 In 2001, the
population of Lesotho was estimated at 2.1 million, 51% of
whom were females. The population is predominantly rural,
with only 17% living in urban areas. Lesotho has one of the
highest HIV/AIDS prevalence rates globally at 31%. HIV/AIDS
has had a significant impact on the population structure and
life expectancy. The current average life expectancy is 45
years for males and 54.2 years for females. This
demonstrates a radical decline over the past ten years when
average life expectancy was over 60 years.
Unlike other tropical countries the climate in Lesotho has
contributed to the absence of problematic communicable
illnesses such as malaria. Communicable diseases such as
Tuberculosis, HIV/AIDS ans sexually transmitted diseases
remain are major health issues in Lesotho. Though
significant achievement has been realised in diagnosis and
treatment of TB, in 2004 alone there were 11,454 new cases,
of which 60% were males. The total number of registered TB
cases was 13,368, this figure excludes those who seek care
from traditional healers. Morbidity and mortality patterns
reveal that the key causes for hospital admission and death
are respiratory diseases and tuberculosis. WHO estimates
that HIV contributes to 68% of these deaths. The advent of
HIV of which the prevalence has been estimated at 31%,
coupled with poverty, resistance to TB treatment,
urbanisation and lack of adequate sanitation facilities are
some key factors contributing to a lack of response in the
control of communicable diseases. The disease burden among
men and women varies if one considers factors such as
incomplete abortion and pregnancy related complications.
Maternal mortality rate in 1999 was estimated at 738/100,000
and contraceptive prevalence at 41%.
Rape is also a serious issue for young women making up 31%
of all reported rape cases in urban areas and 50% in rural
areas. The 2002 UNAIDS/WHO Epidemiological Fact Sheets
indicate that 12% of the new AIDS cases reported in 2000
were young people aged 10-24 years. Girls accounted for 10%
while boys were only 2%, suggesting patterns of
intergenerational sex. Youth and women have been
disproportionately affected by HIV/AIDS, with 75% of all
reported HIV/AIDS cases being young people aged between
15-29 years, and 55% of all reported HIV/AIDS cases being
women. Sentinel surveillance records from the early 1990s
indicate a steady increase in HIV prevalence among women
attending antenatal clinics. In addition, it is reported
that 68% of children admitted at the country’s National
Referral Hospital, Queen Elizabeth II were HIV positive. In
2001, the country was estimated to have 73,000 AIDS orphans,
who live with no formal systems for ensuring their social
security.
Gradual changes in the socio-economic climate have led to
changes in lifestyle and consequently increases in the
incidence of non-communicable diseases such as diabetes,
cancer and hypertension as well as trauma. Over the years
the incidence and prevalence of psychiatric illnesses has
also become rampant.
Differences in terrain and socio-economic conditions between
the rural mountainous and urban lowlands have given rise to
inequities in access to health care and other factors such
as sanitation and clean water. The effect of these
differences is that disease patterns vary geographically.
For instance maternal mortality rates may be higher in the
mountainous areas compared to the lowlands because of the
way that health facilities and other resources are
distributed in the country. In 2004, the sector had to deal
with a number of outbreaks in different parts of the
country, these included typhoid, rabies, meningococcal
meningitis, hepatitis and measles.
In 1996 the infant mortality rate was estimated at
74/100,000 live births, this figure has increases overtime
mainly because of the advent of HIV/AIDS. Currently
respiratory diseases, gastroenteritis and malnutrition
contribute a great deal to under-five mortality and
morbidity in the country. Trauma is also one of the causes
for hospitalisation of children. Immunisation of under-fives
for the control of measles and poliomyelitis remains a key
priority in the national poverty reduction strategy.
The tables below demonstrate a broad overview of the
mortality and morbidity patterns in the country.
