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Prevalence and risk factors of foodborne disease among Iranian pilgrims during the Arbaeen mass gathering in Karbala, Iraq[1]

Jabbary S, Kolivand P, Shamspour N, Saberian P, Doroudi T, Hasani-Sharamin P, Rafiemanesh H · 2026 · Sci Rep

Summary

Cross-sectional survey of 1,030 Iranian pilgrims at the Arbaeen ceremony (Iranian Red Crescent mass-gathering research center) measuring foodborne-disease prevalence, symptoms, and KAP (knowledge/attitudes/practices) food-safety scores. Foodborne-disease prevalence was 23.2% (9.4% moderate, 6.7% severe); commonest symptoms headache (42.5%), abdominal pain (27.0%), nausea (21.4%), diarrhea (20.7%). Independent risk factors: consumption of UNPACKAGED WATER (OR 5.23), longer trip duration (OR 4.33), lower education (OR 2.23), first-time travel (OR 1.65); poor-to-moderate food-safety practices raised risk 2.10x. Recommends food/water safety improvements and targeted education for first-time, elderly, and lower-education travelers.

So what

The quantitative backbone the food-safety shelf needed: nearly a quarter of pilgrims got foodborne illness, and the dominant modifiable risk — unpackaged water, OR 5.23 — is a purchase-order/infrastructure fix, echoing the free-water PPR finding (Locoh-Donou) on the sanitation side. The KAP framing ties it directly to the Zaini education-delivery triad (origin-country, event-long, local-language) and to the campsite/catering Purple Guide chapters. Pairs with Ghanbari (same Arbaeen population, health-service utilization) to build the Arbaeen evidence base the English literature lacks.

Key findings

  • 1,030 Arbaeen pilgrims; foodborne-disease prevalence 23.2% (6.7% severe)
  • Symptoms: headache 42.5%, abdominal pain 27%, nausea 21.4%, diarrhea 20.7%
  • Top risk: unpackaged water OR 5.23; trip duration OR 4.33; first-time OR 1.65
  • Poor food-safety practices 2.10x risk - KAP-modifiable
  • Water safety = the infrastructure fix; targeted education for vulnerable groups

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