Abstract
INTRODUCTION: Dyspepsia affects 6.9% of people globally and significantly impairs quality of life, yet it often remains undiagnosed. Undiagnosed dyspepsia (UD) affects up to one-third of patients and is prevalent among students due to stress, irregular eating, and self-medication. In Uganda, limited access to endoscopy results in many cases being undiagnosed, yet recent data among health program students remains scarce. OBJECTIVE: To determine the prevalence of UD, associated factors, and its relationship with QoL among undergraduate health program students at Makerere University. METHODS: This was a cross-sectional study involving 378 undergraduate health program students from Makerere University between March and April 2025. Participants were pursuing Medicine and Surgery, Nursing, Pharmacy, and Dental Surgery, aged ≥ 18 years, and were selected by stratified simple random sampling. Data on socio-demographics, lifestyle, and dyspeptic symptoms were collected using a structured questionnaire based on various tools. Data was analyzed using STATA 17 in the survey window. Prevalence of UD was estimated with 95% confidence intervals. Modified Poisson regression was used to determine associated factors, while mixed-effects linear regression was used to analyze the relationship between dyspepsia and quality of life. RESULTS: The prevalence of undiagnosed dyspepsia was 13.5% (95% confidence interval: 10.2–17.4). Regular tea consumption was associated with a lower prevalence of undiagnosed dyspepsia, both among participants who drank tea on some days (adjusted prevalence ratio [aPR] = 0.42; 95% CI: 0.20–0.91) and those who drank tea daily (aPR = 0.35; 95% CI: 0.17–0.71). High levels of physical activity were also protective (aPR = 0.37; 95% CI: 0.15–0.93). In contrast, a higher prevalence of undiagnosed dyspepsia was observed among participants who ate two meals per day (aPR = 2.64; 95% CI: 1.21–5.73), consumed alcohol (aPR = 1.78; 95% CI: 1.06–2.97), reported moderate fatigue (aPR = 1.84; 95% CI: 1.13–3.01), were underweight (aPR = 2.20; 95% CI: 1.04–4.68), or slept for longer durations (aPR = 1.93; 95% CI: 1.16–3.20). Quality of life was not significantly associated with undiagnosed dyspepsia (p = 0.217). CONCLUSION: The prevalence of UD among undergraduate health program students was moderately high, though not significantly associated with quality of life. Targeted health education that promotes regular physical activity, addresses fatigue and discourages excessive alcohol and coffee consumption may help reduce the burden of UD in this population. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12876-026-04736-2.