Tracking Australian Hajj Pilgrims’ Health Behavior before, during and after Hajj, and the Effective Use of Preventive Measures in Reducing Hajj-Related Illness: A Cohort Study

This study assessed Australian Hajj pilgrims’ knowledge, attitude and practices throughout their Hajj journey to understand their health behaviors, use of preventative measures and development of illness symptoms. A prospective cohort study with data collection at three phases (before, during and after Hajj) was conducted among Australian pilgrims between August and December 2015. Baseline data were collected from 421 pilgrims before Hajj, with 391 providing follow-up data during Hajj and 300 after their home return. Most participants (78% [329/421]) received one or more recommended vaccines; travel agents’ advice was the main factor affecting vaccination uptake. Most participants (69% [270/391]) practiced hand hygiene with soap and sanitizers frequently, followed by disposable handkerchief use (36% [139/391]) and washing hands with water only (28% [111/391]). During Hajj 74% (288/391) of participants reported one or more illness symptoms, 86% (248/288) of these symptoms were respiratory. Cough was less often reported among pilgrims who received vaccinations, cleaned their hands with soap or alcoholic hand rubs, while a runny nose was less common among those who frequently washed their hands with plain water but was more common among those who used facemasks. This study reveals that most Australian Hajj pilgrims complied with key preventative measures, and that tour group operators’ advice played an important role in compliance. Pilgrims who were vaccinated and practiced hand hygiene were less likely to report infection symptoms.

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The Impact of Receiving Pretravel Health Advice on the Prevention of Hajj-Related Illnesses Among Australian Pilgrims: Cohort Study (Preprint)

10.2196/preprints.10959 ◽

2018 ◽

Author(s):

Amani S Alqahtani ◽

Saeed A Alsharif ◽

Mohammad A Garnan ◽

Mohamed Tashani ◽

Nasser F BinDhim ◽

...

Keyword(s):

Cohort Study ◽

Health Behaviors ◽

General Practitioners ◽

Preventive Measures ◽

Disease Risk ◽

Travel Agents ◽

Travel Health ◽

Health Advice ◽

The Impact

BACKGROUND Pretravel health advice can play a crucial role in improving both travelers’ awareness about disease risk and compliance with preventive measures. General practitioners (GPs) and the internet have been reported internationally to be the main sources of health advice for travelers to non–mass gathering (MG) destinations. However, few studies have attempted to investigate the sources of health advice among travelers to MGs including the Hajj pilgrimage, and none of these studies further investigated the impact of pretravel advice on pilgrims’ health behaviors. OBJECTIVE The objective of this study was to investigate the impact of the source of pretravel health advice (from GPs and specialized Hajj travel agents) on Hajj pilgrims’ awareness of and compliance with health recommendations, and the incidence of Hajj-associated illnesses. METHODS A prospective cohort study (before and during Hajj) was conducted among Australian pilgrims aged ≥18 years in 2015. RESULTS A total of 421 pilgrims participated prior to Hajj, and 391 (93%) provided follow-up data during Hajj. All participants obtained pretravel health advice from one or more sources, with Hajj travel agents (46%) and general practitioners (GPs; 40%) the most commonly reported sources. In total, 288 (74%) participants reported Hajj-related symptoms, of which 86% (248/288) were respiratory symptoms. Participants who obtained pretravel health advice from travel agents were more likely to be aware of the official Saudi recommendations (adjusted odds ratio [aOR] 2.1, 95% CI 1.2-3.8; P=.01), receive recommended vaccines before travel (aOR 2.4, 95% CI 1.4-3.9; P=.01), use hand sanitizers including soap (aOR 2.5, 95% CI 1.1-6.1; P=.03), and wash their hands after touching an ill person during Hajj (aOR 2.9, 95% CI 1.1-7.1; P=.01), compared to those who sought advice from GPs. However, neither advice from travel agents nor GPs was associated with a lower incidence of Hajj-related illnesses. CONCLUSIONS Advice from travel agents appeared to be accessed by more travelers than that from GPs, and was associated with an increased likelihood of positive travel health behaviors.

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The Impact of Receiving Pretravel Health Advice on the Prevention of Hajj-Related Illnesses Among Australian Pilgrims: Cohort Study

JMIR Public Health and Surveillance ◽

10.2196/10959 ◽

2020 ◽

Vol 6 (3) ◽

pp. e10959

Author(s):

Amani S Alqahtani ◽

Saeed A Alsharif ◽

Mohammad A Garnan ◽

Mohamed Tashani ◽

Nasser F BinDhim ◽

...

