Non communicable disease, lecture for second year students

University of Juba, non communicable diseases 2nd lecture for 2nd year students

1. Non Communicable Diseases Prepared by Dr. Niveen Gama

2. Objectives; NCD NCD statistics Major types of NCD NCD impact

3. Non Communicable diseases; Are a group of conditions that are not mainly caused by an acute infection, result in long-term health consequences and often create a need for long-term treatment and care.

4. Non Communicable Disease; Non communicable diseases (NCDs), also known as chronic diseases, tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behavioral factors.

5. NCD; Non-communicable diseases (NCDs) are diseases that are not transmitted (spread) directly from one person to another. NCDs are also known as lifestyle diseases or chronic diseases. The majority of these diseases are caused by the way people live and are preventable

6. How does Non-Communicable Diseases start; They start from a person living an unhealthy lifestyle. They are not transmitted from person to person. They grow slowly and stay on for very long. They affect many important organs in the body: - Brain, heart, arteries, blood vessels, lungs, stomach, intestines, liver, pancreas, spleen, kidneys, bladder, uterus, ovaries and prostate. They may not show any signs or symptoms initially.

7. NCD distribution according to age; Younger age groups; Accidents and injuries Rheumatic heart disease Blindness Diabetes Mental illnesses

8. NCD distribution according to age; Elderly; Hypertension Coronary heart disease Malignancies Diabetes mellitus Stroke Obesity Blindness Respiratory diseases

9. Statistics; Non-communicable diseases (NCDs) kill 41 million people each year, equivalent to 74% of all deaths globally. Each year, 17 million people die from a NCD before age 70; 86% of these premature deaths occur in low and middle-income countries. Of all NCD deaths, 77% are in low and middle income countries. Cardiovascular diseases account for most NCD deaths, or 17.9 million people annually, followed by cancers (9.3 million), chronic respiratory diseases (4.1 million), and diabetes (2.0 million including kidney disease deaths caused by diabetes ).

10. Statistics ; Tobacco use, physical inactivity, the harmful use of alcohol, unhealthy diets and air pollution all increase the risk of dying from a NCD. Detection, screening and treatment of NCDs, as well as palliative care, are key components of the response to NCDs.

11. Types; The common ones contribute to over two-thirds of global deaths . The four major global types of NCDs include: Diabetes Chronic respiratory disease Cardiovascular disease Cancer

12. Diabetes; This is a disorder of metabolism where the body is unable to produce enough of a special hormone called insulin. Insulin regulates blood sugar in the body. Over time, if the poor regulation of blood sugar continues, the diabetes may cause further complications like blindness, nerve damage, kidney failure, or cardiovascular diseases.

13. Diabetes; The  WHO  estimates that 24 million people are living with diabetes in Africa, and it has a projected figure of up to 55 million by 2045; that's about a 129% increase. The reasons for these high numbers are because the region lacks adequate and equipped testing facilities, inadequate number of trained healthcare personnel, poor access to health facilities, and a low public  awareness of the disease.

14. Cardiovascular diseases; These groups of diseases or disorders affect the heart or blood vessels . It's the second-leading cause of death in Africa after communicable diseases. In   2019 , there were over 1 million deaths from CVDs which summed up to 5.4% of all global CVD-related deaths and 13% of all deaths in Africa.

15. Cancer; This is a disease that is characterized by the uncontrolled division and growth of abnormal cells. These cancerous cells may go on to invade nearby tissues, causing a metastatic (uncontrollable growth) condition and other serious health problems. Cancer can affect anyone regardless of age, sex, social status , race, or religion .

16. Cancer; Cancer is the second-deadliest type of NCDs worldwide, claiming up to  9.3 million  lives annually. 1  In  2020 , over 500,000 cancer deaths were estimated to have occurred in sub-Saharan Africa.

