Non-Communicable Disease Burden in Syria: A Cross-Sectional Study of Internal Medicine Challenges, Trends, and Prospects

Abstract

Background: Syria is affected by an unequal emergence of NCDs exacerbated by over a decade of armed conflict, disruption of health systems, displacement and collapse due to socio-economic pressure. Pre and post the war period, NCDs are responsible for about 77% of all deaths in-country with cardiovascular diseases (CVD), Type 2 Diabetes Mellitus (T2DM), chronic respiratory disorders and cancer have been reported as the major contributors [9]. All of this has resulted in the current crisis which is responsible for major NCD prevention, surveillance, and management disruption and constitutes a public health emergency requiring evidence-based actions at all levels from internal medicine practitioners to policymakers. Objective: To systematically characterise the contemporary burden of non-communicable diseases (NCDs) in Syria, quantify pooled prevalence estimates, delineate factors associated with these estimates and examine challenges and prospects for practice appropriate internal medicine in the Syrian context. Methods: PubMed/MEDLINE, Scopus, Embase, Cochrane Library and Google Scholar were systematically accessed. Cross-sectional studies, cohort studies, retrospective analyses, systematic and scoping reviews available in peer-reviewed international journals from January 2020 to November 2025 that report data on prevalence or risk factors of non-communicable diseases (NCD) either in Syria or for Syrian populations. Since heterogeneity was anticipated, random-effects meta-analytic model (DerSimonian-Laird method) was utilised. Pooled prevalence estimates (PEs) with 95% confidence intervals (CIs) were used. The I² statistic was used to quantify heterogeneity. Results: In qualitative synthesis, 51 studies were included; in meta-analysis, 32 eligible studies encompassed data from 237,723 participants across conflict-affected Syrian populations and displaced Syrian communities. Conclusion: An interminable humanitarian crisis underpins an alarming NCD epidemic in Syria. The aggregated prevalence data show that Syrian populations bear high, yet heterogeneous, burdens of cardiometabolic disease and chronic disease. Immediate prioritisation of services for NCDs, a strengthened workforce and restored supply of medicines needs to be supported by integrated health information systems in order to reduce avoidable mortality and morbidity. Longitudinal, nationally representative designs are essential for future research to fill critical evidence gaps.