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Effectiveness of Face Mask for Prevention of Respiratory Tract Infection during Hajj: A Systematic Review and Meta-Analysis
Raghad Alhajaji
Raghad Alhajaji
Public Health Administration, Makkah Health Affairs, Ministry of Health, Makkah, Saudi Arabia;
Alhajj Primary Health Care, Makkah Health Cluster, Makkah, Saudi Arabia;
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Alhajj Primary Health Care, Makkah Health Cluster, Makkah, Saudi Arabia;
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Khalid Al Sulaiman
Khalid Al Sulaiman
Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia;
College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia;
King Abdullah International Medical Research Center, Riyadh, Saudi Arabia;
Saudi Critical Care Pharmacy Research (SCAPE) Platform, Riyadh, Saudi Arabia;
Saudi Society for Multidisciplinary Research Development and Education (SCAPE Society), Riyadh, Saudi Arabia;
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College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia;
King Abdullah International Medical Research Center, Riyadh, Saudi Arabia;
Saudi Critical Care Pharmacy Research (SCAPE) Platform, Riyadh, Saudi Arabia;
Saudi Society for Multidisciplinary Research Development and Education (SCAPE Society), Riyadh, Saudi Arabia;
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Omar A. Abdelwahab
Omar A. Abdelwahab
Faculty of Medicine, Al-Azhar University, Cairo, Egypt;
Medical Research Group of Egypt, Cairo, Egypt;
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Medical Research Group of Egypt, Cairo, Egypt;
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Manal Alfahmi
Manal Alfahmi
Clinical Research Administration at the Executive Administration of Research and Innovation, King Abdullah Medical City (KAMC), Makkah, Saudi Arabia;
Executive Administration of Research and Innovation, King Abdullah Medical City (KAMC), Makkah, Saudi Arabia;
King Abdullah Medical City (KAMC) Medical Ethics Committee, Makkah, Saudi Arabia;
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Executive Administration of Research and Innovation, King Abdullah Medical City (KAMC), Makkah, Saudi Arabia;
King Abdullah Medical City (KAMC) Medical Ethics Committee, Makkah, Saudi Arabia;
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Jameel T. Abualenain
Jameel T. Abualenain
General Directorate of Emergencies, Disasters, & Medical Transportation, Deputyship of Curative Services, Ministry of Health, Riyadh, Saudi Arabia;
Department of Emergency Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia;
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Department of Emergency Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia;
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Sari I. Asiri
Sari I. Asiri
Public Health Administration, Makkah Health Affairs, Ministry of Health, Makkah, Saudi Arabia;
The General Directorate of Hajj and Umrah, Ministry of Health, Riyadh, Saudi Arabia;
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The General Directorate of Hajj and Umrah, Ministry of Health, Riyadh, Saudi Arabia;
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Ohoud Aljuhani
Ohoud Aljuhani
Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia;
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Aisha Alharbi
Aisha Alharbi
Pharmaceutical Care Department, King Abdulaziz Medical City, Jeddah, Saudi Arabia;
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Hadeel Alkofide
Hadeel Alkofide
Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia;
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Malaz Ahmed
Malaz Ahmed
Public Health Administration, Makkah Health Affairs, Ministry of Health, Makkah, Saudi Arabia;
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Ahmed Y. Saeedi
Ahmed Y. Saeedi
Public Health Administration, Makkah Health Affairs, Ministry of Health, Makkah, Saudi Arabia;
The General Directorate of Hajj and Umrah, Ministry of Health, Riyadh, Saudi Arabia;
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The General Directorate of Hajj and Umrah, Ministry of Health, Riyadh, Saudi Arabia;
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Ahmad Alturkistani
Ahmad Alturkistani
Public Health Administration, Makkah Health Affairs, Ministry of Health, Makkah, Saudi Arabia;
The General Directorate of Hajj and Umrah, Ministry of Health, Riyadh, Saudi Arabia;
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The General Directorate of Hajj and Umrah, Ministry of Health, Riyadh, Saudi Arabia;
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Ahmed Al-Jedai
