Regional Variations and Risk Factors of Raised Total Cholesterol Among Ethiopian Adults: Evidence From the 2024 STEPS Survey

Raised total cholesterol (RTC) is a major global public health issue although research on geographical variations and factors associated with raised total cholesterol are limited. A nationwide population-based cross-sectional study was conducted. Data were collected through face-to-face interviews using structured questionnaires. Participants aged 18 to 69 years were selected randomly. A total of 9467 household samples were included. Multilevel logistic regression analysis was employed to identify the determinants of raised cholesterol. In this study, the national prevalence of raised total cholesterol was found to be 5.2%. This investigation identified regional variations in the prevalence of raised total cholesterol, with Somalia reporting the highest percentage at 17.3%, followed by Dire Dawa at 12%. In contrast, the Sidama and South Ethiopia regions had the lowest percentages of raised total cholesterol, each at 1%. Female participants (Adjusted Odds Ratio (AOR) = 2.2, 95% Confidence level (CI): 1.62-3.04), participants aged 30-44 years (AOR = 2.1, 95% CI: 1.39-3.09), participants aged 45-59 years (AOR = 2.9, 95% CI: 1.83-4.46), participants aged 60-69 years (AOR = 2.7, 95% CI: 1.58-4.51), urban residents (AOR = 1.4, 95% CI: 1.07-1.91), obese participants (AOR = 2.2, 95% CI: 1.02-4.64), and participants with raised blood glucose (AOR = 2.4, 95% CI: 1.59-3.52) were significantly associated with raised total cholesterol. Although the prevalence of RTC is relatively low compared to global estimates, the presence of regional disparities and modifiable risk factors warrants public health attention.