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Article ; Online: Epidemiological Differences in Hajj-Acquired Airborne Infections in Pilgrims Arriving from Low and Middle-Income versus High-Income Countries: A Systematised Review.

Mahdi, Hashim A / Alluhidan, Mohammed / Almohammed, Abdulrahman B / Alfelali, Mohammad / Shaban, Ramon Z / Booy, Robert / Rashid, Harunor

Tropical medicine and infectious disease

2023 Volume 8, Issue 8

Abstract: This systematised review aims to compare the epidemiological patterns of Hajj-acquired airborne infections among pilgrims from low and middle-income countries (LMIC) versus those from high-income countries (HIC). A PubMed search was carried out for all ... ...

Abstract	This systematised review aims to compare the epidemiological patterns of Hajj-acquired airborne infections among pilgrims from low and middle-income countries (LMIC) versus those from high-income countries (HIC). A PubMed search was carried out for all published articles before February 2023, using a combination of MeSH terms and text words. The Newcastle-Ottawa Scale (NOS) was used to assess data quality. From a total of 453 titles identified, 58 studies were included in the review (LMIC = 32, and HIC = 26). In the pooled sample, there were 27,799 pilgrims aged 2 days to 105 years (male: female = 1.3:1) from LMIC and 70,865 pilgrims aged 2 months to 95 years (male: female = 1:1) from HIC. Pilgrims from both HIC and LMIC had viral and bacterial infections, but pilgrims from HIC tended to have higher attack rates of viral infections than their LMIC counterparts. However, the attack rates of bacterial infections were variable: for instance, pilgrims from LMIC seemed to have higher rates of meningococcal infections (0.015-82% in LMIC vs. 0.002-40% in HIC) based on the study population, but not
Language	English
Publishing date	2023-08-17
Publishing country	Switzerland
Document type	Journal Article ; Review
ISSN	2414-6366
ISSN (online)	2414-6366
DOI	10.3390/tropicalmed8080418
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Article ; Online: The relationship between hand hygiene and rates of acute respiratory infections among Umrah pilgrims: A pilot randomised controlled trial.

Albutti, Aqel / Mahdi, Hashim A / Alwashmi, Ameen S / Alfelali, Mohammad / Barasheed, Osamah / Barnes, Elizabeth H / Shaban, Ramon Z / Booy, Robert / Rashid, Harunor

Journal of infection and public health

2023 Volume 17 Suppl 1, Page(s) 34–41

Abstract: Background: There is a lack of randomised controlled trials (RCTs) investigating the role of hand hygiene in preventing and containing acute respiratory infections (ARIs) in mass gatherings. In this pilot RCT, we assessed the feasibility of establishing ...

Abstract	Background: There is a lack of randomised controlled trials (RCTs) investigating the role of hand hygiene in preventing and containing acute respiratory infections (ARIs) in mass gatherings. In this pilot RCT, we assessed the feasibility of establishing a large-scale trial to explore the relationship between practising hand hygiene and rates of ARI in Umrah pilgrimage amidst the COVID-19 pandemic. Methods: A parallel RCT was conducted in hotels in Makkah, Saudi Arabia, between April and July 2021. Domestic adult pilgrims who consented to participate were randomised 1:1 to the intervention group who received alcohol-based hand rub (ABHR) and instructions, or to the control group who did not receive ABHR or instructions but were free to use their own supplies. Pilgrims in both groups were then followed up for seven days for ARI symptoms. The primary outcome was the difference in the proportions of syndromic ARIs among pilgrims between the randomised groups. Results: A total of 507 (control: intervention = 267: 240) participants aged between 18 and 75 (median 34) years were randomised; 61 participants were lost to follow-up or withdrew leaving 446 participants (control: intervention = 237:209) for the primary outcome analysis; of whom 10 (2.2 %) had developed at least one respiratory symptom, three (0.7 %) had 'possible ILI' and two (0.4 %) had 'possible COVID-19'. The analysis of the primary outcome found no evidence of difference in the proportions of ARIs between the randomised groups (odds ratio 1.1 [0.3-4.0] for intervention relative to control). Conclusion: This pilot trial suggests that conducting a future definitive RCT to assess the role of hand hygiene in the prevention of ARIs is feasible in Umrah setting amidst such a pandemic; however, outcomes from this trial are inconclusive, and such a study would need to be very large given the low rates of outcomes observed here. Trial registration: This trial was registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) (ACTRN12622001287729), the full protocol can be accessed there.
MeSH term(s)	Adult ; Humans ; Adolescent ; Young Adult ; Middle Aged ; Aged ; Pilot Projects ; Hand Hygiene ; Australia ; Respiratory Tract Infections/epidemiology ; Respiratory Tract Infections/prevention & control ; COVID-19/prevention & control ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2023-04-07
Publishing country	England
Document type	Journal Article
ZDB-ID	2467587-8
ISSN	1876-035X ; 1876-0341
ISSN (online)	1876-035X
ISSN	1876-0341
DOI	10.1016/j.jiph.2023.04.003
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Article: The Impact of COVID-19 Pandemic on Obsession and Compulsion Symptoms in Saudi Arabia.

