Aldabbour Belal, Barakat Yousef, Elamassie Samah, Hmeid Fatima, Dughmoush Manar, Al-Rantisi Maha, Abu-Helal Doaa, Barakat Lina, Bader Diana, Kwaik Afnan
Faculty of Medicine, Islamic University of Gaza, P.O. Box 108, Gaza, State of Palestine.
Ministry of Health, Gaza, State of Palestine.
Confl Health. 2025 Jun 24;19(1):36. doi: 10.1186/s13031-025-00679-9.
The war in the Gaza Strip has put immense strain on the infrastructure and health services. As a consequence, the population faces increased risks of morbidity and mortality, not only from violence but also from lack of access to healthcare. This study examines how the war affected Palestinians with non-communicable diseases (NCDs) in the Strip.
This cross-sectional survey employed a structured questionnaire to recruit 968 patients with six common NCDs from seven leading PHC clinics located in northern and southern Gaza between October and November 2024. The survey collected sociodemographic data, assessed direct war impacts on participants, evaluated accessibility to PHC and medications, and examined health impacts on participants during the war. Following descriptive statistics, inferential analysis investigated the relationships between participants' perceptions of PHC and their areas of residence or displacement.
Hypertension (64.9%), type II diabetes mellitus (44.4%), and cardiovascular disease (17.1%) were the most frequently reported NCDs. 98.0% of participants were displaced during the war, and 68.1% were still displaced. 29.9% had lost a first-degree relative, and the majority suffered inaccessibility to adequate food and drinking water, lost property and income, and suffered adverse impacts on their sleep and physical exercise habits. 92.8% rated their pre-war quality of life (QoL) as excellent or good, while 81.3% rated their QoL during the war as poor. Adherence to regular follow-ups decreased from 96.7% before the war to 40.7% during the war (p < 0.001). Satisfaction with PHC dropped from 92.9% to 57.33% (p = 0.002). In terms of access to PHC, more than 93% changed their PHC doctor or clinic, and most stated that reaching the clinic was dangerous and necessitated long journeys. Medication unavailability or high cost were the most frequently reported reasons for non-compliance during the war, reported by 42.7% and 18.1%, respectively. Nearly one in five participants spent two or more consecutive months without medication. Participants from the southern enclave were significantly less satisfied with PHC and medications (p = 0.001), and their subjective QoL was significantly worse (p = 0.007).
The study offers important insights into the impacts of high-intensity armed conflicts on people with NCDs. The war in the Gaza Strip has profoundly impacted patients with NCDs and hampered their access to healthcare, leaving the population at risk for higher morbidity and excess mortality rates now and well into the future.
加沙地带的战争给基础设施和医疗服务带来了巨大压力。因此，民众不仅面临因暴力导致的发病和死亡风险增加，还面临因无法获得医疗保健而带来的风险。本研究调查了这场战争对该地区患有非传染性疾病（NCDs）的巴勒斯坦人的影响。
这项横断面调查采用结构化问卷，于2024年10月至11月期间，从加沙北部和南部的七家主要初级卫生保健诊所招募了968名患有六种常见非传染性疾病的患者。该调查收集了社会人口统计学数据，评估了战争对参与者的直接影响，评估了获得初级卫生保健和药物的可及性，并调查了战争期间对参与者的健康影响。在进行描述性统计之后，推断性分析研究了参与者对初级卫生保健的看法与其居住地区或流离失所情况之间的关系。
高血压（64.9%）、II型糖尿病（44.4%）和心血管疾病（17.1%）是报告最频繁的非传染性疾病。98.0%的参与者在战争期间流离失所，68.1%的人仍处于流离失所状态。29.9%的人失去了一级亲属，大多数人难以获得充足的食物和饮用水，失去了财产和收入，睡眠和体育锻炼习惯也受到了不利影响。92.8%的人将战前生活质量（QoL）评为优秀或良好，而81.3%的人将战争期间的生活质量评为差。定期随访的依从性从战前的96.7%降至战争期间的40.7%（p<0.001）。对初级卫生保健的满意度从92.9%降至57.33%（p=0.002）。在获得初级卫生保健方面，超过93%的人更换了初级卫生保健医生或诊所，大多数人表示前往诊所很危险，而且路途遥远。药物供应不足或成本高昂是战争期间最常报告的不遵医嘱原因，分别有42.7%和18.1%的人报告了这一情况。近五分之一的参与者连续两个月或更长时间没有药物治疗。来自南部飞地的参与者对初级卫生保健和药物的满意度明显较低（p=0.001），他们的主观生活质量也明显较差（p=0.007）。
该研究为高强度武装冲突对非传染性疾病患者的影响提供了重要见解。加沙地带的战争对非传染性疾病患者产生了深远影响，阻碍了他们获得医疗保健的机会，使民众现在和未来都面临更高的发病率和超额死亡率风险。
