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American Journal of  
Life Science and Innovation (AJLSI)

Characteristics and Outcomes of  Conditions Encountered in Primary Care During FIFA 
World Cup 2022 in Qatar - A Cross-Sectional Study

Lolwa Al-Maslamani1*, Naheel Seyam2

Volume 2 Issue 3, Year 2023
ISSN: 2833-1397 (Online)

DOI: https://doi.org/10.54536/ajlsi.v2i3.2145
https://journals.e-palli.com/home/index.php/ajlsi

Article Information ABSTRACT

Received: September 30, 2023 

Accepted: October 26, 2023 

Published: November 03, 2023

The FIFA World Cup, a massive football event, presents significant challenges to healthcare 
systems. Primary healthcare plays a crucial role in patient-provider interactions and serves as 
a cornerstone of  the system. This study aimed to assess the frequency, characteristics, and 
outcomes of  conditions treated in primary care facilities during the FIFA World Cup Qatar 
2022. A cross-sectional study was conducted from November 15 to December 20, 2022. All 
patients visiting the 29 governmental primary healthcare facilities in Qatar were included. 
Anonymous patient data, including age, sex, nationality, diagnosis, treatments, visit date, 
consultation type, and outcomes, were extracted from electronic medical records. A total 
of  401,962 patients were seen in primary care, with an average age of  34.50 ±19.3 years. 
Less than 1% held Hayya Visa (n=3120, 0.8%), and roughly 2% were referred to secondary 
care (8494, 2.1%). The most prevalent diagnoses were Type 2 diabetes mellitus (n=59670, 
7.7%) and upper respiratory tract infection (n=47364, 6.2%). Paracetamol was the most 
frequently prescribed medication (n=69,960, 11.9%). Elderly patients (OR=1.23), non-
Qatari patients (OR=1.25), and male patients (OR=1.17) were more likely to be referred to 
secondary care. Hayya cardholders were about twice as likely to be transferred (OR=2.40). 
Primary healthcare services operated efficiently during the FIFA World Cup 2022 in Qatar. 
The majority of  cases involved managing chronic diseases and minor respiratory infections. 
Football enthusiasts and non-Qatari individuals were more often referred to secondary 
healthcare. These findings can guide policymakers in enhancing primary healthcare services 
for future mass gatherings.

Keywords

Football, Primary Care, Qatar, 
Diabetes Mellitus, Respiratory 
Tract Infections

INTRODUCTION 
The FIFA World Cup is a major global football event 
that presents substantial challenges to the healthcare 
system (Karami, 2018). According to the World Health 
Organization, mass gatherings refer to planned occasions 
where a large number of  individuals convene, potentially 
straining the resources, planning, and response capabilities 
of  the host community’s health system. Therefore, a well-
prepared plan is necessary to address these challenges 
(Wilder-Smith & Steffen, 2019).
In 2022, Qatar, a member of  the Gulf  Cooperation 
Council in the Middle East, hosted the FIFA World Cup, 
attracting around 1.5 million visitors. Qatar undertook 
significant investments and endeavours to enhance its 
infrastructure and healthcare system in preparation for 
this international event. These efforts encompassed 
augmenting the capacity of  the healthcare system by 
expanding emergency and ambulance services, as well 
as constructing new hospitals and primary healthcare 
centers (Organization, 2023).
Primary healthcare constitutes the initial point of  contact 
between patients and healthcare providers, serving as a 
fundamental pillar of  the healthcare system (Shi, 2012). 
It delivers comprehensive preventive, diagnostic, and 
therapeutic services that are readily accessible, aiming to 
enhance health outcomes, reduce costs, and optimise the 
utilisation of  secondary care services. Due to its broad scope, 
primary healthcare encounters the majority of  patients and 
various medical conditions (Starfield et al., 2005).

