Non-communicable diseases (NCDs) are a leading cause of disability and death in adult worldwide, particularly in the sub-Saharan Africa. When a health problem is not sufficiently documented, it is always difficult to understand its extent and therefore to put in place a health policy such as NCD prevention strategies and NCD control. According to WHO publications, prevalence rate and prematurity death are respectively 28% and 24% [1,2]. Beyond those two data, no other NCD data is found in Burundi health data on NCDs. The report of the third demographic and health survey (EDSB-III) conducted by the Burundi Institute of Statistics and Economic Studies in 2016-2017 did not include NCD data . Indeed, to update NCD epidemiological data in Burundi, a cross-sectional study on NCDs, is carried out in inpatients from the Internal Medicine (MI), and Resuscitation departments of the Bujumbura training Hospital for the period of one year.
This study included in a consecutively manner, all patients, upper 15 years old, who were suffering from at least one of NCDs. Each patient was included once, during his/her first hospitalization. For each patient, all details and events were registered from admission to his/her exit. Data was analyzed per the Epi Info 7 software. The validity tests of outcomes in this study were Chi square test, and Student’s t test with p <0.05.
This study included 739 inpatients (Table I). The prevalence was 37.08% (591) in IM, 15.58% (89) in resuscitation, and 7.39% (59) in surgery departments. Indeed, the NCD prevalence in the two common departments of NCD patients (IM and resuscitation) was 31.41%. The average age was 54.92 ± 16.80 years. The sex ratio was 0.93. Patients came from urban (72.53%), semi urban (4.87%) and rural areas (22.60%). Access to diagnosis, technologies and essential medicines were limited lack of health insurance coverage for cause. Medical expenses were not covered by any insurance company for 61.71% (456) of patients. They were covered by private or public insurance companies in 36.26% (268) and by government assistance for 2.03% (15) of patients.
NCDs disorders was mostly cause of hospitalization. Indeed, 93.78% of patients were treated for a last one NCD. Patients with Cardiovascular diseases represented 59.27% (438). Metabolic diseases, chronic respiratory diseases, chronic kidney diseases and cancers represented respectively 44.38% (328), 10.82% (80), 12.72% (94) and 5.28% (39). Here, co-morbidities (pathologies associated and complications) were present in 59.41%.
At discharge, NCD mortality rate was 18.81% (139). Average of lethality in Internal medicine and resuscitation departments due to NCDs was 43.71%. Premature mortality (16-69 years) was 71.94%. The mortality due on cardiovascular diseases, chronic respiratory diseases, cancers and diabetes was 80.82%. The average age of death was 59.37 ± 15 years, with a sex ratio of 1.32; p> 0.03. Cardiovascular disease is the leading cause of death in 43.88% (61) (p <0.01). Other causes of death include 20.14% renal failure (28), 18.95% diabetes (18), 11.51% (16) chronic respiratory disease and 6.48% (9) cancer.
In conclusion, NCDs are a real health burden in Burundi. The accessibility to diagnosis and essential medicine was limited. Morbidity and mortality are high and tends to be balanced with communicable diseases. A study on determinants of this mortality could be helpful in order to reduce premature death rate, then, to contribute to the achievement of sustainable development goals in Burundi particularly targets 3.4 and 3.5.
Table n° I : Morbi-mortality of NCDs in Burundi
|OMS/ Burundi||In this study|
|Average Age||54,92 ±16,8 years|
|Hospitalization reason||NCDs: 93,78%|
|Major groups||Cardio-vasculary disease , Cancers, Diabetes, chronic respiratory diseases||Cardio-vasculary disease , Cancers, Diabetes, chronic respiratory diseases : 80.52%|
|Average age death||59,37±15years|
|sex ratio||1,32 ; p < 0,03|
Authors: Ntisumbwa A, Niyongere F, Nizigiymana A, Ndikumwenayo F
University of Burundi, CHU of Kamenge, Internal medicine Department.
Contact person: Ndikumwenayo F , Associate Professor, email: firstname.lastname@example.org
1.Réf.: WHO. NCDs. http://www.who.int/mediacentre/factsheets/fs355/en/ consulté le 18 10 2019.
2.WHO. NCDs country profiles 2014. http://www.who.int/nmh/countries/bdi_en.pdf. consulté le 17 10 2019