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.
Key Findings
Results
Prolonged displacement was associated with higher odds of hypertension complications among refugees.
AOR = 1.16; 95% CI: 1.02–1.32; p = 0.023, after adjustment for sociodemographic and access-to-care variables
Study population consisted of 246 Syrian and Sudanese refugees diagnosed with T2D and/or HTN in Cairo, Giza, and Alexandria
Participants were recruited via convenience sampling through refugee-led organizations
Each additional unit of time in displacement was associated with incrementally higher odds of hypertension complications
Results
Lowest tangible social support was associated with substantially higher odds of hypertension complications.
AOR = 5.47; 95% CI: 1.26–23.67; p = 0.023, compared to higher levels of social support
Tangible social support was assessed using a standardized tool included in the survey
This was among the strongest associations observed in the hypertension complications model
Finding was adjusted for sociodemographic characteristics and access-to-care variables
Results
Not needing to seek care was associated with lower odds of hypertension complications.
AOR = 0.30; 95% CI: 0.13–0.70; p = 0.005
This variable served as a reference category contrasting with those who needed care but faced access barriers
Finding was adjusted for sociodemographic and access-to-care variables
Result suggests that perceived healthcare need itself is a marker of disease severity or progression
Results
Medication non-adherence was associated with higher odds of diabetes complications among diabetic participants.
AOR = 3.83; 95% CI: 1.01–14.53; p = 0.048
Unaffordability was the most reported barrier to healthcare access and medication adherence across the full sample
Authors note these diabetic model findings 'warrant cautious interpretation given the small sample and wide confidence intervals in certain variables'
Finding was adjusted for sociodemographic and access-to-care variables
Results
Failure to access needed care was associated with markedly higher odds of diabetes complications.
AOR = 16.01; 95% CI: 3.04–84.27; p = 0.001 among diabetic participants
This was the largest point estimate observed across both disease complication models
Authors caution that the wide confidence interval reflects small diabetic subsample size
Finding highlights structural barriers to care as a key determinant of diabetes outcomes in this population
Results
Moderate carbohydrate intake was associated with lower odds of diabetes complications compared to high carbohydrate intake.
AOR = 0.30; 95% CI: 0.09–0.97; p = 0.044 for moderate versus high carbohydrate intake
Diet was assessed using a standardized dietary tool included in the self-administered questionnaire
Authors note this finding warrants cautious interpretation given small sample size and wide confidence intervals
Refugees generally showed poor health and lifestyle behaviors overall
Results
Unaffordability was the most commonly reported barrier to healthcare access and medication adherence among refugees with T2D and/or HTN.
Finding derived from descriptive statistics of 246 participants
Participants were recruited through refugee-led organizations in Cairo, Giza, and Alexandria
Egypt hosts over 1 million refugees and asylum seekers, with systematic difficulties in access to healthcare services
Cross-sectional design used a self-administered questionnaire and BMI measurement
Results
Refugees with T2D and/or HTN generally showed poor health and lifestyle behaviors across the sample.
246 refugees diagnosed with T2D and/or HTN were included in the cross-sectional study
Survey included standardized tools assessing diet, lifestyle, tangible social support, and access to care
Participants were Syrian and Sudanese refugees living in Cairo, Giza, and Alexandria, Egypt
Recruitment was via convenience sampling through refugee-led organizations, which may limit generalizability
What This Means
This research suggests that Syrian and Sudanese refugees living in Egypt who have diabetes or high blood pressure face a complex set of challenges that increase their risk of serious health complications. The study surveyed 246 refugees in Cairo, Giza, and Alexandria and found that key risk factors included how long someone had been displaced from their home country, how little social support they had from others who could provide practical help, whether they could access and afford medical care, and whether they were able to take their medications consistently. The inability to pay for healthcare was the single most commonly reported barrier across the entire group.
For refugees with high blood pressure specifically, each additional period spent in displacement increased complication risk, and those with the lowest levels of tangible social support (such as having someone to help with practical needs) had more than five times higher odds of complications compared to those with higher support. For refugees with diabetes, failing to access needed medical care was associated with dramatically higher odds of complications, and not taking medications as prescribed nearly quadrupled the odds. Eating moderate rather than high amounts of carbohydrates was linked to lower complication risk in diabetic participants, though these diabetes-specific findings should be interpreted carefully due to the smaller numbers involved.
This research suggests that improving health outcomes for refugees with chronic diseases requires more than just medical treatment. Addressing financial barriers to care, strengthening social support networks, and reducing the health harms of prolonged displacement are all important. These findings point to the need for interventions in refugee-hosting countries like Egypt that tackle both the clinical and social roots of poor health among displaced populations.
Seada N, Chun S. (2026). Exploring the factors associated with diabetes and hypertension complications among refugees living in Egypt.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1818580