Malaysia Restricts 2022 Hajj Health Criteria, Covering Diabetes, Hypertension, Obesity

Tabung Haji-MOH 2022 guidelines bar Hajj for those with diabetes (HbA1c >8%), moderate to severe hypertension, obesity type II with ≥ 1 comorbidity, all cancer stages.

KUALA LUMPUR, May 13 – The Malaysian government has tightened health qualifications for Muslims to undertake their Hajj pilgrimage this year during the Covid-19 pandemic. 

The list of medical conditions prohibited for travel to Saudi Arabia for Hajj in 2022 includes diabetes with HbA1c exceeding 8 per cent, obesity type II with at least one comorbidity and type III (BMI at 40 or higher), moderate to severe hypertension, all stages of cancer, among others, according to the Lembaga Tabung Haji-Ministry of Health’s Guidelines on Pre-Hajj Health Examinations 2022 (Special Pandemic Edition).

In comparison, the 2020 guidelines were looser, prohibiting Hajj for those with diabetes whose HbA1c exceeds 10 per cent, obesity type III, severe hypertension (systolic BP 180 mmHG or higher/ diastolic BP 120 MMHg or higher), and stage 3 or advanced cancer.

This year’s guidelines were also stricter for those with ischaemic heart disease, barring Hajj pilgrimage for individuals with recent myocardial infarction and unstable angina within three months, compared to the 2020 guidelines that barred those experiencing such conditions within the last six weeks. 

As for chronic kidney disease, this year’s guidelines bars those with Stage 3 disease with uncontrolled comorbidity or Stage 4 and higher, compared to 2020 that only banned individuals with Stage 5 chronic kidney disease and Stage 4 with comorbidities.

All cases of chronic lung disease like lung fibrosis, bronchiectasis, and respiratory failure, as well as obstructive sleep apnoea and obesity hypoventilation syndrome, are barred from Hajj pilgrimage this year. 

In comparison, the 2020 guidelines only barred Hajj pilgrimage for those with lung fibrosis, bronchiectasis, and respiratory failure who are on supplemental oxygen therapy, as well as those with obstructive sleep apnoea and obesity hypoventilation syndrome who are untreated or on long-term oxygen therapy.

Smokers with Grade A chronic obstructive pulmonary disease (COPD) are also banned from Hajj in 2022, unlike in 2020.

Tabung Haji and the Health Ministry (MOH) also banned all individuals diagnosed with dementia, schizophrenia and other psychotic disorders, bipolar disorder, and major depression from undertaking Hajj this year.

In 2020, the government did not bar Hajj pilgrimage for all individuals with such mental health issues, restricting prohibition only for moderate and severe dementia, as well as for those with repeated episodes of schizophrenia and other psychotic disorders and major depression in two years, or five years for bipolar disorder.

Covid-19 is more brutal towards people with underlying chronic conditions like diabetes or high blood pressure. 

Health exams are required for all those intending to make their Hajj pilgrimage, with additional tests like chest X-rays for certain high-risk groups like those with diabetes, aged 60 years and older, HIV, chronic lung disease (including COPD), and those on immunosuppressive medication.

Perlis state Islamic affairs executive councillor Ruzani Rais told Utusan Malaysia that only 45 of 85 Muslims in the state who were offered to go on Hajj successfully passed their health screenings. Twenty of them had obesity, diabetes, uncontrolled hypertension, and chronic lung disease.

Besides Covid-19 vaccination, Hajj pilgrims are required to take the meningococcal vaccine that will be offered free to those who pass the health exam at MOH facilities. The seasonal flu and pneumococcal vaccines are encouraged for Hajj pilgrimage, especially for those aged 50 years and above, smokers, individuals with respiratory illnesses like asthma or COPD, and chronic conditions like diabetes, heart disease, kidney disease, neurological conditions, and obesity.

According to the National Health and Morbidity Survey 2019, about 18 per cent of Malaysian adults have diabetes, while nearly 20 per cent are obese. Some 30 per cent have hypertension.

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