Religious Mass Gathering (Hajj) and Antimicrobial Resistance: From Challenges to Opportunities
Hajj pilgrimage, a form of mass gathering (MG), may facilitate rapid multinational spread of antimicrobial resistance (AMR). Hajj has traditionally been linked as an event, which favors the dissemination of various infectious outbreaks. Despite best effor
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Introduction Hajj as a Mass Gathering and the Link to Infectious Diseases Predominant Disease at Hajj: Respiratory Tract Infections (RTI) Predominant Disease at Hajj: Gastrointestinal Diseases AMR Risk Factors at Hajj
S. H. Ebrahim Center for Global Health, CDC, Atlanta, USA e-mail: [email protected] R. F. Kattan Department of Pediatrics, King Abdullah Specialist Children’s Hospital and King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia e-mail: [email protected] S. Elambilakkat Department of Bio-technology, Hindustan Institute of Technology & Science, Chennai, India e-mail: [email protected] A. A. Khan Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia Global Center for Mass Gathering Medicine, Ministry of Health, Riyadh, Saudi Arabia e-mail: [email protected] Z. A. Memish (*) Research and Innovation Center, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia Ministry of Health, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA e-mail: [email protected] Celia M. Manaia, Erica Donner, Ivone Vaz-Moreira, and Peiying Hong (eds.), Antibiotic Resistance in the Environment: A Worldwide Overview, Hdb Env Chem, DOI 10.1007/698_2020_590, © Springer Nature Switzerland AG 2020
S. H. Ebrahim et al. 6 Studies on Hajj and AMR 7 Status of AMR in Selected Countries with Consistent Hajj Participant Numbers 8 The Five-Four-Eight-Four Approach to AMR Prevention at Mass Gatherings 9 Opportunities for AMR Surveillance at Mass Gatherings 10 Opportunities to Increase AMR Awareness Among Hajj Pilgrims 11 Conclusions References
Abstract Hajj pilgrimage, a form of mass gathering (MG), may facilitate rapid multinational spread of antimicrobial resistance (AMR). Hajj has traditionally been linked as an event, which favors the dissemination of various infectious outbreaks. Despite best effort in minimizing such outbreaks through longtime investment in education and medical care, respiratory infection and gastrointestinal diseases still see high occurrences during Hajj. Such diseases have to be treated by antibiotics, and improper use of antibiotics can result in secondary concerns such as that of AMR dissemination. In this chapter, we identify factors that promote AMR dissemination within the Hajj context. This includes socioeconomic and demographic factors of pilgrims, their general health status including vaccine coverage, high antibiotic use, and/or misuse in the home countries of those pilgrims. Using Hajj as a local example, we exemplified strategy plans to mitigate AMR transmission. First, medical services should be coupled with elements of AMR control strategies. Clinicians can be encouraged to use decision tools to rationally prescribe antibiotics. Second, vaccination requirements for Hajj participation can also help reduce the burden of relevant vaccine-preventable disease symptomatology and related antibiotic pre
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