Addressing Public Health Challenges of Hajj Pilgrims: A Comprehensive Narrative Review
Abstract
Introduction: The Hajj pilgrimage is a pillar of Islam that must be carried out by every able-bodied Muslim. However, millions of pilgrims who gather each year face complex health challenges, including advanced age, comorbidities, and extreme environmental conditions. This study aims to identify the health risks of hajj pilgrims and the challenges in efforts to improve pilgrim health.
Methods: The research method used is a narrative review, collecting related literature from various sources. The results of the study indicate that hajj pilgrim mortality is still high, mainly caused by cardiovascular disease, respiratory disorders, and heat stroke.
Results: The mortality rate among Hajj pilgrims ranges from 1-3 per 1,000 per season, with 461 deaths recorded in 2024. Cardiovascular diseases (70%), respiratory infections, and heat stroke are the leading causes. Risk factors include advanced age, diabetes, hypertension, and extreme temperatures. Pilgrims' low compliance with vaccinations, especially meningitis and influenza, increases the risk of disease outbreaks. The crowded environment facilitates respiratory disease transmission, while limited access to healthcare and language barriers further complicate medical response. Health outreach, vaccination programs, international collaboration, and telemedicine are strategic measures that can help reduce mortality rates among Hajj pilgrims by improving health awareness, managing chronic conditions, and ensuring timely medical care.
Conclusion: In conclusion, more comprehensive health interventions and are needed to reduce morbidity and mortality among hajj pilgrims.
References
General Authority for Statistics Saudi Arabia. GASTAT: 1,833,164 Pilgrims Perform Hajj in 1445 AH. 2024 [cited 2024 Sep 29]. Available from: https://www.spa.gov.sa/en/N2123407
Kementerian Agama Republik Indonesia. Kuota 2024 Terbesar Sepanjang Sejarah Penyelenggaraan Ibadah Haji. 2024 [cited 2024 Sep 29]. Available from: https://haji.kemenag.go.id/v5/detail/kuota-2024-terbesar-sepanjang-sejarah-penyelenggaraan-ibadah-haji#:~:text=Kuota%20Indonesia%20pada%20penyelenggaraan%20ibadah,lainnya%20untuk%20jemaah%20haji%20khusus
Kementerian Kesehatan Republik Indonesia. Sederet Inovasi Tekan Angka Kematian Jemaah Haji. 2024 [cited 2024 Sep 29]. Available from: https://sehatnegeriku.kemkes.go.id/baca/rilis-media/20240517/2545520/sederet-inovasi-tekan-angka-kematian-jemaah-haji/
Ahmed QA, Arabi YM, Memish ZA. Health risks and precautions for Hajj pilgrims. Lancet. 2006 Mar 25;367(9515):1008-15. doi:10.1016/S0140-6736(06)68429-8. Available from: https://doi.org/10.1016/S0140-6736(06)68429-8
Demiris G, Oliver D, Washington K. A Roadmap to Behavioral Intervention Research in Hospice and Palliative Care. In: 2019. p. 1–15. doi:10.1007/978-3-030-04894-0_1. Available from: https://doi.org/10.1007/978-3-030-04894-0_1
Paré G, Kitsiou S. Chapter 9?Methods for Literature Reviews. In: Lau F, Kuziemsky C, editors. Handbook of eHealth Evaluation: An Evidence-based Approach [Internet]. Victoria (BC): University of Victoria; 2017 Feb 27. Available from: https://www.ncbi.nlm.nih.gov/books/NBK481583/
Ahmed QA, Arabi YM, Memish ZA. Health risks at the Hajj. Lancet. 2006;367(9515):1008-15. DOI: 10.1016/S0140-6736(06)68430-4. Available from: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(06)68430-4/fulltext
Al-Tawfiq JA, Memish ZA. The Hajj: updated health hazards and current recommendations for 2012. Euro Surveill. 2012;17(41):20295. doi:10.2807/ese.17.41.20295-en. Available from: https://doi.org/10.2807/ese.17.41.20295-en
Rustika, Puspasari HW, Kusnali A. Analisis Kebijakan Pelayanan Vaksinasi Meningitis Jemaah Umrah di Indonesia. Buletin Penelitian Sistem Kesehatan. 2018;21(1):60-70. DOI: 10.22435/hsr.v21i1.96.60-70. Available from: http://dx.doi.org/10.22435/hsr.v21i1.96.60-70
Rustika, Kusnali A, Puspasari HW, et al. Tingkat Pengetahuan, Sikap, dan Tindakan Jemaah Haji Terkait Istithaah Kesehatan di Indonesia. Buletin Penelitian Sistem Kesehatan. 2019;22(4):245-254. DOI: 10.22435/hsr.v22i4.2244. Available from: https://doi.org/10.22435/hsr.v22i4.2244
Memish ZA, Stephens GM, Steffen R, Ahmed QA. Emergence of medicine for mass gatherings: lessons from the Hajj. Lancet Infect Dis. 2012;12(1):56-65. DOI: 10.1016/S1473-3099(11)70337-1. Available from: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(11)70337-1/fulltext
