Real-Time Surveillance for Infectious Diseases and other Health Conditions during Iraq “Arbaeenia” Mass Gathering (Preprint)

BACKGROUND: The most common religious mass gatherings in the Middle East are the Hajj at Mecca in Saudi Arabia, which occurs annually, and the Arbaeenia in Karbala. The importance of developing public health surveillance systems for mass gatherings has been previously emphasized in other reports. OBJECTIVE: This study aimed to describe the common illnesses and health conditions affecting people during the Arbaeenia mass gathering in Iraq in 2016. METHODS: A total of 60 data collectors took part in the field data collection over a period of 11 days, from November 12, 2016 to November 22, 2016. Data were collected from 20 health outlets along the major route from Najaf to Karbala (10 health facilities in each governorate). Two digital forms, the Health Facility Survey and the Case Survey, were used for data collection. RESULTS: A total of 41,689 patients (33.3% female and 66.7% male) visited the 20 health care facilities over a period of 11 days from November 12, 2016 to November 22, 2016. More than three quarters of patients (77.5%; n=32,309) were between 20-59 years of age, more than half of patients were mainly from Iraq (56.5%; n=23,554), and about 38.9% (n=16,217) were from Iran. Patients in this study visited these health care facilities and presented with one or more conditions. Of a total 41,689 patients, 58.5% (n=24,398) had acute or infectious conditions and symptoms, 33.1% (n=13,799) had chronic conditions, 23.9% (n=9974) had traumas or injuries, 28.2% (n=11,762) had joint pain related to walking long distances, and 0.3% (n=133) had chronic dermatologic conditions. CONCLUSIONS: The Arbaeenia mass gathering in 2016 exerted a high burden on the Iraqi health care system. Therefore, efforts must be made both before and during the event to ensure preparedness, proper management, and control of different conditions.