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ABSTRACT Introduction: Medical planning for mass gathering events is founded on the structuring of assistance to the population involved and the preservation of the response capacities of the local healthcare system. Large sporting events attended by crowds are increasingly common in society. These events have been shown to be dangerous, generating higher incidences of injuries and illnesses than usual. Thus, planning and the interaction among various public and private sectors are required for the prevention of and response to emergencies and incidents involving multiple victims. Methods: Recently published studies on medical planning for large sports events and current federal agency legislation were selected to conduct an updated review on the subject. Results: After reading titles and abstracts, 159 papers were chosen for a full reading, 50 of which met the eligibility criteria and were included as the basis for this review. The size of the audience, the weather, and the behavior of the crowd seem to contribute significantly to the estimated need for resources in sporting events. Conclusion: Mass events require planning for prevention and to strengthen the resilience of host communities. There is a still a lack of evidence that these events increase the risk of the mass spreading of disease. Level of Evidence: V; Expert opinion .
RESUMEN Introducción: La planificación médica de eventos masivos tiene como pilares la estructuración de la atención a la población involucrada y la preservación de las capacidades de respuesta del sistema local de salud. Los grandes eventos deportivos a los que asisten multitudes son cada vez más comunes en la sociedad. Estos eventos han demostrado ser peligrosos, generando una mayor incidencia de lesiones y enfermedades de lo habitual. Por lo tanto, es necesaria la planificación y la interacción de diversos sectores, públicos y privados, para la prevención y respuesta a emergencias o incidentes con múltiples víctimas. Métodos: Se seleccionaron estudios recientes publicados sobre la planificación médica de grandes eventos deportivos y la legislación vigente en organismos federales con el objetivo de realizar una revisión actualizada sobre el tema. Resultados: Después de leer los títulos y resúmenes, se eligieron 159 artículos para lectura completa y 50 cumplieron los criterios de elegibilidad y se utilizaron como base para esta revisión. El tamaño del público, las condiciones climáticas y el comportamiento de la multitud parecen contribuir significativamente a la estimación de los requisitos de recursos en los eventos deportivos. Conclusión: Los eventos masivos requieren una planificación para la prevención y el fortalecimiento de la resiliencia de las comunidades anfitrionas. Todavía no hay pruebas de que estos eventos aumenten el riesgo de propagación masiva de enfermedades. Nivel de Evidencia: V; Opinión experta .
RESUMO Introdução: O planejamento médico para eventos de massa tem como pilares a estruturação dos atendimentos à população envolvida e a preservação da capacidade de resposta do sistema de saúde local. Grandes eventos esportivos frequentados por multidões são cada vez mais comuns na sociedade. Esses eventos têm se mostrado perigosos, gerando maiores incidências de lesões e doenças do que o habitual. Dessa forma, é necessário planejamento e interação de diversos setores, públicos e privados, para prevenção e resposta à ocorrência de emergências ou incidentes com múltiplas vítimas. Métodos: Foram selecionados trabalhos recentes publicados sobre o planejamento médico para grandes eventos esportivos e a legislação vigente em órgãos federais com o objetivo de realizar uma revisão atualizada sobre o assunto. Resultados: Após a leitura de títulos e resumos, 159 trabalhos foram escolhidos para leitura integral e 50 preencheram os critérios de elegibilidade e foram usados como base para esta revisão. O tamanho do público, as condições climáticas e o comportamento da multidão parecem contribuir significativamente para a estimativa da necessidade de recursos em eventos esportivos. Conclusão: Eventos de massa exigem planejamento para prevenção e fortalecimento da resiliência das comunidades anfitriãs. Ainda faltam evidências de que esses eventos aumentem o risco de propagação maciça de doenças. Nível de evidência: V; Opinião do especialista .
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Objective: To illustrate the pharmacy indicators during the mass gathering hajj as a new initiative in the Kingdom of Saudi Arabia. Methods: It is a new initiative project drove by national mass gathering pharmaceutical programs. The projects drove the mass gathering medicine guidelines and the international business model, pharmacy project guidelines project management institution guidelines of a new project. The initiative project is written through project management professionals and consisted of several parts, including the initial phase, the planning phase, the execution phase and the monitoring and controlling phase. Results: The mass gathering community pharmacy services with a defined vision, mission and goals. The services had various advantages, including clinical and economic on patients and healthcare services as demonstrated in the review. The continuation of the project assured by risk management elements description. Furthermore, the monitoring and controlling of the services as illustrated. The transition to operation project, though closing project stage declared in the analysis. Conclusion: The mass gathering medication safety is a new initiative project is part of the mass gathering medicine. There are various part of medication safety services can be started during mass gathering; it is highly recommended in Saudi Arabia.
