Non-communicable Diseases And Interventions to minimize it
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Rise of non-communicable diseases like RTA, obesity, psychological disturbance, etc. Its impact towards the healthcare of a nation. The steps or approach that can be taken to minimize the disease.
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Non-communicable Diseases And Interventions to minimize it
- 2. The study of the distribution and determinants of health-related states in specified populations, and the application of this study to control health problems
- 3. Distribution: occurrence of cases by time, place and person Eg: according to study of deaths in country X in 2008, 1034 cervical cancer deaths occurred among women between the ages of 45-54
- 4. Determinants: All the causes and risk factors for the occurrence of a disease, including physical, biological, social, cultural, and behavioral factors Eg: Smoking was a risk factor or determinant for the greater number of cancer deaths among women ages 45-54
- 5. Health related states: Diagnosis of specific disease or cause of death Eg: according to study of deaths in country X in 2008, 1034 cervical cancer deaths occurred among women between the ages of 45-54
- 6. Specified population: A measurable group, defined by location, time, demographics, and other characteristics Eg: women aged 45-54 living in a rural village in country X from 2001 through 2009
- 7. Application: analysis, conclusion, distribution, and timely use of epidemiologic information to protect the health of the population. Eg: As a result of the country X study, free cervical cancer screening programs were implemented. They targeted women living in remote areas in hopes of finding women with cervical cancer at an earlier stage of cancer in order to prevent death Application :
- 8. To measure frequency of disease To asses distribution of disease - who is getting disease? - where is disease occurring? - when is disease occuring? To form hypotheses about causes and preventive factors To identify determinants of disease Purpose of epidemiology
- 9. Approach/ Consideration Clinical Medicine Epidemiolgy Focus Individuals populations Main goal Diagnosis and treatment Prevention and control Questions What is wrong with this patient? What are the leading causes death or disability in this population? Risk factor? Treatment What treatment is appropriate? What can be done to reduce or prevent disease or risk factors? Who is involved? Physician, laboratorian, nurse, and others Epidemiologists, statisticians, and others from diverse disciplines Approaches in Medicine vs Epidemiology
- 10. Descriptive epidemiology - Studies the pattern of health events and their frequency in populations in terms of: place, person, time - Purpose: to identify problems for further study. To plan, provide and evaluate health services Analytic epidemiology - Studies the association between risk factors and disease - Purpose: to determine why disease rates are high in a particular group Approaches to epidemiology
- 11. Public health surveillance Investigation Data analysis Intervention Evaluation Communication Management and team work Function of Epidemiology
- 13. Not communicable, especially with reference to a disease that is NOT transmitted through contact with an infected or afflicted person (not infectious) • Non-communicable diseases (NCDs), also known as chronic diseases. • Long duration and generally slow progression. • Random genetic abnormalities, heredity, lifestyle or environment can cause non-communicable diseases, such as cancer, diabetes, asthma, hypertension and osteoporosis. • Autoimmune diseases, trauma, fractures, mental disorders, malnutrition, poisoning and hormonal conditions are in the category of non- communicable diseases. DEFINITION
- 14. RTA CANCER S HEART DISEASES DIABETES MELLITUS EPILEPSYCHRONIC RESPIRATORY DISEASES MENTAL ILNESSES CHRONIC KIDNEY DISEASES EXAMPLES
- 15. Genetic Diseases Environmental Diseases • Achondroplasia • Albinism • Bardet-Biedl syndrome • Bipolar disorder • Canavan disease • Color blindness • Cystic fibrosis • Down's syndrome • Fragile X syndrome • Galactosemia • Hemophilia • Krabbe disease • Muscular dystrophy • Neurofibromatosis • Noonan syndrome • Osteogenesis • Patau syndrome • Sickle-cell disease • Tay-Sachs disease • Triple X syndrome • Turner syndrome • Usher syndrome • Von Hippel-Lindau syndrome • Waardenburg syndrome • Wilson's disease • Xeroderma pigmentosum • Appendicitis • Anorexia nervosa • Arteriosclerosis • Asthma • Carpal tunnel syndrome • Chronic obstructive pulmonary diseases • Empyema • Fetal alcohol syndrome • Glaucoma • Fibromyalgia • Hyperthyroidism • Hypothyroidism • Irritable Bowel Syndrome • Liver cirrhosis • Narcolepsy • Osteoporosis • Sudden infant death syndrome (SIDS) • Tick paralysis
- 16. • Annual Death : 36.25 millions • 80% of it occurs in low- and middle- income countries
- 17. 1. Cardiovascular Disease (17.3mil.) 2. Cancer (7.6mil.) 3. Respiratory Disease (4.2mil.) 4. Diabetes (1.3mil.) Death Causes
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- 21. MAIN CAUSE OF DEATH IN INDIA
- 22. CARDIOVASCULAR DISEASE DIABETES MELLITUS CHRONIC OBSTRUCTIVE PULMONARY DISEASE CANCER Top 4 NCD
- 23. LUNG CANCER STOMACH CANCER COLORECTAL CANCER LIVER BREAST CANCER COMMON CANCER
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- 25. TOBACCO USE PHYSICAL INACTIVITY OVERWEIGHT/OBESITY HIGH BLOOD PRESSURE HIGH CHOLESTEROL LEVELS HIGH BLOOD GLUCOSE LEVELS LEADING RISKS FACTOR
- 26. 2004 : USD 9.1 Billion out-of-pocket were spent on test, treatment and medical devices to manage NCD 2005 : India experienced “highest loss in potentially productive years of life” 2006-2015 : the projected cumulative loss of national income for India due to NCD mortality will be USD237 billion WHY?
