Hajj in Saudi Arabia is one of the important and rare situations where millions of people accumulate in a relatively small area for a few days; these situations can increase the risk and size of food poisoning outbreaks among the consumers during hajj season. There is high number of reported outbreaks, during the period (1992-2004) and the number of reported cases of food poisoning has ranged from 44-132 in each Hajj season and diarrhea was the third most common cause for hospitalization during hajj 2002. This study was conducted to determine the behaviors related to food that put some of hajjis under high risk of food poisoning during hajj season.
Methodology
A cross sectional study conducted among Arabic and Gulf countries hajjis who come abroad, in Mina area during Hajj 1432H .Sample of this study detected according the numbers of Arab hajjis who came to hajj 1431. 606 hajjis requested to enter to this study. A sample was selected after dividing the site of hajjis into three groups and then it was divided into 116 squares according the Mina map 19 clusters selected after that and 32 hajjis from each cluster were asked to participate in this study A structured questionnaire was designed to collect the information from the participating camps. The questionnaire covered information about demographic data of hajj, source of food and water, preparation of food, keeping of food, serving of food, all practices related to food before and after preparation, consumption of food during hajj and personal hygiene which related to food and drink.
Results
A total of 608 of non-domestic Arab hajjis participated in this study, representing three geographical regions more than two third of them from North Africa, the majority of the participating hajjis were male, and their age ranged from 17 to 81 years with mean 44.8. More than two thirds of participant hajjis (69.1%) performed Hajj for the first time. 56.3% of the participating hajjis had an education level of university and above, and 8.4% were had less than elementary school. One third of the participants brought their food from street vendors whereas more than half of the participant hajjis brought their food from their camps. More than a third of the participant hajjis carried food during movement between holy places in hajj, and most of them (44.7%) held their food in plastic bags .Most of the participants mentioned they didn't use their hands or spoon to eat from a big bowl shared by several persons whereas 7.1% of them used their hands most of the times and 10% of them used a spoon most of the time. Most hajjis ate three meals or more in the last 24 hours prior to the survey (241; 48.0%), whereas the majority of hajjis drank less than five bottles per day, (around two liter) the majority of the participant hajjis used bottles and plastic bags for drinking and for preparing tea and coffee. A majority of the hajjis used a shared tanker or water cooler during hajj, others used their own cup or bottles (47.0) whereas 12.8% of them used their hands and there were 15.5% of hajjis who used any available cup or bottle. According the level of education, the use of street vendors and restaurants was lower among the higher educated hajjis and Hamala was the main source of food for higher level educated hajjis in Mina and Arafat with percentage of (75.7%& 78.4%) compared to the lower educated hajjis.
Conclusion
Most of the participants in this study used a safe source for eating and drinking during hajj season. Personal hygiene for most of the participants was acceptable and the overcrowded toilets during hajj season was responsible for the deficiencies in hygiene among others. Higher level educated hajjis and Arabian Gulf countries have lower risk behaviors compared with other factors