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Objectives: To explore the mass gathering hajj emergency pharmacy as new initiatives in the Kingdom of Saudi Arabia. Methods: It is a new initiative project drove by national mass gathering pharmaceutical programs. The projects drove the mass gathering medicine guidelines and the international business model, pharmacy project guidelines project management institution guidelines of a new project. The initiative project is written through project management professionals and consisted of several parts, including the initial phase, the planning phase, the execution phase and the monitoring and controlling phase. Results: The mass gathering emergency pharmacy services with a defined vision, mission and goals. The services had various benefits, including clinical and economical on pilgrims, as described in the review. The continuity of the project assured by the risk management model description. Moreover, the monitoring and controlling of the services as demonstrated. The transition to operation project though closing project stage exemplified in the analysis. Conclusion: The mass gathering emergency pharmacy is a new initiative project in the mass gathering medicine. There are various emergency pharmacy services can be started during the mass gathering with clinical emergency pharmacy; it is highly suggested in Saudi Arabia.
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Objective: To declare the clinical pharmacy services during the mass gathering hajj period as a new initiative in the Kingdom of Saudi Arabia. Methods: It is a new initiative project drove by national mass gathering pharmaceutical programs. The projects drove the mass gathering medicine guidelines and the international business model, pharmacy project guidelines project management institution guidelines of a new project. The initiative project is written through project management professionals and consisted of several parts, including the initial phase, the planning phase, the execution phase and the monitoring and controlling phase. Results: The mass gathering clinical pharmacy services with a defined vision, mission and goals. The services had multiple benefits, including clinical and economical on the healthcare system, as described in the review. The continuation of the services assured by risk management elements description. Moreover, the monitoring and controlling of the projects as illustrated. The transition to operation project, though closing project stage illustrated in the analysis. Conclusion: The clinical pharmacy services during the mass gathering hajj period is a new initiative project in the mass gathering medicine. Multiple clinical pharmacy services can be started during a mass gathering with an emphasison decrease morbidity and mortality; it is highly recommended in the Kingdom of Saudi Arabia.
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Objective: To demonstrate the mass gathering hajj medication safety as new initiatives in the Kingdom of Saudi Arabia. Methods: It is a new initiative project drove by national mass gathering pharmaceutical programs. The projects drove the mass gathering medicine guidelines and the international business model, pharmacy project guidelines project management institution guidelines of a new project. The initiative project is written through project management professionals and consisted of several parts, including the initial phase, the planning phase, the execution phase and the monitoring and controlling phase. Results: The medication safety services during the mass gathering with a defined vision, mission and goals. The services had multiple benefits, including clinical and economical on patients and healthcare services, as described in the review. The extension of the project assured by risk management elements description. Besides, the monitoring and controlling of the services as illustrated. The conversion of operation project, though closing project stage illustrated in the analysis. Conclusion: The mass gathering medication safety is a new initiative project that is part of the mass gathering medicine. There is various part of medication safety services can be started during the mass gathering; it is highly recommended in Saudi Arabia.
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Objectives: To demonstrate the pharmacy infection control services during the mass gathering Hajj period as new initiatives in the Kingdom of Saudi Arabia. Methods: It is a new initiative project drove by national mass gathering pharmaceutical programs. The projects drove the mass gathering medicine guidelines and the international business model, pharmacy project guidelines project management institution guidelines of a new project. The initiative project is written through project management professionals and consisted of several parts, including the initial phase, the planning phase, the execution phase and the monitoring and controlling phase. Results: The mass gathering pharmacy infection control services with a defined vision, mission and goals. The services had various aids, including clinical and economical on pilgrims, as illustrated in the assessment. The continuation was of the project assured by the risk management model description. Besides, the monitoring and controlling of the services as declared. The transition to operation project, though closing the project stage, explored in the analysis. Conclusion: The mass gathering pharmacy infection control services are a new initiative, part of the mass gathering medicine. There are various pharmacy transition care services can be started during the mass gathering with an emphasis on pharmacy personnel, infection control; it is highly suggested to implement in Saudi Arabia.
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Objective: To explore the pharmaceutical care services during mass gathering (MG) Hajj at the healthcare organizations in Saudi Arabia (SA). Methods: It is a descriptive analysis of a newly established program at the MOH in SA called MG pharmaceutical care program during Hajj and Umra Seasons, which was analyzed within the Pharmacy Strategic Plan 2012-2020 and update the plan with new Saudi vision 2030. Results: MG pharmaceutical care program is a new program established by the healthcare organizations in the last four years, which amongst to provide pharmaceutical care services in various fields. Conclusion: The mass gathering of pharmaceutical care services is a new initiative, part of the mass gathering medicine. The program should expand after the foundation stage with performance indication monitoring and follow up. Further assessment of the new project is required to validate the clinical and economic outcomes to research the high level of quality and professionalism in the future.