Numerous studies have examined the most prevalent 
medical presentations encountered in primary care. For 
example, a systematic review conducted by Finley et al. 
encompassed eighteen studies from twelve countries 
across five continents. It revealed that upper respiratory 
tract infections, hypertension, routine health check-ups, 
diabetes, depression, anxiety, pneumonia, acute otitis 
media, back pain, and dermatitis were among the most 
frequently diagnosed conditions. Simultaneously, patients 
most commonly reported visiting for symptomatic issues, 
including cough, back pain, abdominal discomfort, 
pharyngitis, dermatological concerns, fever, headache, leg 
symptoms, respiratory concerns, and fatigue (Finley et al., 
2018).
Similarly, a cross-sectional study was conducted to evaluate 
prevalent conditions in general practice settings. It found 
that pulmonary, gastrointestinal, orthopaedic, and cardiac 
issues constituted 67.71% of  the total health problems 
encountered in general practice. Furthermore, the study 
identified acute upper respiratory tract infections as the 
most prevalent health issue seen in primary care facilities 
(6.67%), followed by chronic conditions like hypertension 
and diabetes mellitus (Chen et al., 2022). Similar findings 
were reported by other studies as well (Adib et al., 1995; 
Gong et al., 2020).
In Qatar, primary healthcare services are administered 
through a network of  healthcare centres. Aligned with 
health demands, a strategic plan for primary healthcare 
was devised, with health centres strategically distributed 

1 Al Rayyan Health Center, Ar-Rayyan, Qatar
2 Primary Health Care Corporation, Doha, Qatar
* Corresponding author’s e-mail: Lolwaalmaslamani58@outlook.com



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Am. J. Life Sci. Innov. 2(3) 24-29, 2023

across three regions: central, northern, and western areas 
(Al-Kuwari et al., 2020; Ali Abdulmalik et al., 2022). A 
total of  29 government-run health centres provide both 
preventative and therapeutic medical services to the 
entirety of  Qatar’s population (Al-Kuwari et al., 2021). 
The present study aimed to determine the most common 
conditions encountered in primary care facilities during 
the FIFA World Cup 2022 in Qatar. It aims to offer 
clinical insights that can be applied in subsequent mass 
gatherings, contributing to a better understanding of  
prevalent conditions in primary care centres during such 
events and enhancing the preparedness of  the healthcare 
system, particularly primary healthcare, for future large-
scale occasions.

MATERIALS AND METHODS
Between November 15 and December 20, 2022, a cross-
sectional study was carried out to identify the most 
commonly encountered conditions in primary care 
facilities during the World Cup. Qatar’s primary health 
services are provided through 29 governmental primary 
health centres that are dispersed throughout the country. 
These centres operate on weekdays, with 18 of  them 
also remaining open on public holidays and weekends 
and 10 operating around the clock. The analysis included 
all patients who visited these governmental primary 
healthcare centres during the specified period. The 
study included all patients accessing primary healthcare 
centres in Qatar, irrespective of  age, gender, nationality, 
or condition. No exclusion criteria were applied. Given 
that all patients attending the healthcare centres were 
encompassed in the study, a sample size calculation was 
optional.

Study Instrument and Variables 
A data collection tool was devised to gather baseline 
information on patients, encompassing age, gender, 

nationality, diagnosis, treatments, and date of  visit. 
Additionally, the type of  consultation (in-person or 
virtual) and the visit’s outcomes (discharge or transfer) 
were recorded. Diagnoses and related data were extracted 
from electronic records, all of  which were de-identified to 
safeguard patient privacy and confidentiality.

Statistical Analysis 
Data analysis was conducted using the Statistical Package 
for the Social Sciences program for Windows (V.25.0; 
IBM Corp, Armonk, New York, USA). Quantitative 
variables were presented using means and standard 
deviations, while qualitative variables were expressed as 
frequencies and percentages. A bar chart was employed 
for data visualisation. The chi-square test and T-test 
were applied as appropriate to ascertain the statistical 
significance between baseline characteristics of  patients 
and visit outcomes (transfer or discharge). A p-value less 
than 0.05 was considered statistically significant.

