Total cholesterol and the associated factors among adults aged 18–69 years in Uganda: analysis of the 2023 national population-based non-communicable disease survey data

Abstract

OBJECTIVE: Cardiovascular diseases (CVDs) are a leading cause of mortality in people with non-communicable diseases (NCDs). Elevated total blood cholesterol is a modifiable risk factor for several CVDs. In Uganda, there is limited information about factors associated with total cholesterol at the national level. This study examined the factors associated with total cholesterol among adults aged 18-69 years in Uganda using a large, nationally representative dataset. METHODS: The study analyzed the 2023 Nationwide Non-communicable Disease (NCDs) risk factor survey data that involved Ugandans aged 18-69 years. The national survey used a cross-sectional design and adhered to the World Health Organization's STEP-wise approach to surveillance (STEPS). The dependent variable was total cholesterol, measured as a continuous variable. To determine the factors associated with total cholesterol, a multiple linear regression analysis was performed, and Beta coefficients (β) with respective 95% confidence intervals (CIs) were reported. RESULTS: We analyzed data for 3,694 participants, with a median age of 36 years (interquartile range: 27- 49). We found that every 1-year age increase (range, 18-69 years), female sex, completion of secondary or tertiary/university levels of education, being married or in a cohabiting relationship, overweight or obesity, being diabetic, and being hypertensive were positively associated with total cholesterol. Conversely, being underweight and residing in rural, northern, or western Uganda showed a negative association with total cholesterol. CONCLUSION: The study found that total cholesterol is associated with several socio-demographic and metabolic factors that are either modifiable or non-modifiable. Efforts to mitigate the burden of cardiovascular diseases among individuals aged 18-69 years in Uganda should focus on lowering total cholesterol and managing the modifiable underlying risk factors.