{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:13:29Z","timestamp":1788416009957,"version":"build-2803163510"},"reference-count":64,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009229","name":"American University in Cairo","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009229","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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\u202f=\u202f1.16; 95% CI: 1.02\u20131.32;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.023) and lowest tangible social support (AOR\u202f=\u202f5.47; 95% CI: 1.26\u201323.67;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.023) were associated with higher odds of hypertension complications, while not needing to seek care was associated with lower odds (AOR\u202f=\u202f0.30; 95% CI: 0.13\u20130.70;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.005). Among diabetic participants, medication non-adherence (AOR\u202f=\u202f3.83; 95% CI: 1.01\u201314.53;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.048) and failure to access needed care (AOR\u202f=\u202f16.01; 95% CI: 3.04\u201384.27;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.001) were associated with higher odds of complications, while moderate carbohydrate intake was associated with lower odds compared with high intake (AOR\u202f=\u202f0.30; 95% CI: 0.09\u20130.97;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.044). These diabetic model findings warrant cautious interpretation given the small sample and wide confidence intervals in certain variables.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1818580","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:22:38Z","timestamp":1788412958000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring the factors associated with diabetes and hypertension complications among refugees living in Egypt"],"prefix":"10.3389","volume":"14","author":[{"given":"Noura","family":"Seada","sequence":"first","affiliation":[{"name":"Department of Biological, Chemical, and Global Health Science American University in Cairo","place":["Cairo, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sungsoo","family":"Chun","sequence":"additional","affiliation":[{"name":"Department of Biological, Chemical, and Global Health Science American University in Cairo","place":["Cairo, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"ref1","year":"2025"},{"key":"ref2","year":"2025"},{"key":"ref3","year":"2025"},{"key":"ref4","year":"2025"},{"key":"ref5","year":"2023"},{"key":"ref6","volume-title":"Common Situational Analysis Education and Health Services for Migrants and Refugees in Egypt, United Nations\u2013Egypt","year":"2022"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s42506-021-00089-8","article-title":"Healthcare financing in Egypt: a systematic literature review","volume":"97","author":"Fasseeh","year":"2022","journal-title":"J Egypt Public Health Assoc"},{"key":"ref8","year":"2016"},{"key":"ref9","year":"2024"},{"key":"ref10","year":"2023"},{"key":"ref11","year":"2023"},{"key":"ref12","year":"2025"},{"key":"ref13","year":"2024"},{"key":"ref14","year":"2025"},{"key":"ref15","first-page":"544","article-title":"Type 2 diabetes mellitus\u2014a multifactorial disease","volume":"57","author":"Hansen","year":"2002","journal-title":"Ann Univ Mariae Curie-Sk\u0142odowska Sect Med"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"34","DOI":"10.4239\/wjd.v7.i3.34","article-title":"Diabetes in migrants and ethnic minorities in a changing world","volume":"7","author":"Montesi","year":"2016","journal-title":"World J Diabetes"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s42506-024-00158-8","article-title":"Prevalence and predictors of depression, anxiety, and stress among refugees in Egypt","volume":"99","author":"El-Ghitany","year":"2024","journal-title":"J Egypt Public Health Assoc"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"103367","DOI":"10.1016\/j.gerinurse.2025.05.006","article-title":"Resilience and health outcomes among elderly refugees: a nursing perspective on overcoming trauma and isolation","volume":"64","author":"Badawy","year":"2025","journal-title":"Geriatr Nurs N Y N"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1186\/s13031-021-00416-y","article-title":"Inequity and benefit incidence analysis in healthcare use among Syrian refugees in Egypt","volume":"15","author":"Fares","year":"2021","journal-title":"Confl Heal"},{"key":"ref20","year":"2024"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e1003279","DOI":"10.1371\/journal.pmed.1003279","article-title":"Clinical outcomes in a primary-level non-communicable disease programme for Syrian refugees and the host population in Jordan: a cohort analysis using routine data","volume":"18","author":"Ansbro","year":"2021","journal-title":"PLoS Med"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1097","DOI":"10.1186\/s12889-015-2429-3","article-title":"Prevalence and care-seeking for chronic diseases among Syrian refugees in Jordan","volume":"15","author":"Doocy","year":"2015","journal-title":"BMC Public Health"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1186\/s13031-018-0168-7","article-title":"Prevalence of non-communicable diseases and access to care among non-Camp Syrian refugees in northern Jordan","volume":"12","author":"Rehr","year":"2018","journal-title":"Confl Heal"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1111\/1753-0407.12364","article-title":"Prevalence of diabetes mellitus and its risk factors in urban communities of North Sudan: population-based study - 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