Abstract
BackgroundMillions of Iraqi pilgrims travel annually from the southern governorates to Karbala and pass through Thiqar, Muthana, and Diwania Governorates to join the Arbaeenia mass gathering event. During this event, participants are at high risk for diseases and death and stifle local health care resources. In addition, the mass gathering causes considerable burden on health facilities in the hosting localities.ObjectiveThis study aims to estimate the disease burden on health facilities caused by the pilgrims passing through Thiqar, Muthana, and Diwania Governorates en route to Karbala in Iraq.MethodsThis cross-sectional study was conducted on all health facilities in three governorates (Thiqar, Muthana, and Diwania) situated along the southern way to Karbala from Basra. The study started on December 11, 2014, and ended on December 24, 2014. The morbidity and mortality were collected from surveillance logbooks and death registers. Drug purchase data were obtained from the personnel in charge of the pharmacies. The study period was divided into three phases on the basis of the timing of the mass gathering event: pre-event, the event, and postevent.ResultsThere were 884,834 incidents reported during the study. The majority of incidents were reported during the event phase (95%) and were attended mostly at mobile clinics (77%). The average daily incidents during the pre-event, event, and postevent phases were 4300, 56,040, and 4548 incidents, respectively. Musculoskeletal disorders were the most common illness reported (55%). The average number of daily deaths was 43, 36, and 45 during the pre-event, event, and postevent, respectively, and these values did not differ significantly. Cardiovascular diseases (43.5%), injuries (29.8%), and respiratory illnesses (12%) were the leading causes of deaths. Approximately US $1.3 million was spent on drug purchases during this mass gathering in the three governorates.ConclusionsThe Arbaeenia mass gathering causes a tremendous disease and economic burden on governorates that pilgrims pass through to attend this mass gathering in Karbala. Although Iraq’s Ministry of Health is aware of the high burden of this mass gathering on the health facilities in these governorates, more work is needed to ensure quality services during the event.
Highlights
The World Health Organization defines mass gatherings as “events attended by a sufficient number of people to strain the planning and response recourses of a community, state or nation” [1,2]
The majority were addressed in Diwania governorate health facilities (54.8%), and around 22% and 23% were addressed in the health facilities of Thiqar and Muthana Governorates, respectively
The Arbaeenia mass gathering puts a tremendous onus on local health resources
Summary
The World Health Organization defines mass gatherings as “events attended by a sufficient number of people to strain the planning and response recourses of a community, state or nation” [1,2]. Millions of Iraqi pilgrims travel annually from the southern governorates to Karbala and pass through Thiqar, Muthana, and Diwania Governorates to join the Arbaeenia mass gathering event. During this event, participants are at high risk for diseases and death and stifle local health care resources. Objective: This study aims to estimate the disease burden on health facilities caused by the pilgrims passing through Thiqar, Muthana, and Diwania Governorates en route to Karbala in Iraq. Conclusions: The Arbaeenia mass gathering causes a tremendous disease and economic burden on governorates that pilgrims pass through to attend this mass gathering in Karbala. Iraq’s Ministry of Health is aware of the high burden of this mass gathering on the health facilities in these governorates, more work is needed to ensure quality services during the event
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