Gautret P, Benkouiten S, Al-Tawfiq JA, Memish ZA. The spectrum of respiratory pathogens among returning Hajj pilgrims: myths and reality. Int J Infect Dis. 2016;47:83-5. DOI: 10.1016/j.ijid.2016.03.016. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7758857/pdf/JEGH-10-4-263.pdf
Rachmawati L. Analisis kebijakan pelayanan vaksinasi meningitis jemaah umrah di Indonesia. Jurnal Kesehatan Masyarakat Indonesia. 2020;15(2):1-12. DOI: 10.36412/jkmi.v15i2.1699144. Available from: https://download.garuda.kemdikbud.go.id/article.php?article=1699144&val=4892&title=ANALISIS%20KEBIJAKAN%20PELAYANAN%20VAKSINASI%20MENINGITIS%20JEMAAH%20UMRAH%20DI%20INDONESIA
Marbun RM. Tingkat pengetahuan, sikap, dan tindakan jemaah haji terkait istithaah kesehatan di Indonesia. Dedikasi Jurnal Pengabdian Masyarakat. 2020;2(1):11-9. DOI: 10.36412/dedikasi.v2i1.11028. Available from: https://jurnal.uinbanten.ac.id/index.php/dedikasi/article/view/11028
Yezli S, Assiri AM, Alhakeem RF, Turkistani AM, Alotaibi BM. Meningococcal disease during the Hajj and Umrah mass gatherings. Int J Infect Dis. 2016;47:60-4. DOI: 10.1016/j.ijid.2016.03.007. Available from: https://www.ijidonline.com/article/S1201-9712(16)30150-8/fulltext
Hoosen MF, Janse van Rensburg MN, Naidoo R, Erasmus RT. Morbidity amongst South African Hajj pilgrims in 2023: a retrospective cohort study. S Afr Med J. 2023;8(2):133-9. DOI: 10.7196/SAMJ.2023.v8i2.12354. Available from: https://www.researchgate.net/publication/381061085_Morbidity_amongst_South_African_Hajj_pilgrims_in_2023-a_retrospective_cohort_study
Alotaibi BM, Yezli S, Bin Saeed AA, Turkistani AM, Alahmadi YM. Mass gatherings and respiratory diseases: A health threat to the general population. Trop Dis Travel Med Vaccines. 2020;6:3. DOI: 10.1186/s40794-020-00112-8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6958484/
Memish ZA, Ahmed QA. Health risks at mass gatherings. Lancet Infect Dis. 2019;19(5). DOI: 10.1016/S1473-3099(18)30499-9. Available from: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(18)30499-9/fulltext
Abdullah S. Tingkat pengetahuan jemaah haji terkait tindakan pencegahan penyakit saat ibadah. Jurnal Haji dan Kesehatan. 2022;3(2):145-57. doi:10.36412/jhk.v3i2.1215. Available from: https://doi.org/10.36412/jhk.v3i2.1215
Ahmed QA, Memish ZA. Hajj medicine: Implications for global health security. BMC Proc. 2020;14(1):30. DOI: 10.1186/s12919-020-0183-4. Available from: https://bnrc.springeropen.com/articles/10.1186/s42269-022-00801-4
Memish ZA, Ahmed YA, Al-Tawfiq JA, Benkouiten S. Hajj and Umrah: potential health risks and recommendations. J Infect Public Health. 2014;7(6):486-92. DOI: 10.1016/j.jiph.2014.08.005. Available from: https://www.sciencedirect.com/science/article/pii/S1876587814000913
Karam G, Ghandour A, Khalil M, Nassar H. Health status of pilgrims in Hajj: a survey in Saudi Arabia. East Mediterr Health J. 2021;27(2):105-13. DOI: 10.26719/emhj.20.060. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7554292/pdf/EMHJ-27-105.pdf
Alsaadi T, Yezli S, Ghanem T, et al. Health and safety in mass gatherings: lessons learned from the Hajj. Saudi Med J. 2018;39(5):474-8. doi:10.15537/smj.2018.5.21366. Available from: https://smj.org.sa/content/39/5/474
Azzam A, Safar M, Alabdulqader M, et al. Enhancing healthcare access for Hajj pilgrims: an innovative approach. J Multidiscip Healthc. 2022;15:2537-44. DOI: 10.2147/JMDH.S356842. Available from: https://www.dovepress.com/enhancing-healthcare-access-for-hajj-pilgrims-an-innovative-approach-peer-reviewed-fulltext-article-JMDH
Alhakeem RF, Yezli S, Memish ZA. The role of public health surveillance in the prevention of infectious diseases at mass gatherings. J Infect Public Health. 2018;11(2):211-7. DOI: 10.1016/j.jiph.2017.03.008. Available from: https://www.sciencedirect.com/science/article/pii/S1876587817300359
Shafi S, Booy R, Haworth E, Rashid H, Memish ZA. Hajj: Health lessons for mass gatherings. J Infect Public Health. 2008;1(1):27-32. doi:10.1016/j.jiph.2008.08.008. Available from: https://doi.org/10.1016/j.jiph.2008.08.008
Yezli S, Assiri A, Alhakeem RF, Turkistani AM, Alotaibi BM. Prevention of meningococcal disease during the Hajj and Umrah mass gatherings: Past, current, and future measures. Int J Infect Dis. 2016 Mar;47:71-8. doi:10.1016/j.ijid.2016.01.017. Available from: https://doi.org/10.1016/j.ijid.2016.01.017
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