Non communicable diseases

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1. NON COMMUNICABLE DISEASES JOHNY WILBERT, M.Sc [N] LECTURER, APOLLO INSTITUTE OF HOSPITAL MANAGEMENT AND ALLIED SCIENCE

2. Non-communicable disease : a disease that can NOT be spread from person to person. Ex: cancer, heart disease, cirrhosis, etc. which is not infectious with long duration relatively slow in progress which a person is unaware of the disease unless or otherwise examined a silent killer of people

3. NCD DISTRIBUTION A/C TO AGE Younger Age-group Accidents and Injuries Rheumatic Heart Disease Diabetes Blindness Psychiatric disorders Elderly Hypertension Coronary Heart D isease Diabetes Mellitus Stroke Malignancies Obesity Blindness Psychiatric disorders Others Respiratory Diseases 17 August 2018 NCDs- Dr. Anindya 3

4. Common Risk Factors NON-MODIFIABLE Age Sex Family History Genetic Factors Personality MODIFIABLE Cigarette Smoking Alcohol Abuse Dyslipidemia Sedentary Life Style Stress Environmental Risk Factors Inability to avail preventive health care services 17 August 2018 NCDs- Dr. Anindya 4

5. CAUSES/ RISK FACTORS Unhealthy diet Tobacco usage Physical inactivity Stress factors Overweighed (obese) Genetics Harmful use of alcohol Environmental factors

6. RISK FACTOR CLASSIFICATION Background risk factors - age, sex, level of education and genetic composition - cannot be changed Behavioral risk factors - tobacco and alcohol use, unhealthy diet and physical inactivity - can be modified Intermediate risk factors - elevated blood lipids, diabetes, high blood pressure and overweight/obesity - can be controlled

7. Cardiovascular diseases Cardiovascular disease is caused by disorders of the heart and blood vessels, and includes 1.coronary heart disease (heart attacks), 2.cerebrovascular disease (stroke), 3.Raised blood pressure (hypertension), 4.peripheral artery disease, 5.rheumatic heart disease, 6. congenital heart disease 7. Heart failure. Although heart attacks and strokes are major killers in all parts of the world, 80% of premature deaths from these causes could be avoided by controlling the main risk factors: tobacco, unhealthy diet and physical inactivity. 7

8. Cardiovascular diseases: Contributing factors Genetic make-up of a person Life style habits early age Socioeconomic status Mental health Diet Overweight and obesity Occupation Smoking Alcohol Abuse Diabetes Urbanization 8

9. Cardiovascular diseases: Prevention Maintaining a healthy life style habits Focusing on a combination of risk factors for cardiovascular disease Regular medical screening for individuals at risk Providing effective and affordable treatment to those who require it to avoid further complications. 9

10. Cancer Cancer is the abnormal growth and spread of cells that arises from a change in one single cell. The change may be started by external agents and inherited genetic factors and can affect almost any part of the body. The transformation from a normal cell into a tumour cell is a multistage process where growths often invade surrounding tissue and can metastasize to distant sites. 10

11. Cancer: CAUSES Physical carcinogens, such as ultraviolet and ionizing radiation or asbestos; Chemical carcinogens, such as vinyl chloride, or betnapthylamine (both rated by the International Agency for Research into Cancer as carcinogenic), components of tobacco smoke, aflatoxin (a food contaminant) and arsenic (a drinking-water contaminant); and Biological carcinogens, such as infections from certain viruses, bacteria or parasites. Most chemicals to which people are exposed in everyday life have not been tested for their long-term impact on human health. 11

12. contd M ajor organs affected Lung, breast, colorectal, stomach and liver cancers In high-income countries, the leading causes of cancer deaths are lung cancer among men and breast cancer among women. In low- and middle-income countries cancer levels vary according to the prevailing underlying risks. In sub-Saharan Africa, for example, cervical cancer is the leading cause of cancer death among women. 12

13. Cancer: risk factors for cancer tobacco use unhealthy diet insufficient physical activity the harmful use of alcohol Infections (hepatitis B, hepatitis C (liver cancer), human papillomavirus (HPV; cervical cancer), Helicobacter pylori (stomach cancer) Radiation variety of environmental and occupational exposures of varying importance 13

14. Chronic respiratory diseases: Chronic respiratory diseases like Asthma, COPD, lung cancer , etc are caused due to exposure to tobacco, that affects lungs. Second-hand smoke causes severe respiratory health problems in children, such as asthma and reduced lung function; and asthma is now the most common chronic disease among children throughout the Region.  14

