Changes in the prevalence of the common risk factors for non-communicable diseases in Uganda between 2014 and 2023: Informed by nationally representative cross-sectional surveys

Abstract

ABSTRACT Background Non-communicable diseases (NCDs) remain the biggest contributor to global mortality. Although communicable diseases still contribute highest to mortality in the African region, the proportion contributed by NCDs continues to rise. An important way to control NCDs is to focus on reducing the prevalence of the common NCD risk factors. As such, monitoring changes in the prevalence of these risk factors is essential for better NCD prevention planning. Uganda conducted its first nationally representative NCD risk factor survey in 2014, and a second in 2023. We analyzed the prevalence of the common NCD risk factors using data from the two surveys to identify which risk factors changed between 2014 and 2023. Methods Both surveys drew countrywide samples stratified by the four regions of the country, and by rural-urban locations. The World Health Organization’s STEPs tool was used to collect data on demographic and behavioral characteristics, and physical and biochemical measurements. We defined and calculated weighted prevalence of the following common NCD risk factors: high blood pressure, high blood glucose, overweight and obesity, current use of alcohol, current tobacco use, inadequate consumption of fruits and vegetables, inadequate physical activity, and sedentariness. Results The 2014 survey enrolled a total of 3906 participants, whereas that of 2023 enrolled 3694 participants. The NCD risk factor prevalences that increased significantly were: high blood glucose from 1.3% in 2014, to 2.9% in 2023 (p< 0.001); overweight and obesity from 19.4% in 2014 to 24.1% in 2023 (p< 0.001); current alcohol consumption from 28.5% in 2014, to 31.1% in 2023 (p=0.013); and sedentariness from 26.6% in 2014, to 31.9% in 2023 (p< 0.001). It is only the prevalence of current smoke tobacco use that decreased significantly from 9.6% in 2014, to 8.3% in 2023 (p= 0.046). Nationally, no significant changes were observed in the prevalence of high blood pressure, inadequate consumption of fruits and vegetables, and inadequate physical activity. Conclusions Most of the common NCD risk factors increased between 2014 and 2023. There is an agent need for the various stakeholders in Uganda to implement interventions targeting reduction in the prevalence of NCD risk factors to prevent the currently increasing burden of NCDs and associated mortality.