Table 1 Application of Haddon matrix on Hajj morbidity and adverse outcomes risk factors.
Phase | Host | Agent | Physical environment factors | Socio-cultural environment factors |
|---|---|---|---|---|
Pre-event | Age Comorbidities Vaccination status Hydration status Mental health status Lack of acclimatization Lack of physical fitness Hearing impairment Visual impairment Disability Memory and cognitive impairment | Medications Smoking | High temperatures High humidity Heavy rain and wind Improper accommodations and sanitation Poor ventilation in accommodations Unhygienic conditions | Large crowds Lack of acclimatization Cultural practices affecting health behavior Level of awareness |
During-event | Heat stress Physical exhaustion Accidents and injuries Cardiovascular diseases Respiratory infections Delayed medical care attention | Infectious agents Airborne particles Vector-borne Sun heat Antimicrobial resistance | Overcrowding Heat emissions Inadequate water and food availability Walking distances Noise pollution Inadequate emergency response infrastructure | Language barrier Social norms impacting health-seeking behavior Psychological impact of Hajj (mass gatherings) |
Post-event | Complications from pre-existing health conditions Dehydration Post-traumatic stress disorder (PTSD) Staff burnout Poor follow-up care Lack of access to emergency services | Ongoing exposure to Infectious agents Ongoing exposure to sun heat | Inadequate waste management Inadequate medical facilities Transportation issues | Social support systems (Hajj medical missions) Language barrier |
