Background Over the last few decades, the burden of non-communicable diseases (NCDs) has rapidly increased in Sub-Saharan Africa leading to a ‘double burden of diseases.’ The recent burden of NCDs in Uganda has not been specifically investigated at a national level. While infectious illnesses continue to dominate the disease burden in Sub-Saharan Africa, the region is witnessing a demographic change, which is increasing the prevalence of non-communicable diseases (NCDs)

Aim To estimate the burden of NCDs and attributable risk factors to NCDs in Uganda using the 2019 GBD study between 1990 and 2019.

Methods In this descriptive epidemiological study, five major NCDs (cardiovascular diseases, cancers, chronic respiratory diseases, diabetes, and mental health disorders) and four attributable risk factors (smoking, unhealthy diet, physical inactivity, and alcohol use) were examined. Data were extracted from the GBD 2019 study publicly available in the GBD Compare website. Summary statistics included age-standardized incidence rates (ASIR), mortality rates, YLLs (years of life lost), YLDs (years lived with disability) and DALYs (disability-adjusted life years). Estimated annual percentage changes (EAPCs) were calculated to assess the incidence rate, mortality, and disability-adjusted life-years (DALYs) trends of non-communicable diseases (NCDs) between 1990 and 2019. Population attributable fractions (PAFs) were estimated of NCD-related deaths associated with four major common risk factors.

Results Overall, the number of NCDs increased from 166152 (95% Uncertainty Interval [UI]:154554. -178571) in 1990 to 167815 (95% UI:155870–179472) in 2019 with EAPC of 0.034%. ASIR increased continuously in this period from 173,876 (95% UI:165233–183022) to 175,460 (95% UI:166467–184340) per 100,000 with an EAPC of 0.031%.

Age-standardized NCD DALY rate/100,000 declined from 22,728 (95% UI:19647–25922) in 1990 to 21,891 (95% UI:18796–25185) in 2019 with EAPC of -0.13%. Cardiovascular, Neoplasms and Mental disorders respectively contributed the highest DALYs followed by Diabetes and Kidney, and Chronic respiratory diseases.

The fraction of NCDs attributable to smoking, unhealthy diets, alcohol use, and low physical activity was 9.4%, 14.1%, 20.7% and 0.9% respectively at the population level

Conclusion The findings indicated that recent Age-standardized incidence rate, Age-standardized death rate and age-standardized DALY rates remained high with cardiovascular diseases, and neoplasms contributing the highest disease burden in Uganda.

An unhealthy diet and smoking were the two largest NCD-attributable risk factors in Uganda. The findings are crucially important to inform public health interventions and policymaking for the population health and well-being of the Ugandan population.