BACKGROUNDApproximately 2 to 3 million pilgrims perform Hajj every year. Planning for health care requires knowledge of the pattern of diseases, complications, and outcome of pilgrims who require hospitalization during the Hajj period.METHODSIn a cross-sectional study we compiled data on all patients admitted to 1487 beds in four hospitals in Mena (793 beds) and three hospitals in Arafat (694 beds) from the seventh to the thirteenth day of the Hajj season of the Islamic year 1423, corresponding to 8 to 14 February 2003.RESULTSOf 808 patients hospitalized, most (79%) were older than 40 years. There was no sex preponderance. A total of 575 (71.2%) patients were admitted to medical wards, 105 (13.0%) to surgical wards, and 76 (9.4%) to intensive care units. Most patients (84.8%) had one acute medical problem. Pneumonia (19.7%), ischemic heart disease (12.3%), and trauma (9.4%) were the most common admitting diagnoses. More than one third (39%) had co-morbid conditions. A total of 644 (79.7%) patients were discharged from the hospital in stable condition to continue therapy in their residential camps, 140 (17.3%) were transferred to other hospitals in Makkah for specialized services or further care, 19 (2.3%) were discharged against medical advice, and 5 (0.7%) patients died.CONCLUSIONThis study provided information on the most common causes of hospitalization, pattern of diseases, and required medical services for pilgrims in Hajj. It is hoped that this data will be of help to health sector planners and officials to provide optimal and cost-effective health care services to pilgrims in Hajj.

BACKGROUNDApproximately 2 to 3 million pilgrims perform Hajj every year. We describe the pattern of diseases, complications, and outcome of pilgrims who required admission to intensive care units (ICUs) during the Hajj period of the Islamic year 1424 (2004).METHODSThis was a cross-sectional study of all patients admitted to 104 ICU beds in four hospitals in Mena and three hospitals in Arafat during the Hajj.RESULTSOf 140 patients admitted to ICUs, 75 (54%) patients were older than 60 years. The risk of complications and death increased with age, with the highest risk noticed among pilgrims older than 80 years. Ninety-four (67.6%) patients were men. Eighty-nine (63.6%) patients were admitted with cardiovascular diseases and 37 (26.4%) patients with infections. Myocardial infarction (25%) and pneumonia (22%) were the most common admitting diagnoses. Trauma accounted for only 6.4% (9 patients) of admissions. Sixty-three (45.0%) patients recovered and were discharged or transferred to hospital wards in stable condition, 40 (28.6%) were transferred to tertiary care centers for specialized services, 21 (15.0%) were transferred to tertiary care centers after closure of the temporary hospitals in Mena and Arafat, 15 (10.7%) patients died, and one (0.7%) patient was discharged against medical advice.CONCLUSIONThis study revealed information on the pattern of diseases and the most common causes of admission of pilgrims to ICUs and the required medical services during Hajj. It is hoped that this information will be of help to health care planners and officials to provide optimal and cost effective health care services to pilgrims in Hajj.

We assessed hospital infection control knowledge, attitude, and practice (KAP) of healthcare workers (HCWs) during the Hajj season of the Islamic y 1423 (2003). A self-administered structured questionnaire was used to collect the data. A total of 392 HCWs was studied, of whom 215 (54.8%) were nurses and 177 (45.2%) were doctors. 315 (80.4%) HCWs worked in hospitals, whereas 77 (19.6%) worked in primary healthcare centres. Of the 392 HCWs, 164 (41.8%) were from Makkah, and the remaining 228 (58.2%) were recruited from other regions in Saudi Arabia. A good proportion (81.8%) of HCWs correctly answered at least 5 of the 11 knowledge statements. However, obvious deficiency of knowledge appeared concerning other important hospital infection control measures. A smaller proportion (61.9%) of HCWs achieved a score of at least 4 out of 7 for attitude statements with unacceptable attitude for the remaining 3 areas. Response to questions concerning practice showed that nurses tended to be better than doctors (p-value=0.204), but both groups reported variable compliance to hospital infection control practices in terms of strict or near-strict adherence. In conclusion, training of HCWs is needed to improve KAP in infection control.

Tracking, analyzing, interpreting and reporting the rates and reasons for physicians declining to allow their patients to be approached for enrollment provides insights into clinicians' concerns and attitudes to trials. This information can encourage physician communication and education, and potentially enhance efficient recruitment.