Alhujaili, Naseem / Alghamdi, Abdulaziz / Abo Talib, Tariq / Alhaqbani, Muhammad / Alfelali, Mohammad / Alghamdi, Waleed

Cureus

2021 Volume 13, Issue 11, Page(s) e20021

Abstract: Background Obsessive-compulsive disorder (OCD) is a common condition that has a significant impact on people's lives. COVID-19 pandemic imposed a challenging situation for the general population with new precautionary measures. All that can have serious ... ...

Abstract	Background Obsessive-compulsive disorder (OCD) is a common condition that has a significant impact on people's lives. COVID-19 pandemic imposed a challenging situation for the general population with new precautionary measures. All that can have serious implications for those who already have intense concerns about cleanliness and hygiene and those diagnosed with OCD. The aim of this study was to examine the impact of the coronavirus disease 2019 (COVID-19) pandemic on the emergence and severity of obsession and compulsion symptoms in Saudi Arabia. Methods This was a cross-sectional study with 1,190 participants who completed an online three-part questionnaire that included sociodemographic data, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) checklist, and (Y-BOCS) severity scale. On account of the fact that OCD requires a clinical evaluation to confirm the diagnosis, screening positive for OCD was defined based on criteria A of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is selecting at least one of either obsession or compulsion symptoms or both. Screening positive for obsession was defined as selecting at least one of the obsessional symptoms while screening positive for compulsion was defined as selecting at least one of the compulsion symptoms. Results Overall, OCD screening was positive in 82% of participants. Previous diagnosis of OCD was reported by 2.6% (N=36) of the participants and 55.2% of them reported that their symptoms did not change during the pandemic, while 41.1% reported that their symptoms increased. Positive OCD screening was significantly higher in participants who reported previous psychological illness (87.6% vs. 80.9%), those who followed news related to COVID-19 on a daily basis (88.7% vs. 76.1%), and participants who had not acquired the infection (82.9%) compared to those who were infected with COVID-19 (72.3%). Conclusion The aim of this study was to determine the impact of the pandemic on OCD screening and symptoms. New OCD symptoms were reported in a high proportion of the participants. The results of this study can provide guidance for psychiatrists and psychologists in the clinical approach and management of patients with OCD. Further focused research on the factors affecting the emergence or severity of OCD symptoms needs to be conducted in the future.
Language	English
Publishing date	2021-11-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.20021
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Article ; Online: Prevalence of influenza at Hajj: is it correlated with vaccine uptake?

Alfelali, Mohammad / Rashid, Harunor

Infectious disorders drug targets

2015 Volume 14, Issue 3, Page(s) 213–218

Abstract: Travellers attending mass gathering events like Hajj are at high risk of acquisition of respiratory viral infection, especially influenza. Following the official recommendation from the Saudi Ministry of Health in 2005, the coverage rate of influenza ... ...

