Tabriz Valiasr International Hospital Publication International Journal of Aging 2980-9827 2 1 2024 03 11 Risk Factors and Distribution of Infectious Diseases among the Older Adults on a Pilgrimage to Arba’een Mass Gathering e8 e8 10.34172/ija.2024.e8 EN Hosein Azizi https://orcid.org/0000-0002-4163-6158 Behrouz Naghili Pirhossein Kolivand Fariba Abbasi Shahriyar Ghanbarzadeh Javid Elham Davtalab Esmaeili Ehsan Sarbazi Journal Article 10.34172/ija.2024.e8 2023 10 10 2024 04 17 Objectives: To determine the syndromic symptoms associated with infectious diseases in the older adults attending the Arba’een pilgrimage mass gathering. Design: A cross-sectional study. Setting(s): Outpatient clinics during the Arba’een pilgrimage. Participants: A total of 200 subjects were randomly chosen among the older adults attending outpatient clinics during the Arba’een pilgrimage in Iraq in 2022. Outcome measures: The syndromic symptoms of infectious diseases, including acute fever and rash, influenza-like syndrome, severe acute respiratory syndrome (SARS), food poisoning, acute diarrhea, bloody diarrhea, and chronic cough were evaluated using a valid checklist provided by the Center for Disease Control and Prevention (CDC) and the Ministry of Health (Iran). Multiple logistic regression analysis was carried out to estimate the crude and adjusted odds ratios (AORs) with 95% confidence intervals. Results: The mean age of the participants was 68.3 years, with nearly 60% of the participants being men. Among 72 (29.4%) mask users, 71% changed masks in less than 8 hours. The most common syndromic symptom was flu-like illness (42%). In the final analysis, not using a mask (AOR=1.5, 1.1 – 4.7), diabetes (AOR=3.01, 1.4 – 7.7), and smoking (AOR=1.75, 1.02 – 3.8) increased the risk of the flu-like syndrome and severe respiratory disease symptoms. Conclusions: Flu and respiratory illnesses are common among the aging population attending Arba’een mass gatherings. To prevent potential outbreaks, it is necessary to perform a differential diagnosis of respiratory diseases such as influenza and coronavirus disease 2019 (COVID-19).