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The Kumbh Mela is considered the world’s largest mass gathering event (MGE). It represents a unique anthropogenicburden on the river ecosystem and may confer antimicrobial resistance among microbial communities. The present studyexplains the characterization of microbial isolates associated with Godavari River under the advent of the mass bathingevent using culture dependent approach. The isolates were identified by sequencing of 16S rRNA gene and ITS region.Further, the isolates were screened for antibiotic susceptibility against 22 antibiotics using disc diffusion method. A total of63 bacterial and 21 fungal isolates were isolated under the temporal variation of the event. Kocuria and Staphylococcuswere the most prevalent bacterial genera in the samples collected before and during the event, while Meyerozyma andCandida predominate among fungal communities. A group of antibiotics impeding the bacterial protein synthesis werefound to be most effective against C67% of bacterial isolates. However, C37–67% of isolates could escape the action ofinhibitors of bacterial cell wall synthesis. Moreover, bacterial isolates belonging to genera Acinetobacter, Corynebacteriumand Brevibacterium showed higher resistance towards the antibiotics. Observations from the current study suggest likelymicrobial taxa as targets to mitigate the waterborne infections during the MGE.
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@#The World Health Organization recommends that countries or organizations that host mass gatherings plan ahead and prepare for possible public health events to ensure a safe environment for local residents, participants and travellers.1 Public health events during mass gatherings can also affect non-host countries. There are numerous reports of the spread of infectious diseases by travellers returning from mass gatherings,2 which can potentially pose the risk of an outbreak of new infectious diseases to travellers’ home countries. With more frequent travel across borders, it is prudent that non-host countries prepare for mass gathering events.
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Introduction The large-scale international events of the 2015 World Scout Organization Movement (WOSM) were held in Yamaguchi, Japan. Thirty-three thousand participants from 155 nations gathered for 12 days and held an exchange program. We provided health care service facilities and a staff of 200 multinational medical professionals to address various health concerns. The health issues as well as the strategies on how to organize multinational medical staff in the event are described in the study.Methods The author analyzed the contents of the conference/meeting documents, operation manual, daily reports, memorandum, and other various reports, and evaluated the system and activities of the medical services. There was one medical facility (JH) and four first aid points (FAP) on site. Two hundred medical professionals from 20 different countries volunteered to participate in WOSM, and comprised the international service team (IST). We divided IST members into several groups according to their specialties, professional experience, gender, and nationality. Results During the event, there were 3,247 patients at the JH. The major illnesses were heat stroke, dehydration, common colds, pharyngitis, upper respiratory tract inflammations, contusions, cut, sunburn, and sunlight dermatitis. There were 2,291 visitors to the FAPs, and the most frequent ailments were shoe sores, contusions, cuts, heat stroke, dehydration, sunburn, and sunlight dermatitis. While there were differences in medical culture, there were no problems with administering medical treatment or communicating within the teams.Conclusions Individuals who visit Japan during the summer need to be educated on preventative measures for sunburn, sunlight dermatitis, and heat stroke. There were two reasons why multinational medical professionals collaborated in this difficult environment. First, even though there were different cultural backgrounds, medical professionals could still share cultural values. Second, there was good communication and therefore less stress within the work environment.
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Pohnpei State’s Division of Primary Health Care implemented enhanced surveillance for early warning and detection of disease to support the 8th Micronesian Games (the Games) in July 2014. The surveillance comprised 11 point-of-care sentinel sites around Pohnpei, Federated States of Micronesia, collecting data daily for eight syndromes using standard case definitions. Each sentinel site reported total acute care encounters, total syndrome cases and the total for each syndrome. A public health response, including epidemiological investigation and laboratory testing, followed when syndrome counts reached predetermined threshold levels. The surveillance was implemented using the web-based Suite for Automated Global Electronic bioSurveillance Open-ESSENCE (SAGES-OE) application that was customized for the Games. Data were summarized in daily situation reports (SitReps) issued to key stakeholders and posted on PacNet, a Pacific public health e-mail network. Influenza-like illness (ILI) was the most common syndrome reported (55%, n = 225). Most syndrome cases (75%) were among people from Pohnpei. Only 30 cases out of a total of 408 syndrome cases (7%) presented with acute fever and rash, despite the large and ongoing measles outbreak at the time. No new infectious disease outbreak was recorded during the Games. Peaks in diarrhoeal and ILI cases were followed up and did not result in widespread transmission. The technology was a key feature of the enhanced surveillance. The introduction of the web-based tool greatly improved the timeliness of data entry, analysis and SitRep dissemination, providing assurance to the Games organizers that communicable diseases would not adversely impact the Games.
