Limitations of the study
Surveillance and data management for NCDs in the Gambia is still evolving; therefore the NCDs data may be prone to under-reporting or over-reporting. The data are hospital based and may not be a true representation of the morbidity and mortality due to NCDs, as there may be more individuals within the community who do not seek health care due to cost or difficulty with geographical access to health services. This is particularly relevant in the African context where poverty is rife and inverse-care law is very applicable. Apart from this, asymptomatic individuals are more likely to be missed by this hospital-based report, underscoring the need for a population-based survey.