Introduction
The annual Islamic pilgrimage (Hajj) to Makkah, the largest annual gathering of its kind in the world and while performing hajj, hajjis face different risk factors related to the environment, their behaviors and their health conditions resulting in a variety of diseases presented at the health centers and hospitals of the sacred places. The objectives of this study were to determine the pattern of diseases among hajjis seeking medical services in the primary health care centers in Mina in Hajj season 1429 (2008) and to provide evidence-based information for optimal allocation of health resources in these centers during Hajj seasons.
Methodology
A descriptive study based on medical records of a systematic random sample of 5000 patients from 13 out of 25 randomly selected PHCCs in Mina area during a five-day period from eighth of Dhu Alhijjah, 1429H (2008). The proportion of the forms assigned to each PHCC was based on Mina PHCCs statistics of Hajj season 1428 H, and weights were calculated to adjust for the differences between 1428 H and 1429 H.
Results
There was variable workload between the primary health care centers in Mina. Some PHCCs had a heavy daily workload (PHCC Muzdalifa-1) while others did not (PHCC 8) and in all the centers, the number of patients was at the minimal level on day 9 and reached its peak on day 11. The distribution of the patients along the working hours was mostly during the morning shift (58.2%) and of bimodal pattern (at 8:00 am and at 8:00 pm). Some areas in Mina (the northwest and the south near Muzdalifa) were not covered by any center within a distance of more than 500 meters, such as the camps. The majority of patients were males (70.7%), in the age group 45-64 years (42.8%), hajjis (94.9%) and from Arab countries (44.4%) other than Saudis (who constituted 8.3% of patients) and from South Asian countries (27.0%) while Southeast Asian were the least to visit the centers (0.8%). The proportional distribution of nationalities in the centers varied according to their proximity or location in the vicinity of camps assigned for each group of nationalities. The great majority of the patients (79.8%) were suffering from one disease, while only 20.2% had multiple diseases with an average number of diseases per patient of 1.2:1 (±0.44). The most frequently occurring diseases were those pertaining to respiratory system (60.8%), followed by musculoskeletal diseases (17.6%), skin diseases (15.0%) and diseases related to gastrointestinal system (13.1%). Among the chronic diseases, diabetes, asthma and hypertension constituted less than 3% each. Apart from respiratory diseases which were the main workload during the study period, most of patients attended on day 8, 11 and 12 had musculoskeletal diseases and those attended on day 9 had gastrointestinal diseases while those attended on day 10 had skin diseases. Among all nationalities, respiratory diseases were the commonest (59.3%) while other diseases common among specific nationalities included gastrointestinal diseases among Saudis (19.3%), skin diseases among other Arabs (21.5%) and those from Turkey and developed countries (13.9%), musculoskeletal diseases among Non-Arab Africans (28.9%), South Asians (21.6), Iranians (19.6%) and Southeast Asians (6.0%). Among all patients, 19.0% of them received mono-therapy and 80.2% received multiple therapies an average number of drugs per patient of 2.35 (± 0.97). The most frequently prescribed groups of drugs were the analgesics and antipyretics (79.4%) followed by antibiotics (53.9%) and cough syrups (37.1%).
Conclusion
During the Hajj period, most patients visited Mina PHCCs during the morning shift and were within the age group of 45-64 years with a predominance of male gender. Some centers had a higher workload depending on the day of visit, the nearby nationalities and its presence in the traffic pathway of hajjis performing their rituals. Among all patients, respiratory diseases were the commonest complaints, followed by diseases of musculoskeletal system, skin and gastrointestinal system. The most prescribed medications were analgesics, antibiotics and cough syrup.