Background
Globally, the number of forcibly displaced individuals has reached 70.8 million. Lebanon, a middle income country, hosts the highest number of refugees per capita worldwide. The majority of refugees are Syrians who have fled the Syrian war that started in 2011. The migration journey exposes refugees to increased susceptibility to a wide range of medical issues including non-communicable diseases (NCDs). This study aims to determine the prevalence of NCDs among adult Syrian refugees in Lebanon, with a focus on hypertension, diabetes, cardiovascular diseases (CVD) and cancer. The study also aims to explore factors potentially related to the prevalence figures and understand the medication use associated with these morbidities.

Methods
This study is a secondary analysis of de-identified data from the “Sijilli Electronic Health Records for Refugees” Database comprising data on 10,082 Syrian refugees from across informal tented settlements located all over Lebanon. A total of 3,255 records of Syrian refugees aged above 18 years old and reporting having at least one condition of the following were included in the analysis: hypertension, diabetes, Cardiovascular diseases or cancer. Pearson’s Chi-square, independent t-test, and multivariate logistic regressions were used for data analysis.

Results
Hypertension was the most prevalent (10.0%) NCD among refugees, and a higher age was associated with higher NCDs prevalence. A strong linkage has been reported between smoking status and alcohol intake, and increased risk for NCDs. Study findings also revealed that the highest prevalence of hypertension, diabetes and CVDs was observed among refugees originating from Idlib, Aleppo and Homs. An association between adherence to medication and location of diagnosis was noted, with females who were diagnosed before moving to Lebanon being more likely to take corresponding medications compared to those diagnosed in Lebanon, with no difference reported among males.

Conclusions
Our findings suggest that efforts should be directed towards the employment of innovative low-cost approaches for NCD detection and control among refugees, with a focus on the importance of adherence to medication. Such efforts remain imperative to control the increasing burden of NCDs amongst refugee populations and improve equitable access to NCD services.