BackgroundHypertension is an important contributor to global burden of disease and mortality, and is a growing public health problem in sub-Saharan Africa. However, most sub-Saharan African countries lack detailed countrywide data on hypertension and other non-communicable diseases (NCD) risk factors that would provide benchmark information for design of appropriate interventions. We analyzed blood pressure data from Uganda’s nationwide NCD risk factor survey conducted in 2014, to describe the prevalence and distribution of hypertension in the Ugandan population, and to identify the associated factors.MethodsThe NCD risk factor survey drew a countrywide sample stratified by the four regions of the country, and with separate estimates for rural and urban areas. The World Health Organization’s STEPs tool was used to collect data on demographic and behavioral characteristics, and physical and biochemical measurements. Prevalence rate ratios (PRR) using modified Poison regression modelling was used to identify factors associated with hypertension.ResultsOf the 3906 participants, 1033 were classified as hypertensive, giving an overall prevalence of 26.4%. Prevalence was highest in the central region at 28.5%, followed by the eastern region at 26.4%, western region at 26.3%, and northern region at 23.3%. Prevalence in urban areas was 28.9%, and 25.8% in rural areas. The differences between regions, and between rural-urban areas were not statistically significant. Only 7.7% of participants with hypertension were aware of their high blood pressure. The prevalence of pre-hypertension was also high at 36.9%. The only modifiable factor found to be associated with hypertension was higher body mass index (BMI). Compared to participants with BMI less than 25 kg/m2, prevalence was significantly higher among participants with BMI between 25 to 29.9 kg/m2 with an adjusted PRR = 1.46 [95% CI = 1.25–1.71], and even higher among obese participants (BMI ≥ 30 kg/m2) with an adjusted PRR = 1.60 [95% CI = 1.29–1.99]. The un-modifiable factor found to be associated with hypertension was older age with an adjusted PRR of 1.02 [95% CI = 1.02–1.03] per yearly increase in age.ConclusionsThe prevalence of hypertension in Uganda is high, with no significant differences in distribution by geographical location. Only 7.7% of persons with hypertension were aware of their hypertension, indicating a high burden of undiagnosed and un-controlled high blood pressure. Thus a big percentage of persons with hypertension are at high risk of hypertension-related cardiovascular NCDs.

Abstractobjective We analysed fasting blood glucose (FBG) and other data collected as part of a population-based nationwide non-communicable disease risk factor survey, to estimate the prevalence of impaired fasting glycaemia (IFG) and diabetes mellitus and to identify associated factors in Uganda.methods The nationwide cross-sectional survey was conducted between April and July 2014. Participants were adults aged 18-69 years. A multistage stratified sample design was used to produce a national representative sample. Fasting capillary glucose was measured to estimate glycaemia. Data were managed with WHO e-STEPs software and Epi Info. Stata â survey procedures were used to account for the sampling design, and sampling weights were used to account for differential probability of selection between strata.results Of the 3689 participants, 1467 (39.8%) were males, and 2713 (73.5%) resided in the rural areas. The mean age was 35.1 years (standard deviation = 12.6) for males and 35.8 years (13.2) for females. The overall prevalence of IFG was 2.0% (95% confidence interval (CI) = 1.5-2.5%), whereas that of diabetes mellitus was 1.4% (95% CI 0.9-1.9%). The prevalence of IFG was 2.1% (95% CI 1.3-2.9%) among males and 1.9% (95% CI 1.3-2.6%) among females, whereas that of diabetes mellitus was 1.6% (95% CI 0.8-2.6%) and 1.1% (95% CI 0.6-1.7%), respectively. The prevalence of IFG was 2.6% (95% CI 1.4-3.8%) among urban and 1.9% (95% CI 1.3-2.4%) among rural residents, whereas that of diabetes mellitus was 2.7% (95% CI 1.4-4.1) and 1.0% (95% 0.5-1.6%), respectively. The majority of participants identified with hyperglycaemia (90.5% IFG and 48.9% diabetes) were not aware of their hyperglycaemic status. Factors associated with IFG were region of residence, body mass index and total cholesterol; factors associated with diabetes mellitus were age, sex, household floor finish and abdominal obesity.conclusion The prevalence of IFG and of diabetes mellitus is low in the Ugandan population, providing an opportunity for the prevention of diabetes. The majority of persons with hyperglycaemia were not aware of their hyperglycaemic status, which implies a likelihood of presenting late with complications.

