# Temporal trends in the incidence and case severity of COVID-19 cases among the Syrian refugees in Azraq camp in Jordan: A retrospective observational study

## TL;DR

This study examines how COVID-19 affected Syrian refugees in Jordan's Azraq camp, finding lower incidence than national rates and highlighting the need for targeted healthcare.

## Contribution

The study provides a detailed analysis of the epidemiological trends and risk factors for COVID-19 among Syrian refugees in a specific refugee camp.

## Key findings

- The monthly incidence rate of COVID-19 in Azraq camp was over 50% lower than the national rate in Jordan.
- Elderly individuals experienced the greatest disease burden, with higher hospitalization rates.
- Vaccination coverage reached 31.6%, primarily with the Pfizer vaccine.

## Abstract

Azraq Syrian refugee camp, located in Jordan, is where the challenges of managing the COVID-19 epidemic meet the vulnerabilities of displaced people. This study aimed to investigate the epidemiological characteristics, incidence, risk factors, and outcomes of COVID-19 among Azraq camp residents.

COVID-19 data from Azraq camp were collected by International Medical Corps clinics and analyzed retrospectively from August 1, 2020, to August 31, 2022. Data included demographics, risk factors, testing history, contact tracing, and vaccination profiles. We estimated COVID-19 incidence and analyzed risk factors using Poisson and multilevel logistic regression.

A total of 2,468 confirmed COVID-19 cases were identified, with a prevalence of 5.6 per 100 residents. The camp’s monthly incidence rate was more than 50% lower than the national rate, with a 1.7% monthly decrease. Females had a higher incidence than males (6.4% vs. 4.9%, p < 0.001), while the elderly bore the greatest disease burden. Home-based isolation was the main strategy, except during the second wave. Vaccination coverage reached 31.6%, primarily with Pfizer (49.8%). Symptomatic cases made up 44.0% of confirmed cases, with 10.4% requiring hospitalization. Factors independently associated with hospitalization included age, comorbidity, and vaccination status.

The study highlights the need for robust surveillance, targeted healthcare interventions, equitable resource allocation, and vaccination campaigns to manage COVID-19 and future epidemics in refugee camps.

The Azraq Syrian refugee camp in Jordan is home to a vulnerable population living under challenging conditions, making it difficult to manage the COVID-19 pandemic effectively. Our study examined the spread and impact of COVID-19 within this camp from August 2020 to August 2022. We collected and analyzed data on the residents’ demographics, health risks, testing, and vaccination status. We found that COVID-19 spread less rapidly in the camp than in the general Jordanian population, with the monthly infection rate decreasing over time. Women and older residents were particularly affected, with the elderly experiencing the most severe cases. While most patients were treated at home, some required hospitalization, especially those who were older or had underlying health conditions. Vaccination played a crucial role in managing the pandemic, with nearly one-third of the camp’s population receiving the vaccine. Our findings emphasize the need for ongoing health monitoring, tailored medical interventions, and increased vaccination efforts to protect vulnerable communities like those in refugee camps from current and future health crises.