Abstract	Travellers attending mass gathering events like Hajj are at high risk of acquisition of respiratory viral infection, especially influenza. Following the official recommendation from the Saudi Ministry of Health in 2005, the coverage rate of influenza vaccine rose to 100% by the year 2009, and thereafter remained above 80% in pilgrims from resource-rich countries. In a meta-analysis of observational studies, influenza vaccine was found to be significantly effective against laboratory-confirmed influenza; therefore, it is interesting to determine whether there has been any change in the prevalence of influenza. Over the last few decades a score of studies have been undertaken to establish the prevalence of influenza among Hajj pilgrims. The studies varied greatly in their designs; most notably, two separate endpoints were used: 'point prevalence' and 'attack rate'. The attack rate of influenza among Hajj pilgrims has remained stable between 4% and 15%, as did its point prevalence between 1.3% and 10%. However, the prevalence of influenza-like illness (ILI) varied widely between 8% and 63%, depending on how ILI was defined. It is therefore sensible to assume that the prevalence of influenza at Hajj has not declined considerably, and vaccine and other preventive measures may have contributed to keep the epidemiology stable. More studies are needed to understand the epidemiology of influenza at Hajj, particularly by assessing the efficacy of influenza vaccine against laboratory-proven influenza in pilgrims.
MeSH term(s)	Humans ; Incidence ; Influenza Vaccines ; Influenza, Human/epidemiology ; Influenza, Human/prevention & control ; Islam ; Prevalence ; Saudi Arabia/epidemiology ; Travel
Chemical Substances	Influenza Vaccines
Language	English
Publishing date	2015-03-24
Publishing country	United Arab Emirates
Document type	Journal Article
ZDB-ID	2234298-9
ISSN	2212-3989 ; 1871-5265
ISSN (online)	2212-3989
ISSN	1871-5265
DOI	10.2174/1871526515999150320160055
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Zs.A 5598: Show issues

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Article: Evaluation of the Most Visible Symptoms Associated with COVID-19 Vaccines Among the Residents of Makkah, Saudi Arabia: An Observational, Cross-Sectional Study.

Qashqari, Fadi S / Alfelali, Mohammad / Barasheed, Osamah / Almaimani, Ruba / Alghamdi, Anas / Alharbi, Sarah S / Balahmar, Eman / S Alhothali, Ammar / Alsharif, Rahaf Hashim / Jalal, Naif A / Makhdoom, Hatim

Infection and drug resistance

2023 Volume 16, Page(s) 5107–5119

Abstract: Background: This research evaluated the most visible symptoms associated with coronavirus (COVID-19) vaccines among residents in Makkah of Saudi Arabia.: Methods: A cross-sectional study was conducted in 2021 among a representative sample of ... ...

Abstract	Background: This research evaluated the most visible symptoms associated with coronavirus (COVID-19) vaccines among residents in Makkah of Saudi Arabia. Methods: A cross-sectional study was conducted in 2021 among a representative sample of residents receiving COVID-19 vaccination at King Abdullah Medical City, ‏Al Ukayshiyyah, and Umm Al-Qura University vaccination centers. A total of 805 participants selected by a census sampling method were included. Data regarding characteristics, medical history, and post-vaccination symptoms were obtained with an interview-based questionnaire. Results: The participants' mean age was 25.20 ± 15.5 years. Of them, 61.7% and 38.3% received one and two doses of the COVID-19 vaccine, respectively. 2.2% have an allergic reaction to the COVID-19 vaccine. 25.3% were infected with COVID-19, 23% were infected before the first dose, and only 1.6% were infected after the first dose. Significant statistical associations were found between males and females in smoking status, age, body mass index, history of diabetes mellitus, and types of COVID-19 vaccines (P-value < 0.05). After adjustment for confounding variables, male participants had lower odds of having swelling, redness, or pain at the injection site, muscle or joint pain, headache, dizziness, and nausea compared to female participants [OR = 0.596, 95% CI = (0.388-0.916)], [OR = 0.272, 95% CI = (0.149-0.495)], [OR = 0.529, 95% CI = (0.338-0.828)], [OR = 0.263, 95% CI = (0.125-0.554)], and [OR = 0.145, 95% CI = (0.31-0.679), P < 0.05 for all], respectively. Conclusion: The female participants may have a higher risk of post-COVID-19 vaccination symptoms than males among Makkah residents of Saudi Arabia.
Language	English
Publishing date	2023-08-08
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2494856-1
ISSN	1178-6973
ISSN	1178-6973
DOI	10.2147/IDR.S409200
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Article ; Online: Infectious causes of sudden infant death syndrome.

