The prevalence of non-communicable diseases among Syrian refugees in Syria's neighbouring host countries: a systematic review and meta-analysis

Objectives: Alarming rates of non-communicable diseases (NCDs) have been observed in low- and middle-income countries (LMICs) where most refugees reside. There is concern Syrian refugees may experience significant NCD-related health needs, which have significant health implications, including in the context of the COVID-19 pandemic, and which must be addressed by health systems in neighbouring host countries. Although primary studies on this topic exist, there has been no comprehensive synthesis of the existing evidence base. The aim of this systematic review and meta-analysis was to synthesise evidence on the prevalence of NCDs among Syrian refugees residing in neighbouring host countries.

Study design: This was a systematic review and meta-analysis.

Methods: The review was carried out in line with PRISMA guidelines (PROSPERO CRD420201970430). MEDLINE, CINAHL, EMBASE and PubMed databases were searched from 1 January 2011 to 1 November 2021. Peer-reviewed studies reporting prevalence data on the five most common NCDs among adult Syrian refugees living in Turkey, Lebanon or Jordan were included. Methodological quality was assessed using the Joanna Briggs Institute critical appraisal checklist for prevalence studies. Meta-analysis was carried out to estimate the pooled prevalence of these NCDs in community and primary care settings.

Results: A total of 466 citations were identified, 18 of which were included, representing 237,723 Syrian refugees. In community settings, the prevalence of hypertension, diabetes mellitus type II, cardiovascular diseases, chronic respiratory diseases and arthritis was 24% (95% confidence interval: 17-32), 12% (8-15), 5% (3-7), 4% (3-5) and 11% (7-14), respectively. The prevalence of hypertension 35% (33-36) and diabetes mellitus type II 48% (24-72) were significantly higher in primary care settings.

Conclusion: The findings demonstrate a high prevalence of NCDs among Syrian refugees. Evidence-based preventive and management interventions for NCDs are needed in this context to address acute health needs during the COVID-19 pandemic and the longer-term health burden of NCDs.