Arbaeen public health concerns: A pilot cross-sectional survey

Farah Al-Ansari; Mustafa Al Ansari; Grant A Hill-Cawthorne; Mohammed Saeed Abdulzahra; Mohammad Basim Al-Ansari; Basma Al-Ansari; Harunor Rashid; Joel Negin; Katherine M Conigrave

doi:10.1016/j.tmaid.2019.101546

Arbaeen public health concerns: A pilot cross-sectional survey

Travel Med Infect Dis. 2020 May-Jun:35:101546. doi: 10.1016/j.tmaid.2019.101546. Epub 2019 Dec 12.

Authors

Farah Al-Ansari¹, Mustafa Al Ansari², Grant A Hill-Cawthorne³, Mohammed Saeed Abdulzahra⁴, Mohammad Basim Al-Ansari⁵, Basma Al-Ansari⁶, Harunor Rashid⁷, Joel Negin³, Katherine M Conigrave⁸

Affiliations

¹ University of Sydney, Faculty of Medicine and Health, Central Clinical School, Camperdown, 2006, NSW, Australia. Electronic address: farah.alansari@sydney.edu.au.
² University of Sydney, Faculty of Medicine and Health, Central Clinical School, Camperdown, 2006, NSW, Australia; University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Camperdown, 2006, NSW, Australia.
³ University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Camperdown, 2006, NSW, Australia.
⁴ University of Kufa, College of Medicine, Department of Medicine, Najaf, Iraq.
⁵ Office of Ayatollah Al-Ansari, Sydney, NSW, Australia.
⁶ University of Sydney, Faculty of Medicine and Health, Central Clinical School, Camperdown, 2006, NSW, Australia.
⁷ The Children's Hospital at Westmead, National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), Westmead, 2145, NSW, Australia; University of Sydney, Faculty of Medicine and Health, Children's Hospital Westmead Clinical School, The Discipline of Child and Adolescent Health, Westmead, 2145, NSW, Australia.
⁸ Royal Prince Alfred Hospital, Drug Health Services, Missenden Rd, Camperdown, 2050, NSW, Australia; University of Sydney, Faculty of Medicine and Health, Central Clinical School, Camperdown, 2006, NSW, Australia.

PMID: 31838209
DOI: 10.1016/j.tmaid.2019.101546

Abstract

Background: Arbaeen is an annual religious procession in Iraq with an estimated 17-20 million participants. Public health risks associated with such a mass gathering can be serious at both local and global levels. This is the first quantitative examination of risk factors for, and symptoms of, infectious disease among Arbaeen participants.

Methods: A cross-sectional survey was conducted of a convenience sample of 191 Arbaeen participants in 2017. Interviewers administered a structured questionnaire. Questions included food sources, preventive measures used and symptoms of infectious diseases during the procession.

Results: Data were collected for 191 participants (143 males, 58 females). The most prevalent symptoms were respiratory (runny nose: 22.6%, cough: 22.5%). Diarrhoea was reported by 12.6% of participants, with a strong association with high-income country origin and eating (commercial) street food (odds ratios 6.1 and 4.1, respectively, p < 0.05). All symptoms investigated, except breathlessness, were more prevalent in high-income country participants (p < 0.05).

Conclusion: Street food and high-income country origin were independent risk factors for respiratory or gastrointestinal infection symptoms in this sample of Arbaeen participants. However, these results cannot be generalised due to possible selection bias. Further studies are required to inform policy development and health system preparedness to reduce Arbaeen-associated health risks.

Keywords: Arbaeen; Communicable diseases; Global health; Infectious disease transmission; Mass gathering medicine; Public health.

MeSH terms

Adolescent
Adult
Aged
Communicable Diseases / epidemiology*
Cough
Cross-Sectional Studies
Diarrhea
Female
Food / standards
Humans
Iraq / epidemiology
Islam
Male
Middle Aged
Pilot Projects
Rhinorrhea
Risk Factors
Surveys and Questionnaires