BackgroundThere are limited data on levels of alcohol use in most sub-Saharan African countries.ObjectiveWe analyzed data from Uganda's non-communicable diseases risk factor survey conducted in 2014, to identify alcohol use prevalence and associated factors.DesignThe survey used the World Health Organization STEPS tool to collect data, including the history of alcohol use. Alcohol users were categorized into low-, medium-, and high-end users. Participants were also classified as having an alcohol-use-related disorder if, over the past 12 months, they were unable to stop drinking alcohol once they had started drinking, and/or failed to do what was normally expected of them because of drinking alcohol, and/or needed an alcoholic drink first in the morning to get going after a heavy drinking session the night before. Weighted logistic regression analysis was used to identify factors associated with medium- to high-end alcohol use.ResultsOf the 3,956 participants, 1,062 (26.8%) were current alcohol users, including 314 (7.9%) low-end, 246 (6.2%) medium-end, and 502 (12.7%) high-end users. A total of 386 (9.8%) were classified as having an alcohol-use-related disorder. Male participants were more likely to be medium- to high-end alcohol users compared to females; adjusted odds ratio (AOR)=2.34 [95% confidence interval (CI)=1.88–2.91]. Compared to residents in eastern Uganda, participants in central and western Uganda were more likely to be medium- to high-end users; AOR=1.47 (95% CI=1.01–2.12) and AOR=1.89 (95% CI=1.31–2.72), respectively. Participants aged 30–49 years and those aged 50–69 years were more likely to be medium- to high-end alcohol users, compared to those aged 18–29 years, AOR=1.49 (95% CI=1.16–1.91) and AOR=2.08 (95% CI=1.52–2.84), respectively.ConclusionsThe level of alcohol use among adults in Uganda is high, and 9.8% of the adult population has an alcohol-use-related disorder.

PA levels in Uganda are high, mostly achieved through travel and work-related activities of moderate intensity.

IntroductionAdequate consumption of fruits and vegetables has protective benefits against development of coronary heart disease, hypertension and chronic obstructive pulmonary disease. However, approximately 2.7 million deaths annually can be attributed to inadequate fruit and vegetable consumption. We analyzed data from a countrywide survey in Uganda, to estimate the prevalence of adequate fruit and/ or vegetable consumption, and identify associated factors.MethodsData were collected using the World Health Organization STEPwise approach to surveillance, a standard approach to surveillance of risk factors for Non Communicable Diseases. Fruit and vegetable consumption was assessed by asking participants the number of days in a typical week they eat fruits or vegetables and the number of servings eaten in one of those days. Adequate fruit and/ or vegetable consumption was defined as consuming 5 or more servings of fruits and/ or vegetables per day in a typical week. We used modified Poisson regression analysis to estimate prevalence risk ratios (PRRs) and identify factors associated with eating 5 or more servings of fruits and/ or vegetables per day, per week.ResultsOf 3962 participants, 484 (12.2%) consumed 5 or more servings of fruits and/ or vegetables per day in a typical week. Participants who were married or cohabiting were more likely to consume at least 5 servings of fruits and/ or vegetables per day in a typical week compared with those who had never been married PRR = 1.51 [95% CI 1.07–2.14]. Compared with participants from Western region, those from Central region were more likely to consume 5 or more servings of fruits and/ or vegetables per day in a typical week, PRR = 3.54 [95% CI 2.46–5.10] as were those from Northern, PRR = 2.90 [95% CI 2.00–4.23] and Eastern regions PRR = 1.60 [95% CI 1.04–2.47].ConclusionsFruit and vegetable consumption in Uganda is low and does not differ significantly across social and demographic characteristics, except marital status and geographical region of residence. There is a need to develop and strengthen policies that promote adequate consumption of fruits and vegetables in the Ugandan population.

BackgroundOverweight and obesity are associated with health complications the gravity of which, vary with the regional deposition of the excess fat. The Body Mass Index (BMI) is often used to measure obesity although is an inferior predictor of cardiovascular disease risk mortality and morbidity compared with measures of abdominal obesity. We analyzed data from Uganda’s 2014 World Health Organization (WHO) STEPwise approach to surveillance of Non-communicable diseases (NCDs) survey to estimate the prevalence of abdominal obesity and associated factors to provide information on the prevention and control of overweight and obesity.MethodsData were collected using the WHO STEPS protocol. Waist measurement was taken using a non-stretchable standard tape measure mid-way between the lowest rib and iliac crest with the subject standing at the end of gentle expiration. Participants with waist circumference > 102 cm for men and 88 cm for women were classified as abdominally obese. We used weighted modified Poisson regression with robust error variance to estimate the prevalence of abdominal obesity and associated factors.ResultsOf the 3676 participants, 432 (11.8%) were abdominally obese; with the prevalence higher among females 412 (19.5%) compared with males 20 (1.3%). Compared with males, female participants were more likely to be abdominally obese Adjusted Prevalence Rate Ratio (APRR) 7.59 [5.58–10.33]. Participants who were married or cohabiting APRR 1.82 [1.29–2.57] and participants who were separated or divorced APRR 1.69 [1.17–2.46] were more likely to be abdominally obese compared with those who had never married before. Compared with rural dwellers, participants from urban areas were more likely to be abdominally obese APRR 1.29 [1.09–1.53]. Compared with participants with normal blood pressure, those with elevated blood pressure were more likely to be abdominally obese APRR 1.83 [1.57–2.14].Compared with participants without any education, those with secondary education were more likely to be abdominally obese APRR 1.42 [1.12–1.78].ConclusionsThere is a high prevalence of abdominal obesity among adults in Uganda which puts many at risk of developing associated metabolic complications. These data provide useful information for developing interventions and formulation of policies for the control and prevention of abdominal obesity in Uganda.

