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
Almulhem, Munerah Thayakaran, Rasiah Hanif, Shahjehan Gooden, Tiffany Thomas, Neil Hazlehurst, Jonathan Tahrani, Abd A Hanif, Wasim Nirantharakumar, Krishnarajah
Almulhem, Munerah
Thayakaran, Rasiah
Hanif, Shahjehan
Gooden, Tiffany
Thomas, Neil
Hazlehurst, Jonathan
Tahrani, Abd A
Hanif, Wasim
Nirantharakumar, Krishnarajah
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Affiliation
University of Birmingham; University College London; Birmingham Health Partners; University Hospitals Birmingham NHS Foundation Trust
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Publication date
2022-01-13
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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.
Citation
Almulhem M, Thayakaran R, Hanif S, Gooden T, Thomas N, Hazlehurst J, Tahrani AA, Hanif W, Nirantharakumar K. 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. 2022 Jan 13;17(1):e0262530. doi: 10.1371/journal.pone.0262530.
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Article