Refugees who migrated due war conditions in Syria live under extraordinary conditions. How the risk factors affecting NCDs do change under these extraordinary conditions do has not been studied before. This study is the first in applying the well-established WHO-STEPS methodology for measuring the NCD risk factors for ref-ugees. A total of 5,760 Syrian refugees living in-camp and out camp settlements in Turkey have been included in the survey. A stratified survey random sampling plan is used to draw sample households from ten provinces where 80%
of the Syrian refugees were living. The survey implement-ed the first two steps of the STPES methodology. Initial evaluation of NCD risk factor survey revealed significant information on the NCD risks for the Syrian refugees.
High rates of tobacco use, low physical activity, and diet that does not meet the recommendations indicate that the NCDs in Syrian refugees is taking hold.
Findings on tobacco use show that the current Syrian refugees’ consumption of such tobacco products as cig-arettes, cigars, pipes, etc. shows that 34% of the Syrian refugees currently smoke a tobacco product. 30.8% of in-dividuals aged 18-29 years, a 36.3% of those aged 30-44, a 38.3% of those aged 45-59, and a 29.7% of those aged 60-69 currently smoke a tobacco product. The results show that significant differences exist between men and wom-en in tobacco use. While 55.0% of mwom-en stated that they currently smoke a tobacco product, only 11.8% of wom-en refugees currwom-ently smoke a tobacco product. In terms of the age groups, 53.8% of men aged 18-29, 57.4% of those aged 30-44, 55.3% of those aged 45-59, and 46.8%
of those aged 60-69 currently smoke a tobacco product.
In women, 8.2% of those aged 18-29, 14.2% of those aged 30-44, 16.9% of those aged 45-59, and 9.6% of those aged 60-69 currently smoke a tobacco product. The group with the lowest prevalence of tobacco use is women aged 18-29, and the group with the highest is men aged 30-44.
The survey results on alcohol consumption shows that, without disaggregation by sex, 98.6% of the Syrian refugees have never consumed alcohol at all. The propor-tion of those Syrian refugees who have not consumed alcohol in the past 12 months stands at 99.2%. While 0.3% of individuals have consumed alcohol in the past 12 months, the proportion of the current alcohol users who have consumed alcohol in the past 30 days stands only at three per thousand.
The findings on the diet (vegetable and fruit
con-sumption) for Syrian refugees show that they consume vegetables more than 4 days a week. Average values vary marginally between men and women. While this average is 4.4 days a week for men, it is 4.0 for women. When both sexes are considered, a high 40.0% of Syrian refugees do not eat any fruit/vegetables during the day. A 47.5% of the respondents stated they consumed 1 or 2 servings of fruit/vegetables in a day while 9% stated that they con-sumed 3 or 4 servings in a day. A 3.6% of the women and men refugee respondent stated that they consume at least 5 servings of fruit/vegetables per day.
The survey results show that 37.2% of Syrian refugees add salt always/often to their meal before eating. That is, more than one third of the respondents add salt always or often to their meals. Although there is not a statistically significant difference (at 5% significance level) between the sexes with respect to adding salt during eating, there are significant differences between age groups. While 40.0% of individuals aged 18-29 stated they always/often add salt to their meal before eating, this proportion drops to 37.9% in those aged 30-44, to 32.0% in those aged 45-59, and to 24.2% in those aged 60-69. A significant de-cline is visible in salt consumption with age, which is very likely due to health advice. A significant decline is visible in salt consumption with age.
On the cardiovascular disease (CVD), we find that show that 6.4% of all respondents have history of car-diovascular disease (CVD). In terms of the age groups, the highest CVD history is observed for the 60-69 age group with 24.7% of the 342 Syrian refugees in this group reporting positive to CVD history. The 60-69 age group is followed by the 45-59 age group with a 14.7% CVD history. Lastly, for 30-44 and 18-29 age groups a 5.0% and 2.4%, respectively, have CVD history.
