A Longitudinal Study Regarding the Health Profile of the 2017 South African Hajj Pilgrims

Abstract

The Hajj mass gathering annually attracts over two million Muslim pilgrims worldwide to the Kingdom of Saudi Arabia (KSA). We aimed to establish demographics and health profiles for the South African pilgrims performing the 2017 Hajj. Methods: This is a longitudinal survey-based study conducted on 1138 adult South African pilgrims in two phases (during and post-Hajj). Data on demographics, vaccination status, underlying health conditions, pre-Hajj training, health promotion, travel history, and health issues during and post-Hajj were collected using pre-designed questionnaires. Results: Participants had a mean age of 49.2 years (SD = 13.3; range 18–81), with a male: female ratio of 1.2:1. The majority of pilgrims were married (88.2%), of Indian/Asian background (73%), and literate (>99%). Nearly all pilgrims were vaccinated against meningococcal disease and yellow fever, but only 23.7% were vaccinated against Influenza. Hypertension, diabetes, and elevated cholesterol levels were the most common underlying health conditions reported by 22.6%, 13.2%, and 11.5% of pilgrims, respectively. One month after return to South Africa, nearly 65% of pilgrims reported illness during Hajj, while 40% reported falling ill post event upon return to South Africa. Nevertheless, only a few were admitted to hospitals (12 during Hajj and 15 post-Hajj). Among ill pilgrims, respiratory symptoms were the most commonly experienced symptoms during (70.2%) and post-Hajj (82.2%). Other symptoms such as walking-related symptoms include symptoms directly related or mainly caused by walking (e.g., leg pain, sore feet, blisters on the feet), dehydration, and gastrointestinal tract symptoms reported during Hajj. Medication to treat respiratory symptoms and antibiotics were the most commonly used medications during and post-Hajj. Having an underlying health condition was an independent predictor of falling ill during or post Hajj. Conclusion: Our study indicates that a sizable proportion of South African pilgrims are elderly with underlying health conditions and most contract respiratory tract infections during and post Hajj. Our study highlights the need for systematic collection of prospective pilgrims’ demographics and health data and more attention to post-Hajj health follow-ups of pilgrims.

A scoping review of Islamic pilgrimage to Mecca: Mapping the health concerns and proposed solutions

“…Prior to making the Hajj, several vaccinations and vitamin boosters were recommended. Symptom‐based medications as prescribed were allowed with their proper use (Farahmand et al., 2022; Mushi et al., 2021). Health‐risk assessment and management, including technology‐based disease monitoring were included in the current trends regarding protecting their health status (Pane et al., 2019).…”

“…A few studies reported the incidence of death as only 13.89% in this review. There was an incidence rate of about 44 deaths The most common communicable disease during the Islamic pilgrimage to Mecca was respiratory tract infection (Alasmari et al, 2020;Farahmand et al, 2022;Mushi et al, 2021). This was followed by several ambiguous infectious symptoms such as cough, fever, and sore throat.…”

Effect of a Supervised Exercise-Training Programme on Morbidity and Wellness of South African Hajj Pilgrims in 2018: A Pilot Study

“…This was similar to the 2017 study where the prevalence of illnesses or injuries amongst South African Hajj pilgrims was recorded as 65.1%, of which 70.2% of presentations were respiratory conditions. 6 The prevalence of respiratory symptoms was reported as high as 77.6% amongst Iranian pilgrims, 15 in excess of 47.0% in 2016 amongst Indian pilgrims 2 and a reported 95.2% in a cohort of 394 Malaysian pilgrims. 16 Our findings are suggestive of the positive effect of exercise on improving immune function and stress resistance and thereby reducing susceptibility to respiratory infections.…”

“…Pre-existing medical conditions in our study was 34% which is similar to the prevalence described in other studies. 6 The co-morbidities, together with the harsh environmental conditions and large crowds, place these pilgrims at increased risk of developing community acquired pneumonias and invasive pneumococcal disease. 14 In the current study only 13 (14.7%) of participants suffered illness or injury with 6 (46.2% of presentations) reporting respiratory conditions during Hajj.…”

“…5 A 2017 survey amongst 1138 of the 2500 South African Hajj pilgrims indicated that 65.1% of respondents suffered from medical conditions, 70.2% of the medical conditions being respiratory in nature. 6 The Hajj involves the mass physical movement of pilgrims between the various ritual sites amongst crowded conditions in temperatures that probably will exceed 40°C for the next decade. It is estimated that 70% of Hajj activities are of a physical nature with the remaining 30% being spiritual worship.…”