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European Hajj Mission acknowledged in the British Medical Journal of 9th December 2006 |
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European Hajj Mission was given thanks in an article in the British Medical Journal.
Influenza vaccine uptake among British Muslims attending Hajj, 2005 and 2006
Every year 1% of British Muslims travel to Saudi Arabia on the Hajj pilgrimage. High rates of influenza have been reported among pilgrims,1 2 and the Saudi Arabian Ministry of Health recommends that all pilgrims should receive influenza vaccination before travelling. We determined the uptake of influenza vaccination among British Hajj pilgrims who attended the British Hajj Delegation Clinic in Mecca and mobile clinics set up by us in Mina in 2005 and 2006.
In 2005, 196 pilgrims were recruited and in 2006, 146 (age range 2 to 83; 313 men); 104 were from London. Ninety two pilgrims (27%) were categorised as being at risk of influenza, one fifth (19) of them solely because of being 65 or over and the rest because of having chronic diseases regardless of age.
A total of 108 pilgrims (32%) were vaccinated, all but two by their general practitioner. Vaccine coverage among pilgrims at risk was 55% (51/92) and among those not at risk 23% (57/250) (P<0.001). Coverage among over-65s was 63% (19/30) and among under-65s regardless of underlying chronic disease 52% (32/62).
Immunisation uptake by all pilgrims in 2005 was 27% (53/196) and 38% (55/146) in 2006 (P=0.036), and the coverage among those at risk was 51% (29/57) and 63% (22/35) respectively (P=0.26). Uptake by all pilgrims who lived in London in these two years was 20% (21/104) compared with 37% (87/238) in other centres (P=0.003). Uptake by "at risk" residents of London was 38% (10/26) compared with 62% (41/66) elsewhere (P=0.04).
The rate of vaccination among Muslims at risk is worryingly lower (55%) than the nationwide uptake rate among the target population (70%),3 and even lower among the residents of London. Uptake could be improved by advertising, phone calls, patient and staff education, standing orders, targeting people with high risk behaviours at their meeting venues, and offering home visits by nurses.4 Clinics set up, in partnership with community leaders, travel agents, and imams for pilgrims planning to go on Hajj might further improve uptake.
Shuja Shafi , Harunor Rashid , Kamal Ali , Haitham El Bashir , Elizabeth Haworth , Ziad A Memish , Robert Booy
1 Department of Microbiology and HPA Collaborating Laboratory, Northwick Park Hospital, Harrow, Middlesex HA1 3UJ
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Funding: This work was supported from a Department of Health grant. We thank British Hajj Delegation team, European Hajj Mission and the GPs for help with the data collection and staff at HPA laboratory, London & Respiratory Virus Unit, Health Protection Agency, Centre for Infections, London, for performing the PCR tests. Ethical Approval Multicentre Research Ethics Committee, UK (MREC 02/2/12).
Competing interests Roche supplied free courses of Tamiflu for treatment of pilgrims with influenza infection on near-patient testing. SS served as Chair, Health and Medical Committee of the Muslim Council of Britain (until August 2006)
References
1. El Bashir H, Haworth E, Zambon M, Shafi S, Zuckerman J, Booy R. Influenza among UK pilgrims to Hajj, 2003. Emerg Infect Dis 2004;10:882-3.
2. Balkhy HH, Memish ZA, Bafaqeer S, Almuneef MA. Influenza a common viral infection among Hajj pilgrims: time for routine surveillance and vaccination. J Travel Med 2004;11:82-6.[ISI][Medline]
3. Muller D, Nguyen-Van-Tam JS, Szucs TD. Influenza vaccination coverage rates in the UK: A comparison of two monitoring methods during the 2002-2003 and 2003-2004 seasons. Public Health 2006;120:1074-80.[CrossRef][Medline]
4. Ompad DC, Galea S, Vlahov D. Distribution of influenza vaccine to high-risk groups. Epidemiol Rev 2006;28:54-70.
Related Article
Hajj and the risk of influenza
A Rashid Gatrad, Shuja Shafi, Ziad A Memish, and Aziz Sheikh
BMJ 2006 333: 1182-1183. |
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