17. Cancer; According to research, it's projected that there will be an estimated   2.1 million  new cases and 1.4 million cancer-related deaths by 2024. 6   The researchers also noted that dietary and lifestyle changes, along with behavioral and environmental risk factors, are contributing to the increase .

18. Chronic respiratory diseases; Chronic respiratory diseases  affect a person's airways and other structures of the lungs, making it difficult to breathe properly due to a shortage of air volume in the lungs. 7  They're more prevalent in low- and middle-income countries . Some of the diseases included in this category of NCDs include: Chronic obstructive pulmonary disease (COPD) Respiratory infections

19. Chronic respiratory diseases; Asthma Occupational lung diseases CRDs are not  curable , but they can be managed through lifestyle changes , medications, pulmonary rehabilitation, or oxygen therapy. In some cases, surgery may be advised if symptoms worsen and become life-threatening. 

20. Risk factors; In Africa, non-communicable diseases have been on the rise for about two decades, and they're projected to overtake communicable , neonatal, maternal, and nutritional diseases by 2030 .

21. Risk factors; 1. Modifiable (behavioural) risk factor like:   Harmful use of alcohol Physical inactivity Unhealthy diet (high in sodium, fat,  or sugar) Tobacco use (Including vaping) Misuse of prescription or recreational drugs Excess weight or obesity These risk factors are preventable; that's why they're called "behavioral risk factors", so lifestyle changes are advised. 

22. Risk factors; 2. Metabolic risk factors include:   Hypertension Gestational diabetes Autoimmune conditions Preeclampsia or toxemia Family history of heart disease

23. Risk factor classification; Background risk factors ; age, sex, level of education and genetic composition. Behavioral risk factors ; tobacco and alcohol use, unhealthy diet and physical inactivity. Intermediate risk factors ; elevated blood lipids, diabetes, high blood pressure and overweight/obesity.

24. Risk factors; Dietary habits, traditional beliefs, and lifestyle practices often contribute to the risk factors associated with NCDs, making it difficult to curb their prevalence. The healthcare system should collaborate with locals to educate them on the risks of NCDs while integrating traditional medicine with the modern healthcare system to have a better healthcare outcome for locals.  

25. Socioeconomic and Cultural Challenges in Addressing NCDs in sub-Saharan Africa   Sub-Saharan Africa is a vast and diverse region with different people and cultures and non-communicable diseases are shaped by medical, socioeconomic , and cultural factors that play a significant role in their prevalence and how they are addressed in different countries of the region .

26. Socioeconomic and Cultural Challenges in Addressing NCDs in sub-Saharan Africa Two important factors affect how NCDs are addressed in Africa, and they are: 1. Socio-Economic:   NCDs are common in low- or middle-income economies. In Africa, the widespread low financial power is a strong causal factor of limited access to healthcare, and the cost of treatment, medications, and checkups that are often paid out-of-pocket can be overwhelming for most people living in the region. Poor financial power most often causes unnecessary delay in seeking medical help that in turn make the condition worse and cause death in the end.

27. Socioeconomic and Cultural Challenges in Addressing NCDs in sub-Saharan Africa; Cultural:  Africa is a continent with rich culture and values that are deeply rooted in the fabric of the respective societies. Africans hold culture in high esteem and can do anything to protect it. Some African delicacies tend to have high salt or sugar content, contributing to the development of non-communicable diseases like diabetes and hypertension. 

28. Refrences ; Global Burden of Disease Collaborative Network, Global Burden of Disease Study 2019 (GBD 2019) Results (2020, Institute for Health Metrics and Evaluation – IHME) https://vizhub.healthdata.org/gbd-results /   Suliman A. The state of heart disease in Sudan.  Cardiovasc J Africa.  2011; 22(4):191-6   https:// www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases?utm_medium=email&utm_source=transaction World Health Organization (WHO).  Deaths from Non-communicable diseases on the rise in Africa  [Internet, April 11, 2022.. [cited 2023 Sep 2].