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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 international protocols were used to record history of disease, and measure 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.
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Diabetes Mellitus/epidemiología , Hipertensión/epidemiología , Obesidad/epidemiología , Adulto , Estudios Transversales , Países en Desarrollo , Diabetes Mellitus/diagnóstico , Dieta/efectos adversos , Femenino , Encuestas Epidemiológicas , Humanos , Hipertensión/diagnóstico , Masculino , Persona de Mediana Edad , Obesidad/diagnóstico , Proyectos Piloto , Prevalencia , Factores de Riesgo , Salud Rural , Conducta Sedentaria , Distribución por Sexo , Factores Sexuales , Fumar/epidemiología , Uganda/epidemiologíaRESUMEN
Introduction. While the introduction of highly active antiretroviral therapy decreased HIV-related morbidity and mortality rates in the sub-Saharan Africa, a subsequent increase in metabolic abnormalities has been observed. We sought to determine the prevalence of HIV-associated metabolic abnormalities among patients on first-line antiretroviral therapy (ART) in an ART clinic in Kampala, Uganda. Methods. Four hundred forty-two consecutive patients on first-line ART for at least 12 months were screened for eligibility in a cross-sectional study, and 423 were enrolled. Pre-ART patient characteristics were abstracted from medical charts, examinations included anthropometric measurement and physical assessment for lipodystrophy. Results. The prevalence of hyperglycemia and dyslipidemia was 16.3% (69/423) and 81.5% (345/423), respectively. Prevalence of dyslipidemia between stavudine- and zidovudine-based regimens (91% versus 72%; P < 0.001). Being on stavudine (aOR 4.79, 95%, 2.45-9.38) and peak body weight (aOR 1.44, 95% CI 1.05-1.97) were independent risk factors for dylipidemia. Stavudine (aOR 0.50, 95% CI 0.27-0.93) use was associated with lower risk for hyperglycemia while, and older age (aOR 1.31, 95% CI 1.11-1.56) and having a family history of DM (aOR 2.18, 95% CI 1.10-4.34) were independent risk factors for hyperglycemia. Conclusions. HIV-associated metabolic complications were prevalent among patients on thymidine analogue-containing ART regimens. Screening for lipid and glucose abnormalities should be considered in ART patients because of cardiovascular risks.
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PURPOSE: The purpose of this study was to describe illness beliefs and diabetes self-care behaviors of Ugandan adults with type 2 diabetes. METHODS: A convenience sample of 340 adults with type 2 diabetes was recruited from 2 outpatient settings in Kampala, Uganda. Participants were interviewed by a nurse about diabetes self-care behaviors; had their weight, height, and waist and hip circumference measured; and shared with the interviewer the blood glucose and blood pressure values obtained during their clinic visit. RESULTS: The majority of participants viewed diabetes as a serious, life-long condition that they had a good deal of control over; however, while 88% believed they could tell high blood glucose by the presence of symptoms, only 39% said they could detect low blood glucose by the presence of symptoms. Self-care challenges include limited access to appropriate food, diabetes medications, blood glucose testing equipment, and educational materials. Subjects reported significant negative psychosocial outcomes associated with having diabetes. Using selected indicators for metabolic syndrome, 87% had elevated blood pressure, and 67% had elevated blood glucose; 33.4% were overweight, and 18.7% were obese. CONCLUSIONS: Results from this study highlight the challenges of diabetes self-care in resource-poor countries. Improving diabetes care will require systems-level interventions to provide access to basic resources as well as to social support and educational interventions.
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Diabetes Mellitus Tipo 2/psicología , Autocuidado , Actividades Cotidianas , Adulto , Conducta , Automonitorización de la Glucosa Sanguínea , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Dieta para Diabéticos , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Hipoglucemiantes/uso terapéutico , Entrevistas como Asunto , Masculino , Pacientes Ambulatorios , Cooperación del Paciente , Pobreza , Solución de Problemas , Asunción de Riesgos , UgandaRESUMEN
BACKGROUND: Functional adrenal insufficiency (FAI) is associated with increased mortality and is defined as subnormal cortisol production during acute severe illness. METHODS: After screening 200 adult patients admitted in the medical emergency unit of Mulago Hospital, Kampala, Uganda, 113 critically ill HIV-infected adults not receiving corticosteroids were enrolled after obtaining informed consent to determine the prevalence and factors associated with FAI. RESULTS: Functional adrenal insufficiency, defined in this study as morning total serum cortisol level of