Top 10 causes
of adult in-patient admissions 2004
|
|
Males |
% |
Females |
% |
|
1 |
Pulmonary
Tuberculosis |
19.8 |
Pulmonary
Tuberculosis |
12.1 |
|
2 |
Pneumonia |
5.9 |
Incomplete
abortion |
10.8 |
|
3 |
Head
injuries |
5.3 |
Pneumonia |
4.7 |
|
4 |
Pneumoconiosis |
3.9 |
Diarrhoea
&Gastroenteritis |
3.6 |
|
5 |
Diarrhoea |
2.8 |
Pneumoconiosis |
2.7 |
|
6 |
Open wounds |
2.3 |
Diabetes
mellitus |
2.5 |
|
7 |
Assault |
2.1 |
HIV/AIDS |
2.2 |
|
8 |
Cataracts |
2.1 |
Upper
respiratory tract infections |
2.1 |
|
9 |
Motor
accidents |
2.0 |
Cataracts |
2.1 |
|
10 |
Heart
failure |
1.9 |
Haemorrhage
in early pregnancy |
1.9 |
Sequential
cause of institutional deaths among adults
|
|
Disease (males) |
% |
|
1 |
Pulmonary
Tuberculosis |
30.6 |
|
2 |
Pneumonia |
28.7 |
|
3 |
Diarrhoea &
gastroenteritis |
13.6 |
|
4 |
HIV/AIDS |
8.9 |
|
5 |
Pneumoconiosis ass with TB |
6.4 |
|
6 |
Upper
respiratory tract infection |
4.9 |
|
7 |
Diabetes
mellitus |
3.2 |
|
8 |
Head injury |
3.1 |
|
9 |
Incomplete
abortion |
0.5 |
Top 10 causes of
hospitalization by age
|
|
0-4 (%) |
5-14 (%) |
>15 (%) |
All ages (%) |
|
1 |
Respiratory diseases |
28.1 |
Trauma |
34.2 |
Trauma |
15.5 |
Trauma |
16.1 |
|
2 |
Gastroenteritis |
14.2 |
Respiratory diseases |
12.3 |
Tuberculosis |
13.3 |
Respiratory diseases |
12.5 |
|
3 |
Nutritional deficiencies |
12.6 |
Diseases: digestive system |
6.4 |
Respiratory diseases |
8.2 |
Tuberculosis |
11.3 |
|
4 |
Trauma |
8.0 |
Gastroenteritis |
5.4 |
Abortions |
7.4 |
Gastroenteritis |
6.6 |
|
5 |
Tuberculosis |
3.0 |
Diseases: nervous system |
5.0 |
Diseases: digestive system |
5.0 |
Abortions |
5.0 |
|
6 |
Diseases of digestive
system |
2.9 |
Tuberculosis |
3.8 |
Obstetric conditions |
4.9 |
Diseases:/ digestive
system |
4.6 |
|
7 |
Burns |
2.4 |
Nutritional deficiencies |
2.8 |
Gastroenteritis |
4.7 |
Obstetric conditions |
3.2 |
|
8 |
Epilepsy |
2.4 |
Burns |
2.2 |
Diseases: female genital
organs |
3.8 |
Nutritional deficiencies |
3.5 |
|
9 |
Metabolic/immunity
disorders |
2.3 |
Diseases / urinary system |
2.1 |
Hypertensive diseases |
3.3 |
Diseases: female genital
organs |
2.6 |
|
10 |
Skin diseases |
1.4 |
Skin diseases |
2.0 |
Heart diseases |
2.9 |
Hypertensive diseases |
2.8 |
Age
specific death rates, both sexes, 2003
|
Age |
Admissions |
Deaths |
ASDR |
|
0-4 |
6945 |
1086 |
0.1564 |
|
5-9 |
1823 |
90 |
0.0494 |
|
10-14 |
1226 |
41 |
0.0334 |
|
15-19 |
2052 |
100 |
0.0487 |
|
20-14 |
3746 |
331 |
0.0884 |
|
25-29 |
4093 |
508 |
0.1241 |
|
30-34 |
3720 |
592 |
0.1591 |
|
35-39 |
3009 |
536 |
0.1781 |
|
40-44 |
2564 |
449 |
0.1751 |
|
45-49 |
1885 |
397 |
0.2106 |
|
50-54 |
1544 |
285 |
0.1846 |
|
55-59 |
1237 |
| |
