Predictive Performance of Pre-Hajj Health Screening for Morbidity, Hospitalization and Mortality
DOI:
https://doi.org/10.59890/ijgsr.v4i10.9Keywords:
Pre-Hajj Health Screening, Hajj Pilgrims, Predictive Performance, Risk Prediction Model, Morbidity, Hospitalization, Mortality, Mass Gathering MedicineAbstract
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
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