RESULTS 
A total of  401,962 patients were encompassed in the 
study. Their ages spanned from 0 to 109 years, with an 
average age of  34.50 ± 19.3. Notably, about two-thirds of  
these patients were of  non-Qatari nationality (n=261,598, 
65.1%), and the majority were females (n=236,160, 
58.8%). It was observed that one in every four 
consultations took place virtually (n=99,821, 24.8%). A 
small proportion of  participants, less than 1%, possessed 
a Hayya Visa (n=3,120, 0.8%), and approximately 2% 
were transferred to secondary care facilities (8,494, 2.1%). 
The detailed baseline characteristics of  the patients can 
be found in Table 1.
The frequency of  visits to primary healthcare facilities 
fluctuated throughout the course of  the event. Illustrated 
in Figure 1, the daily visits ranged from 2,335 to 17,261 
visits per day.

Table 1: Baseline Characteristics of  the Patients
Baseline Characteristics of  the Patients n (%)
Age, mean, SD 34.50 ± 19.3
Age in years 0-17 80118 (11.1)

18-45 205604 (19.9)
46-59 71788 (51.2)
>=60 44452 (17.9)

Nationality Non-Qatari 261598 (65.1)
Qatari 140364 (34.9)

Sex Male 165802 (41.2)
Female 236160 (58.8)

Consultation type In-person 302141 (75.2)
Virtual Consultation 99821 (24.8)

Hayaa-Visa holder No 398842 (99.2)
Yes 3120 (0.8)

Discharge status Discharged 393468 (97.9)
Transferred 8494 (2.1)



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Most Common Diagnosis
Physicians recorded a total of  769,945 diagnoses. Type 2 
diabetes mellitus without complications (n=59,670, 7.7%) 
was the most frequently registered diagnosis, followed 

closely by upper respiratory tract infections (n=47,364, 
6.2%). Patients holding the Hayya card exhibited similar 
diagnoses to those without it as shown in Table 2.

Figure 1: Number of  Visits to Primary Healthcare Centers During World Cup 2022 in Qatar

Table 2: Most common registered diagnoses 
The most common diagnosis among Hayya card 
holders, TN=4656

The most common diagnosis among other patients, 
TN=765289

Diagnosis n (%) Diagnosis n (%)
Viral upper respiratory tract infection 637 (13.7) Type 2 diabetes mellitus without complication 59504 (7.8)
Type 2 diabetes mellitus without complication 166 (3.6) Viral upper respiratory tract infection 46727 (6.1)
Essential (primary) hypertension 119 (2.6) Essential (primary) hypertension 27216 (3.6)
Unspecified place of  occurrence 96 (2.1) Issue of  repeat prescription 16223 (2.1)
Unspecified activity 95 (2.0) Vitamin D deficiency 13843 (1.8)
Well baby 73 (1.6) Telephone consultation 13007 (1.7)
Abdominal pain 58 (1.2) Well baby 11079 (1.4)

The Most Commonly Prescribed Medications
Over the evaluated period, primary care physicians issued 
a total of  589,155 prescriptions. The most frequently 
prescribed medication was Paracetamol (n=69,960, 

11.9%). Following closely, Cholecalciferol tablets 
(n=40,931, 6.9%) and Ibuprofen tablets (n=20,901, 3.5%) 
were among the commonly recommended medications 
by physicians as shown in Table 3.

Table 3: Most common prescribed medications
The most common medications are given to Hayya 
card holders, TN=5753

The common medications are given to other 
patients, TN=583402

Diagnosis n (%) Diagnosis n (%)
Paracetamol 975 (16.9) Paracetamol 68985 (11.8)
Ibuprofen 288 (5.0) Cholecalciferol 40931 (7.0)
Vitamin C 261 (4.5) Ibuprofen 20613 (3.5)
Chlorhexidine 252 (4.4) Chlorhexidine 17934 (3.1)
levocetirizine 248 (4.3) Vitamin C 16556 (2.8)
Amoxicillin/clavulanate 223 (3.9) Levocetirizine 14750 (2.5)
Dextromethorphan (Cough Suppressant) 189 (3.3) Diclofenac topical 13399 (2.3)
Diclofenac topical 185 (3.2) Cetirizine/pseudoephedrine 13131 (2.3)
Cetirizine/pseudoephedrine 179 (3.1) Xylometazoline 12172 (2.1)
Diphenhydramine/ammonium chloride 155 (2.7) Amoxicillin/clavulanate 12020 (2.1)



