Pilot use of a novel smartphone application to track traveller health behaviour and collect infectious disease data during a mass gathering: Hajj pilgrimage 2014

Abstract This study examines the feasibility of using a smartphone application (app) to conduct surveys among travellers during the Hajj pilgrimage, where the use of apps has not been evaluated for infectious disease surveillance. A longitudinal study was conducted among pilgrims at the Hajj 2014 using an iPhone app with separate questionnaires for three study phases covering before, during, and after Hajj. Forty-eight pilgrims from 13 countries downloaded the app. Respondents were aged between 21 and 61 (median 36) years and 58.5% (24/41) were male. Of these, 85% (41/48) completed the first phase, 52% (25/41) completed both the second and third phases, and 25 of these reported meningococcal vaccination, with 36% (9/25) receiving other vaccines. All (25) reported hand hygiene use and 64% (16/25) wore a facemask at some point during the pilgrimage. Four (6%) reported close contact with camels. Respiratory symptoms commenced from the 4th day of Hajj, with sore throat (20%) and cough (12%) being the most common. Three participants (12%) reported respiratory symptoms after returning home. Conducting a prospective survey using a smartphone app to collect data on travel-associated infections and traveller compliance to prevention is feasible at mass gatherings and can provide useful data associated with health-related behaviour.

[1]  A. Heywood,et al.  Australian Hajj pilgrims' infection control beliefs and practices: Insight with implications for public health approaches. , 2015, Travel medicine and infectious disease.

[2]  P. Brouqui,et al.  Protective measures against acute respiratory symptoms in French pilgrims participating in the Hajj of 2009. , 2011, Journal of travel medicine.

[3]  J. Car,et al.  Smartphone Versus Pen-and-Paper Data Collection of Infant Feeding Practices in Rural China , 2012, Journal of medical Internet research.

[4]  R. Brookmeyer,et al.  Incubation periods of acute respiratory viral infections: a systematic review , 2009, The Lancet Infectious Diseases.

[5]  Esme Jordaan,et al.  Illness and injury in athletes during the competition period at the London 2012 Paralympic Games: development and implementation of a web-based surveillance system (WEB-IISS) for team medical staff , 2013, British Journal of Sports Medicine.

[6]  Adi V. Gundlapalli,et al.  Influenza, Winter Olympiad, 2002 , 2006, Emerging infectious diseases.

[7]  Lyndal Trevena,et al.  Who Uses Smoking Cessation Apps? A Feasibility Study Across Three Countries via Smartphones , 2014, JMIR mHealth and uHealth.

[8]  P. Brouqui,et al.  French Hajj pilgrims' experience with pneumococcal infection and vaccination: A knowledge, attitudes and practice (KAP) evaluation , 2015, Travel Medicine and Infectious Disease.

[9]  Matthew H Samore,et al.  Hospital electronic medical record-based public health surveillance system deployed during the 2002 Winter Olympic Games. , 2007, American journal of infection control.

[10]  R. Booy,et al.  Has Hajj‐associated Middle East Respiratory Syndrome Coronavirus transmission occurred? The case for effective post‐Hajj surveillance for infection , 2014, Clinical Microbiology and Infection.

[11]  A. Cook,et al.  Causes of Mortality for Indonesian Hajj Pilgrims: Comparison between Routine Death Certificate and Verbal Autopsy Findings , 2013, PloS one.

[12]  A. Heywood,et al.  Vaccinations against respiratory tract infections at Hajj. , 2015, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[13]  N. Shamspour,et al.  Health Knowledge, Attitude and Practice Among Iranian Pilgrims , 2015, Iranian Red Crescent Medical Journal.

[14]  Z. Memish,et al.  Prevention of influenza at Hajj: applications for mass gatherings , 2013, Journal of the Royal Society of Medicine.

[15]  Z. Memish,et al.  Health conditions for travellers to Saudi Arabia for the Umra and pilgrimage to Mecca (Hajj) – 2014 , 2014, Journal of Epidemiology and Global Health.

[16]  E O Nsoesie,et al.  New digital technologies for the surveillance of infectious diseases at mass gathering events , 2014, Clinical Microbiology and Infection.

[17]  Alimuddin Zumla,et al.  Travel implications of emerging coronaviruses: SARS and MERS-CoV , 2014, Travel Medicine and Infectious Disease.

[18]  山本 保博,et al.  集団災害時における一般医の役割 : Mass‐gathering medicine , 2002 .

[19]  Z. Memish,et al.  Protective practices and respiratory illness among US travelers to the 2009 Hajj. , 2012, Journal of travel medicine.

[20]  Becky Freeman,et al.  Pro-smoking apps for smartphones: the latest vehicle for the tobacco industry? , 2012, Tobacco Control.

[21]  Nasser F. BinDhim,et al.  Confirming The One-Item Question Likert Scale To Measure Anxiety , 2013 .

[22]  H. Willaby,et al.  Australian Hajj pilgrims' knowledge, attitude and perception about Ebola, November 2014 to February 2015. , 2015, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[23]  Philippe Brouqui,et al.  Circulation of Respiratory Viruses Among Pilgrims During the 2012 Hajj Pilgrimage , 2013, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[24]  Gwen Stephens,et al.  Detection of Respiratory Viruses Among Pilgrims in Saudi Arabia During the Time of a Declared Influenza A(H1N1) Pandemic , 2011, Journal of travel medicine.

[25]  Lyndal J. Trevena,et al.  Depression screening via a smartphone app: cross-country user characteristics and feasibility , 2015, J. Am. Medical Informatics Assoc..

[26]  P. Brouqui,et al.  Non-pharmaceutical interventions for the prevention of respiratory tract infections during Hajj pilgrimage , 2014, Travel Medicine and Infectious Disease.

[27]  P. Brouqui,et al.  Hajj Pilgrims’ Knowledge about Acute Respiratory Infections , 2009, Emerging infectious diseases.

[28]  M. Carter,et al.  Adherence to a Smartphone Application for Weight Loss Compared to Website and Paper Diary: Pilot Randomized Controlled Trial , 2013, Journal of medical Internet research.

[29]  Christian Drosten,et al.  Evidence for camel-to-human transmission of MERS coronavirus. , 2014, The New England journal of medicine.

[30]  Z. Memish,et al.  Mass gathering medicine: 2014 Hajj and Umra preparation as a leading example , 2014, International Journal of Infectious Diseases.

[31]  N. Othman,et al.  The prevalence of acute respiratory symptoms and role of protective measures among Malaysian hajj pilgrims. , 2010, Journal of travel medicine.