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Abstract
Background: The Hajj pilgrimage is largest mass gathering, creating a high risk for acute respiratory infections (ARI) transmission. Post-Hajj ARI represents a major public health concern, as returning pilgrims may serve as carriers and potentially transmit pathogens to their home communities. Identifying the proportion and risk factors of post-Hajj ARI is essential for developing effective preventive strategies.
Objectives: The aim of this study is to know the proportion of post-Hajj ARI and associated risk factors among pilgrims from KBIHU (Indonesian hajj guidance group) Multazam Ad-Dakwah Yogyakarta 2025.
Methods: This cross-sectional study utilized an online questionnaire. Respondents were pilgrims from KBIHU Multazam Ad-Dakwah Yogyakarta who experienced ARI symptoms after returning from the 2025 Hajj. Sociodemographic characteristics, vaccination history, preventive behaviors, and metabolic risk factors are collected. Data were analyzed using multivariate logistic regression. Odd ratios with 95% CIs were calculated, and p-values <0.05 were considered statistically significant.
Result: A total of 112 pilgrims were included, with 20.5% aged >60 years and 57.1% reporting comorbidities, mainly hypertension and dyslipidemia. Most participants were non-smokers (82.1%) and reported moderate adherence to preventive behaviors, including mask use (54.5%) and hand hygiene (56.3%). Meningococcal vaccination coverage was universal, while influenza coverage (75.0%), COVID-19 (46.4%), and pneumococcal vaccines (6.3%) was lower. Overall, 100 pilgrims (89.3%) experienced ARI symptoms. Bivariate analysis showed that age >60 years was significantly associated with ARI (cOR 4.697; 95%CI: 1.206–18.295; p=0.026). Multivariate logistic regression including age and pneumococcal vaccination status confirmed that older age remained the only significant determinant of ARI (aOR 4.88; 95%CI: 1.22–19.53; p=0.02).
Conclusion: Older age (>60 years) is a significant risk factor for post-Hajj acute respiratory infections. Focused preventive strategies targeting elderly pilgrims are essential to reduce ARI-related morbidity and mortality following the Hajj.
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Copyright (c) 2026 Ninda Devita, Farida Juliantina Rachmawaty, Eko Andriyanto, Afivudien Muhammad
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