Non communicable diseases part 1

part 1 NCDS

1. EPIDEMIOLOGY OF NON COMMUNICABLE DISEASES (NCDs ) part 1 Zagazig university By Alaa Nouh Under supervision Of Prof Dr. Mona Aboserea

2. Learning Objectives : 1 . To understand the definition, risk factors & prevention of the NCDs & to recognize the epidemiology of some common NCDs. 2. To understand the types, risk factors & prevention of accidents . 3. To Recognize the definition of mental health &mental illness , to describe the risk factors affecting mental health, to identify the interaction between physical and mental illness, & to understand different levels of prevention in mental health. 4. To understand the magnitude, new trends in Egypt, risk factors, consequences, and prevention of substance abuse .

3. Definition of NCD

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

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

6. Reasons of the increasing prevalence of NCDs

7. 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”

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

9. 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

10. International communication

11. Environmental changes

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

13. 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

14. Prevention of ncd

15. Screening tests

16. 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.

17. Hypertension

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

19. Types & RF of hypertension

20. 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.

21. Complications

22. Prevention

23. DIABETES MELLITUS

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

25. RFs

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

27. Laboratory diagnosis of DM

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

29. 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.

30. 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 .

31. 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.

32. Risk factors

33. Prevention of cancer

34. BRONCHIAL ASTHMA

35. Primary prevention

36. SECONDRY PREVENTION

37. TERTIARY PREVENTION Rehabilitation