Predictive performance of pre-hajj health screening for morbidity, hospitalization and mortality

Indrawan, Doby ORCID: https://orcid.org/0009-0008-4074-1942 (2026) Predictive performance of pre-hajj health screening for morbidity, hospitalization and mortality. International Journal of Global Sustainable Research, 4 (10). pp. 1327-1344. ISSN 3026-4677

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Abstract

Background: Hajj is one of the largest annual mass gatherings worldwide, involving millions of pilgrims with diverse health conditions and vulnerabilities. Pre-Hajj health screening is widely implemented to identify high-risk pilgrims; however, its ability to predict morbidity, hospitalization, and mortality remains unclear. Objective: This systematic review aimed to evaluate the predictive performance of pre-Hajj health screening components for adverse clinical outcomes among Hajj pilgrims and identify gaps in current risk prediction approaches. Methods: A systematic literature review was conducted following the PRISMA 2020 guidelines. Studies published from January 2020 to 2026 were identified through Scopus, PubMed/MEDLINE, Web of Science, and additional sources. Eligible studies evaluated pre-Hajj health assessment variables, including demographic characteristics, chronic diseases, cardiovascular risk factors, and functional status, in relation to morbidity, hospitalization, or mortality outcomes. Evidence was synthesized narratively based on predictive factors, analytical approaches, and methodological limitations. Results: The findings demonstrated that advanced age, diabetes mellitus, hypertension, cardiovascular disease, multimorbidity, and functional impairment were consistently associated with adverse Hajj outcomes. However, most studies focused on identifying risk factors rather than developing validated prediction models. Measures of predictive performance, including discrimination, calibration, and external validation, were rarely reported, indicating that current screening systems remain primarily risk identification tools rather than individualized prediction models. Conclusion: This review highlights a critical gap between existing pre-Hajj screening practices and modern predictive medicine approaches. Future research should develop validated Hajj-specific prediction models integrating demographic, clinical, cardiovascular, and functional variables to enable personalized risk stratification and improve preventive healthcare management during mass gatherings.

Item Type:	Journal Article
Keywords:	pre-hajj health screening; hajj pilgrims; predictive performance; risk prediction model; morbidity; hospitalization; mortality; mass gathering medicine
Subjects:	11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111716 Preventive Medicine 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services
Divisions:	Faculty of Medical and Health Sciences > Department of Medical Education
Depositing User:	Doby Indrawan
Date Deposited:	26 Oct 2026 15:43

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