Faris Lami, PhD, is an Associate Professor, Department of Community Medicine, College of Medicine, Baghdad University, Bab Al Muadham, Baghdad, Iraq. Mirwais Amiri, MD, MPH, is Research and Policy Team Leader and Mohannad Al Nsour, MD, MSc, PhD, is Executive Director; both at Center of Excellence for Applied Epidemiology Global Health Development, Amman, Jordan. Yasir Majeed, MD, is Director, Field Epidemiology Training Program, Public Health Directorate, Ministry of Health, Baghdad, Iraq. Kira M. Barr is a Graduate Student, Epidemiology, Ohio State University, Columbus, OH. Yousef S. Khader, ScD, is a Professor, Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Health Secur. 2021 May-Jun;19(3):280-287. doi: 10.1089/hs.2020.0074. Epub 2021 May 3.
The Arba'een pilgrimage in Iraq is now the largest annual gathering in a single place worldwide. To monitor and address the health needs of pilgrims in field clinics near the pilgrimage route, a syndromic surveillance system was designed and implemented by Global Health Development/Eastern Mediterranean Public Health Network in collaboration with Iraq Ministry of Health. This study aimed to analyze the effectiveness of the surveillance system and the data it gathered in evaluating the burden of common acute and infectious conditions, chronic conditions, and trauma and injuries during the Arba'een pilgrimage in 2018. Data were collected at 152 field clinics located across 11 governorates in Iraq at strategic points along the Arba'een pilgrimage route from all governorates to Karbala between October 8 and November 3, 2018. A team of 24 surveillance supervisors trained, oversaw, and provided technical support for 304 data collectors. The data collectors recorded data from 338,399 patients (42.5% female and 57.5% male) in the span of 26 days. The vast majority of patients were from Iraq (n = 294,260, 87.6%) and Iran (n = 34,691, 10.3%). Of the 338,399 patients whose data were recorded by the surveillance system, 246,469 (72.8%) reported acute and infectious conditions, 202,032 (59.70%) reported chronic conditions, and 6,737 (2.0%) reported traumas and injuries. Many patients reported several conditions in multiple categories. The most prevalent acute condition treated was influenza-like illness, identified through patients exhibiting a combination of fever and cough symptoms. Findings from this study will help inform future planning efforts so healthcare workers can be better prepared for treating such cases at mass gatherings. With the latest challenges posed by the COVID-19 pandemic, preparations for a possible future outbreak of the novel coronavirus are also discussed. The information from this study serves as a foundation to inform and optimize future planning of wide-scale surveillance efforts and address challenges in health service delivery and health security.
伊拉克的阿巴因朝觐是目前全球范围内在单一地点举行的最大年度集会。为了监测和满足朝觐路线附近现场诊所朝圣者的健康需求，全球卫生发展/东地中海公共卫生网络与伊拉克卫生部合作设计并实施了一种综合征监测系统。本研究旨在分析该监测系统及其收集的数据在评估 2018 年阿巴因朝觐期间常见急性和传染性疾病、慢性疾病以及创伤和损伤负担方面的有效性。2018 年 10 月 8 日至 11 月 3 日期间，在伊拉克 11 个省的战略地点，在从各省前往卡尔巴拉的阿巴因朝觐路线上的 152 个现场诊所收集了数据。一个由 24 名监测主管组成的团队对 304 名数据收集员进行了培训、监督和提供技术支持。数据收集员在 26 天内记录了 338399 名患者（42.5%为女性，57.5%为男性）的数据。绝大多数患者来自伊拉克（n=294260，87.6%）和伊朗（n=34691，10.3%）。在通过监测系统记录数据的 338399 名患者中，246469 名（72.8%）报告急性和传染性疾病，202032 名（59.70%）报告慢性疾病，6737 名（2.0%）报告创伤和损伤。许多患者在多个类别中报告了几种疾病。治疗的最常见急性疾病是流感样疾病，通过出现发热和咳嗽症状的患者来确定。本研究的结果将有助于为未来的规划工作提供信息，以便医疗保健工作者能够更好地为大型集会中的此类病例做好准备。鉴于 COVID-19 大流行带来的最新挑战，还讨论了为新型冠状病毒的未来爆发做准备的问题。本研究提供的信息为广泛的监测工作提供信息并优化未来规划以及解决卫生服务提供和卫生安全方面的挑战奠定了基础。
