Risk factors for symptoms of infection and the acquisition of pathogens among pilgrims at the Grand Magal of Touba, 2017–2021

Abstract

BackgroundRespiratory and gastrointestinal symptoms are frequent in pilgrims at the Grand Magal of Touba (GMT). MethodsPilgrims were prospectively investigated in 2017–2021 for demographics, chronic conditions, preventive measures, respiratory and gastrointestinal symptoms, and pathogen carriage using PCR assays. Results535 pilgrims were included. 54.8% and 13.3% reported respiratory and gastrointestinal symptoms, respectively. 18.4% acquired respiratory viruses, notably rhinovirus (10.1%) and coronaviruses (5.6%) and 39.9% bacteria, notably Haemophilus influenzae (18.9%) and Streptococcus pneumoniae (14.1%). The acquisition of gastrointestinal pathogens was lower, with enteroaggregative Escherichia coli (18.9%) and enteropathogenic Escherichia coli (10.5%) being the most frequent. A decrease was observed in the acquisition rates of pathogens in 2020–2021 GMT.Female pilgrims were more at risk of respiratory and gastrointestinal symptoms. Respiratory symptoms were associated with virus acquisition (aRR: 2.20, 95%CI [1.38–3.50]) and S. pneumoniae acquisition (aRR: 2.76, 95%CI = [1.64–4.62]). Using hand soap was associated with a decrease in the acquisition of rhinovirus (aRR: 0.42, 95%CI [0.22–0.80]) and coronavirus (aRR: 0.42, 95%CI [0.22–0.81]). Using face masks was associated with a decrease in reporting of respiratory symptoms (aRR: 0.54, 95% [0.35–0.86]). ConclusionHand washing with soap and wearing face masks should be recommended to GMT pilgrims.