Abstract
Introduction
Non-communicable diseases (NCDs) account for 74% of global deaths, with high global prevalence of diabetes and hypertension. Egypt hosts over 1 million refugees and asylum seekers, with systematic difficulties in the access to healthcare services. This study assessed factors associated with Type 2 Diabetes (T2D) and Hypertension (HTN) complications among Syrian and Sudanese refugees in Egypt, focusing on healthcare access, sociodemographic characteristics, lifestyle, and health behaviors.
Methods
This cross-sectional study used a self-administered questionnaire and BMI measurement among 246 refugees diagnosed with T2D and/or HTN in Cairo, Giza, and Alexandria, recruited via convenience sampling through refugee-led organizations. The survey included standardized tools assessing diet, lifestyle, tangible social support, and access to care. Descriptive statistics and ordinal regression identified factors associated with self-reported disease complications.
Results
Refugees generally showed poor health and lifestyle behaviors; unaffordability was the most reported barrier to healthcare access and medication adherence. After adjustment for sociodemographic and access-to-care variables, prolonged displacement (AOR = 1.16; 95% CI: 1.02–1.32;
p
= 0.023) and lowest tangible social support (AOR = 5.47; 95% CI: 1.26–23.67;
p
= 0.023) were associated with higher odds of hypertension complications, while not needing to seek care was associated with lower odds (AOR = 0.30; 95% CI: 0.13–0.70;
p
= 0.005). Among diabetic participants, medication non-adherence (AOR = 3.83; 95% CI: 1.01–14.53;
p
= 0.048) and failure to access needed care (AOR = 16.01; 95% CI: 3.04–84.27;
p
= 0.001) were associated with higher odds of complications, while moderate carbohydrate intake was associated with lower odds compared with high intake (AOR = 0.30; 95% CI: 0.09–0.97;
p
= 0.044). These diabetic model findings warrant cautious interpretation given the small sample and wide confidence intervals in certain variables.
Conclusion
NCD complications among Syrian and Sudanese refugees in Egypt reflect a complex interplay of structural and behavioral determinants, including duration of displacement, access to care, tangible social support, medication adherence, and carbohydrate intake. These findings highlight the need for interventions addressing both clinical care and upstream social determinants of health in refugee-hosting settings.