Alfelali, Mohammad / Khandaker, Gulam

Paediatric respiratory reviews

2014 Volume 15, Issue 4, Page(s) 307–311

Abstract: Investigators have long suspected the role of infection in sudden infant death syndrome (SIDS). Evidence of infectious associations with SIDS is accentuated through the presence of markers of infection and inflammation on autopsy of SIDS infants and ... ...

Abstract	Investigators have long suspected the role of infection in sudden infant death syndrome (SIDS). Evidence of infectious associations with SIDS is accentuated through the presence of markers of infection and inflammation on autopsy of SIDS infants and isolates of some bacteria and viruses. Several observational studies have looked into the relation between seasonality and incidence of SIDS, which often showed a winter peak. These all may suggest an infectious aetiology of SIDS. In this review we have summarised the current literature on infectious aetiologies of SIDS by looking at viral, bacterial, genetic and environmental factors which are believed to be associated with SIDS.
MeSH term(s)	Humans ; Infant ; Infant, Newborn ; Infection/complications ; Risk Factors ; Sudden Infant Death/etiology
Language	English
Publishing date	2014-12
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2147664-0
ISSN	1526-0550 ; 1526-0542
ISSN (online)	1526-0550
ISSN	1526-0542
DOI	10.1016/j.prrv.2014.09.004
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Zs.A 5919: Show issues

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Article ; Online: Hand Hygiene Knowledge, Perception, and Practices among Domestic Visitors to the Prophet's Mosque in Al Madinah City Amid the COVID-19 Pandemic: A Cross-Sectional Study.

Mahdi, Hashim A / Assaggaf, Hamza M / Alfelali, Mohammad / Ahmed, Omar B / Alsafi, Radi / Shaban, Ramon Z / Booy, Robert / Rashid, Harunor

International journal of environmental research and public health

2021 Volume 18, Issue 2

Abstract: This study aimed to assess hand hygiene knowledge, perception, and practices of visitors to the Prophet's Mosque in Al Madinah City, Saudi Arabia. Using a self-administered electronic questionnaire, a cross-sectional survey was conducted among domestic ... ...

Abstract	This study aimed to assess hand hygiene knowledge, perception, and practices of visitors to the Prophet's Mosque in Al Madinah City, Saudi Arabia. Using a self-administered electronic questionnaire, a cross-sectional survey was conducted among domestic residents, who visited the mosque between 31 July and 3 August 2020. Participants' demographic data, hand hygiene knowledge, perception, and practices were collected. Four hundred participants aged 18-65 (median 36) years completed the survey, of which 215 (53.8%) were female. The visitors' mean knowledge score about hand hygiene was 6.4 (± standard deviation (SD) 1.35) of total 12. Most participants (392, 98%) were aware of the role of hand hygiene in preventing Coronavirus Disease 2019 (COVID-19); nevertheless, 384 (96%) said hand hygiene lowers body immunity and 316 (79%) thought <60% alcohol is sufficient for hand disinfection. Males had a higher knowledge score than females (6.46 (±1.41) vs. 6.14 (±1.27),
MeSH term(s)	Adolescent ; Adult ; Aged ; COVID-19/prevention & control ; Cross-Sectional Studies ; Female ; Hand Disinfection ; Hand Hygiene ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Middle Aged ; Pandemics ; Saudi Arabia ; Surveys and Questionnaires ; Young Adult
Language	English
Publishing date	2021-01-14
Publishing country	Switzerland
Document type	Journal Article
ISSN	1660-4601
ISSN (online)	1660-4601
DOI	10.3390/ijerph18020673
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Article ; Online: Mismatching between circulating strains and vaccine strains of influenza: Effect on Hajj pilgrims from both hemispheres.