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The Ministry of Health in Samoa, in partnership with the Pacific Community, successfully implemented enhanced surveillance for the high-profile Third United Nations Conference on Small Island Developing States held concurrently with the popular local Teuila festival during a widespread chikungunya outbreak in September 2014. Samoa’s weekly syndromic surveillance system was expanded to 12 syndromes and 10 sentinel sites from four syndromes and seven sentinel sites; sites included the national hospital, four private health clinics and three national health service clinics. Daily situation reports were produced and were disseminated through PacNet (the email alert and communication tool of the Pacific Public Health Surveillance Network) together with daily prioritized line lists of syndrome activity to facilitate rapid response and investigation by the Samoan EpiNet team. Standard operating procedures for surveillance and response were introduced, together with a sustainability plan, including a monitoring and evaluation framework, to facilitate the transition of the mass gathering surveillance improvements to routine surveillance. The enhanced surveillance performed well, providing vital disease early warning and health security assurance. A total of 2386 encounters and 708 syndrome cases were reported. Influenza-like illness was the most frequently seen syndrome (17%). No new infectious disease outbreaks were recorded. The experience emphasized: (1) the need for a long lead time to pilot the surveillance enhancements and to maximize their sustainability; (2) the importance of good communication between key stakeholders; and (3) having sufficient staff dedicated to both surveillance and response.
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Mass gatherings pose public health challenges to host countries, as they can cause or exacerbate disease outbreaks within the host location or elsewhere. In July 2012, the 11th Festival of Pacific Arts (FOPA), a mass gathering event involving 22 Pacific island states and territories, was hosted by Solomon Islands. An enhanced syndromic surveillance (ESS) system was implemented for the event. Throughout the capital city, Honiara, 15 sentinel sites were established and successfully took part in the ESS system, which commenced one week before the FOPA (25 June) and concluded eight days after the event (22 July). The ESS involved expanding on the existing syndromic surveillance parameters: from one to 15 sentinel sites, from four to eight syndromes, from aggregated to case-based reporting and from weekly to daily reporting. A web-based system was developed to enable data entry, data storage and data analysis. Towards the end of the ESS period, a focus group discussion and series of key informant interviews were conducted. The ESS was considered a success and played an important role in the early detection of possible outbreaks. For the period of the ESS, 1668 patients with syndrome presentations were received across the 15 sentinel sites. There were no major events of public health significance. Several lessons were learnt that are relevant to ESS in mass gathering scenarios, including the importance of having adequate lead in time for engagement and preparation to ensure appropriate policy and institutional frameworks are put in place.
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Objective To investigate clinical service delivered at the Polyclinic of Beijing 2008 Olympic and Paralympic Village and outcomes of the medical patients visited there.to provide experiences in medical care service for other mass-gatherings in the future.Methads Clinical data of all the medical patients evaluated at the Polyclinic during July 27 to August 27 and during August 29 to September 19,2008 were reviewed retrospectively.with univariate and multivariate analyses.Results In total.1537 and 1206 medical patients visited the Polyclinic at the Olympic and Paralympic Village,respectively.Proportion of athletes visited was hisher during the Paralympic Games than that during the Olympic Games(14.2% vs.9.8%,P<0.01).We reeeived 775 patients(50.4%)with acute respiratory tract disorders,including 16 cases(1.0%)with asthma,during the Olympic Games,and 686(56.9%),including eight cases (0.7%)with asthma,during the Paralympic Games,and antibiotics were prescribed for 149(9.7%)and162(13.4%)of them,respectively.Twelve(0.8%)patients were hospitalized during the Olympic Games and four(0.3%)during the Paralyrnpie Games,and age equal to or nlore than 55 years and digestive disease were independent risk factors for hospitalization,with odds ratios(ORs) of 5.3 and 9.5 and their 95% confidence intervals(Cls)of 1.4-19.6 and 2.5-36.4,respectively.Conclusions Acute respiratory disorder was the most connnon cause for medical visits in the Polyclinic.Asthma did not play a significant role to iniluence athletes'performance in the Beijing 2008 Olympic and Paralympic Games.Antibiotic prescription in the Polyclinic had been controled to an acceptable level.Conditions in elder patients and those with digestive disorder tended to be severe.deserving more attention infuture's mass gathering.