CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 3, April 2013
52
AFRICA
Cardiovascular Topics
The prevalence and distribution of non-communicable
diseases and their risk factors in Kasese district, Uganda
CHARLES KIIZA MONDO, MARCEL ANDREW OTIM, GEORGE AKOL, ROBERT MUSOKE, JACKSON OREM
Abstract
Background:
To date there has been no population-based
survey of the major risk factors for non-communicable
diseases (NCD) in Uganda. Hospital-based data from urban
centres report an increasing burden of NCDs in Uganda. This
population-based survey aimed to describe the prevalence of
risk factors for NCDs in a rural Ugandan district.
Methods:
The survey was conducted using the WHO
STEPwise approach to surveillance of non-communicable
diseases (STEPS) methodology. Participants (
n
=
611) were
residents of the Kasese district selected in a one-step,
complete survey of a rural district. Standardised internation-
al protocols were used to record history of disease, and meas-
ure behavioural risk factors (smoking, alcohol consumption,
fruit and vegetable consumption, physical activity), physical
characteristics [weight, height, waist and hip circumferences,
blood pressure (BP)], fasting blood glucose (BG) and total
cholesterol (TC) levels. Data were analysed using simple
descriptive analysis.
Results:
In this sample, the prevalence of hypertension
(systolic BP
≥
140 mmHg and/or diastolic BP
≥
90 mmHg)
was 22.1% for men and 20.5% for women. Fifteen per cent of
men and 16.8% of women were overweight [body mass index
(BMI)
≥
25 kg/m
2
] and 4.9% of men and 9.0% of women were
obese (BMI
≥
30 kg/m
2
). Nine per cent of participants were
diabetic, 7.2% ate five or more combined servings of fruit per
day while only 1.2% ate five or more combined servings of
vegetables per day. Fifty-one per cent of the population were
physically inactive and 9.6% were daily smokers. Thirty-one
per cent of females had fasting blood sugar levels (FBS)
≥
6.1
mmol/l while 10% of males had FBS
>
6.1 mmol/l.
Conclusion:
This study presents evidence on the magnitude
of NCDs, their risk factors and gender distribution in a rural
population in Uganda, a poor country in east-central Africa.
These data, when combined with urban population data,
could be useful in the formulation and advocacy of NCD
policy and plans of action in Uganda.
Keywords:
non-communicable diseases, WHO STEPs, smok-
ing, obesity, physical activity
Submitted 24/4/12, accepted 28/11/12
Cardiovasc J Afr
2013;
24
: 52–57
DOI: 10.5830/CVJA-2012-081
Non-communicable diseases (NCDs) are currently responsible
for 35% of all deaths in low- and middle-income countries,
1
and this alarming figure is predicted to rise in the near future.
The World Health Organisation projects that the burden of
disease due to NCDs will increase rapidly in the years ahead.
From a projected total of 58 million deaths from all causes
in 2005, it was estimated that NCDs would account for 35
million deaths, which was double the number of deaths from
all communicable diseases (including HIV/AIDS, tuberculosis
and malaria), maternal and perinatal conditions and nutritional
deficiencies combined.
1
This epidemiological transition in global health from infectious
diseases to NCDs is posing not only a threat to the health of
those affected but also places an enormous burden on the health
systems of nations, particularly those of the least-developed
countries, as they must now address a double burden of acute
and chronic diseases amidst scarce resources.
2-4
Furthermore,
this epidemiological transition is adversely impacting on
socio-economic development of nations, as NCDs tend to be
more prevalent in young working class people.
2
As a more
sophisticated workforce becomes a highly valued and harder-to-
replace economic investment, the increasing prevalence of NCD
risk factors in developing countries, particularly sub-Saharan
Africa (SSA), becomes a real threat to economic progress,
adversely impacting on all the previous gains made in combating
HIV, malaria, tuberculosis and other infectious diseases.
5
In Uganda, while acute infectious communicable diseases
still contribute the major (75%) disease burden, with malaria,
acute respiratory infections and HIV/AIDS among the top
10 causes of illness and death,
6
the burden of NCDs is
increasingly posing a threat of dual epidemics of communicable
and non-communicable diseases. The International Diabetes
Federation put estimates of incidence of diabetes mellitus in
Uganda at 50 000 affected individuals in the year 2003, and
projected a 10-fold increase in the cases of diabetes by 2025 if no
interventions are initiated.
7
Estimates suggest that as many as 8%
Department of Medicine, College of Health Sciences,
Makerere University, Kampala, Uganda
CHARLES KIIZA MONDO, MB ChB, MMed, PhD, charlesmon-
MARCEL ANDREW OTIM, MB ChB, MMed, MD
ROBERT MUSOKE, MB ChB, MSc
Alcomed Specialist Diagnostic Service, Kasese, Uganda
GEORGE AKOL, MB ChB, MMed, MRCP
Uganda Cancer Institute and Department of Medicine, College
of Health Sciences, Makerere University, Kampala, Uganda
JACKSON OREM, MB ChB, MMed
