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Ramadan is not associated with increased infection risk in Pakistani and Bangladeshi populations: Findings from controlled interrupted time series analysis of UK primary care data

Author

Listed:
  • Munerah Almulhem
  • Rasiah Thayakaran
  • Shahjehan Hanif
  • Tiffany Gooden
  • Neil Thomas
  • Jonathan Hazlehurst
  • Abd A Tahrani
  • Wasim Hanif
  • Krishnarajah Nirantharakumar

Abstract

Background: The effect of fasting on immunity is unclear. Prolonged fasting is thought to increase the risk of infection due to dehydration. This study describes antibiotic prescribing patterns before, during, and after Ramadan in a primary care setting within the Pakistani and Bangladeshi populations in the UK, most of whom are Muslims, compared to those who do not observe Ramadan. Method: Retrospective controlled interrupted time series analysis of electronic health record data from primary care practices. The study consists of two groups: Pakistanis/Bangladeshis and white populations. For each group, we constructed a series of aggregated, daily prescription data from 2007 to 2017 for the 30 days preceding, during, and after Ramadan, respectively. Findings: Controlling for the rate in the white population, there was no evidence of increased antibiotic prescription in the Pakistani/Bangladeshi population during Ramadan, as compared to before Ramadan (IRR: 0.994; 95% CI: 0.988–1.001, p = 0.082) or after Ramadan (IRR: 1.006; 95% CI: 0.999–1.013, p = 0.082). Interpretation: In this large, population-based study, we did not find any evidence to suggest that fasting was associated with an increased susceptibility to infection.

Suggested Citation

  • Munerah Almulhem & Rasiah Thayakaran & Shahjehan Hanif & Tiffany Gooden & Neil Thomas & Jonathan Hazlehurst & Abd A Tahrani & Wasim Hanif & Krishnarajah Nirantharakumar, 2022. "Ramadan is not associated with increased infection risk in Pakistani and Bangladeshi populations: Findings from controlled interrupted time series analysis of UK primary care data," PLOS ONE, Public Library of Science, vol. 17(1), pages 1-15, January.
    • Handle: RePEc:plo:pone00:0262530
    DOI: 10.1371/journal.pone.0262530
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    References listed on IDEAS

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    1. Katherine Baicker & Theodore Svoronos, 2019. "Testing the Validity of the Single Interrupted Time Series Design," NBER Working Papers 26080, National Bureau of Economic Research, Inc.
    2. Ariel Linden, 2015. "Conducting interrupted time-series analysis for single- and multiple-group comparisons," Stata Journal, StataCorp LLC, vol. 15(2), pages 480-500, June.
    3. Katherine Baicker & Theodore Svoronos, 2019. "Testing the Validity of the Single Interrupted Time Series Design," CID Working Papers 364, Center for International Development at Harvard University.
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