title: Trend of diseases among Iranian pilgrims during five consecutive years based on a Syndromic Surveillance System in Hajj.
abstract: BACKGROUND
  Every year more than 2 million people depart from Iran to Saudi Arabia for Hajj ritual whichcan be faced with some different diseases. There are not much information about frequencies and trend of diseasesin Hajj. The main objective of this study was to determine the trend of prevalent diseases during five consecutiveHajj rituals among Iranian pilgrims.
  
  
  METHODS
  We established a specific surveillance system for all Iranian pilgrims who had participated in Hajjfrom 2004 to 2008. We monitored the pilgrims' health status before departure, through their journey. The understudieddiseases were 19 selected types of diseases in the Hajj. The occurrences of diseases were recorded on aresearchers-made questionnaire. We used chi-square test for analysis with the alpha lower than 5% to reject thenull hypothesis.
  
  
  RESULTS
  During 5 consecutive periods, a total of 254,823 of Iranian pilgrims were monitored for more commondiseases with this system. The most prevalent diseases were as follows: at least one type of respiratory involvement(71.26%), common cold like syndrome (47.15%), and musculoskeletal disorders (18.67%), The frequencyof respiratory involvement was lower in 2006 than other years (p <0.001).There were statistically significantdifferences between the numbers of hospitalization and patients who were referred back to Iran with theyear of Hajj (p <0.001).
  
  
  CONCLUSIONS
  Health managers should be informed about trend and frequency of more prevalent diseases inHajj. Easy access to health information via such surveillance system can be possible.
authors.affiliation: Professor of infectious diseases, Department of Community Medicine, Tehran University of Medical Sciences, Tehran, Iran. razavy@sina.tums.ac.ir.
authors.forename: Seyed Mansour
authors.initials: SM
authors.lastname: Razavi
authors.affiliation: Educational Development Center, Tehran University of Medical Sciences, Tehran, Iran. Sabourika@yahoo.com.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Sabouri-Kashani
authors.affiliation: Associate Professor of Ophthalmology, Department of Ophthalmology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. drhziai@gmail.com.
authors.forename: Hossein
authors.initials: H
authors.lastname: Ziaee-Ardakani
authors.affiliation: General Practitioner, Hajj Medical Center, Tehran, Iran. aminrezataba@yahoo.com.
authors.forename: Aminreza
authors.initials: A
authors.lastname: Tabatabaei
authors.affiliation: Associate Professor of Community Medicine, Department of Community Medicine, Tehran University of Medical Sciences, Tehran, Iran. mkarbakh@tums.ac.ir.
authors.forename: Mojgan
authors.initials: M
authors.lastname: Karbakhsh
authors.affiliation: Professor of Physiology, Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. sadeghipour@sina.tums.ac.ir.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Sadeghipour
authors.affiliation: MD, PhD of Proteomics, Proteomics Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. rtaba@yahoo.com.
authors.forename: Seyed Abdolreza
authors.initials: SA
authors.lastname: Mortazavi-Tabatabaei
authors.affiliation: Associate Professor of Community Medicine, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. psalamati@sina.tums.ac.ir.
authors.forename: Payman
authors.initials: P
authors.lastname: Salamati
keywords: Disease; Iran; Saudi Arabia; prevalence; respiratory disorders