization, the common treatment for acute exacerbations was inhaled corticosteroids 224 (86.3%), IV corticosteroids 129 (47.6%), Inhaled short-acting beta-agonists 244 (90%) and inhaled bronchodilators (ipratropium bromide) 237(87.5 5%). Conclusion:This periodic mapping of asthma-related admissions and its management during these massive gathering events is indeed a significant effort to explore issues of acute asthma exacerbations management and to provide information to plan for future interventions and policies.

Mass Gathering (Hajj) Pharmacy Infection Control: New Initiative in Saudi Arabia

Objectives: To demonstrate the pharmacy infection control 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 infection control services with a defined vision, mission and goals. The services had various aids, including clinical and economical on pilgrims, as illustrated in the assessment. The continuation was of the project assured by the risk management model description. Besides, the monitoring and controlling of the services as declared. The transition to operation project, though closing the project stage, explored in the analysis. Conclusion: The mass gathering pharmacy infection control services are a new initiative, part of the mass gathering medicine. There are various pharmacy transition care services can be started during the mass gathering with an emphasis on pharmacy personnel, infection control; it is highly suggested to implement in Saudi Arabia.

Respiratory viruses in returning Hajj & Umrah pilgrims with acute respiratory illness in 2014-2015

Background & objectives: Respiratory tract infections are common among Hajj and Umrah pilgrims which pose a public health risk of spread of respiratory infections. Influenza has been reported from Indian Hajj and Umrah returning pilgrims, but data on other respiratory pathogens are sparse in India. Here we report the presence of common respiratory viral pathogens in returning Hajj and Umrah pilgrims suffering from acute respiratory illness (ARI) in 2014-2015. Methods: Respiratory specimens (nasopharyngeal and throat swabs) were collected from 300 consenting pilgrims with ARI in the past one week and tested for influenza and Middle East Respiratory Syndrome coronavirus (MERS-CoV) and other respiratory viruses using in-house standardized quantitative real-time reverse-transcription polymerase chain reaction. Clinical features among the pathogen positive and negative patients were compared. The patients received symptomatic treatment and antivirals where appropriate and were followed telephonically to collect data on illness outcome. Results: Ninety seven (32.3%) of the 300 participants were tested positive for any virus, most common being influenza viruses (n=33, 11%). Other respiratory viruses that were detected included human coronaviruses [n=26, 8.7%; OC43 (n=19, 6.3%) and C229E (n=7, 2.3%)], rhinovirus (n=20, 6%), adenoviruses (n=8, 2.6%), parainfluenza viruses (n=7, 2.3%), respiratory syncytial virus (n=3, 1%) and bocaviruses (n=2, 0.6%). Clinical features observed in pathogen positive and pathogen negative patients did not differ significantly. Eighteen influenza positive patients were treated with oseltamivir. Interpretation & conclusions: Pilgrims returning from mass gatherings are often afflicted with respiratory pathogens with a potential to facilitate transmission of respiratory pathogens across international borders. The study reinforces the need for better infection prevention and control measures such as vaccination, health education on cough etiquette and hand hygiene.

The Fundamental Of Hajj Demand For Health Care Services Within Congestion In Makkah

The large population of human congestion in Makkah during Hajj would promote contagious diseases. Thus, the pilgrims require health care services that are efficient, effective, and high quality. The aim of this study is to determine the type of health-related problems among Malaysian pilgrims and to identify the health care services required by them during Hajj in Makkah. A cross-sectional study was conducted in which involved 379 Malaysian pilgrims in 2013/14234H. The survey was conducted after the pilgrims completed their Hajj ritual. A total of 400 sets of questionnaires were distributed at Abraj Janadriyah Hotel, which was occupied by more than 3000 Malaysian pilgrims. The response rate for this survey was 93%. Male respondents were constituted of 49.6% and female respondents were 50.4% with the mean age 52 years old. The underlying disease among Malaysian pilgrims during Hajj was respiratory disease (77.5%). The demands for health personnel (36.1%) and quality medication (34.7%) are among the important healthcare services required by the Malaysian pilgrims in Makkah. Respiratory disease is a common disease experienced by Malaysian pilgrims in Makkah. A certain types of services such as health personnel and quality medicine are strongly demanded by the Malaysian pilgrims to overcome their health problem during Hajj. This research provides a fundamental input to the health care providers, and also benefited the Hajj management authority to improve the quality of hajj management in future

Profile of bacterial pneumonia during Hajj.

Background & objectives The congregation of a large number of people during Hajj seasons from different parts of the world in overcrowded conditions within a confined area for a long period of time presents many public health challenges and health risks. One of the main health problems of the crowding is ease transmission of pneumonia by air droplets. This study was aimed to determine the most common causes of bacterial pneumonia during the 2005 Hajj season and to relate the findings with clinical conditions. Methods A total of 141 patients with suspected pneumonia from the three main tertiary care hospitals in Makkah, Saudi Arabia, were investigated during Hajj season, 2005. Sputum and serum samples were collected and investigated for the possible presence of typical or atypical causative agents. Results Of the 141 clinically suspected pneumonia cases, 76 (53.9%) were confirmed positive by microbiological tests. More than 94 per cent of the confirmed cases were in the age group >50 yr, and 56.6 per cent of the cases were men. The most frequent isolates were Candida albicans (28.7%) and Pseudomonas aeruginosa (21.8%), followed by Legionella pneumophila (14.9%) and Klabsiella pneumoniae (9.2%). More than one causative pathogens were isolated in 15 patients (16.3%), and 55 per cent of patients were diabetic. Interpretation & conclusions Clinicians should be aware that typical pneumonia treatment regimens may not work well during the Hajj season due to the wide variety of isolated organisms. This necessitates taking a sputum sample before starting treatment for identification and sensitivity testing. Special precautions need to be taken for >50 yr old patients.