Health Risks, Preventive Behaviours and Respiratory Illnesses at the 2019 Arbaeen: Implications for COVID-19 and Other Pandemics

Farah Al-Ansari, Masoud Mirzaei, Basma Al-Ansari, Mohammad Basim Al-Ansari, Mohammed Saeed Abdulzahra, Harunor Rashid, Grant A. Hill-Cawthorne, Mustafa Al Ansari, Joel Negin and Katherine Conigrave
Additional contact information
Farah Al-Ansari: Faculty of Medicine and Health, Sydney School of Medicine (Central Clinical School), University of Sydney, Camperdown, NSW 2006, Australia
Masoud Mirzaei: Yazd Cardiovascular Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd 89151-73160, Iran
Basma Al-Ansari: Faculty of Medicine and Health, Sydney School of Medicine (Central Clinical School), University of Sydney, Camperdown, NSW 2006, Australia
Mohammad Basim Al-Ansari: Office of Ayatollah Al-Ansari, Sydney, NSW 2200, Australia
Mohammed Saeed Abdulzahra: Department of Medicine, College of Medicine, University of Kufa, Najaf 540011, Iraq
Harunor Rashid: The Children’s Hospital at Westmead, National Centre for Immunisation Research and Surveillance (NCIRS), Westmead, NSW 2145, Australia
Grant A. Hill-Cawthorne: Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Camperdown, NSW 2006, Australia
Mustafa Al Ansari: Faculty of Medicine and Health, Sydney School of Medicine (Central Clinical School), University of Sydney, Camperdown, NSW 2006, Australia
Joel Negin: Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Camperdown, NSW 2006, Australia
Katherine Conigrave: Faculty of Medicine and Health, Sydney School of Medicine (Central Clinical School), University of Sydney, Camperdown, NSW 2006, Australia

IJERPH, 2021, vol. 18, issue 6, 1-27

Abstract: COVID-19 poses grave challenges for mass gatherings. One of the world’s largest annual gatherings, Arbaeen, occurs in Iraq. We studied respiratory symptoms and risk and protective factors using representative sampling of Arbaeen pilgrims in 2019 to inform prevention of COVID-19 transmission. Structured sampling was used to recruit walking pilgrims. A questionnaire asked about respiratory symptoms, risk, and preventive factors, including hygiene-related resources of toilet facilities. The commonest symptom reported by the 1842 participants (63.3% male, 36.7% female) was cough (25.6%). Eating in mawkibs (rest areas) with indoor kitchens and drinking only packaged water were associated with lower risk of cough (AOR = 0.72, CI = 0.56–0.94; AOR = 0.60; CI = 0.45–0.78, p < 0.05). Facemask use was associated with increased risk of cough (AOR = 2.71, CI = 2.08–3.53, p < 0.05). Handwashing was not protective against cough, or against (one or more of) cough, fever, or breathlessness in multivariate analysis. Toilet facilities often lacked running water (32.1%) and soap (26.1%), and had shared hand towels (17%). To reduce risk of respiratory infections including COVID-19 during Arbaeen or other mass gatherings, needs include running water, soap, and hygienic hand drying options or hand sanitiser. Education on proper handwashing and facemask approaches and monitoring around food preparation and eating spaces are needed.

Keywords: Arbaeen; global health; infectious disease transmission; public health; communicable diseases; mass gathering medicine; COVID-19; facemasks; handwashing (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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