Meningococcal carriage among Hajj pilgrims, risk factors for carriage and records of vaccination: a study of pilgrims to Mecca

Abrar Alasmari; Joanna Houghton; Brian Greenwood; David Heymann; Phil Edwards; Heidi Larson; Abdullah Assiri; Fathia Ben-Rached; Arnab Pain; Ron Behrens; Amaya Bustinduy

doi:10.1111/tmi.13546

Meningococcal carriage among Hajj pilgrims, risk factors for carriage and records of vaccination: a study of pilgrims to Mecca

Abrar Alasmari^*, Joanna Houghton, Brian Greenwood, David Heymann, Phil Edwards, Heidi Larson, Abdullah Assiri, Fathia Ben-Rached, Arnab Pain, Ron Behrens, Amaya Bustinduy

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

10 Scopus citations

Abstract

Objective: The Saudi government requires that all pilgrims receive a quadrivalent meningococcal vaccine at least 10 days before the Hajj. We conducted a study to determine the uptake of meningococcal vaccine and antibiotic use. We also investigated risk factors of meningococcal carriage and carriage of Neisseria meningitidis pathogenic serogroups A, C, W and Y. Methods: A cross-sectional oropharyngeal carriage survey was conducted in 2973 Hajj pilgrims in September 2017. A real-time polymerase chain reaction (rt-PCR) assay was used to identify N. meningitidis from the oropharyngeal swabs. A questionnaire investigated potential risk factors for carriage of N. meningitidis. Results: Two thousand two hundred forty nine oropharyngeal swabs were obtained. The overall prevalence of carriage of N. meningitidis was 4.6% (95% CI: 3.4%–6%). Carriage of pathogenic serogroups was not associated significantly with any of the meningococcal risk factors evaluated. 77% of pilgrims were vaccinated but 22.58 % said they were carrying unofficial vaccination cards. Conclusion: Carriage of serogroups A, C, W and Y was not significantly associated with any of the risk factors investigated. Almost a quarter of pilgrims were unlikely to have been vaccinated, highlighting a need to strengthen compliance with the current policy of vaccination to prevent meningococcal disease outbreaks during and after the Hajj.

Original language	English (US)
Pages (from-to)	453-461
Number of pages	9
Journal	Tropical Medicine and International Health
Volume	26
Issue number	4
DOIs	https://doi.org/10.1111/tmi.13546
State	Published - Apr 2021

Bibliographical note

Funding Information:
We gratefully acknowledge the permission and assistance given to conduct this study provided by the Health Surveillance Centres at King Abdulaziz International Airport and its head Ayman Samman, as well as Dr. Homoud Algarni and all the medical students who assisted with the data collection. We would like to acknowledge the valuable advice and support provide by Ray Borrow, Steve Gray and Chrissy Roberts. This work was partially supported by a faculty baseline fund (BAS/1/1020‐01‐01) from the King Abdullah University of Science and Technology (KAUST) to AP and by the Royal Embassy of Saudi Arabia Cultural Bureau in London, United Kingdom.

Publisher Copyright:
© 2021 The Authors Tropical Medicine & International Health Published by John Wiley & Sons Ltd

Keywords

antibiotic
Hajj
meningococcal
Neisseria meningitides
pharyngeal carriage
vaccination

ASJC Scopus subject areas

Parasitology
Public Health, Environmental and Occupational Health
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1111/tmi.13546

Cite this

Alasmari, A., Houghton, J., Greenwood, B., Heymann, D., Edwards, P., Larson, H., Assiri, A., Ben-Rached, F., Pain, A., Behrens, R., & Bustinduy, A. (2021). Meningococcal carriage among Hajj pilgrims, risk factors for carriage and records of vaccination: a study of pilgrims to Mecca. Tropical Medicine and International Health, 26(4), 453-461. https://doi.org/10.1111/tmi.13546

