NIHR Global Health Research Unit on Respiratory Health (RESPIRE)

First paper published from RESPIRE

The first publication from RESPIRE has appeared in the August 2018 issue of The Lancet Respiratory Medicine.

The paper, authored by Su May Liew, Norita Hussein, Nik Sherina Hanafi, Hilary Pinnock, Aziz Sheikh and Ee Ming Khoo, examines the risks of COPD and asthma among Hajj pilgrims.

A physically demanding journey

As one of the five pillars of Islam, all able-bodied Muslims are required to undertake the Hajj at least once in their lifetime if they can afford to do so. Each year, over two million Muslims gather in Mecca, Saudi Arabia, to take part.

The Hajj is a physically demanding five-day journey. Pilgrims walk between 5-15 km each day, in a desert environment where temperatures can reach over 40°C.

Mortality rates among pilgrims are high, with respiratory diseases the most prevalent health problem; they account for nearly 40% of admissions to hospitals in Mecca and 28% of mortality during the Hajj.

Exacerbation of chronic respiratory conditions 

A combination of factors can lead to an exacerbation of chronic respiratory conditions in Hajj pilgrims. The paper states:

In pilgrims with pre-existing long-term respiratory conditions—in particular, asthma and chronic obstructive pulmonary disease (COPD)—the combination of physical exercise (to which many are unaccustomed), the dusty environment, development of respiratory tract infections, and poor adherence with preventer therapies (on account of the disruption of normal routines) can lead to exacerbations of their asthma and COPD. Studies have shown that 15–22% of people admitted to hospital in Mecca during the Hajj season had a pre-existing chronic respiratory condition.

Su May Liew, Norita Hussein, Nik Sherina Hanafi, Hilary Pinnock, Aziz Sheikh and Ee Ming KhooDangers of COPD and asthma under-recognised among Hajj pilgrims

Optimising asthma care among Hajj pilgrims

The study, led by the RESPIRE Malaysia team, aims to develop, assess and implement interventions to optimise asthma care among Hajj pilgrims.

Initial work in Malaysia will extend to partners in Bangladesh, India and Pakistan with the ultimate aim of reducing the risk of undertaking the Hajj pilgrimage for people with asthma.

The team also hope to extend the study to COPD and other chronic respiratory disorders.

Read the paper in full at The Lancet Respiratory Medicine