Non Communicable Diseases:
Preventable through knowledge and attitudes
According to it’s ability or inability in transferring to another person the ailments are
divided into two groups as, communicable and non communicable diseases.
Communicable diseases , caused by organisms such as bacteria, viruses, parasites or
fungi are contagious or transferable to others but non communicable diseases are not
transmitted to others from the affected person.
Non communicable diseases (NCDs) are considered as the leading cause of deaths world
wide. It represents 60% of all deaths globally. The burden is more on low and middle
income countries as 80% of deaths due to NCDs are shared by them. The proportion of
people suffering from NCDs is rapidly increasing in the South East Asia region.
Cardiovascular diseases, diabetes, asthma and chronic obstructive pulmonary diseases
and cancers are among the more prevalent non communicable diseases in this region,with
their major modifiable risk factors of unhealthy diet, physical inactivity and tobacco use.
These risk factors, namely alcohol use, obesity, hypertension, tobacco use , physical
inactivity and dyslipidaemias or an abnormal amount of lipids such as cholesterol or fat
in the blood are also commonly seen in our country.
The mortality rates relevant to NCDs in Sri Lanka are higher than middle and high
income countries of the world. While traumatic injuries represent the first place in the list
of leading causes of hospitalization, ischemic heart disease has taken over the
responsibility for the highest number of hospital deaths. According to the annual health
statistics , 620,377 persons were hospitalized due to traumatic injuries and 4,125 hospital
deaths were due to ischemic heart disease in 2006.
It has been mentioned that 50% of hospital deaths due to traumatic injuries are caused by
accidents of motor vehicles in our country. The reported number of 30,420 road traffic
accidents has lead to 2157 deaths in 2008.
The prevalence of NCDs in Sri Lanka is also linking to the population aging. As the life
expectancy has gone up to 76.4 years for the females and 71.7 years for the males and the
total fertility rate or total births in a family has declined to 2.6 , the proportion of elderly
population is increasing rapidly. It was estimated that the proportion of people in 60
years or more will double from 12.1% to 24.4% from 2010 to 2040.
The mortality rates due to cardiovascular diseases in Sri Lanka are almost double when
compared to developed countries. Asthma has become another more problematic NCD
as mortality rates have been doubled from 2,000 to 4,000 from 1991 to 2003. It accounts
for 4% of all deaths currently.
Hypertension or high blood pressure is a major risk factor for cardiovascular and
cerebrovascular diseases including stroke. The current prevalence of the hypertension in
the country is 13% in males and 14% in females.
The prevalence of the diabetes also appears to be increasing gradually. It was estimated
that around 1.5 million adult population has type 2 diabetes with 10.3% prevalence.
The prevailing risk is further increased as only half of these patients know about their
hidden illness. The lack of basic knowledge about the illness and negligence has lead to
The prevalence of the cancers is also increasing in the country. According to the health
statistics, the rate has been increased from 37.6 to 70.6 in 100,000 population from 1985
It should be emphasized that the majority of the NCDs are preventable. All must have
basic knowledge on the prevailing risk factors relevant to the NCDs and the need of
early detection of diseases through timely screening. Therefore it is necessary to educate
the public on these issues without further delaying.
Fetal under nutrition has been recognized as a long term risk factor in the development of
ischemic heart disease, stroke, hypertension and diabetes later in the life. Fetal nutrition is
solely dependent on nutritional status of the mother. Maternal under nutrition is still
considered as a prevailing issue in the country. It should be given a priority in correcting
these root causes for the NCDs in the future.
The prevalence of smoking in Sri Lanka is slightly lower than the other countries in
South East Asian region but still higher than the developed countries. Tobacco smoking
is a major risk factor for heart disease, chronic respiratory disease and cancers. Current
prevalence of smoking in the country is estimated as 32% in males and 2% in females.
Physical inactivity is another important factor to be addressed in reducing the NCD
burden , in the country. It is a known risk factor for cardiovascular disease and diabetes.
There is a need for interventions in counteracting this problem at home and work places.
A moderate physical activity is advised , preferably for 30 minutes in a day. It could be
achieved even with three 10 minutes sessions in a day if there is a difficulty in investing
the time to engage in these activities. Brisk walking would be ideal for this type of
Alcohol consumption is well known risk factor for liver disease, cancers and diseases of
the cardiovascular and central nervous systems. Alcohol consumption and heavy drinking
could be commonly seen in poorer and less educated people in the country. This
unhealthy habit has created a vicious cycle in loosing money and health . A correct
awareness must be built among these people, considering their sociocultural and
educational status in preventing this hazard
Obesity is another risk factor for cardiovascular disease, diabetes, dyslipidaemia,
hypertension, bone and joint disorders and and some cancers. It was found that 20.3% of
males and 36.5% of females ,aged 30 to 65 years in the country are obese as their body
mass index ( BMI) is more than 25 kg per square meter. It has been shown in health
statistics that the obesity levels in the country have being increasing during the period of
past 20 years.
Everyone has a responsibility in keeping qualitative healthy life, themselves. The lifestyle
changes may be necessary to maintain physical, psychological and social wellbeing while
living in this rapidly changing world. The mixture of sound knowledge and healthy
attitudes will be the best therapy in relieving the burden of NCDs.
Dr. SHANTHA HETTIARACHCHI
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