• Alimuddin Zumla, Abdulaziz Bin Saeed, Badriah Alotaibi, Saber Yezli, Osman Dar, Kingsley Bieh, Matthew Bates, Tamara Tayeb, Peter Mwaba, Shuja Shafi, Brian McCloskey, Eskild Petersen, and Esam I Azhar.
• Division of Infection and Immunity, University College London, and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK; Global Centre for Mass Gatherings, Ministry of Health, Riyadh, Saudi Arabia; Global Health Department, Public Health England, London, UK; University of Zambia-University College London Medical School Research and Training Project University Teaching Hospital, Lusaka, Zambia; Special Infectious Agents Unit, King Fahd Medical Research Centre, and Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdul Aziz University, Jeddah, Saudi Arabia.
• Int. J. Infect. Dis. 2016 Jun 1; 47: 86-91.

AbstractTuberculosis (TB) is now the most common infectious cause of death worldwide. In 2014, an estimated 9.6 million people developed active TB. There were an estimated three million people with active TB including 360000 with multidrug-resistant TB (MDR-TB) who were not diagnosed, and such people continue to fuel TB transmission in the community. Accurate data on the actual burden of TB and the transmission risk associated with mass gatherings are scarce and unreliable due to the small numbers studied and methodological issues. Every year, an estimated 10 million pilgrims from 184 countries travel to the Kingdom of Saudi Arabia (KSA) to perform the Hajj and Umrah pilgrimages. A large majority of pilgrims come from high TB burden and MDR-TB endemic areas and thus many may have undiagnosed active TB, sub-clinical TB, and latent TB infection. The Hajj pilgrimage provides unique opportunities for the KSA and the 184 countries from which pilgrims originate, to conduct high quality priority research studies on TB under the remit of the Global Centre for Mass Gatherings Medicine. Research opportunities are discussed, including those related to the definition of the TB burden, transmission risk, and the optimal surveillance, prevention, and control measures at the annual Hajj pilgrimage. The associated data are required to develop international recommendations and guidelines for TB management and control at mass gathering events. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

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