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Association Between Visit Outcomes and Baseline 
Characteristics of  the Patients 
As indicated in Table 4, individuals aged 60 years and 
older exhibited elevated rates of  referral in comparison 
to their younger counterparts (P=<0.001). Non-Qatari 
patients (P<0.001), male patients (P<0.001), those opting 
for in-person consultations (P<0.001), and individuals 
holding the Hayya card (P<0.001) demonstrated higher 
instances of  transfer to secondary care.
The outcomes of  the logistic regression analysis are 

detailed in Table 5. The findings indicate that patients 
of  advanced age (OR=1.23), non-Qatari nationality 
(OR=1.25), and male gender (OR=1.17) exhibit a 
higher likelihood of  being referred to secondary care 
facilities. Notably, individuals holding the Hayya card were 
approximately twice as likely to be transferred (OR=2.40). 
Moreover, patients who opted for in-person consultations 
were four times more inclined to be transferred to 
secondary care hospitals compared to those who chose 
virtual consultations (OR=4.063, 95% CI 3.732-4.423).

Table 5: Logistic Regression of  the Association Between Visit Outcomes and Baseline Characteristics
Variable Odds ratio, 95% Confidence interval P value
Age 1.004 (1.001-1.008) 0.013
Age*; 0 – 17 years 1.29 (1.19-1.41) <0.001
Age: 18 – 45 years 1.01 (0.94-1.09) 0.747
Age; > 60 years 1.23 (1.15-1.30) <0.001
Nationality** 1.25 (1.19-1.31) <0.001
Sex*** 1.17 (1.12-1.22) <0.001
Consultation type ***** 4.52 (4.15-4.91) <0.001
Hayya card holder ***** 2.40 (2.08-2.78) <0.001

Table 4: Logistic Regression of  the Association Between Visit Outcomes and Baseline Characteristics 
Baseline Characteristics of  the Patients Visit outcome P value

Discharged Transferred
Age, years ±SD 34.5 ± 19.3 35.1 ± 19.8 0.004
Age, group 0-18 78487 (98.0) 1631 (2.0) <0.001

18-45 201127 (97.8) 4477 (2.2)
45-60 70488 (98.2) 1300 (1.8) 
>=60 43366 (97.6) 1086 (2.4)

Nationality Non-Qatari 255821 (97.8) 5777 (2.2) <0.001
Qatari 137647 (98.1) 2717 (1.9)

Sex Male 161821 (97.6) 3981 (2.4) <0.001
Female 231647 (98.1) 4513 (1.9)

Consultation type In-person 294241 (97.4) 7900 (2.6) <0.001
Virtual Consultation 99227 (99.4) 594 (0.6)

Hayya card holder No 390555 (97.9) 8287 (2.1) <0.001
Yes 2913 (93.4) 207 (6.6)

DISCUSSION
The primary objective of  this study was to identify 
the most prevalent conditions encountered in primary 
care facilities during the World Cup 2022 while also 
examining their attributes and outcomes. The research 
findings highlighted that type 2 diabetes mellitus without 
complications and upper respiratory tract infections were 
the most frequently observed cases. Virtual consultations 
emerged as a widely adopted approach, with the majority 
of  cases not necessitating a referral. It was noteworthy 
that a significant number of  visits were dedicated to the 
ongoing management of  diabetes mellitus, underscoring 
that routine care remained unaffected by the international 
sporting event. Additionally, chronic conditions like 

hypertension and dyslipidemia constituted common 
reasons for seeking care at these centres, as discerned 
from the results. In consonance with established literature, 
our study corroborated the prevalence of  acute upper 
respiratory infections as a frequent presentation in primary 
care. The prescription patterns further substantiated this 
observation. Notably, widely used medications included 
pain relievers such as Paracetamol and Ibuprofen, along 
with treatments for upper respiratory infections such as 
Vitamin C, Levocetirizine, and Dextromethorphan.
Furthermore, our study findings were consistent with the 
annual statistical report from Qatar’s primary healthcare 
corporation, which underscored that type 2 diabetes 
mellitus without complications and upper respiratory 



