Non communicable disease

Non-infectious & Non-transmissible between persons.
Mostly chronic diseases of long duration & slow progression which require chronic care management.

1. EPIDEMIOLOGY OF NON COMMUNICABLE DISEASES (NCDs)

2. Definition of NCD

3. Common risk factors of (NCDs) Almost all NCDs have unknown cause, but they have some related RFs.

4. WHO global status Report 2014: identified 5 important RFs for NCDs in the top 10 leading risks to health.

5. Reasons of the increasing prevalence of NCDs

6. Transition Items Demographic Epidemiologic Nutrition transition Past situations -↑ Fertility -↑ Mortality ↑ I nfectious diseases ↑ Under nutrition Interventions -Family planning -Prevention & control of infectious disease - Env . sanitation -Immunization -Antibiotics -Insecticides Food production Reducing Famines Shift To -↓ Fertility -↑ Life expectancy -Aging -↓ Infectious diseases -↓ Mortality from infectious diseases ↑ intake of saturated fat & refined carb. + ↓ dietary fibers Present situation NCDs associated with aging. NCDs predominates ↑ Obesity “↑ fat & carb. intake + Sedentary life”

7. Multi-factorial nature of the risk factors for NCDs

8. Migration from low risk culture ( e.g. rural areas) to high risk culture (e.g. Urban areas ) follow the new life style → ↑NCDs risk. Migration of population across different cultures

9. International communication

10. Environmental changes

11. Epidemiology of NCDs differs across countries &changing all the time

12. R apid & successful achievements in the science of risk detection, use of medication & technologies to prevent & control NCDs. However , in the developing countries high cost of NCDs prevention & control programs is challenging. Limited use of scientific progress in management of NCDs

13. Prevention of ncd

14. Screening tests

15. Egypt National Multisectoral Action Plan for Prevention & Control of NCD 2018-2022 (Egypt MAP-NCD) Framework Element Baseline Target 2021 Target 2025 Premature mortality from NCD 25% 15% relative reduction 20% relative reduction Physical inactivity 32.1% 5% relative reduction 10% relative reduction Salt/sodium intake 12.8 g/day 20% relative reduction (10.0 g/ day) 10% relative reduction (9.0 g/ day) Tobacco use 24.4% 10% relative reduction (22.0 %) 20% relative reduction (20 %) Raised blood Pressure 39% 15%relative reduction (33%) 10 %relative reduction (30%) Diabetes & obesity 17.2% DM 31.3% Obesity Halt the rise in DM & obesity Drug therapy to prevent CVD *N/A % 10 % coverage 15% coverage Essential NCDs medicines & basic technologies to treat major NCDs 60% 70% availability 80 % availability *As there is currently no available baseline data, the approach will be piloted in selected PHC settings.

16. Hypertension

17. Hypertension “HPN” is one of the major risk factors for CVDs.

18. Types & RF of hypertension

19. Screening tests for HPN For screening purpose in the community-based epidemiological cross-sectional studies, these standards could be used. 2 readings should be taken at least 5 minutes apart & average result represents current Bl.Pr . measurement In the medical settings, diagnosis of HPN depends on findings of Bl.Pr . levels for >2 times few weeks apart.

20. Complications

21. Prevention

22. DIABETES MELLITUS

23. It is a common metabolic disorder of impaired carbohydrate utilization by the body due to insulin deficiency.

24. RFs

25. Non-modifiable RF for T2DM M odifiable RF for T2DM

26. Laboratory diagnosis of DM

27. Health technology & diabetes management Continuous glucose monitoring (CGM) technology: helps improve glycemic control for adults with T1DM starting at age 18.

28. Diabetes management in specific groups I ndividualizing pharmacologic therapy for older adults to reduce the risk of hypoglycemia, avoid overtreatment & simplify complex regimens while maintaining personalized blood glucose targets.

29. New guideline recommends all pregnant women with preexisting T1DM or T2DM should consider daily low-dose aspirin starting at the end of the 1 st trimester → ↓ the risk of pre- eclampsia .

30. DEFINITION It is an abnormal proliferation of cells in any organ in the body forming mass or tumor. It invades the surrounding tissues and destroys them.

31. Risk factors

32. Prevention of cancer

33. BRONCHIAL ASTHMA

34. Primary prevention

35. SECONDRY PREVENTION

36. TERTIARY PREVENTION Rehabilitation

37. ACCIDENTS

38. It is unexpected, unplanned event that produces injury, death, property loss or damage. A n increasing problem in both developed & developing countries. It is the 2 nd leading cause of deaths in developing countries

39. Road traffic accidents Injuries such as laceration, contusions, bleeding, paralysis, fractures, and amputation are common. Death is commonly associated with road traffic accidents. Egypt loses about 12 000 lives due to road traffic crashes every year. It has a road traffic fatality rate of 42 deaths per 100 000 population.

40. Risk factors

41. Prevention of road traffic accidents

42. Home accidents

43. Risk factors

44. Prevention

45. Occupational accidents

46. Indicators of occupational accidents

47. Impact of accidents on workers, industry, and economy

48. Prevention of occupational accidents

49. Importance of Mental Health

50. Criteria of individuals with good mental health

51. Risk Factors of Mental Disorders

52. ↓ Iodine during pregnancy & ↓ O2 at birth, injuries & early childhood brain infections → MR . Nutritional deficiencies “ PEM ” → MR . Depression interacts with CVDs & vice versa. Anxiety , depression & substance abuse can also complicate existing physical disorders. Interaction between Physical & Mental Health Problems

53. Types of Mental Disorders

54. Mental illness & poor mental health are public problems G reat impact on: The Impact of Mental Disorders

55. Prevention of Mental Illness

56. primary prevention

57. primary prevention

58. Intervention undertaken to reduce complications & all specific ttt . Secondary prevention

59. Interventions that ↓ disability & all forms of rehabilitation + prevention of relapses of illness. The integration of needy groups in the society is needed. TERTIARY PREVENTION

60. Mental Health Program in Egypt: In Egypt the national mental health program focuses on: The new policy may ↓ no. of psychiatric inpatients. After-care services are still limited because of the poor understanding of most people

61. SUBSTANCE ABUSE

62. In Egypt, drug abuse is considered one of the most serious public health problems, especially among the young people at working ages. In Middle Eastern Arab countries, there is scarce information on mental health issues, including drug dependence. This is related to the context of the conservative nature of these societies that reject disclosing about drug intake as well as to stigmatization. Magnitude of the problem

63. Types of psycho active drugs

64. Risk factors of drug addiction

65. Impacts of drug abuse

66. Pattern of substance abuse in Egypt

67. 70 % of admissions to the addiction wing of Cairo’s massive Qasr el- Aini hospital were linked to tramadol in 2014 alone.

68. Prevention of drug dependence

69. Primary prevention

70. Secondary prevention

71. Tertiary prevention Rehabilitation of addicts, find suitable jobs & no community stigma