Prevalence of non-communicable diseases and access to care among non-camp Syrian refugees in northern Jordan

Rehr, Manuela; Shoaib, Muhammad; Ellithy, Sara; Okour, Suhib; Ariti, Cono; Ait-Bouziad, Idriss; Bosch, Paul; Deprade, Anais; Altarawneh, Mohammad; Shafei, Abdel; Gabashneh, Sadeq; Lenglet, Annick

doi:10.1186/s13031-018-0168-7

Cited by 120 publications

(138 citation statements)

References 16 publications

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“…Looking at the non-modi able risk factors for NCDs, we found that higher age was associated with higher NCDs prevalence, consistent with previous ndings (45,63). This is further supported by evidence suggesting that susceptibility to NCDs increases with age (71).…”

Section: Prevalence Of Ncdssupporting

confidence: 90%

Prevalence of Non-Communicable Diseases and Associated Medication Use Among Syrian Refugees in Lebanon: An Analysis of Country-Wide Data from the Sijilli Electronic Health Records Database

Saleh

Abdouni

Dimassi

et al. 2020

Preprint

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Background Globally, the number of forcibly displaced individuals has reached 70.8 million. Lebanon, a middle income country, hosts the highest number of refugees per capita worldwide. The majority of refugees are Syrians who have fled the Syrian war that started in 2011. The migration journey exposes refugees to increased susceptibility to a wide range of medical issues including non-communicable diseases (NCDs). This study aims to determine the prevalence of NCDs among adult Syrian refugees in Lebanon, with a focus on hypertension, diabetes, cardiovascular diseases (CVD) and cancer. The study also aims to explore factors potentially related to the prevalence figures and understand the medication use associated with these morbidities. Methods This study is a secondary analysis of de-identified data from the “Sijilli Electronic Health Records for Refugees” Database comprising data on 10,082 Syrian refugees from across informal tented settlements located all over Lebanon. A total of 3,255 records of Syrian refugees aged above 18 years old and reporting having at least one condition of the following were included in the analysis: hypertension, diabetes, Cardiovascular diseases or cancer. Pearson’s Chi-square, independent t-test, and multivariate logistic regressions were used for data analysis. Results Hypertension was the most prevalent (10.0%) NCD among refugees, and a higher age was associated with higher NCDs prevalence. A strong linkage has been reported between smoking status and alcohol intake, and increased risk for NCDs. Study findings also revealed that the highest prevalence of hypertension, diabetes and CVDs was observed among refugees originating from Idlib, Aleppo and Homs. An association between adherence to medication and location of diagnosis was noted, with females who were diagnosed before moving to Lebanon being more likely to take corresponding medications compared to those diagnosed in Lebanon, with no difference reported among males. Conclusions Our findings suggest that efforts should be directed towards the employment of innovative low-cost approaches for NCD detection and control among refugees, with a focus on the importance of adherence to medication. Such efforts remain imperative to control the increasing burden of NCDs amongst refugee populations and improve equitable access to NCD services.

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Section: Prevalence Of Ncdssupporting

confidence: 90%

Prevalence of Non-Communicable Diseases and Associated Medication Use Among Syrian Refugees in Lebanon: An Analysis of Country-Wide Data from the Sijilli Electronic Health Records Database

Saleh

Abdouni

Dimassi

et al. 2020

Preprint

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“…The daily stressors, financial precarity, the myriad barriers to accessing care experienced by Syrian refugee NCD patients in Jordan and the potentially harmful decisions they make as a result of stretched finances have been well documented in our own and others' studies [43,[55][56][57][58]. The free care provided by MSF goes some way to alleviating the NCD-related financial burden affecting their current cohort.…”

Section: Implications For Integrated Mhpss and Ncd Services In Humanimentioning

confidence: 99%

“To die is better for me”, social suffering among Syrian refugees at a noncommunicable disease clinic in Jordan: a qualitative study

