Neisseria meningitidis nasopharyngeal carriage during the Hajj: A cohort study evaluating the need for ciprofloxacin prophylaxis

Background The annual Muslim pilgrimage has the potential of increase risk for acquisition of Neisseria meningitidis. Here, we evaluate the Hajj impact on the prevalence of N. meningitidis carriage in a paired and non-paired cohort of pilgrims. Secondary objectives were to calculate the compliance with recommended vaccination. Methods This is a prospective paired (arriving and departing), non-paired arriving and non-paired departing cohort study with the collection of nasopharyngeal samples at the start and the end of the Hajj. Results The study included unpaired arriving pilgrims at King Abdul Aziz International Airport (N = 1055), unpaired departing cohort (N = 373), and a paired cohort (N = 628) who were tested on arrival and departure. Meningococcal vaccination was received by all pilgrims, 98.2% received quadrivalent polysaccharide vaccine (ACWY), and 1.8% received meningococcal quadrivalent conjugate vaccine (MCV4). Only 1.61% and 23.03% received pneumococcal and influenza vaccines, respectively. Of the 1055 arriving unpaired pilgrim, 36 (3.4%) tested positive for nasopharyngeal carriage of N. meningitidis, and 24 (66.7%) of these were serogroup B, the remainder were non-groupable. Haemophilus influenza was detected among 45 (4.3%), and 11 (1%) carriers were positive for both N. meningitidis and H. influenzae. Out of 373 in the unpaired departing cohort, 6 (1.61%) tested positive for N. meningitidis, and 34 (9.1%) were positive for H. influenzae. Of the 628 paired cohort pilgrims, 36 (5.7%) pilgrims were positive for N. meningitidis at arrival and 16 (2.5%) pilgrims were positive after the hajj. Conclusion This the largest study of the epidemiology of N. meningitidis among pilgrims. The study showed a significant difference in the carriage between pilgrims from high endemicity and other pilgrims with a predominance of serogroup B. The continued use of ciprofloxacin as prophylactic antibiotics should be reconsidered as well as the consideration to add serogroup B as a required vaccination

Relationship of electronic device usage with obesity and speech delay in children

Background. Smart device usage has become favorable among children worldwide. Objectives. The study aimed to identify the relation between usage of electronic devices with obesity and speech delay. Material and methods. A cross-sectional study was conducted among 452 healthy children (18 months to 14 years old) from pediatric clinics of the Ministry of Health (MOH), Jeddah, Saudi Arabia. Data was collected from June to July 2018. Analysis included linear regression, logistic regression, chi-square, t-test and ANOVA. Results and discussion. Male participants totalled 57.7% and females 42.3% (mean age 82.27 months) (SD = 40.18). Mean duration of usage: 3.1 hours (SD = 2.58) per day. Among toddlers only, 31.1% had speech delay. The results showed no relation between the duration of smart device usage and obesity (p-value = 0.904) or speech delay (p-value = 0.538). Duration of usage was not influenced by gender or parents’ marital status; however, children who live with both parents spent less time on smart devices than others. The smart device most used was a tablet (47%), and the main usage was primarily entertainment (60.8%) and games (47.6%). Only 57.8% reported having parental supervision. Among children, 59.3% eat chips and 48.9% eat candy as snacks during usage. Among parents, 71.5% believe devices reduce children’s physical activities, 64.8% believe that the smart device is a problem, 62.5% of parents should control time of use, and 60.5% believe that their children are attached to the devices. Conclusions. There is no association between the duration of using smart devices and obesity, nor speech delay. Future directions and recommendations should be discussed