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Analytical summary - Non-communicable diseases and conditions

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Although morbidity and mortality of noncommunicable diseases in Botswana is not well documented, they are estimated to account for 31% of all deaths in the country. The most common ones are cardiovascular disease, hypertension, cancer, chronic obstructive pulmonary disease and diabetes. Before the 1980s, common diseases in Botswana were infectious diseases and those associated with unsanitary conditions, poverty and inadequate hygiene.

From the 1980s, new patterns of conditions associated with affluent lifestyles such as hypertension, diabetes and cardiovascular diseases emerged, although the magnitude of such diseases has been overshadowed by the re-emergence of infectious diseases such as tuberculosis and HIV/AIDS. For instance, cases of hypertension increased from barely 100 to 2000 in 1996. It has been reported that hypertension increased fivefold between 1980 and 1998.

Cancer cases increased four times between 1980 and 1996, while mental disorders increased from 100 to 1500 during the same period. Injuries related to road traffic accidents have also been on the rise, commonly occurring during festive seasons and public holidays.

The increase of noncommunicable diseases can be attributable to urbanization and the changing lifestyle as well as the improved standard of living, such as improved road infrastructure and increased volume of traffic, as well as high levels of food and alcohol consumption. Common risk factors for such diseases include tobacco use, unhealthy diet and excessive use of alcohol.

A survey carried out in 2009 on people aged over 50 years revealed that 67% had hypertension while 12.3% had diabetes. The prevalence rates for musculoskeletal diseases were not different from those of hypertension, suggesting that the two groups could be associated with advancing age. Road traffic accidents, alcohol-associated problems and mental illnesses have also increased the burden of disease.

Since the establishment of the Botswana National Cancer Registry in 1999, a report in 2005 indicated that 2000 cases (56.7% women and 43.3% men) of malignant cancers were registered between 1986 and 2004. Cancer of the cervix is one of the main gynaecological causes of hospitalization in Botswana, accounting for more than 25% of all cancers and just less that 50% of all female cancers in 2005. HIV/AIDS has a role to play in the increasing cases of cancer.

Although noncommunicable diseases are to a large extent integrated into the primary health care services, there are a few special clinics for chronic diseases such as diabetes and cardiac diseases in referral hospitals.