Prevalence and factors associated with atrial fibrillation among adults with type 2 diabetes mellitus at Hoima Regional Referral Hospital, Western Uganda: a cross-sectional study

Abstract

Atrial fibrillation (Afib) and type 2 DM (T2DM) are common conditions associated with substantial cardiovascular morbidity and mortality. However, data on the burden of Afib among patients with T2DM in sub-Saharan Africa remain limited. This study aimed to determine the prevalence, clinical features, and factors associated with Afib among adults with T2DM at Hoima Regional Referral Hospital (HRRH), western Uganda. A hospital-based cross-sectional study was conducted among 355 adults with T2DM attending HRRH. Participants underwent clinical evaluation, glycated hemoglobin (HbA1c) testing, and 12-lead electrocardiography (ECG) for Afib diagnosis. Logistic regression analysis was used to identify factors associated with Afib, with statistical significance set at p < 0.05. The prevalence of Afib was 7.9% (28/355). Patients with Afib commonly presented with palpitations, dizziness, fatigue, chest pain, and dyspnea, with tachycardia and irregular pulse frequently observed on examination. In multivariable analysis, hypertension (aOR 3.027, 95% CI 1.419–6.431; p = 0.020), human immunodeficiency virus (HIV) infection (aOR 2.026, 95% CI 1.738–6.538; p = 0.048), body mass index (BMI ≥ 25 kg/m²) (aOR 3.014, 95% CI 1.242–7.930; p = 0.029), and poor glycemic control (HbA1c ≥ 8%) (aOR 3.813, 95% CI 1.762–8.265; p = 0.007) were independently associated with Afib. Afib is relatively common among adults with T2DM in western Uganda, affecting nearly one in ten patients. Hypertension, HIV infection, obesity, and poor glycemic control were significant associated factors. Integrating ECG screening into diabetes care, particularly for high-risk patients may improve early detection and management in resource-limited settings.