Caracterización epidemiológica y factores de riesgo asociados a la peregrinación religiosa a Arabia Saudí: resultados de una cohorte prospectiva 2008-2009

introduction: religious pilgrimage to saudi arabia, or hajj, is a basic tenet of the islamic doctrine and, after ramadan, annually represents the largest human concentration (with up to 5% of from the eu) around the world. such a gathering entails health risks. methods: a prospective observational study was conducted of a cohort of pilgrims attended for pre-travel preventive activities in the north metropolitan international health unit (santa coloma de gramenet, barcelona, spain) from 2009-2010. results: a total of 193 pilgrims were assessed and 135 (69.9%) were men. their mean age (sd) was 37.1 (16.9) years. among the pilgrims, 176 (91.2%) were immigrants, mainly from pakistan (54.9%), morocco (29%), bangladesh (4.1%) or other countries (7.2%). the pilgrims stayed in saudi arabia a mean (sd) of 16.3 (9.2) days. eighty (41.5%) opted for the 1 month-long pilgrimage (hajj) and 113 (58.5%) for the shorter umra. one or more pathological antecedent was recorded in 29 (15%). vaccination coverage was >75% for tetanus-diphtheria, pneumococcal and quadrivalent meningitis but was only 70.4% for influenza. after returning, 41 (13.5%) pilgrims reported some health problem; of these, 61% were respiratory tract symptoms. the risk factors independently correlated with the presence of diseases was the number of days in saudi arabia (or=1.06; 95% ci: 1.01-1.11) and taking part in the hajj compared with the umra (or=1.08; 95% ci: 1.07-1.12). conclusions: religious pilgrims from spain to saudi arabia are mainly young and healthy. those with longer stays abroad contracted a higher number of diseases.