“…The fact that TB patients living in the Western provinces and in the Eastern province have, respectively, significantly higher and lower risks of MDR-TB than those in the rest of the country, which has instead important implications for TB and MDR-TB control. A recent study showed that western provinces, and in particular the Makkah province, have the highest TB incidence in the country (26/ 100,000 in Makkah) (15). This is explained by the fact that Makkah is the holy place for Muslims and is visited annually by millions of pilgrims from high countries where TB is highly en- demic, including Pakistan, Bangladesh, India, Somalia, Sudan, Ethiopia, and Eritrea.…”