Prevalent Foot Injuries among Pilgrims during 2023 Hajj Season: A Cross-sectional Study

Background:-Hajj to Makkah is a significant Islamic pilgrimage where around 3 million people gather annually. The journey can be challenging for pilgrims, as they often experience foot injuries due to multiple factors, including chronic conditions such as diabetes, which can result in severe consequences. Despite the significance of these injuries, there is limited research on this topic. Therefore, this study aims to explore the prevalent types of foot injuries during Hajj, associated risk factors, and possible complications. Methods:-We formed a questionnaire based on literature review to address common foot injuries. Using a cross-sectional study design, pilgrims of all age groups and both genders who received medical care for foot injuries during the 2023 Hajj season in Minna region of Makkah city were included. The participants were interviewed by medical students who specialize in providing first aid and wound care for pilgrims. We received 209 valid responses from injured pilgrims. Results:-Blisters accounted for most injuries (61.5%), followed by ulcers (20.9%). Most people have one (42.6%) or two (36.4%) foot injuries, with the forefoot, hallux, and second toe being the most affected sites. In terms of risk factors for foot injuries, 58.9% of the participants were overweight or obese, with hypertension being the most prevalent chronic disease (50.8%). Diabetes mellitus was found in 45.2% of participants, and the majority of diabetic patients stopped their medication during Hajj (58.9%), and more than half (55.4%) were unaware of their HgA1c level. Most of the injured pilgrims (76.1%) noticed hotness, worsening redness, or visible pus. These foot injuries had a significant impact on mobility for most pilgrims, with 76.1% mentioning that walking after their injuries required more effort. Conclusion:-The most common foot injuries encountered during Hajj are foot blisters and ulcers. Factors such as uncontrolled chronic diseases, ill-fitting footwear, long-distance walking, and excessive sweating may contribute to their occurrence. These injuries have a great impact on pilgrims' ability to walk and mobilize, with a high rate of possibly infected injuries. Our results emphasize the importance of prevention and early management of foot injuries among pilgrims to prevent complications and allow pilgrims to complete their Hajj comfortably.