Journal of travel medicine
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Review
Sacred journeys and pilgrimages: health risks associated with travels for religious purposes.
Pilgrimages and travel to religious mass gatherings (MGs) are part of all major religions. This narrative review aims to describe some characteristics, including health risks, of the more well-known and frequently undertaken ones. ⋯ Communicable and NCD differ among the different religious MGs. Gaps exists in the surveillance, reporting and data accessibility of health risks associated with religious MGs. A need exists for the uniform implementation of a system of real-time monitoring of diseases and morbidity patterns, utilizing standardized modern information-sharing platforms. The health needs of pilgrims can then be prioritized by developing specific and appropriate guidelines.
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Travel-related skin problems are a common reason for healthcare consultations. We present a clinical approach to diagnosing skin diseases in travellers, emphasizing clinical examination and epidemiological clues such as travel history, incubation time and at-risk behaviours. ⋯ Diagnostic approaches emphasize the importance of travel history, at-risk activities during travel and lesion distribution. At-risk activities include sun exposure, walking barefoot, exposure to sea and fresh water, hiking in forested or jungle areas, exposure frequency to mosquitoes and sandflies, poor hygiene and food intake, drug history and sexual behaviour. Morphological characteristics (vesicula, bullae, pustule, papule, nodule, plaque, oedema and ulcer), distinguishing between single and multiple skin lesions, localized or generalized, and whether mucosa, scalp, palmar or plantar surfaces are affected, provide further clinical clues. Systemic signs and symptoms such as fever and pruritus will aid in the differential diagnosis algorithms. With a thorough clinical assessment and knowledge of geographic and exposure-related risk factors, the differential diagnosis of travel-associated skin conditions can be narrowed down allowing for timely clinical management.