Clinical and molecular study of infectious pathologies associated with the Grand Magal of Touba

Le Grand Magal de Touba (GMT) se déroule chaque année au Sénégal regroupant 4-5 millions de pèlerins. Les infections semblent fréquentes chez les pèlerins malades pendant leur séjour à Touba. Ce travail se compose de quatre axes : 1) surveillance syndromique dans les structures sanitaires de la région médicale de Diourbel durant le GMT de 2016. Les registres de consultations documentés par les soignants ont été analysés. Les symptômes les plus fréquents étaient les céphalées, les symptômes d’infection gastro-intestinale, la fièvre, les symptômes d’infection respiratoire et le paludisme, 2) surveillance des infections chez les pèlerins de Dielmo et Ndiop participant au GMT de 2017-2021 a montré que les symptômes respiratoires étaient associés avec l’acquisition de virus et de S. pneumoniae et l’efficacité des mesures préventives sur les pathogènes et les symptômes, 3) investigation microbiologique des patients ayant consulté au centre de santé de Mbacké durant le GMT de 2018 à 2021 pour des symptômes d’infection qui nous a permis de démontrer que les taux de positivité des agents pathogènes potentiels chez les patients souffrant de symptômes respiratoires ou gastro-intestinaux ou d'une maladie systémique fébrile étaient élevés et 4) revue de littérature sur les éléments factuels attestant de la transmission du SARS-CoV-2 lors des principaux rassemblements religieux de masse. Malgré le risque potentiel de propagation du COVID-19 dans les pays où se déroulent ces grands rassemblements religieux, la plupart des événements organisés jusqu'à présent n'ont pas déclenché de grandes épidémies, à l'exception notable du Kumbh Mela en 2021.The Grand Magal of Touba (GMT) takes place each year in the holy city of Touba in Senegal. An estimated 4 to 5 million pilgrims participate each year. Infections are common among pilgrims during their stay in Touba. In this work we developed four parts: 1) syndromic surveillance among ill pilgrims during the 2016 GMT in Diourbel medical region structures. The consultation registers documented by the medical staff were analyzed. The most frequent symptoms were headache, symptoms of gastrointestinal infection, fever, symptoms of respiratory infection and malaria, 2) Surveillance of infections among pilgrims in the villages of Dielmo and Ndiop, participating to the GMT from 2017 to 2021 showed that respiratory symptoms were associated with the acquisition of viruses and S. pneumoniae and the effectiveness of preventive measures on pathogens and symptoms, 3) microbiological investigation of patients who consulted at the Mbacké health center during the GMT from 2018 to 2021 for symptoms of infection which demonstrated that the positivity rates of potential pathogens in patients with respiratory or gastrointestinal symptoms or febrile systemic illness were high and 4) literature review of the evidence for SARS-CoV-2 transmission at major mass religious gatherings. Despite a high risk of large religious gatherings being superspreading events for SARS-CoV-2, most events held to date have not triggered large outbreaks, with the notable exception of the Kumbh Mela in 2021

An epidemic threshold on which to base risk assessment for COVID-19 outbreaks at mass gathering events

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Lack of SARS-CoV-2 among Grand Magal de Touba pilgrims consulting for respiratory symptoms in October 2020

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The 2020 Grand Magal of Touba, Senegal in the time of the COVID-19 pandemic

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Tokyo olympics, Hajj pilgrimage, Grand Magal of Touba and COVID-19

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Epidemiological Investigations of Infectious Diseases among Mobile Populations at the University Hospital Institute Mediterranean Infection in Marseille, France

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The Grand Magal of Touba was spared by the COVID-19 pandemic

International audienceIn the context of the coronavirus disease-2019 (COVID-19) pandemic, all mass gathering (MG) events have been cancelled. The Grand Magal took place on October 6, 2020, in Touba, Senegal, which was the only MG event organized in 2020. This Muslim pilgrimage gathers about four million Muslim Mourides from Senegal and beyond. No significant increase in COVID-19 cases was therefore observed at the national level in the weeks following the Grand Magal. This successful strategy is an invitation to better promote community commitments by public authorities in their various strategies

Risk factors for symptoms of infection and the acquisition of pathogens among pilgrims at the Grand Magal of Touba, 2017–2021

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Circulation of SARS-CoV-2 virus among pilgrims at the 2022 Grand Magal of Touba

International audienceAmong pilgrims departing from two villages in South Senegal who participated to the event, 45% had respiratory symptoms and 7% acquired SARS-CoV-2 nasopharyngeal carriage. Among patients with respiratory symptoms sampled at a health care centre close to Touba, 5% tested positive. In contrast, no SARS-CoV-2 infection was observed in 2020–21

Epidemiology of bacterial resistance at the Grand Magal of Touba in Senegal

Background: The Grand Magal of Touba (GMT) associates with risks of infection, but no study on the circulation of resistant bacteria has yet been conducted. Materials and methods: qPCR was performed on rectal samples from GMT pilgrims between 2018 and 2021, before and after their participation in the gathering. Rectal samples from between 2018 and 2020 were also cultured on specific media, and antibiotic susceptibility testing was performed. Results: Forty-one of the 296 (13.8%) pilgrims had at least one gastrointestinal symptom and 91/290 (31.4%) acquired pathogenic bacteria, mostly Escherichia coli. A total of 54.7% of pilgrims reported washing their hands more frequently than usual and 89.2% used soap. One hundred and five (36.2%) acquired at least one resistance gene, notably CTX-M A (21.0%), SHV (16.5%) and TEM (8.2%). The strains isolated by culture were mostly E. coli. These bacteria were found to be sensitive to carbapenems and resistant to amoxicillin and amoxicillin-clavulanic acid. The acquisition of enteroaggregative E. coli was independently associated with CTX-M A and TEM acquisition. Conclusion: Pilgrims presented a risk for acquisition of CTX-M A after the GMT. Surveillance of the prevalence of resistant bacteria and the occurrence of associated clinical infections among pilgrims are necessary in the future