Keyword(s):

Cohort Study ◽

Health Behaviors ◽

General Practitioners ◽

Preventive Measures ◽

Disease Risk ◽

Travel Agents ◽

Travel Health ◽

Health Advice ◽

The Impact

Background Pretravel health advice can play a crucial role in improving both travelers’ awareness about disease risk and compliance with preventive measures. General practitioners (GPs) and the internet have been reported internationally to be the main sources of health advice for travelers to non–mass gathering (MG) destinations. However, few studies have attempted to investigate the sources of health advice among travelers to MGs including the Hajj pilgrimage, and none of these studies further investigated the impact of pretravel advice on pilgrims’ health behaviors. Objective The objective of this study was to investigate the impact of the source of pretravel health advice (from GPs and specialized Hajj travel agents) on Hajj pilgrims’ awareness of and compliance with health recommendations, and the incidence of Hajj-associated illnesses. Methods A prospective cohort study (before and during Hajj) was conducted among Australian pilgrims aged ≥18 years in 2015. Results A total of 421 pilgrims participated prior to Hajj, and 391 (93%) provided follow-up data during Hajj. All participants obtained pretravel health advice from one or more sources, with Hajj travel agents (46%) and general practitioners (GPs; 40%) the most commonly reported sources. In total, 288 (74%) participants reported Hajj-related symptoms, of which 86% (248/288) were respiratory symptoms. Participants who obtained pretravel health advice from travel agents were more likely to be aware of the official Saudi recommendations (adjusted odds ratio [aOR] 2.1, 95% CI 1.2-3.8; P=.01), receive recommended vaccines before travel (aOR 2.4, 95% CI 1.4-3.9; P=.01), use hand sanitizers including soap (aOR 2.5, 95% CI 1.1-6.1; P=.03), and wash their hands after touching an ill person during Hajj (aOR 2.9, 95% CI 1.1-7.1; P=.01), compared to those who sought advice from GPs. However, neither advice from travel agents nor GPs was associated with a lower incidence of Hajj-related illnesses. Conclusions Advice from travel agents appeared to be accessed by more travelers than that from GPs, and was associated with an increased likelihood of positive travel health behaviors.

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Preliminary Evidence of Children’s Weight Gain From 5 Months of Home Quarantine During the COVID-19 Pandemic

American Journal of Lifestyle Medicine ◽

10.1177/15598276211006657 ◽

2021 ◽

pp. 155982762110066

Author(s):

Keith Brazendale ◽

Jeanette Garcia ◽

Ethan T. Hunt ◽

Michael Blankenship ◽

Daniel Eisenstein ◽

...

Keyword(s):

Weight Status ◽

Preventive Measures ◽

Preliminary Evidence ◽

Normal Weight ◽

Preventative Measures ◽

Significant Difference ◽

The Impact ◽

Weight Data ◽

Overweight Or Obesity

Purpose. Preventive measures to curtail the spread of the Coronavirus Disease 2019 (COVID-19)—such as home quarantine, closure of schools/programs—are necessary, yet the impact of these restrictions on children’s weight status is unknown. The purpose of this case report was to investigate changes in children’s body mass index (BMI) and zBMI during COVID-19 quarantine. Methods. Children had their heights and weights recorded early March 2020 (pre-COVID-19) and 5 months later (early August 2020). Paired sample t tests examined changes in BMI and zBMI from baseline to follow-up. Results. Twenty-nine children (62% female; mean age 9.3 years; 27.5% with overweight or obesity) provided height and weight data at both time points. There was a significant difference in pre-COVID-19 BMI (mean [M] = 20.1, standard deviation [SD] = 6.0) and follow-up BMI (M = 20.7, SD = 6.4); t(57) = −3.8, P < .001, and pre-COVID-19 zBMI (M = 0.8, SD = 0.9) and follow-up zBMI (M = 0.9, SD = 0.9); t(57) = -3.1, P = .003. Five of the 29 children moved from normal weight to overweight (n = 4) or obese (n = 1) during 5 months of quarantine. Conclusions. Preliminary evidence shows most children increased their BMI and zBMI values from pre-COVID-19 assessment to the follow-up assessment, 5 months later. These initial findings identify potential incidental negative health consequences of children as a result of COVID-19 preventative measures such as home quarantine.

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Changes in compliance to personal preventive measures and mental health status among Chinese factory workers during the COVID-19 pandemic: observational prospective cohort study (Preprint)

10.2196/preprints.29828 ◽

2021 ◽

Author(s):

Jinqiu Yuan ◽

Bolin Cao ◽

Changhua Zhang ◽

Meiqi Xin ◽

Yuan Fang ◽

...

