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We assessed hospital infection control knowledge, attitude, and practice (KAP) of healthcare workers (HCWs) during the Hajj season of the Islamic y 1423 (2003). A self-administered structured questionnaire was used to collect the data. A total of 392 HCWs was studied, of whom 215 (54.8%) were nurses and 177 (45.2%) were doctors. 315 (80.4%) HCWs worked in hospitals, whereas 77 (19.6%) worked in primary healthcare centres. Of the 392 HCWs, 164 (41.8%) were from Makkah, and the remaining 228 (58.2%) were recruited from other regions in Saudi Arabia. A good proportion (81.8%) of HCWs correctly answered at least 5 of the 11 knowledge statements. However, obvious deficiency of knowledge appeared concerning other important hospital infection control measures. A smaller proportion (61.9%) of HCWs achieved a score of at least 4 out of 7 for attitude statements with unacceptable attitude for the remaining 3 areas. Response to questions concerning practice showed that nurses tended to be better than doctors (p-value=0.204), but both groups reported variable compliance to hospital infection control practices in terms of strict or near-strict adherence. In conclusion, training of HCWs is needed to improve KAP in infection control.

Approximately 2 to 3 million pilgrims perform Hajj every year. Planning for health care requires knowledge of the pattern of diseases, complications, and outcome of pilgrims who require hospitalization during the Hajj period.In a cross-sectional study we compiled data on all patients admitted to 1487 beds in four hospitals in Mena (793 beds) and three hospitals in Arafat (694 beds) from the seventh to the thirteenth day of the Hajj season of the Islamic year 1423, corresponding to 8 to 14 February 2003.Of 808 patients hospitalized, most (79%) were older than 40 years. There was no sex preponderance. A total of 575 (71.2%) patients were admitted to medical wards, 105 (13.0%) to surgical wards, and 76 (9.4%) to intensive care units. Most patients (84.8%) had one acute medical problem. Pneumonia (19.7%), ischemic heart disease (12.3%), and trauma (9.4%) were the most common admitting diagnoses. More than one third (39%) had co-morbid conditions. A total of 644 (79.7%) patients were discharged from the hospital in stable condition to continue therapy in their residential camps, 140 (17.3%) were transferred to other hospitals in Makkah for specialized services or further care, 19 (2.3%) were discharged against medical advice, and 5 (0.7%) patients died.This study provided information on the most common causes of hospitalization, pattern of diseases, and required medical services for pilgrims in Hajj. It is hoped that this data will be of help to health sector planners and officials to provide optimal and cost-effective health care services to pilgrims in Hajj.

To review the epidemiology of invasive Candida infections in a single center in Saudi Arabia over a subsequent 10-year period.This retrospective study was carried out in a single center in Saudi Arabia over a 10-year period. Records of all patients with invasive Candida infections (ICI) over the period from January 2003 to December 2012 were reviewed. Mann-Whitney U test was used for comparison of Candida albicans (C. albicans) versus non-albicans Candida species, and fluconazole resistance versus fluconazole susceptible in relation to crude mortality at 30 days and 90 days.Eight hundred positive sterile site cultures, associated with 652 ICI were identified. Median age was 52 years and 53% of patients were males. Candida albicans were the most common species (38.7%), followed by Candida tropicalis (18.9%), and Candida glabrata (C. glabrata) (16.3%). The proportion of ICI caused by C. albicans remained stable over time (p=0.07), but C. glabrata increased significantly (p0.001). The median rate of ICI per 1,000 hospital discharges per year was 1.65, with a significant trend towards higher rates over time (p=0.01). Most isolates were susceptible to fluconazole, voriconazole, and amphotericin B. Only 66.7% of Candida krusei were susceptible to caspofungin. Overall 30-day crude mortality was 40.6%. There was no significant difference in crude mortality in association with C. albicans compared with non-albicans species, nor in association with fluconazole resistance.The rate of ICI increased significantly in the proportion of ICI caused by C. glabrata. Most isolates remain susceptible to caspofungin, voriconazole, and amphotericin B. The crude mortality remains high.

We describe the third confirmed case of novel coronavirus infection in a resident of the Arabian Peninsula. Our patient presented, as did 2 prior cases, with severe pneumonia and renal dysfunction requiring intensive care support including assisted ventilation. However, unlike the earlier cases, and despite underlying chronic disease and a single kidney, he survived his infection and has been discharged home. The Ministry of Health continues active surveillance for additional cases. As this case report goes to press, 2 additional confirmed cases have been identified in Riyadh, Saudi Arabia. Contact investigations are in progress. Future work will focus not only on the origin of the virus and mechanisms of transmission, but also the host factors that influence pathogenesis and prognosis.

BACKGROUND: Approximately 2 to 3 million pilgrims perform Hajj every year. We describe the pattern of diseases, complications, and outcome of pilgrims who required admission to intensive care units (ICUs) during the Hajj period of the Islamic year 1424 (2004). METHODS: This was a cross-sectional study of all patients admitted to 104 ICU beds in four hospitals in Mena and three hospitals in Arafat during the Hajj. RESULTS: Of 140 patients admitted to ICUs, 75 (54%) patients were older than 60 years. The risk of complications and death increased with age, with the highest risk noticed among pilgrims older than 80 years. Ninety-four (67.6%) patients were men. Eighty-nine (63.6%) patients were admitted with cardiovascular diseases and 37 (26.4%) patients with infections. Myocardial infarction (25%) and pneumonia (22%) were the most common admitting diagnoses. Trauma accounted for only 6.4% (9 patients) of admissions. Sixty-three (45.0%) patients recovered and were discharged or transferred to hospital wards in stable condition, 40 (28.6%) were transferred to tertiary care centers for specialized services, 21 (15.0%) were transferred to tertiary care centers after closure of the temporary hospitals in Mena and Arafat, 15 (10.7%) patients died, and one (0.7%) patient was ddischarged against medical advice. CONCLUSION: This study revealed information oo the pattern of diseases and the most common causes of admission of pilgrims to ICUs and the required medical services during Hajj. It is hoped that this information will be of help to health care planners and officials to provide optimal and cost effective health care services to pilgrims in Hajj.

Background the objective of this study was to evaluate the impact of annual review of the infection control practice in all Ministry of Health hospitals in the holy city of Makkah, Saudi Arabia, during the Hajj period of four lunar Islamic years, 1423 to 1426 corresponding to 2003 to 2006. Methods audit of infection control service was conducted annually over a 10-day period in six community hospitals with bed capacities ranging from 140 to 557 beds. Data were collected on standardized checklists on various infection control service items during surprise visits to the medical, pediatric, surgical, and critical care units, and the kitchens. Percentage scores were calculated for audited items. The results of the audit for hospitals were confidentially sent to them within four weeks after the end of Hajj. Results deficiencies observed in the first audit included lack of infection control committees, infection control units, infection control educational activities, and surveillance system and shortage of staff. These deficiencies were resolved in the subsequent audits. The average (range) scores of hospitals in 11 infection control items increased from 43% (20–67%) in the first audit to 78% (61–93%) in the fourth audit. Conclusion regular hospital infection control audits lead to significant improvement of infection control practice. There is a need to build a rigorous infection control audit into hospitals' ongoing monitoring and reporting to the Ministry of Health and to provide these hospitals with feed back on such audits to continuously strengthen the safety standards for patients, visitors, and employees.