Prevalence and determinants of hypertension, diabetes, and obesity among civil servants in rural Southwestern Uganda: a cross-sectional survey

The increasing number of people with Non-communicable diseases (NCDs) is a global public health concern. Least-developed countries are especially affected, due to the double burden of acute and chronic diseases amidst scarce resources. Although, research from High income countries (HICs) show a growing concern about the increase in NCDS in Less developed countries, the prevalence of NCDs and risk factors are not well documented in literature. The available studies are among the general population with limited studies in a special group of civil servants. This study assessed the prevalence of NCDs of (hypertension, diabetes and obesity) and their associated factors among civil servants in the rural districts of Uganda. Methods A cross-sectional survey was conducted in the four districts of Kigezi Southwestern Uganda among civil servants age 28-68 years. Using the modified WHO STEPs survey instrument, risk factors such as age, sex, lifestyle, physical activity, BMI, dietary habits were assessed while hypertension and diabetes were assessed using anthropometry and blood glucose measurements. Of the 296 civil servants assessed, 140 (47.3%) with complete data were included in the final analysis; 156 were excluded due to incomplete data resulting from COVID-19 restrictions and missing questionnaires. The study assessed 140 civil servants (70 males, 70 females; mean age 42 years) across four districts in Kigezi sub-region, southwestern Uganda, using the modified WHO STEPs survey instrument. In this study, Hypertension was defined as systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg; diabetes as fasting blood glucose ≥7.0 mmol/L; and obesity as BMI ≥30 kg/m2. Logistic regression identified factors associated with NCDs. Results Prevalence of hypertension was 40.0% (95% CI: 32.0-48.5%), diabetes was 10.7% (95% CI: 6.2-17.2%), and obesity was 65.0% (95% CI: 56.6-72.6%). Risk factors included physical inactivity (91.4%), inadequate fruit consumption (49.3%), and alcohol consumption (48.6%). Age (aOR: 2.12, 95% CI: 0.70-6.37) and hypertension (aOR: 4.89, 95% CI: 1.43-16.67) were associated with diabetes. Walking or cycling to work (aOR: 0.25, 95% CI: 0.10-0.63) was protective against hypertension. Increased fasting blood sugar and weight were associated with hypertension while increasing age and blood pressure were associated with development of type 2 diabetes mellitus. Conclusion There is a high prevalence of hypertension, diabetes, and obesity among civil servants in rural Uganda. Preventive NCDs focused interventions such as regular sensitization and health checkups, diet and lifestyle modification are recommended.