BMC Public Health 2006, 6:268 http://www.biomedcentral.com/1471-2458/6/268 Diabetic refugees N = 197 Non-diabetic refugees N = 197 p-value Chi-square Table 1: Socio-economic characteristics of the sample (%) Characteristic Matching factors Gender Male Female Age groups <30 30–39 40–49 50–60 > 60 Other variables Education None Primary Secondary Tertiary Higher Marital status Single Married Widowed Divorced House type Owned Refugee shelter* Rented Monthly Income Below 200 US$ 200–500 US$ >500 US$ Employment No Yes Number of people financially depending on the respondent 0–5 6–10 > 10 52.8 47.2 6.1 10.7 24.9 33.5 24.9 28.4 14.7 15.2 20.3 21.3 7.1 76.6 17.7 1.5 69.5 24.5 5.1 65.5 24.9 9.6 59.4 40.6 58.9 38.1 3.0 52.8 47.2 6.1 10.7 24.9 33.5 24.9 4.1 4.11 13.7 35.0 43.1 8.6 87.3 3.6 0.5 68.5 22.3 9.1 50.8 42.1 7.1 66.5 33.5 61.9 27.4 10.7 - - <0.001 0.001 0.26 0.001 <0.001 0.003 * The temporary houses built by the United Nations Relief and Works Agency for Palestinian Refugees in the Near East (UNRWA) in 1948 as the first shelter. on HRQOL among patients younger than 50 than for older patients. In the age group below 50 years, being in the category with lowest income was comparable to hav- ing diabetes in terms of impact on physical health and psychological domain. The socio-economic status had even a higher impact on social relationships and environ- ment domain in this comparison. Being married had a small positive effect on HRQOL. Discussion We analysed the HRQOL in a sample of diabetic patients living in refugee camps in the Gaza strip in comparison to gender- and age-matched non-diabetic controls from the same camps. Diabetes and its complications affected neg- atively all of the domains of the WHOQOL-BREF, how- ever the effects were strongest for the physical health and psychological domains and weaker for the social relation- ships and environment domains. We found a strong effect of interactions between gender and disease status (dia- betic patients vs. controls). Whereas this finding could be partly explained by the worse situation of female patients in respect to the disease in our sample, this is still an evi- dence for gender inequalities. Similar difference in HRQOL of both genders was observed in a study con- ducted in Iran [13]. Lower HRQOL in women with diabe- tes was also reported in other studies [4,5]. Age strongly affected the HRQOL of diabetic patients in physical health and psychological domains and had almost no effects on HRQOL among controls. Had we not taken into account the interactions, we would have found mistakenly that Page 4 of 7 (page number not for citation purposes)