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Change in carriage rate of meningococcal meningitis among Hajjis from low and high endemic countries.


Despite a lot of studies, the pattern of meningococcal carriage in sub-Saharan Africa and Hajj is still unclear. This study was conducted to measure the meningococcal meningitis carriage rate among hajjis, determine its change during Hajj and study some determinants related to this change.


A longitudinal descriptive study was conducted at King Abdul Aziz International Airport. Single stage stratified random cluster sampling technique, with probability proportionate to size used to determine sample size with stratification based on the basis of endemicity data. The data was collected using self-administered questionnaires and collecting a throat swab from all participating hajjis.


A total of 829 hajjis were recruited at arrival and 886 hajjis were recruited at departure. Meningococcal carriage rate for allhajjis was 5.7% at arrival and 6.3% at departure. N. meningitides carriage rate was slightly higher among arrived than departed African and South Asian hajjis and vice versa for Southeast Asian. Of all socio-demographic characteristics only the sex was related significantly with the N. meningitides carriage during the arrival (P value = 0.0196). Health status, vaccination status or health related experiences during stay at Makkah were not related significantly to the change in N. meningitides carriage rate during arrival and departure of international hajjis. Hajjis who received ciprofloxacin tablet at arrival had lower carriage rate than those who did not (P=0.206).


Meningococcal carriage rate among hajjis was modestly higher at departure as compared to arrival for Hajj, while it is much lower as compared to previous studies; Carriage was higher among South Asians and Africans as compared to Southeast Asians on arrival; and after Hajj the situation reversed. No statistically significant association was observed between demographic characteristics, Hajj health experiences and meningococcal meningitis vaccination with carriage rate.