Hand Hygiene Knowledge and Practices among Domestic Hajj Pilgrims: Implications for Future Mass Gatherings Amidst COVID-19

Hashim Mahdi; Amani Alqahtani; Osamah Barasheed; Amjad Alemam; Mohammed Alhakami; Ibrahim Gadah; Hadeel Alkediwi; Khadijah Alzahrani; Lujain Fatani; Lamis Dahlawi; Saeed Alsharif; Ramon Shaban; Robert Booy; Harunor Rashid

doi:10.3390/tropicalmed5040160

Hand Hygiene Knowledge and Practices among Domestic Hajj Pilgrims: Implications for Future Mass Gatherings Amidst COVID-19

Trop Med Infect Dis. 2020 Oct 16;5(4):160. doi: 10.3390/tropicalmed5040160.

Authors

Hashim Mahdi^{1

2

3}, Amani Alqahtani⁴, Osamah Barasheed⁵, Amjad Alemam⁶, Mohammed Alhakami⁷, Ibrahim Gadah⁸, Hadeel Alkediwi⁹, Khadijah Alzahrani⁹, Lujain Fatani¹⁰, Lamis Dahlawi¹¹, Saeed Alsharif¹², Ramon Shaban^{13

14}, Robert Booy^{1

2}, Harunor Rashid^{1

2}

Affiliations

¹ National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia.
² Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia.
³ College of Health Sciences, Saudi Electronic University, Jeddah 23442, Saudi Arabia.
⁴ Saudi Food and Drug Authority (SFDA), Riyadh 13312, Saudi Arabia.
⁵ The Executive Administration of Research and Innovation, King Abdullah Medical City in Holy Capital (KAMC-HC), Makkah 24246, Saudi Arabia.
⁶ Faculty of Dentistry, Umm Al-Qura University, Makkah 24381, Saudi Arabia.
⁷ College of Medicine, King Saud Bin Abdulaziz University for Health Science, Jeddah 22384, Saudi Arabia.
⁸ College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Science, Jeddah 22384, Saudi Arabia.
⁹ College of Pharmacy, Umm Al-Qura University, Makkah 24381, Saudi Arabia.
¹⁰ College of Nursing, Umm Al-Qura University, Makkah 24381, Saudi Arabia.
¹¹ Ghaya Community Pharmacy, Makkah 24234, Saudi Arabia.
¹² Command and Control Centre of Infectious Diseases of Public Health Department of Ministry of Health, Taif 26521, Saudi Arabia.
¹³ Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery & Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, NSW 2006, Australia.
¹⁴ Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and Western Sydney Local Health District, Westmead, NSW 2151, Australia.

Abstract

This study examined Hajj pilgrims' knowledge and reported practice of hand hygiene. In Hajj 2019, a cross-sectional survey was undertaken in Mina, Makkah, Saudi Arabia, of domestic Saudi pilgrims aged ≥18 years by using a self-administered Arabic questionnaire that captured data on pilgrims' socio-demographics, hand hygiene knowledge, and reported practices of hand cleaning following certain actions. A total of 348 respondents aged 18 to 63 (median 32) years completed the survey, of whom 200 (57.5%) were female. The mean (±standard deviation (SD)) hand hygiene knowledge score was 6.7 (±SD 1.9). Two hundred and seventy one (77.9%) and 286 (82.2%) of respondents correctly identified that hand hygiene can prevent respiratory and gastrointestinal infections respectively, but 146 (42%) were not aware that it prevents hand-foot-mouth disease. Eighty-eight (25.3%) respondents erroneously reported that hand hygiene prevents HIV. Washing hands with water and soap was the most preferred method practiced before a meal (67.5% (235/348)), after a meal (80.2% (279/348)), after toilet action (81.6% (284/348)), when hands were visibly soiled (86.2% (300/348)), and after waste disposal (61.5% (214/348)). Hajj pilgrims demonstrated a good knowledge and practice of hand hygiene, but there are gaps that are vital to control outbreaks such as COVID-19.

Keywords: COVID-19; Hajj; hand hygiene; infection prevention and control; infectious disease; mass gathering.