# Heatstroke knowledge and predictors among Hajj health volunteers in Saudi Arabia: a cross-sectional study

**Authors:** Fatmah Alamoudi, Halah Almulla, Magda Yousif, Nouf Alnaimi, Adil Abdalla, Mahmoud Abdel Hameed Shahin, Faizan Kashoo

PMC · DOI: 10.7717/peerj.20816 · 2026-02-19

## TL;DR

This study examines heatstroke knowledge among Hajj health volunteers in Saudi Arabia, finding that while most have satisfactory knowledge, significant disparities exist based on education, employment, and region.

## Contribution

The study identifies specific predictors of heatstroke knowledge among health volunteers and highlights regional disparities in knowledge levels.

## Key findings

- 74.6% of health volunteers had satisfactory heatstroke knowledge, but pathophysiological understanding was poor.
- Medical education, employment, and first aid training significantly predicted better knowledge.
- Regional disparities were found, with the Southwest Region having notably lower knowledge levels.

## Abstract

Heatstroke is a life-threatening condition resulting from prolonged exposure to high temperatures or intense physical activity, especially during the summer. Pilgrims performing Hajj are particularly vulnerable because of factors such as advanced age, chronic health conditions, and failure to follow safety guidelines. Health volunteers play a key role in prevention and response.

This study aimed to assess health volunteers’ knowledge and identify predictors of such knowledge.

A cross-sectional study was conducted among 772 health volunteers during Hajj 2024 in Saudi Arabia. A self-designed questionnaire was developed and utilized to assess participants’ knowledge of heatstroke and to identify predictors of such knowledge. Data were collected electronically and analyzed via Jeffrey’s Amazing Statistics Program (JASP).

Analysis revealed that (n = 576) 74.6% of health volunteers had satisfactory heatstroke knowledge, though critical gaps persisted. While recognition of specific symptoms (e.g., lethal temperatures >39.5 °C; 90.8%) and preventive measures was strong, pathophysiological understanding was poor, with only 5.2% correctly interpreting body temperature thresholds. Logistic regression identified significant predictors: a medical educational background (odds ratio (OR) = 4.51, p < .001), employment (OR = 2.45, p < .001), and previous first aid training (OR = 2.51, p = .003) increased odds of satisfactory knowledge. Significant regional disparities existed, with the Middle Region associated with higher odds (OR = 2.14, p = .019) and the Southwest Region with lower odds (OR = 0.31, p = .004).

In conclusion, this study found that while a majority of Hajj health volunteers possess satisfactory heatstroke knowledge, significant and systematic disparities exist. The findings robustly demonstrate that knowledge is not uniformly distributed but is significantly predicted by educational background, occupational status, and geographic region. To ensure a uniformly high standard of care, preparedness initiatives must be strategically refined. Resources should be deliberately channeled into enhancing the training of non-medical volunteers and addressing the pronounced knowledge gaps in underperforming regions, thereby fortifying the overall resilience of the health volunteer system against the formidable threat of heatstroke.

## Full-text entities

- **Diseases:** Obesity (MESH:D009765), acute kidney injury (MESH:D058186), confusion (MESH:D003221), delirium (MESH:D003693), neurological disorders (MESH:D009461), hypotension (MESH:D007022), seizures (MESH:D012640), EHS (MESH:D018882), multiorgan injury (MESH:D014947), headache (MESH:D006261), diabetes (MESH:D003920), respiratory, renal, or psychiatric disease (MESH:D001523), central nervous system (CNS) dysfunction (MESH:D002493), organ damage (MESH:D000092124), kidney dysfunction (MESH:D007674), occupational injuries (MESH:D060051), Heat stroke (MESH:D018883), coma (MESH:D003128), Mortality (MESH:D003643), cardiovascular disease (MESH:D002318), coagulopathy (MESH:D001778)
- **Chemicals:** aspirin (MESH:D001241), water (MESH:D014867), acetaminophen (MESH:D000082)
- **Species:** watermelon [taxon 260674], Cucumis sativus (cucumber, species) [taxon 3659], Homo sapiens (human, species) [taxon 9606]

## Figures

5 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12925418/full.md

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Source: https://tomesphere.com/paper/PMC12925418