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. 2021 Apr;26(4):453-461.
doi: 10.1111/tmi.13546. Epub 2021 Jan 31.

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

Abrar Alasmari  1 , Joanna Houghton  1 , Brian Greenwood  2 , David Heymann  3   4 , Phil Edwards  5 , Heidi Larson  4   6 , Abdullah Assiri  7 , Fathia Ben-Rached  8 , Arnab Pain  8   9 , Ron Behrens  1 , Amaya Bustinduy  1
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Meningococcal carriage among Hajj pilgrims, risk factors for carriage and records of vaccination: a study of pilgrims to Mecca

Abrar Alasmari et al. Trop Med Int Health. 2021 Apr.

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: Neisseria meningitides; Hajj; antibiotic; meningococcal; pharyngeal carriage; vaccination.

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Figures

Figure 1
Figure 1
Vaccination status of pilgrim by country classification by income.
See this image and copyright information in PMC

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