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Prevalence of non-communicable diseases and access to care among non-camp Syrian refugees in northern Jordan
BACKGROUND: Tackling the high non-communicable disease (NCD) burden among Syrian refugees poses a challenge to humanitarian actors and host countries. Current response priorities are the identification and integration of key interventions for NCD care into humanitarian programs as well as sustainabl...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6040066/ https://www.ncbi.nlm.nih.gov/pubmed/30008800 http://dx.doi.org/10.1186/s13031-018-0168-7 |
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author | Rehr, Manuela Shoaib, Muhammad Ellithy, Sara Okour, Suhib Ariti, Cono Ait-Bouziad, Idriss van den Bosch, Paul Deprade, Anais Altarawneh, Mohammad Shafei, Abdel Gabashneh, Sadeq Lenglet, Annick |
author_facet | Rehr, Manuela Shoaib, Muhammad Ellithy, Sara Okour, Suhib Ariti, Cono Ait-Bouziad, Idriss van den Bosch, Paul Deprade, Anais Altarawneh, Mohammad Shafei, Abdel Gabashneh, Sadeq Lenglet, Annick |
author_sort | Rehr, Manuela |
collection | PubMed |
description | BACKGROUND: Tackling the high non-communicable disease (NCD) burden among Syrian refugees poses a challenge to humanitarian actors and host countries. Current response priorities are the identification and integration of key interventions for NCD care into humanitarian programs as well as sustainable financing. To provide evidence for effective NCD intervention planning, we conducted a cross-sectional survey among non-camp Syrian refugees in northern Jordan to investigate the burden and determinants for high NCDs prevalence and NCD multi-morbidities and assess the access to NCD care. METHODS: We used a two-stage cluster design with 329 randomly selected clusters and eight households identified through snowball sampling. Consenting households were interviewed about self-reported NCDs, NCD service utilization, and barriers to care. We estimated the adult prevalence of hypertension, diabetes type I/II, cardiovascular- and chronic respiratory conditions, thyroid disease and cancer and analysed the pattern of NCD multi-morbidities. We used the Cox proportional hazard model to calculate the prevalence ratios (PR) to analyse determinants for NCD prevalence and logistic regression to determine risk factors for NCD multi-morbidities by calculating odds ratios (ORs). RESULTS: Among 8041 adults, 21.8%, (95% CI: 20.9–22.8) suffered from at least one NCD; hypertension (14.0, 95% CI: 13.2–14.8) and diabetes (9.2, 95% CI: 8.5–9.9) were the most prevalent NCDs. NCD multi-morbidities were reported by 44.7% (95% CI: 42.4–47.0) of patients. Higher age was associated with higher NCD prevalence and the risk for NCD-multi-morbidities; education was inversely associated. Of those patients who needed NCD care, 23.0% (95% CI: 20.5–25.6) did not seek it; 61.5% (95% CI: 54.7–67.9) cited provider cost as the main barrier. An NCD medication interruption was reported by 23.1% (95% CI: 20–4-26.1) of patients with regular medication needs; predominant reason was unaffordability (63.4, 95% CI: 56.7–69.6). CONCLUSION: The burden of NCDs and multi-morbidities is high among Syrian refugees in northern Jordan. Elderly and those with a lower education are key target groups for NCD prevention and care, which informs NCD service planning and developing patient-centred approaches. Important unmet needs for NCD care exist; removing the main barriers to care could include cost-reduction for medications through humanitarian pricing models. Nevertheless, it is still essential that international donors agencies and countries fulfill their commitment to support the Syrian-crisis response. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13031-018-0168-7) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6040066 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-60400662018-07-13 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 van den Bosch, Paul Deprade, Anais Altarawneh, Mohammad Shafei, Abdel Gabashneh, Sadeq Lenglet, Annick Confl Health Research BACKGROUND: Tackling the high non-communicable disease (NCD) burden among Syrian refugees poses a challenge to humanitarian actors and host countries. Current response priorities are the identification and integration of key interventions for NCD care into humanitarian programs as well as sustainable financing. To provide evidence for effective NCD intervention planning, we conducted a cross-sectional survey among non-camp Syrian refugees in northern Jordan to investigate the burden and determinants for high NCDs prevalence and NCD multi-morbidities and assess the access to NCD care. METHODS: We used a two-stage cluster design with 329 randomly selected clusters and eight households identified through snowball sampling. Consenting households were interviewed about self-reported NCDs, NCD service utilization, and barriers to care. We estimated the adult prevalence of hypertension, diabetes type I/II, cardiovascular- and chronic respiratory conditions, thyroid disease and cancer and analysed the pattern of NCD multi-morbidities. We used the Cox proportional hazard model to calculate the prevalence ratios (PR) to analyse determinants for NCD prevalence and logistic regression to determine risk factors for NCD multi-morbidities by calculating odds ratios (ORs). RESULTS: Among 8041 adults, 21.8%, (95% CI: 20.9–22.8) suffered from at least one NCD; hypertension (14.0, 95% CI: 13.2–14.8) and diabetes (9.2, 95% CI: 8.5–9.9) were the most prevalent NCDs. NCD multi-morbidities were reported by 44.7% (95% CI: 42.4–47.0) of patients. Higher age was associated with higher NCD prevalence and the risk for NCD-multi-morbidities; education was inversely associated. Of those patients who needed NCD care, 23.0% (95% CI: 20.5–25.6) did not seek it; 61.5% (95% CI: 54.7–67.9) cited provider cost as the main barrier. An NCD medication interruption was reported by 23.1% (95% CI: 20–4-26.1) of patients with regular medication needs; predominant reason was unaffordability (63.4, 95% CI: 56.7–69.6). CONCLUSION: The burden of NCDs and multi-morbidities is high among Syrian refugees in northern Jordan. Elderly and those with a lower education are key target groups for NCD prevention and care, which informs NCD service planning and developing patient-centred approaches. Important unmet needs for NCD care exist; removing the main barriers to care could include cost-reduction for medications through humanitarian pricing models. Nevertheless, it is still essential that international donors agencies and countries fulfill their commitment to support the Syrian-crisis response. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13031-018-0168-7) contains supplementary material, which is available to authorized users. BioMed Central 2018-07-11 /pmc/articles/PMC6040066/ /pubmed/30008800 http://dx.doi.org/10.1186/s13031-018-0168-7 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Rehr, Manuela Shoaib, Muhammad Ellithy, Sara Okour, Suhib Ariti, Cono Ait-Bouziad, Idriss van den Bosch, Paul Deprade, Anais Altarawneh, Mohammad Shafei, Abdel Gabashneh, Sadeq Lenglet, Annick Prevalence of non-communicable diseases and access to care among non-camp Syrian refugees in northern Jordan |
title | Prevalence of non-communicable diseases and access to care among non-camp Syrian refugees in northern Jordan |
title_full | Prevalence of non-communicable diseases and access to care among non-camp Syrian refugees in northern Jordan |
title_fullStr | Prevalence of non-communicable diseases and access to care among non-camp Syrian refugees in northern Jordan |
title_full_unstemmed | Prevalence of non-communicable diseases and access to care among non-camp Syrian refugees in northern Jordan |
title_short | Prevalence of non-communicable diseases and access to care among non-camp Syrian refugees in northern Jordan |
title_sort | prevalence of non-communicable diseases and access to care among non-camp syrian refugees in northern jordan |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6040066/ https://www.ncbi.nlm.nih.gov/pubmed/30008800 http://dx.doi.org/10.1186/s13031-018-0168-7 |
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