Ansbro

Maconick

Ellithy

et al. 2019

Preprint

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Background The conflict in Syria has required humanitarian agencies to implement primary-level services for non-communicable diseases (NCDs) in Jordan, given the high NCD burden amongst Syrian refugees; and to integrate mental health and psychosocial support into NCD services given their comorbidity and treatment interactions. However, no studies have explored the mental health needs of Syrian NCD patients. This paper aims to examine the interaction between physical and mental health of patients with NCDs at a Médecins Sans Frontières (MSF) clinic in Irbid, Jordan, in the context of social suffering. Methods This qualitative study involved sixteen semi-structured interviews with Syrian refugee and Jordanian patients and two focus groups with Syrian refugees attending MSF’s NCD services in Irbid, and eighteen semi-structured interviews with MSF clinical, managerial and administrative staff. These were conducted by research staff in August 2017 in Irbid, Amman and via Skype. Thematic analysis was used.Results Respondents describe immense suffering and clearly perceived the interconnectedness of their physical wellbeing, mental health and social circumstances, in keeping with Kleinman’s theory of social suffering. There was a ‘disconnect’ between staff and patients’ perceptions of the potential role of the NCD and mental health service in alleviating this suffering. Possible explanations identified included respondent’s low expectations of the ability of the service to impact on the root causes of their suffering, normalisation of distress, the prevailing biomedical view of mental ill-health among national clinicians and patients, and humanitarian actors’ own cultural standpoints. Conclusion NCD patients recognised the psychological dimensions of their illness but may not utilize clinic-based humanitarian mental health and psychosocial support services. Humanitarian agencies must engage with NCD patients to elicit their needs and design culturally relevant services.

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“…The Middle East and North Africa (MENA) accounts for 6% of the global population but comprises 25% of the 'population of concern' to the UN Refugee Agency (including refugees, internally displaced persons, asylum-seekers and stateless persons). The vast majority of refugees in the MENA region live outside of camp settings in urban and semi-urban environments in Jordan, Lebanon and Turkey [1][2][3]. In addition to large numbers of displaced persons in urban settings, the region is also undergoing an epidemiologic transition towards more noncommunicable diseases (NCDs).…”

Section: Introductionmentioning

confidence: 99%

Addressing noncommunicable diseases among urban refugees in the Middle East and North Africa - a scoping review

McNatt

2020

Confl Health

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Background: More than 5.5 million Syrian refugees have fled violence and settled in mostly urban environments in neighboring countries. The Middle East and North Africa (MENA) region accounts for 6% of the global population but 25% of the population are 'of concern' to the UN Refugee Agency. In addition to large amounts of forced migration, the region is also undergoing an epidemiologic transition towards a heavier burden of noncommunicable diseases (NCDs), which in 2018 accounted for 74% of all deaths in the region. To address NCD needs globally, a myriad of policies and interventions have been implemented in low-income stable country settings. However, little is known about which policies and interventions are currently being implemented or are best suited for refugee hosting countries across the Middle East and North Africa. Methods: A scoping review of peer-reviewed literature was conducted to identify policies and interventions implemented in the Middle East and North Africa to address the needs of urban refugees with noncommunicable diseases. Results: This scoping review identified 11 studies from Jordan, Lebanon, Iran, West Bank, Gaza and Syria. These studies addressed three foci of extant work, (1) innovative financing for expensive treatments, (2) improvements to access and quality of treatment and, (3) efforts to prevent new diagnoses and secondary complications. All interventions targeted refugee populations including Palestinians, Sudanese, Syrians, Afghans and Iraqis. Discussion: The scoping review highlighted five key findings. First, very few studies focused on the prevention of noncommunicable diseases among displaced populations. Second, several interventions made use of health information technologies, including electronic medical records and mHealth applications for patients. Third, the vast majority of publications were solely focused on tackling NCDs through primary care efforts. Fourth, the literature was very sparse in regard to national policy development, and instead favored interventions by NGOs and UN agencies. Last, the perspectives of refugees were notably absent. Conclusion: Opportunities exist to prioritize prevention efforts, scale up eHealth interventions, expand access to secondary and tertiary services, address the scarcity of research on national policy, and incorporate the perspectives of affected persons in the broader discourse.

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Prevalence of non-communicable diseases and access to care among non-camp Syrian refugees in northern Jordan

Cited by 120 publications

References 16 publications

Prevalence of Non-Communicable Diseases and Associated Medication Use Among Syrian Refugees in Lebanon: An Analysis of Country-Wide Data from the Sijilli Electronic Health Records Database

Prevalence of Non-Communicable Diseases and Associated Medication Use Among Syrian Refugees in Lebanon: An Analysis of Country-Wide Data from the Sijilli Electronic Health Records Database

“To die is better for me”, social suffering among Syrian refugees at a noncommunicable disease clinic in Jordan: a qualitative study

Addressing noncommunicable diseases among urban refugees in the Middle East and North Africa - a scoping review

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