Authors
M H Feiz Haddad4; K Safaei1; R Feiz Haddad3; B Jahani2; 1 Ahvaz Jundishapur University of Medical Sciences , Iran; 2 Ahvaz Jundishapur University of Medical Sciences, Iran, Iran; 3 Department of Nursing, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran; 4 Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Discussion
Background and Objectives: In recent years, a religious festival movement as one of the largest human gathering drew an estimated 20 million pilgrims at the holy confluence of the Iraq. This phenomenal movement and its impacts have gone for the most part undocumented. To address this new phenomenon in terms of leishmaniasis prevalence, authors decided to study and evaluate collected data to monitor and preparedness as well as response to public health emergencies at the event. This study also describes the trends of the cutaneous leishmaniasis around the event with particular emphasis on preventive and mitigation strategies; the capacity for surveillance and response to disease outbreaks and implications of lessons learned for future religious mass gatherings. Methodology: A cross-sectional demography and epidemiological study was carried out on examined 2637 patients with cutaneous leishmaniasis during righteous festival monitoring trends fluctuations on the disease for the period of 2011 to 2016. Furthermore, Biometric parameters included age, gender, season, habitation situation, and lesion numbers’, sites’, and sizes’ were recorded in cutaneous leishmaniasis epidemiologic data summary forms. Findings & discussion: Of 2637 patients, 1174 (44.5%) were females and 1463 (55.5%) males. Maximum and minimum prevalence were observed in winter (52.33%) and summer (7.62%) which trend fluctuation was matched perfectly with the timing of this religious community (Table 1). Furthermore, maximum infection rate was recorded for patients above 20 year-old (45.3%) and minimum rate was documented for patients over 60 year old (0.9%). Habitation situation showed 1557 (59%) were settled in temporary accommodations and 1080 (41%) were housed in tents which probably set up on hosts liars during of the festival. From lesion location point of view most lesions were on hands (37.5%), face (30%), feet (26.3%), and other organs (6.2%) and the number of lesions ranged from 1 to 5 and sized varied from 0.5 to 5.5 cm. The trend of the disease showed a constant growth from which 2011 begun to rise and reached to a peak at 2015. Conclusion: Conclusively, cutaneous leishmaniasis became a serious der¬matological health problem due to a recent great demographic movement to neigh¬boring country Iraq with a high incidence to an already en¬demic area. In addition, unfavorably factors on the prevalence of cutaneous leishmaniasis in studied region could increase the risk of exposure to leishmaniasis because study of biometric parameters in endemic regions confirmed significant effects on prevalence of cutaneous leishmaniasis during holding of this religious event. These findings can be effective for assessing disease prevention programs for the next mass gathering. For that reason, in order to decrease the risk of exposure, we suggest routine health controls must be implemented, effec¬tive measures must be set in place for vector control, temporary accommodations conditions in hi 
