Analytical summary - Non-communicable diseases and conditions
There is an increasing burden of non-communicable diseases in the country, which adds to the continuing burden of communicable diseases, perinatal and nutritional disorders. A comprehensive analytical description of the magnitude of the burden of increasing of non-communicable diseases is hindered by lack of accurate and reliable information.
Available data suggest an increasing prevalence of non-communicable risk factors. Available records from hospitals and health facilities in the country show that non-communicable diseases comprise the top five reasons for hospitals admissions. The MOH/WHO 2009 survey attempted to determine the prevalence of diabetes mellitus among the Swaziland population. The report suggested a general increase in prevalence of diabetes mellitus with increase in age and a higher prevalence in women than in males (Fig. 10.1).
Fig. 10.1 Prevalence of Diabetes Mellitus
This data suggests that in 2007, when the survey was conducted, diabetes mellitus was a serious NCD problem in Swaziland. In addition, the MOH and WHO (2009) reported that cardiovascular disease, in particular hypertension was another NCD that was rapidly rising in the populace. However, to make an appropriate and efficient analysis of the situation, it is necessary to have baseline data with which to compare the 2010 findings. Unfortunately, such data is not available. Out-patient data from 2007 – 2010 on key non-communicable diseases was sourced from the Health Management Information System (HMIS).
An analysis of out-patient data collected between 2007 and 2010 in health facilities suggests that there has been an increase of the number of diabetes mellitus patients attended to over these years (Fig. 10.2).
The number of cases with cardiovascular disease attended to has continued to increase between 2007 and 2010 both in each region and in the whole country, particularly in the Manzini region (Fig.10.3). However, this could be due to many people country-wide attending the only specialist heart surgery in Manzini.
The prevalence of hypertension among the Swazi populace was also determined (MOH & WHO, 2009). A general increase of the prevalence of hypertension with increase in age was reported (Fig. 10.4). Hypertension was also found to be common among females than among males in all age groups.
The number of out-patient cases of hypertension attended to in the health facilities of the country has continuously increased each year nationally and in each region between 2007 and 2010 (Fig.10.5).
Respiratory diseases commonly arise due inhalation of air pollutants or from cigarette smoking. The HMIS data suggests that cases of respiratory diseases attended to have increased between 2007 and 2010 in all the regions of the country and therefore, nationally.
Respiratory diseases are caused by inhalation of polluted air either from smoke emitted at the work place, from vehicle exhausts or from tobacco use (smoking). Injuries could result from violence, self-inflicted injuries, poisonings, falls, fires, drowning, road traffic accidents and other unintentional injuries. The number of all forms of injury (violence or occupational) attended in the country’s health facilities has been investigated. The number of injuries has continued to increase between 2007 and 2010 both at national level and in all the regions, particularly in the Hhohho and Manzini regions (Fig.10. 7).
These two regions are the highest in terms of human and automobile populations and it is expected that they should carry the largest burden of injuries. Data showing prevalence of road traffic accidents in Swaziland is further presented separately in the next section because of the importance of this source of injury.
There appears to have been an inconsistent collection of data in the Hhohho region, particularly in 2009, hence the disturbance in the number of national cases attended to in the same year. Otherwise, there is sufficient evidence to draw conclusion that the number of cases of road traffic accidents has been generally increasing between 2007 and 2010 (Fig. 9).