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Analytical summary

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Morbidity and mortality for all ages are dominated by infectious diseases that, together with AIDS and tuberculosis, account for 45% of all deaths. HIV/AIDS accounts for 50% of all deaths. However, deaths due to AIDS have declined during the past few years following effective antiretroviral therapy.

Conditions related to pregnancy, childbirth and the puerperium account for 16% of inpatient morbidity, while injuries and poisoning account for 11% of inpatient morbidity for all ages, excluding neonatal conditions. A review of progress towards the Millennium Development Goals (1990–1994 and 2002–2006) showed significant progress in reducing the number of underweight children aged under 5 years and in increasing access to safe drinking water (see table). However, during the same period, mortality rate for infants and for children aged under 5 years increased from 48 to 56 per 1000 and from 63 to 74 per 1000, respectively.

Progress towards the Millennium Development Goals - selected indicators. Data from Central Statistics Office, Government of Botswana

Maternal mortality rate remains high, increasing from 140 per 100 000 live births in 2005 to 193 per 100 000 live births in 2007. However, HIV-specific maternal mortality has shown a decline from 43 per 100 000 in 2006 to 19 per 100 000 in 2007. Life expectancy was 54 years in 2009 (48.8 years for males and 60 years for females), having increased from 40 years in 2003 after the introduction of the antiretroviral therapy programme.

Botswana has made great strides in reducing the prevalence of malaria and is one of the four Southern African Development Community countries selected to eliminate malaria by 2015. Between 2000 and 2010, confirmed cases dropped from 8065 to 1046, while deaths attributed to malaria dropped from 35 to 8 (Ministry of Health data, 2011). However, insecticide-treated bednet coverage for children and pregnant women falls well below the 2010 Abuja target of over 80%, with coverage rates of 27% and 9% reported for children aged under 5 years and pregnant women, respectively, in a survey carried out in 2007.[1]

Following its resurgence in the early 1990s, tuberculosis accounts for 13% of adult mortality and 40% of persons infected with HIV have tuberculosis.[2] Other commonly occurring communicable diseases are acute respiratory infections, sexually transmitted diseases and diarrhoeal diseases. There have been sporadic outbreaks of influenza A, H1N1, cholera and polio that were effectively controlled.[3]

Chronic noncommunicable diseases such as hypertension and diabetes are common, especially among the adult population. Their increasing prevalence has been attributed to changing lifestyles associated with urbanization.

References

  1. Guidelines for the diagnosis and treatment of malaria in Botswana. Gaborone, Government of Botswana, Ministry of Health, 2007
  2. National tuberculosis programme manual, 7th ed. Gaborone, Government of Botswana, Ministry of Health, 2011
  3. Sentinel disease surveillance report. Gaborone, Government of Botswana, Ministry of Health, 2009