- 27. In Malaysia
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- 30. Arthritis was the most common non-communicable disease (NCD), followed by HBP, diabetes, asthma and CHD. Older females were more likely than males to have arthritis and HBP, but males were more likely to have asthma. Diabetes and CHD were most prevalent among Indians, while arthritis and HBP were most prevalent among the Indigenous groups. Older people were more likely to report poor health if they suffered from NCD, especially CHD. Chinese that had HBP were more likely to report poor health compared to other ethnic groups with the same disease. Among those with arthritis, Indians were more likely to report poor health.
- 36. Replace saturated & trans – fat with unsaturated fat consumption of vegetables, fruits and whole grains sodium intake and excessive calories HEALTHY DIET
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- 38. Schools :provide not only good nutrition curricula but also healthy meals Workplace : Not only inform about role of physical activity but also promote use of non-motorized transportation Mass media : promote healthy lifestyle Health centres : promote healthy lifestyle etc..
- 39. URBAN DESIGN AND TRANSPORTATION POLICY Use public and non – motorized transport, more walking and using bicycle.
- 40. NATIONAL TRANSPORTATION POLICY AUTOMOBILE USE DEPENDENCY BAD Low taxes on gasoline, free parking, wide street design QUITE GOOD Narrow streets, limited parking, high gasoline costs HIGH INCOME COUNTRIES BAD Lowering taxes, simplify registration procedures, allow foreign finance QUITE GOOD Restrict funding, down payment 40 to 50 %, high taxes MIDDLE AND LOW INCOME COUNTRIES
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- 43. POLICY Fortify foods with micronutrients Limit advertising for unhealthy foods Provide incentives for food manufacturers to replace unhealthy ingredients with healthy ones Netherlands reduced the trans fat content of the food supply from about 6 percent of the energy content to approximately 1 percent in a single decade. government policies replaced commonly used palm oils for cooking with soybean oil, which reduced the intake of fatty acids and lowered serum cholesterol levels.
- 45. Type 1 •Insulin injection Type 2 •Insulin injection(severe) + change in diet and lifestyle + oral glucose lowering agents CHALLENGES: Access to insulin very low in African nations Glycemic control costs less than managing complications that arises in its absence.
- 46. Anticlotting agents (aspirin , heparin) – prevent venous thromboembolism Benzathine penicillin injection – rheumatic fever ACE inhibitors : For CHF and HT Anti coagulants : mitral stenosis and atrial fibrillation Others
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- 49. PRIMARY PREVENTION •Eliminates exposure to cancer causing agent SECONDARY PREVENTION •Detecting and treating pre- cancerous lesions TREATMENT •Surgery, Chemotheraphy, Radiotheraphy PALLIATIVE CARE •Physical and physiological comfort from diagnosis through death
- 50. PRIMARY Immunizing against infectious agents, dietary interventions, tobacco control programs, reducing excessive alcohol consumption, chemoprophylaxis SECONDARY Screening programs to detect and treat precursors of cancer TREATMENT Surgery, radiation therapy, chemotherapy PALLIATIVE CARE End of life care
- 52. Genetic screening and counselling for couples Vaccinating against Hib & Meningitis (Neurological damage) + Rubella vaccine Readdressing nutritional deficiencies among pregnant women Screening for metabolic disorders (develop neurological damage after ingesting certain foods) Screening for sickle cell anemia + penicillin prophylaxis Screening and treatment for congenital hypothyroidism Prompt treatment for cerebral malaria HEALTH INTERVENTIONS
- 53. Stop alcohol use during pregnancy Eliminating environmental exposure to toxins such as Lead BEHAVIOURAL INTERVENTION
- 54. Treatment ensues What if Prevention fails? •Blood transfusion with washed RBCThalassemia •Treat with analgesics if severe bone pain •Nutrition, rehabilitation, special education to reduce impairment Sickle cell disease
- 55. Interventions at associated health conditions Address environmental constraints on participation in family and social life IF BOTH PREVENTION AND TREATMENT FAILS.. DOWN SYNDROME • Therapy for poor vision and hearing • Congenital heart defect • Low mental capacity Wheelchair accessible mass transit, buildings, restrooms Social support network Eliminating social stigma, promote inclusiveness
- 57. FIRST •Manage exposure to risk •Substitute safe mode of transport from more dangerous one •Minimize high – risk scenarios (raise legal age for riding motorcycle) SECOND •Construct safer roads •Place speed bumps •Separate vehicle lanes from paths used by pedestrians and bicycles •Construct median barriers •Provide passing lanes •Improve street lighting THIRD •Encourage people to adopt safer behaviors (Education) •Introduce legislation and enforce it in relation to Speed limit, Blood alcohol level, wearing helmets.. Interventions
- 58. TOBACCO USE
- 59. Increase tobacco taxes Disseminate info about tobacco’s health risks Restrict smoking in public places and workplaces Banning tobacco advertising Increase access to cessation therapies Interventions
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- 61. ALCOHOL USE
- 62. Legislative measures and taxes •Increase alcohol taxing •Restricting sales to a limited number of licensed retail outlets Improved Law enforcem ent •Strict drunk driving laws Mass media campaigns •Bans on advertising alcohol products •Manufacturers substitute other methods of marketing Eg: Sponsoring sporting events Education POPULATION LEVEL • School based education about risks of drinking alcohol
- 63. Educational sessions •Discussing risks of drinking alcohol Psychosocial counselling PERSONAL LEVEL
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- 67. MENTAL HEALTH
- 70. Pharmacological Treatment • Antidepressants • Antipsychotic • Antimanic Psychosocial therapies • Cognitive behavioural therapy • Group therapy Relieving symptoms • Eg: Hypertension in anxiety( give anti-hypertensives) Easing burden on patients family • Training caregivers about proper diet • Establishing bowel and bladder habits