Prevalence and risk factors survey for hypertension and diabetes in rural western Kenya

Background Hypertension and diabetes are rising causes of morbidity and mortality in sub-Saharan Africa, yet rural community-level data remain limited. National surveys often obscure local variation, hindering targeted prevention. Methods A population-based cross-sectional study was conducted in Kakum-Kombewa, Siaya County, Kenya (Dec 2024-Jun 2025). Multistage sampling identified 816 households, yielding 1,046 adults aged ≥ 18 years. Participants underwent household screening for blood pressure, random blood glucose, and anthropometry, with positive cases being referred to the hospital for confirmatory testing. Prevalence was estimated using descriptive statistics, while associations were examined with chi-square tests and generalized linear models. Results Known hypertension, diabetes, and comorbidity prevalence were 13.9%, 8.7%, and 4.9%, respectively. Confirmatory testing identified an additional 16.7% with hypertension, 9.1% with diabetes, and 9.9% with both. Risk factors included age ≥ 50 years, overweight/obesity, high waist-to-height ratio, elevated waist circumference, family history, and physical inactivity. Female sex, central adiposity, low activity, and family history remained significant predictors in multivariable models. Conclusion This study confirms a substantial burden of both diagnosed (known) and undiagnosed (previously unknown) hypertension and diabetes in rural Western Kenya. The high prevalence of undetected cases underscores the need for expanded community-based screening, improved follow-up, and integration of NCD care into primary health services. Many individuals with prior diagnoses exhibited poor disease control, highlighting the importance of adherence support, household-level monitoring, lifestyle modification, and regular risk assessment. Community-based screening served a dual role: identifying new cases and flagging poorly controlled patients, reinforcing its value as part of a continuum of care that bridges community health initiatives with formal health systems. Strengthening routine screening, lifestyle interventions, and consistent follow-up within rural health systems is essential to improve early detection, enhance disease control, and reduce long-term complications. Community-level screening emerges as a critical tool for surveillance, linkage, and continuity, ensuring that hypertension and diabetes care is continuous, coordinated, and population-centered.