@article{98b466911ae84248ab910917a9a4fe32,

title = "Meningococcal carriage among Hajj pilgrims, risk factors for carriage and records of vaccination: a study of pilgrims to Mecca",

abstract = "Objective: The Saudi government requires that all pilgrims receive a quadrivalent meningococcal vaccine at least 10 days before the Hajj. We conducted a study to determine the uptake of meningococcal vaccine and antibiotic use. We also investigated risk factors of meningococcal carriage and carriage of Neisseria meningitidis pathogenic serogroups A, C, W and Y. Methods: A cross-sectional oropharyngeal carriage survey was conducted in 2973 Hajj pilgrims in September 2017. A real-time polymerase chain reaction (rt-PCR) assay was used to identify N. meningitidis from the oropharyngeal swabs. A questionnaire investigated potential risk factors for carriage of N. meningitidis. Results: Two thousand two hundred forty nine oropharyngeal swabs were obtained. The overall prevalence of carriage of N. meningitidis was 4.6% (95% CI: 3.4%–6%). Carriage of pathogenic serogroups was not associated significantly with any of the meningococcal risk factors evaluated. 77% of pilgrims were vaccinated but 22.58 % said they were carrying unofficial vaccination cards. Conclusion: Carriage of serogroups A, C, W and Y was not significantly associated with any of the risk factors investigated. Almost a quarter of pilgrims were unlikely to have been vaccinated, highlighting a need to strengthen compliance with the current policy of vaccination to prevent meningococcal disease outbreaks during and after the Hajj.",

keywords = "antibiotic, Hajj, meningococcal, Neisseria meningitides, pharyngeal carriage, vaccination",

author = "Abrar Alasmari and Joanna Houghton and Brian Greenwood and David Heymann and Phil Edwards and Heidi Larson and Abdullah Assiri and Fathia Ben-Rached and Arnab Pain and Ron Behrens and Amaya Bustinduy",

note = "Funding Information: We gratefully acknowledge the permission and assistance given to conduct this study provided by the Health Surveillance Centres at King Abdulaziz International Airport and its head Ayman Samman, as well as Dr. Homoud Algarni and all the medical students who assisted with the data collection. We would like to acknowledge the valuable advice and support provide by Ray Borrow, Steve Gray and Chrissy Roberts. This work was partially supported by a faculty baseline fund (BAS/1/1020‐01‐01) from the King Abdullah University of Science and Technology (KAUST) to AP and by the Royal Embassy of Saudi Arabia Cultural Bureau in London, United Kingdom. Publisher Copyright: {\textcopyright} 2021 The Authors Tropical Medicine & International Health Published by John Wiley & Sons Ltd",

year = "2021",

month = apr,

doi = "10.1111/tmi.13546",

language = "English (US)",

volume = "26",

pages = "453--461",

journal = "Tropical Medicine and International Health",

issn = "1360-2276",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "4",

}

Alasmari, A, Houghton, J, Greenwood, B, Heymann, D, Edwards, P, Larson, H, Assiri, A, Ben-Rached, F , Pain, A, Behrens, R & Bustinduy, A 2021, 'Meningococcal carriage among Hajj pilgrims, risk factors for carriage and records of vaccination: a study of pilgrims to Mecca', Tropical Medicine and International Health, vol. 26, no. 4, pp. 453-461. https://doi.org/10.1111/tmi.13546

TY - JOUR

T1 - Meningococcal carriage among Hajj pilgrims, risk factors for carriage and records of vaccination

T2 - a study of pilgrims to Mecca

AU - Alasmari, Abrar

AU - Houghton, Joanna

AU - Greenwood, Brian

AU - Heymann, David

AU - Edwards, Phil

AU - Larson, Heidi

AU - Assiri, Abdullah

AU - Ben-Rached, Fathia

AU - Pain, Arnab

AU - Behrens, Ron

AU - Bustinduy, Amaya

N1 - Funding Information: We gratefully acknowledge the permission and assistance given to conduct this study provided by the Health Surveillance Centres at King Abdulaziz International Airport and its head Ayman Samman, as well as Dr. Homoud Algarni and all the medical students who assisted with the data collection. We would like to acknowledge the valuable advice and support provide by Ray Borrow, Steve Gray and Chrissy Roberts. This work was partially supported by a faculty baseline fund (BAS/1/1020‐01‐01) from the King Abdullah University of Science and Technology (KAUST) to AP and by the Royal Embassy of Saudi Arabia Cultural Bureau in London, United Kingdom. Publisher Copyright: © 2021 The Authors Tropical Medicine & International Health Published by John Wiley & Sons Ltd

