Long-Term Effects of Yoga Practice on Metabolic, Hormonal, and Anthropometric Parameters in Climacteric Women.

Hajj represents one of the central pillars of Islam and constitutes a major annual mass gathering, drawing approximately 2.5–3 million pilgrims from over 150 countries each year, except during the COVID-19 pandemic. The pilgrimage poses substantial public health challenges due to extreme environmental conditions, high population density, and the convergence of individuals with diverse health profiles. These factors increase susceptibility to a wide spectrum of communicable and non-communicable diseases, elevating the risk of morbidity during the pilgrimage. A considerable proportion of Indonesian Hajj Pilgrims require inpatient care, which can interrupt the completion of pilgrimage rituals. The Indonesian government has established a tiered healthcare system. Primary care services are delivered at the flight-group, while secondary referral care is provided through Indonesian Hajj Health Clinics. Cases requiring advanced management are referred to designated hospitals under the Saudi Ministry of Health. The most common causes of hospitalization among pilgrims in Saudi Arabia include pneumonia (36.7%; 32.8 per 10 000 pilgrims), chronic obstructive pulmonary disease (21.4%; 19.2 per 100 000), cardiovascular conditions such as acute myocardial infarction and coronary heart disease (12.4%; 11.1 per 100 000), diabetes (10.2%, 9.1 per 100 000), heart failure (10.1%, 9.1 per 100 000), dyspepsia (4.4%, 3.9 per 100 000), stroke (2.6%, 2.4 per 100 000), and dyspnea (2.2%, 3.9 per 100 000). Several of these conditions identified as the leading causes of mortality among pilgrims. Previous studies identified advanced age, cardiovascular disease, diabetes mellitus, hypertension, and respiratory infections as key risk factors associated with hospitalization during Hajj. However, evidence specifically on Indonesian pilgrims remains limited, particularly studies using longitudinal data and retrospective cohort design. Existing research largely emphasized disease prevalence and clinical complications rather than elucidating the determinants of hospitalization. A more comprehensive of these determinants is essential to inform targeted prevention strategies and optimize healthcare planning during the Hajj pilgrimage. This study aimed to identify the determinants of hospitalization among Indonesian Hajj pilgrims and quantify their relative contributions to the burden of hospitalization using retrospective cohort data from the 2016-2019 and 2022 Hajj seasons. The findings are expected to inform morbidity prevention programs and guide the strategic planning of logistics, medicine, and human resources within the Hajj health system, ultimately contributing to safer pilgrimage in the future.