CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 3, April 2013
AFRICA
55
The prevalence of underweight, overweight and obesity were
more frequent in women than men (35.9 vs 20.2%, 16.7 vs
14.7% and 9.0 vs 4.9%) (Fig. 6). Raised total cholesterol was
more frequent in women than men (16 vs 11%). Ten per cent of
the population had elevated total cholesterol levels while 21%
had elevated triglyceride levels (Fig. 7). Nine per cent of males
and 5.7% females ate five or more servings of fruit per day;
1.2% of males and 1.1% of females ate five or more servings of
vegetables per day.
Tobacco smoking, alcohol drinking (any amount) and
excessive alcohol drinking were more common in men than
women (22.5 vs 15.5%, 23.9 vs 10.3%, 4.1 vs 1.2%, respectively).
There was no significant difference between the genders with
regard to physical activity (52% male, 50% female,
p
=
0.703)
(Figs 8–11).
Discussion
This is the first population-based survey using internationally
standardised protocols to report the prevalence of risk factors for
NCDs in the Kasese district of Uganda. This study demonstrated
that chronic non-communicable diseases and their risk factors
constitute a public health problem in the Kasese district, with
at least one in five men smoking tobacco, one in five with
hypertension, one in 10 with a positive family history of DM,
one in five being pre-diabetic and therefore a candidate for the
metabolic syndrome, and one in five overweight/obese.
The first major finding of this study was the high prevalence
of hypertension, both self-reported and point-measured BP
during the survey. The majority of people with hypertension did
not know they had this medical problem, which is consistent
with findings from other studies in sub-Saharan Africa.
17
Hypertension is the leading cause of stroke in Africa. A further
finding that only 3.7% were on treatment reflects the low level
of knowledge of the dangers of untreated hypertension in the
population. A striking finding was that there was no difference in
the prevalence of hypertension between the genders.
Factors not measured in this survey, and which may explain
the observed risk among women, were hormonal status, saturated
fat consumption and salt intake. Also, further studies should be
done to document the proportion of those on treatment whose
BP is under control, as well as the presence of hypertensive heart
disease among those with hypertension.
The second major finding was that the risk profile of
this predominantly rural population of Kasese was markedly
different from that reported previously for the urban and peri-
Fig. 4. Family history of DM and on treatment for DM;
13.9% of the total study population had a family history
of DM; 2.9% were diabetic.
16
14
12
10
8
6
4
2
0
Male
Female
M + F
% of total population
Diabetes category
Family History
Diabetic
Fig. 5. Fasting blood sugar (FBS) levels. (a) 19% had FBS
of 6.1–6.9 mmol/l; 9%
≥
7.0 mmol/l. (b) 31% of females had
FBS
≥
6.1 mmol/l, 10% of males
≥
6.1 mmol/l.
100
90
80
70
60
50
40
30
20
10
0
35
30
25
20
15
10
5
0
<
6.1 6.1–6.9
≥
7.0
Male Female
%
%
Fasting glucose,
n
=
128
FBS,
n
≥
6.1
Male
Female
A
B
Fig. 6. Body mass index; 29.9% were underweight, 15.6%
were overweight, and 6.7% were obese.
60
50
40
30
20
10
0
<
19
19–25
26–29
≥
30
%
BMI
Male
Female
Under wt (%) Over wt (%)
Obese (%)
F
35.9
16.7
9.0
M
20.2
14.7
4.9
F + M
29.9
15.6
6.7
Fig. 7. Cholesterol and triglycerides; 14% of males had
elevated lipid levels, 18% of females had elevated lipid
levels.
100
90
80
70
60
50
40
30
20
10
0
20
18
16
14
12
10
8
6
4
2
0
<
5.2
≥
5.2
<
1.7
≥
1.7
Male Female
%
%
Total
Cholesterol
Triglyc-
erides
High Cholesterol +
Triglycerides
Male
Female
