title: Sociodemographic distribution of non-communicable disease risk factors in rural Uganda: a cross-sectional study.
abstract: BACKGROUND
  Non-communicable diseases (NCDs) are rapidly becoming leading causes of morbidity and mortality in low- and middle-income countries, including those in sub-Saharan Africa. In contrast to high-income countries, the sociodemographic distribution, including socioeconomic inequalities, of NCDs and their risk factors is unclear in sub-Saharan Africa, particularly among rural populations.
  
  
  METHODS
  We undertook a cross-sectional population-based survey of 7809 residents aged 13 years or older in the General Population Cohort in south-western rural Uganda. Information on behavioural, physiological and biochemical risk factors was obtained using standardized methods as recommended by the WHO STEPwise Approach to Surveillance. Socioeconomic status (SES) was determined by principal component analysis including household features, ownership, and occupation and education of the head of household.
  
  
  RESULTS
  SES was found to be associated with NCD risk factors in this rural population. Smoking, alcohol consumption (men only) and low high-density lipoprotein (HDL) cholesterol were more common among those of lower SES. For example, the prevalence of smoking decreased 4-fold from the lowest to the highest SES groups, from 22.0% to 5.7% for men and 2.2% to 0.4% for women, respectively. In contrast, overweight, raised blood pressure, raised HbA1c (women only) and raised cholesterol were more common among those of higher SES. For example, the prevalence of overweight increased 5-fold from 2.1% to 10.1% for men, and 2-fold from 12.0% to 23.4% for women, from the lowest to highest SES groups respectively. However, neither low physical activity nor fruit, vegetable or staples consumption was associated with SES. Furthermore, associations between NCD risk factors and SES were modified by age and sex.
  
  
  CONCLUSIONS
  Within this rural population, NCD risk factors are common and vary both inversely and positively across the SES gradient. A better understanding of the determinants of the sociodemographic distribution of NCDs and their risk factors in rural sub-Saharan African populations will help identify populations at most risk of developing NCDs and help plan interventions to reduce their burden.
authors.affiliation: Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK, Wellcome Trust Sanger Institute, Hinxton, UK, Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Uganda Research Unit on AIDS, Entebbe, Uganda, London School of Hygiene and Tropical Medicine, London, UK and School of International Development, University of East Anglia, Norwich, UK.
authors.forename: Georgina Av
authors.initials: GA
authors.lastname: Murphy
authors.forename: Gershim
authors.initials: G
authors.lastname: Asiki
authors.forename: Kenneth
authors.initials: K
authors.lastname: Ekoru
authors.forename: Rebecca N
authors.initials: RN
authors.lastname: Nsubuga
authors.forename: Jessica
authors.initials: J
authors.lastname: Nakiyingi-Miiro
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Young
authors.forename: Janet
authors.initials: J
authors.lastname: Seeley
authors.forename: Manjinder S
authors.initials: MS
authors.lastname: Sandhu
authors.forename: Anatoli
authors.initials: A
authors.lastname: Kamali
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000453:epidemiology*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D050177:Overweight / Q000453:epidemiology*; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D012907:Smoking / Q000453:epidemiology*; D012923:Social Class; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult
keywords: Uganda; epidemiological transition; non-communicable diseases; risk factors; sociodemographic