PY - 2021/4

Y1 - 2021/4

N2 - Objective: The Saudi government requires that all pilgrims receive a quadrivalent meningococcal vaccine at least 10 days before the Hajj. We conducted a study to determine the uptake of meningococcal vaccine and antibiotic use. We also investigated risk factors of meningococcal carriage and carriage of Neisseria meningitidis pathogenic serogroups A, C, W and Y. Methods: A cross-sectional oropharyngeal carriage survey was conducted in 2973 Hajj pilgrims in September 2017. A real-time polymerase chain reaction (rt-PCR) assay was used to identify N. meningitidis from the oropharyngeal swabs. A questionnaire investigated potential risk factors for carriage of N. meningitidis. Results: Two thousand two hundred forty nine oropharyngeal swabs were obtained. The overall prevalence of carriage of N. meningitidis was 4.6% (95% CI: 3.4%–6%). Carriage of pathogenic serogroups was not associated significantly with any of the meningococcal risk factors evaluated. 77% of pilgrims were vaccinated but 22.58 % said they were carrying unofficial vaccination cards. Conclusion: Carriage of serogroups A, C, W and Y was not significantly associated with any of the risk factors investigated. Almost a quarter of pilgrims were unlikely to have been vaccinated, highlighting a need to strengthen compliance with the current policy of vaccination to prevent meningococcal disease outbreaks during and after the Hajj.

AB - Objective: The Saudi government requires that all pilgrims receive a quadrivalent meningococcal vaccine at least 10 days before the Hajj. We conducted a study to determine the uptake of meningococcal vaccine and antibiotic use. We also investigated risk factors of meningococcal carriage and carriage of Neisseria meningitidis pathogenic serogroups A, C, W and Y. Methods: A cross-sectional oropharyngeal carriage survey was conducted in 2973 Hajj pilgrims in September 2017. A real-time polymerase chain reaction (rt-PCR) assay was used to identify N. meningitidis from the oropharyngeal swabs. A questionnaire investigated potential risk factors for carriage of N. meningitidis. Results: Two thousand two hundred forty nine oropharyngeal swabs were obtained. The overall prevalence of carriage of N. meningitidis was 4.6% (95% CI: 3.4%–6%). Carriage of pathogenic serogroups was not associated significantly with any of the meningococcal risk factors evaluated. 77% of pilgrims were vaccinated but 22.58 % said they were carrying unofficial vaccination cards. Conclusion: Carriage of serogroups A, C, W and Y was not significantly associated with any of the risk factors investigated. Almost a quarter of pilgrims were unlikely to have been vaccinated, highlighting a need to strengthen compliance with the current policy of vaccination to prevent meningococcal disease outbreaks during and after the Hajj.

KW - antibiotic

KW - Hajj

KW - meningococcal

KW - Neisseria meningitides

KW - pharyngeal carriage

KW - vaccination

UR - http://www.scopus.com/inward/record.url?scp=85100017033&partnerID=8YFLogxK

U2 - 10.1111/tmi.13546

DO - 10.1111/tmi.13546

M3 - Article

C2 - 33415766

AN - SCOPUS:85100017033

SN - 1360-2276

VL - 26

SP - 453

EP - 461

JO - Tropical Medicine and International Health

JF - Tropical Medicine and International Health

IS - 4

ER -

Meningococcal carriage among Hajj pilgrims, risk factors for carriage and records of vaccination: a study of pilgrims to Mecca

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this