Prevalence of hypertension, diabetes, and associated risk factors in a rural community in Western Kenya: a population-based cross-sectional survey

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 We conducted a population-based cross-sectional study 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. Individuals with screened positive values were referred to linked primary healthcare facilities for diagnostic confirmation. Prevalence was estimated using descriptive statistics, and associations were assessed with chi-square tests and generalized linear models. Results The prevalence of known hypertension, diabetes, and comorbidity was 13.9%, 8.7%, and 4.9%, respectively. Diagnostic confirmation identified an additional 4.2% newly confirmed hypertension, 2.3% newly confirmed diabetes, and 2.5% newly confirmed comorbidity, yielding total prevalence estimates of 18.1% (95% CI: 15.8–20.6), 11.0% (95% CI: 9.2–13.1), and 7.4% (95% CI: 5.9–9.2). Risk factors included age ≥ 50 years, overweight/obesity, central adiposity, family history, and physical inactivity. Female sex, central adiposity, low activity, and family history remained significant predictors in multivariable models. Conclusion This study reveals a substantial burden of both known and previously undiagnosed hypertension and diabetes in rural Western Kenya. Community-based screening, followed by referral and confirmatory testing, was effective in detecting new cases and identifying poor disease control among those with prior diagnoses. Strengthening routine NCD screening and linkage to primary care could improve early detection and management in similar rural settings.