BMC Public Health Research article Health-related quality of life in diabetic patients and controls without diabetes in refugee camps in the Gaza strip: a cross-sectional study Ashraf Eljedi†1, Rafael T Mikolajczyk*†2, Alexander Kraemer2 and Ulrich Laaser3 BioMed Central Open Access Address: 1Faculty of Nursing, The Islamic University of Gaza, Gaza strip, Palestinian Territories, 2Department of Public Health Medicine, School of Public Health, University of Bielefeld, Bielefeld, Germany and 3Department of Epidemiology and International Public Health, School of Public Health, University of Bielefeld, Bielefeld, Germany Email: Ashraf Eljedi - aajedi19772@hotmail.com; Rafael T Mikolajczyk* - rmikolajczyk@uni-bielefeld.de; Alexander Kraemer - alexander.kraemer@uni-bielefeld.de; Ulrich Laaser - ulrich.laaser@uni-bielefeld.de * Corresponding author †Equal contributors Published: 30 October 2006 BMC Public Health 2006, 6:268 doi:10.1186/1471-2458-6-268 This article is available from: http://www.biomedcentral.com/1471-2458/6/268 Received: 20 April 2006 Accepted: 30 October 2006 © 2006 Eljedi et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: Prevalence of diabetes mellitus is increasing in developed and developing countries. Diabetes is known to strongly affect the health-related quality of life (HRQOL). HRQOL is also influenced by living conditions. We analysed the effects of having diabetes on HRQOL under the living conditions in refugee camps in the Gaza strip. Methods: We studied a sample of 197 diabetic patients who were recruited from three refugee camps in the Gaza strip and 197 age- and sex-matched controls living in the same camps. To assess HRQOL, we used the World Health Organization Quality of Life questionnaire (WHOQOL-BREF) including four domains (physical health, psychological, social relations and environment). Domain scores were compared for cases (diabetic patients) and controls (persons without diabetes) and the impact of socio-economic factors was evaluated in both groups. Results: All domains were strongly reduced in diabetic patients as compared to controls, with stronger effects in physical health (36.7 vs. 75.9 points of the 0–100 score) and psychological domains (34.8 vs. 70.0) and weaker effects in social relationships (52.4 vs. 71.4) and environment domains (23.4 vs. 36.2). The impact of diabetes on HRQOL was especially severe among females and older subjects (above 50 years). Low socioeconomic status had a strong negative impact on HRQOL in the younger age group (<50 years). Conclusion: HRQOL is strongly reduced in diabetic patients living in refugee camps in the Gaza strip. Women and older patients are especially affected. Background Diabetes mellitus is a serious disease and a cause for a growing public health concern in both developed and developing countries. Globally, the number of people with diabetes is expected to double between 2000 and 2030 while public awareness about this disease remains low [1,2]. Several studies have demonstrated that diabetes has a strong negative impact on the health-related quality Page 1 of 7 (page number not for citation purposes)