The rural Uganda non-communicable disease (RUNCD) study: prevalence and risk factors of self-reported NCDs from a cross sectional survey

Trishul Siddharthan ,Robert Kalyesubula ,Katharina Kast ,Alex Kayongo ,Richard Munana ,Bruce Kirenga ,Asghar Rastegar ,Theresa Ermer ,Brooks Morgan ,Felix Knauf ,Nora Anton ,Elke Schaeffner ,H Kraus ,Tracy L Rabin ,Faith Nassali ,Rural Uganda Non Communicable Disease Study Investigators

doi:10.1186/s12889-021-12123-7

Abstract

BackgroundNon-communicable diseases (NCDs) are an increasing global concern, with morbidity and mortality largely occurring in low- and middle-income settings. We established the prospective Rural Uganda Non-Communicable Disease (RUNCD) cohort to longitudinally characterize the NCD prevalence, progression, and complications in rural Africa.MethodsWe conducted a population-based census for NCD research. We systematically enrolled adults in each household among three sub-counties of the larger Nakaseke Health district and collected baseline demographic, health status, and self-reported chronic disease information. We present our data on self-reported chronic disease, as stratified by age, sex, educational attainment, and sub-county.ResultsA total of 16,694 adults were surveyed with 10,563 (63%) respondents enrolled in the self-reported study. Average age was 37.8 years (SD = 16.5) and 45% (7481) were male. Among self-reported diseases, hypertension (HTN) was most prevalent (6.3%). 1.1% of participants reported a diagnosis of diabetes, 1.1% asthma, 0.7% COPD, and 0.4% kidney disease. 2.4% of the population described more than one NCD. Self-reported HTN was significantly higher in the peri-urban subcounty than in the other two rural sub-counties (p < 0.001); diagnoses for all other diseases did not differ significantly between sub-counties. Odds for self-reported HTN increased significantly with age (OR = 1.87 per 10 years of age, 95% CI 1.78–1.96). Male sex was associated with lower odds of reporting asthma (OR = 0.53, 95% CI 0.34–0.82) or HTN (OR = 0.31, 95% CI 0.26–0.40).ConclusionsThe RUNCD will establish one of the largest NCD patient cohorts in rural Africa. First analysis highlights the feasibility of systematically enrolling large numbers of adults living in a rural Ugandan district. In addition, our study demonstrates low levels of self-reported NCDs compared to the nation-wide established levels, emphasizing the need to better educate, characterize, and care for the majority of rural communities.

Highlights

Non-communicable diseases (NCDs) are an increasing global concern, with morbidity and mortality largely occurring in low- and middle-income settings
First analysis highlights the feasibility of systematically enrolling large numbers of adults living in a rural Ugandan district
We propose to establish The Rural Uganda Non-Communicable Disease study (RUNCD) as a longitudinal cohort of individuals with NCDs

Summary

Introduction

Non-communicable diseases (NCDs) are an increasing global concern, with morbidity and mortality largely occurring in low- and middle-income settings. The global prevalence of non-communicable diseases (NCDs) has risen over the past decade, especially in lowand middle-income countries (LMICs). The most prevalent NCDs in these settings include cardiovascular diseases, cancers, chronic respiratory diseases, type 2 diabetes mellitus (DM), and chronic kidney disease (CKD) [1, 2]. Many of these NCDs share a set of modifiable risk factors, such as tobacco use, obesity, poor diet, physical inactivity, and alcohol abuse [1]. It is not surprising that 85% of premature deaths related to NCDs occur in LMICs [4]

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