BackgroundTobacco use and the exposure to tobacco smoke is one of the most preventable causes of death and disability globally. The risk is even higher among daily tobacco users. The World Health Organization (WHO) has recommended that surveillance of major risk factors for Non Communicable Diseases (NCDs) such as tobacco use is imperative to predict the future burden of NCDs, identify interventions to reduce future burden and monitor emerging patterns and trends. In 2014 the first Uganda nation-wide NCD risk factor survey was carried out to estimate the prevalence of major NCD risk factors. We analyzed data from this survey to estimate the prevalence of daily tobacco use and associated risk factors.MethodsA nationally representative sample was drawn stratified by the four regions of the country. The WHO’s STEPwise tool was used to collect data on demographic and behavioral characteristics including tobacco use, physical and biochemical measurements. Tobacco use was divided into three categories; daily tobacco use, daily smoked tobacco use and daily smokeless tobacco use. Weighted logistic regression analysis was used to identify factors associated with daily tobacco use.ResultsOf the 3983 participants, 9.2 % (366) were daily tobacco users, 7.4 % (294) were daily smoked tobacco users and 2.9 % (115) were daily smokeless tobacco users. Male participants were more likely to be daily tobacco users compared with female participants AOR 5.51 [3.81–7.95]. Compared with participants aged 18–29 years, those aged 30–49 years were more likely to be daily tobacco users AOR 2.47 [1.54–3.94] as were those aged 50–69 years AOR 2.82 [1.68–4.74]. Compared with participants without any education, those with primary education were less likely to be daily tobacco users AOR 0.43 [0.29–0.65], as were those with secondary education AOR 0.21 [0.14–0.33] and those with university level of education AOR 0.23 [0.11–0.48]. Compared with participants in the central region, those in the eastern region were more likely to be daily tobacco users AOR 2.14 [1.33–3.45] as were those in the northern region AOR 4.31 [2.79–6.45] and those in the western region AOR 1.87 [1.18–2.97]. Participants who were underweight were more likely to be daily tobacco users compared with people with normal BMI AOR 2.19 [1.48–3.24].ConclusionsIn agreement with previous surveys on tobacco use, there is a high prevalence of tobacco use in Uganda with almost 1 in every 10 Ugandans using tobacco products daily. Being older, male, having no formal education, residing in the east, north and western regions and having low BMI were significantly associated with daily tobacco use. This information provides a useful benchmark to the National Tobacco Control Program for the designing of public health interventions for the control and prevention of tobacco use in Uganda.Electronic supplementary materialThe online version of this article (doi:10.1186/s12971-016-0093-8) contains supplementary material, which is available to authorized users.

BackgroundModification of known risk factors has been the most tested strategy for dealing with non-communicable diseases (NCDs). The cumulative number of NCD risk factors exhibited by an individual depicts a disease burden. However, understanding the risk factors associated with increased NCD burden has been constrained by scarcity of nationally representative data, especially in the developing countries and not well explored in the developed countries as well.MethodsAssessment of key risk factors for NCDs using population data drawn from 3987 participants in a nationally representative baseline survey in Uganda was made. Five key risk factors considered for the indicator variable included: high frequency of tobacco smoking, less than five servings of fruit and vegetables per day, low physical activity levels, high body mass index and raised blood pressure. We developed a composite indicator dependent variable with counts of number of risk factors associated with NCDs per participant. A statistical modeling framework was developed and a multinomial logistic regression model was fitted. The endogenous and exogenous predictors of NCD cumulative risk factors were assessed.ResultsA novel model framework for cumulative number of NCD risk factors was developed. Most respondents, 38 · 6% exhibited one or two NCD risk factors each. Of the total sample, 56 · 4% had at least two risk factors whereas only 5.3% showed no risk factor at all. Body mass index, systolic blood pressure, diastolic blood pressure, consumption of fruit and vegetables, age, region, residence, type of residence and land tenure system were statistically significant predictors of number of NCD risk factors (p < 0 · 05). With exception to diastolic blood pressure, increase in age, body mass index, systolic blood pressure and reduction in daily fruit and vegetable servings were found to significantly increase the relative risks of exhibiting cumulative NCD risk factors. Compared to the urban residence status, the relative risk of living in a rural area significantly increased the risk of having 1 or 2 risk factors by a multiple of 1.55.ConclusionsThe non-communicable disease burden is on the increase, with more participants reporting to have at least two risk factors. Our findings imply that, besides endogenous factors, exogenous factors such as region, residence status, land tenure system and behavioral characteristics have significant causal effects on the cumulative NCD risk factors. Subsequently, while developing interventions to combat cumulative risk factors of NCDs, the Ministry of Health needs to employ a more holistic approach to facilitate equitable health and sensitization across age, residence and regional divide.