Syndromic surveillance during 2022 Uganda martyrs’ commemoration

Abstract Mass gatherings frequently include close, prolonged interactions between people, which presents opportunities for infectious disease transmission. Over 20,000 pilgrims gathered at Namugongo Catholic and Protestant shrines to commemorate 2022 Uganda Martyr’s Day. We described syndromes suggestive of key priority diseases particularly COVID–19 and viral hemorrhagic fever (VHF) among visiting pilgrims during May 25−June 5, 2022. A suspected COVID–19 case was defined as ≥2 signs or symptoms of: fever >37.5 0 C, flu, cough, and difficulty in breathing whereas a suspected VHF case was defined as fever >37.5 0 C and unexplained bleeding among pilgrims who visited Namugongo Catholic and Protestant shrines from May 25 to June 5, 2022. Pilgrims were sampled systematically at entrances and demarcated zonal areas to participate in the survey. Additionally, we extracted secondary data on pilgrims who sought emergency medical services from Health Management Information System registers. Descriptive analysis was conducted to identify syndromes suggestive of key priority diseases based on signs and symptoms. Among 1,350 pilgrims interviewed, 767 (57%) were female. The mean age was 37.9 (±17.9) years. Nearly all pilgrims 1,331 (98.6%) were Ugandans. A total of 236 (18%) reported ≥1 case definition symptom and 25 (2%) reported ≥2 symptoms. Twenty-two (1.6%) were suspected COVID–19 cases and three (0.2%) were suspected VHF cases from different regions of Uganda. Among 5,582 pilgrims who sought medical care from tents, 538 (9.6%) had suspected COVID–19 and one had suspected VHF. Almost one in fifty pilgrims at the 2022 Uganda Martyrs’ commemoration had at least one symptom of COVID–19 or VHF. Overall, we identified 4 Viral Hemorrhagic Fever and 560 COVID-19 suspected cases during the 2022 Uganda Martyrs’ commemoration. Intensified syndromic surveillance and planned laboratory testing capacity at mass gatherings is important for early detection of public health emergencies that could stem from such events.