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tract infections rank as the most common conditions 
treated in primary care in the country (PHCC, 2023).
Concerns were initially raised regarding the potential 
risk of  outbreaks of  Middle East respiratory syndrome 
coronavirus (MERS-CoV) and COVID-19 during the 
FIFA World Cup 2022 in Qatar (Al-Tawfiq et al., 2022; 
Llorente-Nieto et al., 2023). However, the results of  our 
report were against these concerns. Although upper 
respiratory tract infections were prevalent, chronic 
conditions such as diabetes and hypertension took 
precedence over respiratory infections as the primary 
reasons for seeking care in primary health settings. 
The results of  this study revealed notable variation in the 
volume of  visits to primary healthcare facilities during 
the assessed period. This fluctuation could be attributed 
to the reduced availability of  healthcare centres on 
weekends. Another contributing factor was that certain 
routine consultations and procedures, including child 
screenings, antenatal care, and routine immunisations, 
were exclusively conducted on weekdays.
Moreover, the majority of  patients were discharged; our 
findings revealed that individuals of  advanced age were 
more likely to be referred to secondary care hospitals. This 
could potentially be attributed to the higher likelihood 
of  elderly patients presenting with multiple health issues 
and urgent conditions necessitating expedited referral to 
secondary care settings.
The findings that non-Qatari patients and Hayya card 
holders were more inclined to be referred could be 
explained by their tendency to present with acute 
conditions that may need to be fully addressed in the 
primary care setting. In contrast, Qatari and non-
Hayya cardholders often sought care for chronic 
disease management alongside acute concerns. Another 
possibility could be a lower threshold for referral for 
patients holding Hayya cards.
Of  particular interest, nearly one-quarter of  all 
consultations were conducted virtually. This utilisation 
rate of  telemedicine services aligned with previous 
reports from Qatar (PHCC, 2023). Hence, the expansion 
of  telemedicine services was not impeded by the mass 
gathering at the World Cup 2022.
Parallel to the primary healthcare services, Qatar 
established over 110 clinics and 212 mobile units in the 
most frequented areas during the tournament, ensuring 
convenient and efficient access to medical services. This 
proactive approach resulted in effective case management 
and enhanced preparedness. (“Qatar’s Healthcare Sector 
Treated 51,809 Patients During-FIFA World Cup 
Qatar-2022,” 2022).
This study has several strengths. It is the first study to 
determine the characteristics and outcomes of  the 
conditions encountered in primary care during a FIFA 
World Cup event. All encountered patients were included. 
Several measures were assessed, and a multivariate analysis 
was performed. However, this study has some limitations. 
Participants’ comorbidities and the outcomes of  referrals 
were not assessed.

CONCLUSIONS
In conclusion, the study revealed that primary healthcare 
services, including the successful integration of  virtual 
consultations, throughout the FIFA World Cup 2022 
in Qatar. Predominantly, routine cases involving the 
management of  chronic illnesses and common upper 
respiratory conditions were the predominant encounters. 
Notably, visitors and non-Qatari patients exhibited 
higher referral rates compared to their counterparts. This 
underscores the pivotal role of  primary healthcare in 
fortifying readiness for large-scale gatherings.

LIMITATIONS
The study has some limitations, such as its lack of  
assessment of  participants’ comorbidities, which could 
have provided valuable insights into the complexity 
of  cases encountered in primary care during the FIFA 
World Cup. Additionally, outcomes of  referrals were 
not investigated, leaving a gap in understanding the 
effectiveness and appropriateness of  transfers to 
secondary care facilities.

Suggestion for Further Study
Future research endeavours could delve into a 
comprehensive evaluation of  comorbidities among 
patients attending primary care facilities during mass 
gatherings, providing a more nuanced understanding 
of  complex cases. Additionally, investigating the long-
term outcomes and experiences of  patients referred to 
secondary care following such events would contribute to 
a holistic assessment of  healthcare delivery. Furthermore, 
comparative studies across various international 
sporting events could offer valuable insights into the 
generalizability of  findings and the optimisation of  
healthcare preparedness strategies.

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