Management of hospitalized drug sensitive pulmonary tuberculosis patients during the Hajj mass gathering: A cross sectional study

Badriah Alotaibi; Kingsley Bieh; Yara Yassin; Abdulaziz Mushi; Fuad Maashi; Amnah Awam; Gamal Mohamed; Amir Hassan; Saber Yezli

doi:10.1016/j.tmaid.2019.07.007

Management of hospitalized drug sensitive pulmonary tuberculosis patients during the Hajj mass gathering: A cross sectional study

Travel Med Infect Dis. 2019 Nov-Dec:32:101451. doi: 10.1016/j.tmaid.2019.07.007. Epub 2019 Jul 13.

Authors

Badriah Alotaibi¹, Kingsley Bieh², Yara Yassin², Abdulaziz Mushi², Fuad Maashi², Amnah Awam², Gamal Mohamed³, Amir Hassan³, Saber Yezli²

Affiliations

¹ The Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia. Electronic address: bmalotaibi@moh.gov.sa.
² The Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia.
³ Liverpool School of Tropical Medicine, Liverpool, United Kingdom.

Abstract

Background: To document the management of drug-sensitive TB patients during the Hajj and assess compliance with the Saudi TB management guidelines.

Method: The study was conducted in hospitals in Makkah during the 2016 and 2017 Hajj seasons. Structured questionnaire was used to collect data on relevant indices on TB management and a scoring system was developed to assess compliance with guidelines.

Results: Data was collected from 31 TB cases, 65.4% (17/26) were Saudi residents. Sputum culture was the only diagnostic test applied in 67.7% (21/31) of patients. Most (96.8%, 30/31) confirmed TB cases were isolated, but only 12.9% (4/28) were tested for HIV and merely 37% (10/27) received the recommended four 1st-line anti-TB drugs. Guideline compliance scores were highest for infection prevention and control and surveillance (9.6/10) and identifying TB suspects (7.2/10). The least scores were obtained for treating TB (5.0/10) and diagnosing TB (3.0/10).

Conclusions: Healthcare providers training and supervision are paramount to improve their knowledge and skill and ensure their compliance with existing TB management guidelines. However, there may be a need for the introduction of an international policy/guideline for TB control and management during mass gatherings such as the Hajj to guide providers' choices and facilitate monitoring.

Keywords: Global health; Hajj; Mass gathering; TB management guidelines; Tuberculosis.