Prevalence and Associated Factor of Meningococcal Carriers of Indonesian Umrah Pilgrims.

Abstract

Background: Meningococcal meningitis (MM) cases are increasing in 2024. The infection spread widely during mass gatherings, including religious activities like Umrah. In 2023, the total number of Indonesia's Umrah pilgrims was 1.2 million people, much larger than the Hajj pilgrims (209.782 people). Thus, it is estimated that the number of meningococcus carriers also increased. Besides, there is no surveillance system for the Umrah pilgrimage to prevent Neisseria meningitidis from entering the country. The conducted study aimed to describe the proportion of meningococcal carriers among Indonesian Umrah pilgrims and their associated factors.

Methods: The study was cross-sectional among the Umrah pilgrims who arrived via Soekarno-Hatta International Airport and Juanda International Airport. A self-administered questionnaire was sent to each participant and validated at arrival. An oropharyngeal swabs and blood draws (only if symptoms were present) were obtained. RT-PCR examinations were performed to identify N. meningitidis.

Results: The study enrolled 900 pilgrims with a mean age of 51.34 ± 12.98 (17-79), with 50.9% female. Nearly 9.5% of pilgrims declared having a comorbid disease, and 100% had been vaccinated. N. meningitidis was detected in 201 participants (22.3%) in oropharyngeal swabs as indicator of transmission potential and the need for surveillance.

Conclusions: The analysis data showed that marital status and timing of meningococcal vaccine significantly correlate with meningococcal Carrier. Meningitis surveillance must be done routinely and systematically to decrease the risk of the disease.