Ahmed Al-Jedai
Therapeutic Affairs Deputyship, Ministry of Health, Riyadh, Saudi Arabia;
Colleges of Medicine and Pharmacy, Al-Faisal University, Riyadh, Saudi Arabia
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Colleges of Medicine and Pharmacy, Al-Faisal University, Riyadh, Saudi Arabia
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The Hajj is an annual mass gathering of people in Makkah, Saudi Arabia. Respiratory infections are common due to their potential for rapid spread in crowded settings. There is a lack of data regarding the effectiveness of face masks in preventing respiratory tract infections (RTIs), specifically during Hajj. We systematically searched PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials until July 3, 2023 for studies comparing the incidence or prevalence of RTIs in those who used any face mask during Hajj compared with no mask. Risk ratio (RRs) and 95% CIs were calculated using either a fixed or random-effect model, depending on the heterogeneity. A comprehensive analysis encompassed 10 studies involving 5007 participants. The overall RR favored wearing masks over not wearing masks regarding the incidence of RTIs; however, the difference was not statistically significant (RR = 0.78; 95% CI = 0.55–1.10; P = 0.16). A significantly lower incidence of RTIs was found in those wearing masks most of the time versus intermittently (RR = 0.59; 95% CI = [0.38–0.94; P = 0.02). In subgroup analyses, there was no difference between wearing masks and not wearing masks across different study designs (cohort/case-control), different groups (pilgrims/healthcare workers), and different years of Hajj, except from 2000 to 2008, when there was a significant difference favoring wearing face masks. This meta-analysis found wearing masks most of the time was associated with significantly lower risk of RTIs than wearing it intermittently.
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Author Notes
Disclosure: This article does not contain any studies with human participants or animals performed by any of the authors. The protocol of this study was registered on PROSPERO (CRD42023449026).
Current contact information: Raghad Alhajaji, Public Health Administration, Makkah Health Affairs, Ministry of Health, Makkah, Saudi Arabia, and Alhajj Primary Health Care, Makkah Health Cluster, Makkah, Saudi Arabia, E-mail: raghad.alhajaji@gmail.com. Khalid Al Sulaiman, Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia; College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; and Saudi Critical Care Pharmacy Research (SCAPE) Platform, Riyadh, Saudi Arabia, E-mail: alsulaimankh@hotmail.com. Omar A. Abdelwahab, Faculty of Medicine, Al-Azhar University, Cairo, Egypt, and Medical Research Group of Egypt, Cairo, Egypt, E-mail: omarabdelwahab.216@azhar.edu.eg. Manal Alfahmi, Clinical Research Administration at the Executive Administration of Research and Innovation, King Abdullah Medical City (KAMC), Saudi Arabia, and King Abdullah Medical City (KAMC) Medical Ethics Committee, Makkah, Saudi Arabia, E-mail: Manalalfahmi@gmail.com. Jameel T. Abualenain, General Directorate of Emergencies, Disasters, & Medical Transportation, Deputyship of Curative Services, Ministry of Health, Riyadh, Saudi Arabia, and Department of Emergency Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia, E-mail: Jameel.abualenain@gmail.com. Sari I. Asiri and Ahmed Y. Saeedi, Public Health Administration, Makkah Health Affairs, Ministry of Health, Makkah, Saudi Arabia, and The General Directorate of Hajj and Umrah, Ministry of Health, Riyadh, Saudi Arabia, E-mails: SMOHD-ASIRI@moh.gov.sa and Aysaeedi@moh.gov.sa. Ohoud Aljuhani, Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia, and Saudi Critical Care Pharmacy Research (SCAPE) Platform, Riyadh, Saudi Arabia, E-mail: Oaljuhani@kau.edu.sa. Aisha Alharbi, Pharmaceutical Care Department, King Abdulaziz Medical City, Jeddah, Saudi Arabia, E-mail: aalharbi0755@gmail.com. Hadeel Alkofide, Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia, E-mail: hadeel.alkofide@gmail.com. Malaz Ahmed and Ahmad Alturkistani, Public Health Administration, Makkah Health Affairs, Ministry of Health, Makkah, Saudi Arabia, E-mails: malazelbashir@gmail.com and aalturkstani@moh.gov.sa. Ahmed Al-Jedai, Therapeutic Affairs Deputyship, Ministry of Health, Riyadh, Saudi Arabia, and Colleges of Medicine and Pharmacy, Al-Faisal University, Riyadh, Saudi Arabia, E-mail: ahaljedai@moh.gov.sa.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 553 | 553 | 135 |
| Full Text Views | 13 | 13 | 6 |
| PDF Downloads | 17 | 17 | 5 |