{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T18:31:42Z","timestamp":1790015502530,"version":"4.0.1"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,1,31]],"date-time":"2021-01-31T00:00:00Z","timestamp":1612051200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The Saudi government requires that all pilgrims receive a quadrivalent meningococcal vaccine at least 10\u00a0days before the Hajj. We conducted a study to determine the uptake of meningococcal vaccine and antibiotic use. We also investigated risk factors of meningococcal carriage and carriage of <jats:italic>Neisseria meningitidis<\/jats:italic> pathogenic serogroups A, C, W and Y.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross\u2010sectional oropharyngeal carriage survey was conducted in 2973 Hajj pilgrims in September 2017. A real\u2010time polymerase chain reaction (rt\u2010PCR) assay was used to identify <jats:italic>N.\u00a0meningitidis<\/jats:italic> from the oropharyngeal swabs. A questionnaire investigated potential risk factors for carriage of <jats:italic>N.\u00a0meningitidis<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two thousand two hundred forty nine oropharyngeal swabs were obtained. The overall prevalence of carriage of <jats:italic>N.\u00a0meningitidis<\/jats:italic> was 4.6% (95% CI: 3.4%\u20136%). Carriage of pathogenic serogroups was not associated significantly with any of the meningococcal risk factors evaluated. 77% of pilgrims were vaccinated but 22.58 % said they were carrying unofficial vaccination cards.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Carriage of serogroups A, C, W and Y was not significantly associated with any of the risk factors investigated. Almost a quarter of pilgrims were unlikely to have been vaccinated, highlighting a need to strengthen compliance with the current policy of vaccination to prevent meningococcal disease outbreaks during and after the Hajj.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13546","type":"journal-article","created":{"date-parts":[[2021,1,13]],"date-time":"2021-01-13T05:05:57Z","timestamp":1610514357000},"page":"453-461","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Meningococcal carriage among Hajj pilgrims, risk factors for carriage and records of vaccination: a study of pilgrims to Mecca"],"prefix":"10.1111","volume":"26","author":[{"given":"Abrar","family":"Alasmari","sequence":"first","affiliation":[{"name":"Department of Clinical Research London School of Hygiene &amp; Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Houghton","sequence":"additional","affiliation":[{"name":"Department of Clinical Research London School of Hygiene &amp; Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Greenwood","sequence":"additional","affiliation":[{"name":"Department of Disease Control London School of Hygiene &amp; Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Heymann","sequence":"additional","affiliation":[{"name":"Chatham House Centre on Global Health Security London UK"},{"name":"Department of Infectious Disease Epidemiology London School of Hygiene &amp; Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phil","family":"Edwards","sequence":"additional","affiliation":[{"name":"Department of Population Health London School of Hygiene &amp; Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Larson","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Epidemiology London School of Hygiene &amp; Tropical Medicine London UK"},{"name":"Department of Global Health Institute for Health Metrics and Evaluation University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Assiri","sequence":"additional","affiliation":[{"name":"Preventive Health Ministry of Health Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fathia","family":"Ben\u2010Rached","sequence":"additional","affiliation":[{"name":"Biological and Environmental Sciences and Engineering Division King Abdullah University of Science and Technology (KAUST) Thuwal\u2010Jeddah Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnab","family":"Pain","sequence":"additional","affiliation":[{"name":"Biological and Environmental Sciences and Engineering Division King Abdullah University of Science and Technology (KAUST) Thuwal\u2010Jeddah Saudi Arabia"},{"name":"Global Institution for Collaborative Research and Education Research Center for Zoonosis Control Hokkaido University Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"Behrens","sequence":"additional","affiliation":[{"name":"Department of Clinical Research London School of Hygiene &amp; Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amaya","family":"Bustinduy","sequence":"additional","affiliation":[{"name":"Department of Clinical Research London School of Hygiene &amp; Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,1,31]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200105033441807"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.inf.0000147642.85129.05"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)00279-7"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2015.12.010"},{"key":"e_1_2_6_6_1","volume-title":"Mina: the city of tents origination and development","author":"Imam A","year":"2014"},{"issue":"37","key":"e_1_2_6_7_1","first-page":"20581","article-title":"Laboratory\u2010confirmed invasive meningococcal disease: effect of the Hajj vaccination policy. 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