World Youth Day 2008: did it stress Sydney hospitals?

The planned annual Hajj to the holy shrines in Makkah, Saudi Arabia, is recognized as one of the largest recurring religious mass gatherings globally, and the outbreak of infectious diseases is of major concern. We aim to study the incidence, etiology, risk factors, length of hospital stay, and mortality rate of pneumonia amongst pilgrims admitted to Al-Ansar general hospital, Madinah, Saudi Arabia during the Hajj period of December 2004-November 2013. A retrospective analysis of all patients diagnosed and admitted as pneumonia was done. Patients were assessed according to the CURB-65 scoring system and admitted to the ward or intensive care unit accordingly. Throat and nasopharyngeal swabs, sputum, and blood culture were collected prior to antibiotic treatment. 1059 patients were included in the study (23% of total hospital admissions and 20% of ICU admissions). The mean age of participants was 56.8 years, the Male:Female ratio was 3:1, and the lengths of stay in the ward and intensive care units were 5 and 14.5 days, respectively. The main organisms cultured from sputum were Klebsiella Pneumoniae, Streptococcus Pneumoniae, Haemophilus Influenzae, Staphylococcus Aureus, Pseudomonas aeruginosa, and community-acquired MRSA. The mortality rate in the ward was 2.4%, while the rate in the ICU was 21.45%. The organisms which caused pneumonia were found to be different during Hajj. The usual standard guideline for the treatment of pneumonia was ineffective for the causative organisms. Therefore, specific adjustments in the guidelines are needed. All efforts should be made to determine the infectious agent. Healthcare workers and pilgrims should adhere to preventive measures.

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“…Olympic Games and World Cup football tournament) or recurrent events at the same location (e.g. the Hajj pilgrimage in Saudi Arabia) [6].…”

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confidence: 99%

Mass gathering medicine (Hajj Pilgrimage in Saudi Arabia): The clinical pattern of pneumonia among pilgrims during Hajj

Shirah

Zafar²,

Alferaidi³

et al. 2017

Journal of Infection and Public Health

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“…Variation existed in the studies regarding the impact of MGEs on local hospitals. Eight studies reported a raw number of patients who presented or were admitted to EDs/hospitals, (ranging from three to 401), 19,20 while the other three studies reported either the rate of patient presentations to EDs (0.005/1000) 21 or hospital administration rate (3.6-102/1000). 22,23 Syndromic Indicators used in EDs for Communicable Diseases Most studies (n = 7; 64%) mentioned the use of a surveillance system based on patients' signs and symptoms.…”

Section: Measurement Of Ed Activities During Mgesmentioning

confidence: 99%

“…33 Previous studies have reported some syndromes used to detect communicable diseases during MGEs, such as fever, rash, and abdominal pain, indicating diseases such as measles, influenza, and respiratory tract infections. [23][24][25] However, information as to the exact SIs and corresponding diagnosis codes (ie, International Classification of Diseases 10th Revision [ICD-10]) used to detect the impact of communicable diseases on EDs in MGE is still very limited, 21,30 which makes comparative research and recommendations for standardized Figure 1. PRISMA Flow Diagram, Adapted from Liberati, et al 15 Abbreviations: ED, emergency department; MGE, mass-gathering event; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.…”

Section: Syndromic Indicators Used In Eds For Communicable Diseasesmentioning

confidence: 99%

The Impact of Mass Gatherings on Emergency Department Patient Presentations with Communicable Diseases Related to Syndromic Indicators: An Integrative Review

Qiu

Crilly

Zimmerman

et al. 2020

Prehosp. Disaster med.

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Background:Mass-gathering events (MGEs) are commonly associated with a higher than average rate of morbidity. Spectators, workers, and the substantial number of MGE attendees can increase the spread of communicable diseases. During an MGE, emergency departments (EDs) play an important role in offering health care services to both residents of the local community and event attendees. Syndromic indicators (SIs) are widely used in an ED surveillance system for early detection of communicable diseases.Aim:This literature review aimed to develop an understanding of the effect of MGEs on ED patient presentations with communicable diseases and their corresponding SIs.Method:An integrative literature review methodology was used. Online databases were searched to retrieve relevant academic articles that focused on MGEs, EDs, and SIs. Inclusion/exclusion criteria were applied to screen articles. The Standard Quality Assessment Criteria for Evaluating Primary Research (QualSyst) assessment tool was used to assess the quality of included papers.Results:Eleven papers were included in this review; all discussed the impact of an MGE on patient presentations with communicable diseases at EDs/hospitals. Most included studies used the raw number of patients who presented or were admitted to EDs/hospitals to determine impact. Further, the majority of studies focused on either respiratory infections (n = 4) or gastrointestinal infections (n = 2); two articles reported on both. Eight articles mentioned SIs; however, such information was limited. The quality of evidence (using QualSyst) ranged from 50% to 90%.Conclusions:Limited research exists on the impact of MGEs on ED presentations with communicable diseases and related SIs. Recommendations for future MGE studies include assessing differences in ED presentations with communicable diseases regarding demographics, clinical characteristics, and outcomes before, during, and after the event. This would benefit health care workers and researchers by offering more comprehensive knowledge for application into practice.

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“…Mass gatherings are one of the most signiﬁcant items on the global health security agenda [3] and can occur spontaneously without previous alerts, such as political rallies, protests, or planned gatherings. They can be either periodic at different localities like the Olympics and World Soccer Cup or repeated events at the same place like the Hajj in Saudi Arabia, which is one of the largest mass gathering worldwide [4].…”

Section: Introductionmentioning

confidence: 99%

Disease Burden on Health Facilities in Governorates South of Karbala During the Arbaeenia Mass Gathering in Iraq in 2014: Cross-Sectional Study

Hantoosh

Lami

Saber

2019

JMIR Public Health Surveill

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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.

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World Youth Day 2008: did it stress Sydney hospitals?

Cited by 9 publications

References 13 publications

Mass gathering medicine (Hajj Pilgrimage in Saudi Arabia): The clinical pattern of pneumonia among pilgrims during Hajj

Mass gathering medicine (Hajj Pilgrimage in Saudi Arabia): The clinical pattern of pneumonia among pilgrims during Hajj

The Impact of Mass Gatherings on Emergency Department Patient Presentations with Communicable Diseases Related to Syndromic Indicators: An Integrative Review

Disease Burden on Health Facilities in Governorates South of Karbala During the Arbaeenia Mass Gathering in Iraq in 2014: Cross-Sectional Study

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