The survey also included questions on screening for cervical cancer for women. The results show that, among all adult women aged 18-69 years, 7.2 percent had screen-ing for cervical cancer. When we consider the age groups, percentage of woman having cervical cancer screening does not exceed 12% for all age groups and this maximum is observed for the 45-59 age group for which 11.9% of the women had cervical cancer screening.
Based on results of the question of diabetes, the pro-portion of individuals who have had their blood sugar measured but have not been diagnosed with high blood sugar 15.9%. Overall 79.1%, i.e., close to four fifths, of
Syrian refugees have never had their blood sugar meas-ured. This proportion is strikingly higher in youth. While 88.6% of individuals aged 18- 29 have never had their blood sugar checked, this proportion drops to 78.9% in those aged 30-44, to 61.7% in those aged 45-59, and to 52.4% in those aged 60-69. Overall for both sexes, 4.1%
of individuals have been diagnosed with high blood sugar in the past 12 months. This proportion varies significantly between younger and older individuals. While four per thousands of individuals aged 18-29 have been diagnosed with high blood sugar in the past 12 months, this propor-tion increases to 2.6% in those aged 30-44, to 13.0% in those aged 45-59, and to 18.8% in those aged 60-69.
The survey included physical measurements on hy-pertension. The findings show that prevalence of hyper-tension significantly increases with age for both sexes. The hypertension prevalence rate for men is 15.1% for 18-29 years age group, 25.9% for 30-44 years age group, 49.3%
for 45-59 years age group, and 63.7% for 60-69 years age group (first panel of Table 44). Similarly, we see from Ta-ble 44 that the hypertension prevalence rate for women is 11.8% for 18-29 years age group, 22.5% for 30-44 years age group, 49.3% for 45-59 years age group, and 67.8%
for 60-69 years age group. In terms of hypertension con-trol, the findings shows that 23.4% in hypertensive men and 18.9% hypertensive women are not drugs. However, there is a significant increasing trend with age for people with having hypertensions and not drugs. For instance, of those who has hypertensions (i.e. SBP≥140 and/or DBP≥90 mmHg), 40.5% and 52.6% are not on any an-tihypertensive drug for the 45-59 and 60-69 age groups, respectively, while this is only 12.5% for the 18-29 age group. We do not observe any significant difference across sexes for those who have hypertensive women and not on any antihypertensive drug.
In terms of the weight and height measurements, the survey results for Body Mass index (BMI) risk categories for the Syrian refugees living in Turkey showed that the survey results on BMI risk categories for the Syrian refu-gees living in Turkey showed that 1.4% of 18-69 years old refugee population found to be as underweight, 38.3% as normal, 32.6% as overweight, and that of the remaining 27.7% as obese. More importantly, the survey findings on the BMI risk categories showed that 35.6% of men are
are overweight and 36.2% are obese. The findings show that the prevalence of overweight and obesity across sex-es and age groups are statistically significant. The rsex-esults show that women are significantly more likely to suffer from overweight obesity than men (60.3% compared with 56.2%). The overweigh difference between women and men is statistically significant. The prevalence of over-weight has a significant increasing trend with age reaching from 41.0% in 18-29 age group to 83.3% in 18-69 age group when both sexes are considered.
When the combined risk factors are considered, the survey finds that 0.3% of the Syrian refugees aged 18-69 was at low risk of noncommunicable diseases (i.e., with none of the five risk factors) compared to 41.1% at mod-erate risk (with 1 -2 risk factors) and high 58.7% in high risk (with 3-5 risk factors). Moreover, we find that having 3-5 risk factors were more common among men (61.3%) than women (56.1%). In general, the proportion of high risk (i.e., 3 or more of five risk factors) increases with age for both sexes, the younger cohort are also at high risk for noncommunicable diseases, with 45.7 % of men and 46.1% of women in the 18-44 years age group at high risk.
A strikingly a high percentage of men (81.7%) and wom-en (87.1%) aged 45-69 years have high combined risk (more than 3 risk factors).