Health issues in the Hajj pilgrimage: a literature review.

The Hajj pilgrimage to Mecca, Saudi Arabia, is one of the largest annual mass gatherings in the world, and has a strong impact on international public health. This paper presents an overview from a systematic search of the published literature on health risks and services in the Hajj for 2005-2014, with the aim of providing health policy recommendations to prevent health risks. Of the 335 studies initially identified, 60 met the inclusion criteria for the review. Studies identified were diverse in methodology and focus. The results were classified into 3 main categories: communicable diseases, noncommunicable diseases and health services. Although, improvement was observed throughout the years, there are always new public health challenges in each Hajj season. There is a need to improve health management of the Hajj, particularly by strengthening international collaboration.