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Behavioral Risk Factors for Diseases during the Hajj to Makkah, 1418 H (1998).*


The aim of this study is to assess Behavioral Risk Factors for important diseases and conditions among the Hajjees to Makkah,


A Cross-sectional survey was conducted in Mina, a holy place where more than 2 million Hajjees camp for at least 3 days. A total of 1613 Hajjees (53 nationalities) were interviewed using a self-administered standard questionnaire translated into 15 languages (two-stage cluster sampling). The Main Outcome Measures were behaviors predisposing to the major Hajj-related illnesses.


Out of 1613 respondents, 71% were performing the Hajj for the first time, 15% were residents of Saudi Arabia, and 61% wore identifying wristbands. Eighty-eight percent (95% CI 87-90) had the required vaccination against meningococcal meningitis. Risky behavior for food poisoning included bringing foods from home countries (37%) and eating food from street vendors (32%). Heat stroke prevention included using umbrellas (59%). Of all the Hajjees, 3-5% moved between holy places on foot. Nineteen percent lost their way in Mina for a median of 2 hours, drank a median (interquartile range) of 2500 (1500-3750) ml of fluids, and slept for a median of 6 hours per day. After completing the Hajj rites, 56% (95% CI 54-59) had their heads shaved with razor blades and 25% (95% CI 21-29) put themselves at risk of blood-borne disease by reusing razor blades used by other Hajjees. The Hajjees also risk injuring themselves by hanging on the backs of buses (12%, 95% CI 10-13).


Data were consistent with a previous report and indicate the need for simple, innovative cross-cultural educational programs aimed at reducing Behavioral Risk Factors among religious visitors.