Alfelali, Mohammad / Khandaker, Gulam / Booy, Robert / Rashid, Harunor

Human vaccines & immunotherapeutics

2016 Volume 12, Issue 3, Page(s) 709–715

Abstract: The trivalent seasonal influenza vaccine is expected to provide optimum protection if the vaccine strains match the circulating strains. The effect of worldwide mismatch between the vaccine strains and extant strains on travelers attending Hajj ... ...

Abstract	The trivalent seasonal influenza vaccine is expected to provide optimum protection if the vaccine strains match the circulating strains. The effect of worldwide mismatch between the vaccine strains and extant strains on travelers attending Hajj pilgrimage is not known. Annually 2-3 million Muslims coming from north and south hemispheres congregate at Hajj in Mecca, Saudi Arabia, where intense congestion amplifies the risk of respiratory infection up to eight fold. In order to estimate, to what extent mismatching increases the risk of vaccine failure in Hajj pilgrims, we have examined the global data on influenza epidemiology since 2003, in light of the available data from Hajj. These data demonstrate that globally mismatching between circulating and vaccine strains has occurred frequently over the last 12 years, and the mismatch seems to have affected the Hajj pilgrims, however, influenza virus characteristics were studied only in a limited number of Hajj seasons. When the vaccines are different, dual vaccination of travelers by vaccines for southern and northern hemispheres should be considered for Hajj pilgrims whenever logistically feasible. Consideration should also be given to the use of vaccines with broader coverage, i.e., quadrivalent, or higher immunogenicity. Continuous surveillance of influenza at Hajj is important.
MeSH term(s)	Crowding ; Humans ; Influenza Vaccines/administration & dosage ; Influenza Vaccines/immunology ; Influenza, Human/epidemiology ; Influenza, Human/prevention & control ; Religion ; Saudi Arabia ; Travel
Chemical Substances	Influenza Vaccines
Keywords	covid19
Language	English
Publishing date	2016--03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2664176-8
ISSN	2164-554X ; 2164-5515
ISSN (online)	2164-554X
ISSN	2164-5515
DOI	10.1080/21645515.2015.1085144
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Zs.A 6967: Show issues

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Article ; Online: Low Prevalence of Syndromic Respiratory Tract Infections among Returning Hajj Pilgrims Amidst the COVID-19 Pandemic: A Post-Hajj Survey.

Mahdi, Hashim A / Qashqari, Fadi S / Hariri, Sumyya H / Bamerdah, Shahad / Altayyar, Shahad A / Almalki, Hazim M / Alwadani, Fayez A / Alabbasi, Renan A / Alqahtani, Mohammed H / Alfelali, Mohammad / Shaban, Ramon Z / Booy, Robert / Rashid, Harunor

Tropical medicine and infectious disease

2022 Volume 7, Issue 8

Abstract: This study estimates the point prevalence of symptomatic respiratory tract infections (RTIs) among returned Hajj pilgrims and their contacts in 2021. Using the computer-assisted telephone interview (CATI) technique, domestic pilgrims were invited to ... ...