15. Chronic respiratory diseases: Children are particularly susceptible to the health effects of damp, which include respiratory disorders such as irritation of the respiratory tract, allergies and exacerbation of asthma. Damp is often associated with poor housing and social conditions, poor indoor air quality and inadequate housing hygiene. 15

16. Diabetes Diabetes is a chronic metabolic disorder that occurs when the pancreas does not produce enough insulin (a hormone that regulates blood sugar) or alternatively, when the body cannot effectively use the insulin it produces. The overall risk of dying among people with diabetes is at least double the risk of their peers without diabetes. 16

17. Diabetes: About 347 million people worldwide have diabetes. There is an emerging global epidemic of diabetes that can be traced back to rapid increases in overweight, obesity and physical inactivity. 17

18. Diabetes: 80% of diabetes deaths occur in low- and middle-income countries. In developed countries most people with diabetes are above the age of retirement, whereas in developing countries those most frequently affected are aged between 35 and 64. 18

19. Diabetes: Elevated blood sugar is a common effect of uncontrolled diabetes, and over time can damage the heart, blood vessels, eyes, kidneys, and nerves. Some health complications from diabetes include: Diabetic retinopathy Diabetic neuropathy Diabetes is among the leading causes of kidney failure; 10-20% of people with diabetes die of kidney failure. Diabetes increases the risk of heart disease and stroke; 50% of people with diabetes die of cardiovascular disease (primarily heart disease and stroke). 19

20. Diabetes: Prevention Without urgent action, diabetes-related deaths will increase by more than 50% in the next 10 years. To help prevent type 2 diabetes and its complications, people should: Achieve and maintain healthy body weight. Be physically active - at least 30 minutes of regular, moderate-intensity activity on most days. Early diagnosis can be accomplished through relatively inexpensive blood testing. Treatment of diabetes involves lowering blood sugar and the levels of other known risk factors that damage blood vessels. Tobacco cessation is also important to avoid complications. 20

21. Diabetes: Control People with type 1 diabetes require insulin; people with type 2 diabetes can be treated with oral medication, but may also require insulin. Blood pressure control Foot care Other cost saving interventions include: Screening and treatment for retinopathy (which causes blindness); Blood lipid control (to regulate cholesterol levels); Screening for early signs of diabetes-related kidney disease and treatment. These measures should be supported by a healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use. 21

22. Obesity Obesity is one of the greatest public health challenges of the 21st century. Its prevalence has tripled in many countries of the WHO European Region since the 1980s, and the numbers of those affected continue to rise at an alarming rate, particularly among children. In addition to causing various physical disabilities and psychological problems, excess weight drastically increases a person’s risk of developing a number of noncommunicable diseases (NCDs), including cardiovascular disease, cancer and diabetes. The risk of developing more than one of these diseases (co-morbidity) also increases with increasing body weight. 22

23. Obesity Overweight and obesity are defined as "abnormal or excessive fat accumulation that may impair health“ Body mass index (BMI) – the weight in kilograms divided by the square of the height in meters (kg/m2) – is a commonly used index to classify overweight and obesity in adults. WHO defines overweight as a BMI equal to or more than 25, and obesity as a BMI equal to or more than 30. 23

24. Obesity: Childhood obesity is one of the most serious public health challenges of the 21st century. Overweight children are likely to become obese adults. They are more likely than non-overweight children to develop diabetes and cardiovascular diseases at a younger age, which in turn are associated with a higher chance of premature death and disability. Supportive environments and communities are fundamental in shaping people’s choices and preventing obesity 24

25. Obesity: Individual responsibility can only have its full effect where people have access to a healthy lifestyle, and are supported to make healthy choices. WHO mobilizes the range of stakeholders who have vital roles to play in shaping healthy environments and making healthier diet options affordable and easily accessible. 25

26. Noncommunicable diseases: Prevention and Control Millions of deaths can be prevented by stronger implementation of measures that exist today. These include policies that promote government-wide action against NCDs: stronger anti-tobacco controls promoting healthier diets, physical activity, reducing harmful use of alcohol; along with improving people's access to essential health care. 26

27. Prevention Ways to prevent Non-Infectious or Non-Communicable diseases Avoiding triggers of allergies or asthma Having a healthy diet, getting plenty of exercise to prevent high blood pressure, cancer, heart disease, stroke, and type 2 diabetes. Taking medication for diseases you are born with, like asthma, allergies, and type 1 diabetes Going to the doctor regularly to get tested for things that may run in your family, like high blood pressure, cancer, heart disease, et c .