Abstract
Background:Given the protracted nature of the crisis in Syria, the large caseload of Syrian refugee patients with non-communicable diseases, and the high costs of providing non-communicable disease care, implications for Lebanon’s health system are vast.Objective:To provide a profile of the health status of diabetes and hypertension patients enrolled in a longitudinal cohort study in Lebanon.Methods:A longitudinal cohort study was implemented from January 2015 through August 2016 to evaluate the effectiveness of treatment guidelines and an mHealth application on the quality of care and health outcomes for patients in primary health care facilities in Lebanon offering low-cost services serving both Syrian refugees and Lebanese host communities. This paper presents baseline characteristics of enrolled patients, providing an overall health status profile.Results:Among participants, 11.5% of patients with hypertension and 9.7% of patients with diabetes were previously undiagnosed. Quality of care, measured as the proportion of patients with biometrics reported and whose condition is controlled, is less than ideal and varied by geographic location. Controlled blood pressure measurements were observed in 64.2% of patients with hypertension; HbA1C values indicated diabetes control in 43.5% of the patients.Conclusion:Differences in diagnostic history and disease control between Syrian and Lebanese patients and across geographic regions were observed, which could be applied to inform strategies aimed at improving diagnosis and quality of care for hypertension and diabetes in primary care settings in Lebanon.
Highlights
The Syrian Civil War, which began in March 2011, has resulted in widespread displacement with more than 6.5 million Syrians internally displaced and an exodus of over five million refugees to countries throughout the region [1]
We present the baseline characteristics of Syrian refugee and Lebanese patients enrolled in the study, which provides a profile of the health status of patients with type 2 diabetes and hypertension at primary health care facilities offering low-cost services in Lebanon
Observed differences between Syrian and Lebanese patients and between patients in different regions could inform strategies aimed at improving diagnosis and quality of care for hypertension and diabetes in primary care settings in Lebanon
Summary
The Syrian Civil War, which began in March 2011, has resulted in widespread displacement with more than 6.5 million Syrians internally displaced and an exodus of over five million refugees to countries throughout the region [1]. Like many countries in the region, Lebanese and Syrian populations are in the late stages of epidemiologic transition from communicable, maternal, neonatal, and nutritional conditions to Non-Communicable diseases (NCDs) [3 - 7]. The United Nations High Commissioner for Refugees (UNHCR) estimates that 14.6% of adult Syrian refugees in Lebanon have a chronic disease and two similar surveys found that 39.8% and 43.4% of Syrian refugee households in Jordan had at least one household member with a chronic health condition (including hypertension, cardiovascular disease, diabetes, chronic respiratory disease, and arthritis) [18, 19]. While estimates of chronic disease prevalence among Syrian refugees in the region are few, the most recently published rates among adult Syrian refugees in Jordan (2015) estimated 9.7% prevalence for hypertension and 5.3% for diabetes. Given the protracted nature of the crisis in Syria, the large caseload of Syrian refugee patients with non-communicable diseases, and the high costs of providing non-communicable disease care, implications for Lebanon’s health system are vast
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