Undiagnosed Chronic Conditions and Health Risks among Ivorian Hajj Pilgrims: Implications of Pre-travel Biochemical Screening

Abstract

Introduction: The Hajj pilgrimage to Mecca is a religious event that attracts millions of Muslims every year. The physical demands of this journey can pose health risks, particularly for older pilgrims. To satisfy administrative requirements, pilgrims undergo medical evaluations before their journeys. However, these medical results are not integrated into the selection decision-making process. This study aimed to determine the relevance of the biochemical profile of Hajj candidates in light of their age and the difficult conditions in which they are performed, which may decompensate for pre-existing pathologies. Materials and Methods: This descriptive retrospective study examined the medical records of 1511 Hajj candidates in 2012. A total of 674 files were selected based on the completeness of medical history, clinical examination, and the results of biochemical blood tests conducted at the laboratory of the National Institute of Public Hygiene in Abidjan, Ivory Coast. Results: The average age of the population was 52 years. Anemia was observed in 50.7% of cases. High blood glucose levels were found in 13.9% of cases, and awareness of the candidates' diabetic status was 9.8%. The frequency of high blood pressure (HBP) was 44.4%. High blood creatinine and urea nitrogen levels were common, occurring in 24% and 23.7% of patients, respectively. An association between elevated blood creatinine and elevated blood urea nitrogen levels was noted in 17.9% of the candidates, suggesting renal failure requiring further investigation. The frequencies of increased aspartate aminotransferase and alanine aminotransferase activities were 8% and 12.3%, respectively. Conclusion: This study revealed a high prevalence of suspected diabetes and possible renal dysfunction cases that were previously undiagnosed and identified only through pre-Hajj biochemical screening. Laboratory tests indicated a higher prevalence of chronic pathologies compared to clinical examinations or patient self-reports. Furthermore, older candidates exhibited more frequent biological disorders, increasing the risk of decompensation during the Hajj. These findings highlight the importance of enhancing health awareness initiatives for future pilgrimages.