Botswana Substance Abuse Support Network (BOSASNet) says unbeknown to many, there is a correlation between harmful alcohol use and Non-communicable diseases (NCDs).

Clinical Programme Manager at BOSASNet, Lorato Koosaletse says harmful use of alcohol is one of the world’s leading risk factors for illness, disability and death. “It is a primary cause of more than 200 diseases and injuries and globally, results in approximately 3.3 million deaths each year, greater than HIV/AIDS, violence or tuberculosis,” she said.

Koosaletse further says alcohol is casually linked to varying degrees to eight different cancers, with the risk increasing with the volume consumed. “Similarly alcohol use is detrimentally related to many cardiovascular outcomes, including hypertension, haemorrhagic stroke and atrial fibrillation,” she said, adding that for other cardiovascular outcomes, the relationship is more complex.

Alcohol is further linked to various forms of liver disease, particularly with fatty liver, alcoholic hepatitis and cirrhosis and pancreatitis. Koosaletse further explains that for diabetes, the relationship is also complex.

Koosaletse adds that just as alcohol, tobacco use is also a major risk factor for non-communicable diseases such as chronic respiratory diseases, cancer, diabetes, heart disease, and stroke as well as a factor for some communicable diseases such as tuberculosis and HIV/AIDS.

“Tobacco use contributes to increased health care costs, strained health care systems and reduced worker productivity,” Koosaletse said.

NCDs kill 41 million people each year, equivalent to 74 percent of all deaths globally. Of all NDC death, 77 percent are in low and middle-income countries including Botswana.

Minister of Health, Dr Edwin Dikoloti said recently that many studies indicate that the co-existence of NCDs such as hypertension and diabetes with depression and other psychological morbidities is detrimental to care and prognosis leading to poor glycaemic control, uncontrolled hypertension, greater risk of cardiovascular complications and higher.

He said the severity and high mortality rates in common NCDs may be due to comorbid mental health disorders.

“Depression is one of the most common mental health disorders and is the leading cause of ill health and disability worldwide,” he said.

According to Dr Dikoloti, depression is common with an estimated 3.8 percent of the population affected worldwide, including 5.0 percent among adults and 5.7 percent among adults older than 60 years.

Approximately 280 million people in the world have depression. It can cause the affected person to suffer greatly and function poorly at work, at school and in the family. At its worst, depression can lead to suicide. “Over 700 000 people die due to suicide every year. Suicide is the fourth leading cause of death on 15 to 29 year olds,” Dr Dikoloti said.

Dr Dikoloti says though there is known, effective treatment for mental disorders, more than 75 percent of people in low and middle-income countries receive no treatment. He attributed this to barriers including lack of resources, lack of trained health-care providers and social stigma associated with mental disorders.

“In countries of all income levels, people who experience depression are often not correctly diagnosed, and others who do not have the disorder are too often misdiagnosed and inappropriately prescribed antidepressants,” he said.

He further said there are interrelation between depression and physical health. For example, cardiovascular disease can lead to depression and vice versa.

He further said prevention programmes have proven to reduce depression. “Effective community approaches to prevent depression include school-based programmes to enhance a pattern of positive coping in children and adolescents,” Dr Dikoloti said, adding that interventions for parents of children with behavioural problems

may reduce parental depressive symptoms and improve outcomes for their children. In addition, he said exercise programmes for older persons have also been shown to be effective in depression prevention.