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Heart Disease in Adult Syrian Refugees: Experience at Jordan University Hospital
Amjad Bani Hani1, Mahmoud Abu Abeeleh, Moaath Al Smady
1General Surgery Department, School of Medicine, The University of Jordan, Amman. amjadbh@yahoo.com.
Insights
Cardiovascular disease (CVD) is prevalent among Syrian refugees in Jordan, with coronary artery disease being common. Many faced challenges with treatment funding and follow-up, impacting the Jordanian healthcare system.
Area of Science:
- Public Health
- Epidemiology
- International Health
Background:
- Over 1.26 million Syrian immigrants in Jordan since 2011 have strained healthcare services.
- Data on cardiovascular disease (CVD) among Syrian refugees in Jordan is largely unknown.
Purpose of the Study:
- To describe CVD diagnoses, presentations, and outcomes in Syrian refugee adults referred to Jordan University Hospital (JUH).
- To analyze treatment funding sources and patient follow-up post-discharge.
Main Methods:
- Retrospective analysis of Syrian patients with CVD referred to JUH from January 2012 to October 2016.
- Data collection included diagnoses, treatment, outcomes, funding, and follow-up until January 2017.
Main Results:
- 969 patients with CVD were referred; 69.6% had coronary artery disease (CAD).
- Common risk factors included hypertension (60%), diabetes (31%), and dyslipidemia (29%).
- Only 33.2% of referred patients received treatment; 13.3% were denied funding. Mortality was 3%, with 49.2% lost to follow-up.
Conclusions:
- CVD, particularly CAD and its risk factors, poses a significant challenge for Syrian refugees and Jordan's healthcare system.
- Inadequate primary care, poor living conditions, funding gaps, and loss to follow-up are critical issues for this population.
Background:
Since 2011, 1.26 million Syrians have immigrated to Jordan, increasing demands on Healthcare service. Information about cardiovascular disease (CVD) in Syrian refugees in general, and specifically in Jordan, is unknown.
Objectives:
The study aimed to describe CVD in Syrian refugee adults who were referred to Jordan University Hospital (JUH) in terms of diagnosis, presentation, outcome, sources of funding for treatment, and to follow these patients after their discharge.
Methods:
From January 2012 to October 2016, retrospective analysis was performed on the data of Syrian patients who were referred to JUH. This study describes the diagnoses, treatment, and outcome. It also discusses the funding sources; a follow-up was conducted until January 2017.
Results:
There were 969 patients referred to JUH with CVD; median age was 56 years, 686 (72.2%) of them were males and 283 (27.8%) were females. Of the patients, 584 had hypertension (60%), 308 (31%) had diabetes mellitus, 281 (29.0%) suffered from dyslipidemia, and 237 were smokers (24%). There were 69.6% who had coronary artery disease (CAD) and 20 patients (2%) had valvular heart disease. Treatment was offered to 489 patients (49.5%), but only 322 (65.8% of treatment offered and 33.2% of referrals) of them received the intended treatment. Mortality rate was 3% and loss of follow-up was 49.2%. Funding for procedures mostly came from the Jordanian Health Aid Organization, the United Nations, NGOs, and charities. Sixty-four (13.3% of referred) patients were denied any funding during the time frame of this study.
Conclusions:
CVD is a major issue for both Syrian refugee patients and the Jordanian healthcare system. CAD and classic cardiovascular risk factors (specifically arterial hypertension, diabetes, and dyslipidemia) are most common in this specific population. Inadequate primary healthcare, suboptimal living conditions, lack of funding, and loss of patient contact are among the major challenges facing this vulnerable population.
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