Abstract	This study estimates the point prevalence of symptomatic respiratory tract infections (RTIs) among returned Hajj pilgrims and their contacts in 2021. Using the computer-assisted telephone interview (CATI) technique, domestic pilgrims were invited to participate in this cross-sectional survey two weeks after their home return from Hajj. Of 600 pilgrims approached, 79.3% agreed to participate and completed the survey. Syndromic definitions were used to clinically diagnose possible influenza-like illnesses (ILI) and COVID-19. Median with range was applied to summarise the continuous data, and frequencies and proportions were used to present the categorical variables. Simple logistic regression was carried out to assess the correlations of potential factors with the prevalence of RTIs. The majority of pilgrims (88.7%) reported receiving at least two doses of the COVID-19 vaccine before Hajj. Eleven (2.3%) pilgrims reported respiratory symptoms with the estimated prevalence of possible ILI being 0.2%, and of possible COVID-19 being 0.4%. Among those who were symptomatic, five (45.5%) reported that one or more of their close contacts had developed similar RTI symptoms after the pilgrims' home return. The prevalence of RTIs among pilgrims who returned home after attending the Hajj 2021 was lower compared with those reported in the pre-pandemic studies; however, the risk of spread of infection among contacts following Hajj is still a concern.
Language	English
Publishing date	2022-08-13
Publishing country	Switzerland
Document type	Journal Article
ISSN	2414-6366
ISSN (online)	2414-6366
DOI	10.3390/tropicalmed7080182
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Article ; Online: Effect of the COVID-19 Vaccine on the Menstrual Cycle among Females in Saudi Arabia.

Qashqari, Fadi S I / Dahlawi, Maryam / Assaggaf, Hamza M / Alsafi, Radi / Gari, Abdulrahim / Abudawood, Abdulrahman / Al-Doboke, Amal / Alsulami, Seham / Bukhari, Rahaf / Majeed, Shaza Adnan / Salih, Elaf Abdullah / Alfelali, Mohammad / Makhdoom, Hatim / Jalal, Naif A

Ethiopian journal of health sciences

2022 Volume 32, Issue 6, Page(s) 1083–1092

Abstract: Background: The number of reports of menstrual changes after COVID-19 vaccination in the Saudi population is still unknown. Therefore, this study aimed to assess the effect of the COVID-19 vaccine(Pfizer, AstraZeneca, and Moderna) on the menstrual cycle ...

Abstract	Background: The number of reports of menstrual changes after COVID-19 vaccination in the Saudi population is still unknown. Therefore, this study aimed to assess the effect of the COVID-19 vaccine(Pfizer, AstraZeneca, and Moderna) on the menstrual cycle among females in Saudi Arabia. Methods: This descriptive cross-sectional study was conducted in Saudi Arabia at Umm Al-Qura University (UQU) from August 2021 to February 2022. Data was collected through a previously validated online questionnaire. Results: A total of 2338 participants who received the first dose of the COVID-19 vaccine participated in this study; 1606 (68.7%) of them received the second dose in addition to the first. The mean age of the study participants was 35.4±9.5 years. No significant associations were found between the type of COVID-19 vaccine and the impact on the menstrual cycle, either for the first or second dose (P-values > 0.05). A significant association was found only between the first dose vaccination day and the impact on the menstrual cycle in the second question of "After receiving the COVID-19 vaccine, your next period was" (P-value ≤ 0.05). Significant associations were found between the second dose vaccination day and the impact on the menstrual cycle in the first and second questions of "After receiving the COVID-19 vaccine, your next period was", and "After receiving the first dose, your next period was," respectively (P-values ≤ 0.05). Conclusion: The study found a potential association between the COVID-19 vaccine and menstrual cycle irregularities, which could impact females' quality of life.
MeSH term(s)	Female ; Humans ; Adult ; COVID-19 Vaccines ; Cross-Sectional Studies ; Quality of Life ; COVID-19/epidemiology ; COVID-19/prevention & control ; Menstrual Cycle
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2022-12-02
Publishing country	Ethiopia
Document type	Journal Article
ZDB-ID	2705970-4
ISSN	2413-7170 ; 2413-7170
ISSN (online)	2413-7170
ISSN	2413-7170
DOI	10.4314/ejhs.v32i6.4
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