Keyword(s):

Mental Health ◽

Cohort Study ◽

Preventive Measures ◽

Significant Decline ◽

Factory Workers ◽

Good Compliance ◽

Observational Prospective Cohort Study ◽

Work Resumption ◽

Chinese Factory Workers

BACKGROUND Factory workers who resumed work during the pandemic is a sub-population of higher risk of COVID-19 infection than that of the general population. Maintaining good compliance with personal preventive measures during the pandemic plays an important role in achieving the balance between COVID-19 control and work resumption. OBJECTIVE This observational prospective cohort study investigated the changes in compliance to personal preventive measures (i.e., facemask wearing, hand hygiene, household disinfection, avoiding social/meal gathering and avoiding crowed places), depressive symptoms and sleep quality among factory workers who resumed work within a 3-month follow-up period. METHODS Inclusion criteria for this cohort study were the following: 1) full-time employees aged ≥18 years who had resumed work, and 2) willing to leave contacts (mobile or social media account) to complete the follow-up survey. A stratified two-stage cluster sampling design was used. We randomly selected 12 factories in Shenzhen. And all eligible employees in these factories were invite to complete two web-based surveys three months apart. A total of 1311 Chinese adult factory workers completed the baseline survey in March 2020, and 663 (50.6%) completed the follow-up survey three months later. RESULTS Significant decline was observed in consistent facemask wearing in workplace (from 98.0% at baseline to 90.3% at Month 3, P<.001) and in other public spaces (from 97.1% at baseline to 94.4% at Month 3, P=.02), sanitizing hands (from 70.9% at baseline to 48.0% at Month 3, P<.001), household disinfection (from 47.7% at baseline to 37.9% at Month 3, P<.001) and moderate-to-severe depression (from 6.0% at baseline to 0.6% at Month 3, P<.001) over the follow-up period. Significant improvement in avoiding crowed places (from 69.8% at baseline to 77.4% at Month 3, P=.002) and sleep quality (proportion of participants reporting poor sleeping quality dropped from 3.9% at baseline to 1.2% at Month 3, P=.002) was also observed. CONCLUSIONS There were significant decline in some personal preventive measures and significant improvement in mental health status among a cohort of Chinese factory workers who resumed work during COVID-19. Health promotion are needed to maintain good compliance to personal preventive measures. Psychological support for workers during work resumption is necessary.

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SARS-CoV-2 serological findings and exposure risk among employees in school and retail after first and second wave COVID-19 pandemic in Oslo, Norway: a cohort study

10.1101/2021.04.27.21256214 ◽

2021 ◽

Author(s):

Anne-Mari Gjestvang Moe ◽

Mina Eriksen ◽

Tiril Schjølberg ◽

Fred Haugen

Keyword(s):

Cohort Study ◽

Preventive Measures ◽

School Closure ◽

Serum Samples ◽

Positive Serology ◽

School Employees ◽

Serological Data ◽

Second Wave ◽

Virus Testing

Background: During initial phases of the coronavirus disease 2019 (COVID-19) pandemic, many workplaces were affected by closures and various preventive measures intended to limit infections. Here, we characterize and compare in an ambidirectional cohort study SARS-CoV-2 serology among Norwegian school employees and retail employees at baseline following the first epidemiological wave, and at follow-up after a second wave. Methods: We enrolled a cohort of 238 school and retail employees after the first COVID-19 pandemic wave. Self-reported exposure history and serum samples were collected at 10 schools and 15 retail stores in Oslo, Norway, sampled at two time-points, baseline (May 18. to July 2. 2020) and follow-up (Jan 7. to Mar 17. 2021). SARS-CoV-2 antibodies targeting both spike and nucleocapsid were characterized by multiplex microsphere-based serological methods. Results: At baseline, 6 enrolled workers presented with positive SARS-CoV-2 serology (3%; CI [1, 6]; P=0.019), which was significantly higher than the expected 1% prevalence in the general Oslo-population at this time-point. Five of the positive cases were retail employees. However, school and retail groups distributions at baseline were not significantly different as the number of seropositive observations were limited. Due to a school closure effectuated during the first wave, half of the school employees reported ≤2 days of physical workplace presence per week, while 65% of the retail employees reported ≥5 days per week. Eight months later, after passing a second epidemiological wave, school and retail groups presented 11 new seropositive cases altogether, but there was still no significant differences between the groups. Physical attendance at the workplace was similar between the groups during the second wave, but some preventive measures against viral transmission at workplaces were different. Self-reported virus diagnostics (RNA) for the same period were compared to the serological data obtained in this study, showing that all but one positive SARS-CoV-2 serological findings arising between baseline and follow-up had been diagnosed with virus testing. Conclusions: After the first wave, distribution of SARS-CoV-2 positive serology was slightly higher than expected in a cohort of school and retail employees. Distribution of infection was not significantly different between the groups at baseline nor at follow-up, even though physical workplace attendance had been different. Nearly all new seropositive cases discovered in this study between baseline and follow-up, had already been diagnosed due to widespread virus testing during the second wave. This highlights the importance of extensive viral testing among workers.

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