RESUMO
Introduction Trauma and injuries are common among pilgrims during Hajj, the biggest mass gathering event. Trauma and injury causes vary from falling and pressing in crowds to being burned by boiled water and road traffic accidents (RTA). Time to reach the hospital during highly condensed areas in Hajj are challenges for the public health authorities and the healthcare system to achieve optimum control, management, and outcome. This study aims to explore the pattern of trauma and injuries during Hajj as it is crucial to improve future preventive measures and care quality. Methods A cross-sectional questionnaire-based study was conducted in one hospital in each of the Mena and Arafat (Al-Mashaar's areas) in Makkah City, Saudi Arabia, from July 8 to 10, 2022. Data was collected through interviews with patients who visit the hospitals or enter the emergency department and are diagnosed with trauma or injury during the Hajj season of 1443 Hijri date (2022). Results A total of 264 people volunteered to participate in the survey. The mean age by years was 43.5 ± 10.7, and the majority (56%) were between 41 and 64. There were multiple nationalities - the most common nationality was Egyptian (25%), followed by Saudi (10%). The commonest type of trauma was cutting wounds (50%), and the commonest cause was falling (39%), followed by foot twisting (31%). There were 142 cases in Arafat and 122 cases in Mena in the study duration. Tissue contusions are higher in Arafat. Fractures (5%) were in both areas but higher in Mena with burns and sprains. Friction blister injuries were only in Mena and were statistically associated with walking barefoot (p<0.01), which was associated with Egyptians (p<0.05). Also, thigh chafing is only in Mena, while eye traumas and abrasion are only in Arafat. There were four causes of injury that are statistically significantly associated with the area (p<0.05): foot twisting in Arafat, pressing in overcrowding, stoning, and burning in Mena. Moreover, all the RTA cases (n=4) were in Arafat, and all the stoning and burning by boiling water were in Mena. Admission was only for burning (n=2) and falling (n=2) cases and only in Mena emergency hospital; otherwise, all trauma cases were discharged after receiving management - no deaths among the study sample. Injuries in Mena are likely to happen in the evening and night (n=91), while in Arafat, it is more likely in two periods (n=113), in the early morning and afternoon. This difference is statistically significant between the two areas (p<0.05). Most pilgrims (n=129/253) reach the hospital in 16 to 30 minutes. A statistically significant association exists between the duration and the area (p<0.05). Most patients in Arafat (88%) reach the hospital in less than 30 minutes, while only 50% take the same duration in Mena. Conclusion The Hajj season of 1443 H (2022) has a similar trauma pattern and improved outcomes compared to previous seasons. Discovering and digging into the causes of traumas and injuries should be optimized in future research for better control and customized prevention measures. Establishing new and remodeling current prevention measures is recommended for more control.
RESUMO
Aim The aim of this study was to investigate the patterns and determinants of drug resistance to tuberculosis (TB) in a large population from Makkah, Saudi Arabia. Methods A retrospective, cross-sectional cohort study was conducted on all patients with TB who were referred to the National Tuberculosis Prevention Program in Makkah, Saudi Arabia, between January 2016 and September 2020. For each TB case, demographic data were collected in addition to the results of drug susceptibility testing (DST) for anti-TB drugs. The Statistical Package for Social Sciences (SPSS) software for Windows, version 23 (IBM Corporation, Armonk, NY, USA), was used for the statistical analysis. Results A total of 472 TB-confirmed cases were included in the analysis. The mean ± standard deviation of the age was 38.5 ± 17.7 years. The vast majority of patients were male (62.7%) and had pulmonary TB (91.7%). Only a small proportion of the patients with TB had diabetes mellitus (8.5%). Overall, the prevalence of monodrug-resistant TB ranged from 2.1% to 3.4%. Specifically, the prevalence of monodrug-resistant TB to isoniazid and streptomycin was ranked first and was equal to 3.4%. Pyrazinamide had the lowest prevalence of monodrug-resistant TB (2.1%). The prevalence of polydrug-resistant TB (PDR-TB) and multidrug-resistant TB (MDR-TB) was 1.5%. In the univariate analysis, sex (male) was the only sociodemographic factor that significantly correlated with a higher prevalence of MDR-TB. Conclusions This is the second study from Makkah to analyze the prevalence and associated risk factors of MDR-TB among patients from Makkah. Our data demonstrated that the prevalence of monodrug-resistant TB and MDR-TB was low (2.1%-3.4% and 1.5%, respectively). Diabetes mellitus was not a substantial factor correlated with a higher occurrence of MDR-TB. Additional epidemiologic studies are required to validate our results.
