Noncommunicable Diseases Lifestyle Diseases Demographic transition Is a
Noncommunicable Diseases (Lifestyle Diseases)
Demographic transition Is a phenomenon and theory which refers to the historical shift from high birth rates and high infant death rate in societies with minimal technology, education (especially of women) and economic development, to low birth rates and low death rates in societies with advanced technology, education and economic development
l As mortality declined, the age structure of population is changed to become mostly of aged population. People are exposed to the risk factors for longer periods.
Epidemiological transition l l Change of patterns of health and disease in the community and their determinants and consequences. The pattern of diseases has been changed from communicable to non-communicable diseases.
Drivers of the epidemiological transition in low and middle income countries Population ageing l Major socio-economic changes (especially urbanisation) consume unhealthy diets high in energy, saturated fats, salt and sugar, physical inactivity, smoking etc. l 5
Noncommunicable disease l l A disease that is not transmitted by another person, a vector, or the environment They are caused by how people live, conditions they are born with, or environmental hazards. They are not spread by contact because most are not caused by germs; instead they are the breakdown in body cells and tissues.
COMMUNICABLE VERSUS NON-COMMUNICABLE DISEASES Communicable diseases Sudden onset Single cause Short natural history Short treatment schedule Cure is achieved Single discipline Short follow up Back to normalcy Non-communicable diseases Gradual onset Multiple causes Long natural history Prolonged treatment Care predominates Multidisciplinary Prolonged follow up Quality of life after treatment
A global problem Worldwide, NCD currently represent 43% of the burden of disease l In 2004 there were 59 million deaths world-wide. NCD accounted for 60% of these deaths and injuries and violence 10%. l Among low- and middle-in-come countries, 79% of deaths, and 85% of the global disease burden, were due to the major NCDs. l By 2020 it is estimated that non-communicable disease will account for 73% of all deaths l 8
BURDEN OF NON COMMUNICABLE DISEASES 4 WHO 2014 –GLOBAL BURDEN OF DISEASES –
Situation of Non. Communicable Diseases in Egypt: There has been a recent concern about chronic NCDs in Egypt. The country is undergoing an epidemiological transition with an increasing burden of chronic NCDs. l MOH statistics show that such diseases represent most of the ten leading causes of mortality for the age groups of five years and over for the past years. l
l l Egypt is faced with a double burden of disease with a high prevalence of non-communicable diseases, such as diabetes, cardiovascular disease, accidents and communicable diseases such tuberculosis. Accidents and injuries: are rapidly on the increase and appear to emerge as the leading causes of morbidity and mortality in the age group of 15 to 34 years (triple burden) l l According to a MOH report, 41% of all deaths in Egypt are from NCDs and this was expected to increase as the population aged.
These non-communicable diseases include: l Degenerative Diseases: Cause further breakdown or degeneration in body cells and tissues as they progress e. g. Alzheimer’s, Arthritis and Multiple Sclerosis (MS). Diseases Present at Birth • Genetic Disorder- A disorder that is caused partly or completely by a defect in genes e. g. Sickle Cell Anemia and Down Syndrome. l • Birth Defect- Abnormality present at birth that causes physical or mental disability. Can be caused by problems during pregnancy e. g. Medications, X-rays
Chronic Diseases l Chronic non communicable diseases include cardio vascular diseases Diabetes Chronic respiratory disease Cancer. l Most of these diseases are attributed to common preventable risk factors.
NON MODIFIABLE RISK FACTORS A risk factor that cannot be reduced or controlled by intervention; AGE SEX RACE FAMILY HISTORY (GENETICS)
MODIFIABLE RISK FACTORS 7
The causal chain explains the risk factor approach for surveillance of non communicable diseases Behavioral risk factors • Tobacco • Alcohol • Physical inactivity • Nutrition Physiological risk factors • • Body mass index Blood pressure Blood glucose Cholesterol Disease outcomes • Heart disease • Stroke • Diabetes • Cancer • Respiratory diseases
PREVENTION OF NCD LEVELS OF PREVENTION 1. Primordial 2. Primary 3. Secondary 4. Tertiary For healthy people For unhealthy people
1. Primordial prevention- Prevention of the emergence or development of risk factors in countries or population groups in which they have not yet appeared. Efforts are directed towards discouraging children from adopting harmful life styles. 2. Primary prevention- Action taken prior to the onset of disease which removes the possibility that the disease will ever occur. Can be divided into population & high risk strategy.
Secondary prevention-EARLY DIAGNOSIS AND TREATMENT The main concern with NCDs is detection in early stages. However, even after detection, the cure for these NCDs is extremely expensive and out of reach for most of the patients. Health services are frequently oriented towards care rather than prevention, and acute rather than chronic models of care, leading to missed opportunities for prevention, early detection and treatment. Tertiary prevention- to reduce impairments & disabilities AND REHABILITATION
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