State of Nation’s Health reveals NCDs like hypertension and diabetes are on the rise
The latest health data reveals a notable increase in the ‘burden of diseases’ across Bhutan for the year 2023. The total number of new cases surged by 10.59%, climbing from 1,231,919 in 2022 to 1,362,574 in 2023. This marks the highest annual increase observed during the study period, according to the annual health bulletin 2024.
Simultaneously, the number of existing cases rose by 18.46%, from 877,541 to 1,039,794, representing the most significant rise in the analyzed years. As a result, the total caseload grew by 13.87%, from 2,109,460 to 2,402,368.
Despite the rise in new cases, their proportion within the total caseload decreased slightly from 58.42% in 2022 to 56.71% in 2023. This shift indicates a relatively smaller share of new cases compared to the overall caseload. Conversely, the proportion of old cases increased from 41.58% to 43.29%, reflecting a growing dominance of long-standing cases.
Morbidity Trends
The leading causes of morbidity in Bhutan have remained consistent over recent years. Health facilities continue to report high incidences of common cold, skin infections, peptic ulcer symptoms, and dental caries. Notably, the number of common cold cases saw a significant rise, reaching 223,953 in 2023, up from 197,774 in 2022. Conjunctivitis also experienced a dramatic increase, with cases climbing from 12,217 in 2022 to 38,199 in 2023.
Other conditions, including acute pharyngitis/tonsillitis, dental caries, diarrhea, diseases of teeth and gums, and hypertension, also saw increases compared to the previous year. However, there was a slight decrease in cases of skin infections, peptic ulcer syndrome, and work-related injuries among the top ten morbidity categories for 2023. Overall, the data highlights a growing burden of various diseases.
Inpatient Department Data
Analysis of Inpatient Department (IPD) data reveals substantial yearly variations. The number of IPD cases decreased from 78,110 in 2019 to 72,110 in 2020, likely due to the COVID-19 pandemic. Cases then rose slightly to 75,618 in 2021, followed by a significant increase to 82,842 in 2022. The most notable rise occurred in 2023, with 94,347 cases, indicating a sharp increase in hospital admissions. This surge may reflect post-pandemic healthcare utilization, deferred treatments, or emerging health issues, emphasizing the need for targeted healthcare strategies and resource allocation.
WASH and Respiratory Diseases
Monitoring diseases related to Water, Sanitation, and Hygiene (WASH) and respiratory conditions remains crucial for effective public health management. In 2023, the incidence of acute pharyngitis/tonsillitis rose to 52,078 from 42,379 in 2022. Common cold cases increased to 223,953, while conjunctivitis cases spiked to 38,199 from 12,217 the previous year, likely due to an outbreak in late summer. Diarrhea cases also saw an increase to 33,533 from 29,085 in 2022, though dysentery cases slightly decreased. Other respiratory and nasal disease cases rose to 69,609 from 61,836 in 2022. These trends underline the importance of continuous monitoring and rapid response to outbreaks to effectively manage disease spread.
Chronic Diseases and Mortality
In 2023, alcohol liver disease cases slightly increased to 2,625 from 2,387 in 2022. Arthritis and arthrosis cases showed a significant rise to 10,134 from 8,021. Diabetes cases saw a substantial increase to 17,299, up from 12,373 in 2022. This aligns with the National Health Survey (NHS) 2023, which reported a rise in diabetes prevalence from 2.1% in 2019 to 5.6% in 2023. Hypertension cases also rose to 27,916 from 25,770, consistent with the NHS report of an increase in hypertension prevalence from 28% in 2019 to 30.1% in 2023. Ischemic heart disease cases increased to 508 from 439, while rheumatic heart disease cases decreased slightly to 584 from 686. The NHS also highlighted an increase in cardiovascular disease risk from 3.7% in 2019 to 5.1% in 2023, reflecting a growing burden of chronic diseases and the need for enhanced preventive measures.
Mortality data for 2023 shows a slight decrease in deaths from alcohol liver diseases, from 146 cases in 2022 to 129 cases, though it remains the leading cause of death in Bhutan. Mortality from conditions originating in the perinatal period and hypertension also saw slight decreases. However, there were increases in deaths due to cerebrovascular diseases, pneumonia, mental health and behavioral disorders related to alcohol, stomach/gastric cancer, meningitis/encephalitis, tuberculosis, accidental falls, and epilepsy compared to the previous year. Overall, mortality trends in 2023 remained largely consistent with those observed in 2022.
By Tashi Namgyal, Thimphu
