NON - COMMUNICABLE DISEASES - Aditi...
Transcript of NON - COMMUNICABLE DISEASES - Aditi...
NON - COMMUNICABLE
DISEASES
What we have to discuss…
Definition
Causative agent, Prevention, care and
control of,
1. Cancer
2. Diabetes
3. Blindness
4. Cardiovascular diseases
a diseases,
Caused due to
Multiple causes
are not passed or transmitted
Directly or indirectly
from person to another
By any agency.
E .g: Cancer etc
Definition
“Non-communicable diseases is a diseases,
caused due to multiple causes and are not
passed or transmitted directly or indirectly
from person to another by any agency”. E .g: Cancer etc
“Non-communicable diseases (NCDs), is a diseases
which are not passed from person to another”.
E .g: Cancer etc
Definition
M o re than nine million of all deaths attributed to noncommunicable diseases (NCDs) occur before the age of 60.
• Around the world,
NCDs affect women and
men almost equally.
Risk factors
1. Smoking
2. Consumption of alcohol
3. Bad Life style pattern
(E.g.: Diet, Physical activity etc)
4. Insufficient health services
5. Environmental factors
(E.g.: air & water pollution, etc)
6. Stress conditions
Cancer
Cardiovascular diseases Cardiovascular disease is caused by disorders of the
heart and blood vessels, and includes coronary heart
disease (heart attacks), cerebrovascular disease (stroke),
raised blood pressure (hypertension), peripheral artery
disease, rheumatic heart disease, congenital heart
disease and 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.
Cardiovascular diseases: Facts and figures
Cardiovascular disease (CVD) causes more than half of all
deaths across the European Region.
8 0 % of premature heart disease and stroke is
preventable.
Cardiovascular diseases: Contributing factors
A person’s genetic make-up T h e foundations of adult health are laid in early life Socioeconomic group Mental health D i e t Overweight and obesity Inactivity Tobacco Alcohol Diabetes Globalization and urbanization
Cardiovascular diseases: Prevention
Focusing on a combination of risk factors for
cardiovascular disease
Implementing medical screening for individuals at
risk
Providing effective and affordable treatment to
those who require it
Cardiovascular diseases: Prevention
It has been predicted that mortality from coronary heart disease (CHD) in the United Kingdom could be halved by small changes in cardiovascular risk factors: a 1% decrease in cholesterol in the population could lead to a 2–4% CHD mortality reduction; a 1% reduction in smoking prevalence could lead to 2000 fewer CHD deaths per year; and a 1% reduction in population diastolic blood pressure could prevent around 1500 CHD deaths each year.
80% of the reduction in CHD mortality in Finland during the
period of 1972–1992 has been explained by a decline in the major risk factors. Similarly, in Ireland, almost half (48.1%) of the reduction in CHD mortality rates during 1985–2000 among those aged 25–84 years has been attributed to favorable trends in population risk factors. In both countries, the greatest benefits appear to have come from reductions in mean cholesterol concentrations, smoking prevalence and blood pressure levels.
Cardiovascular diseases: Treatment
Effective measures are available for people at high
risk. For example, combination drug therapy (such
as aspirin, beta blocker, diuretic and statin) can
lead to a 75% reduction in myocardial infarction
(heart attack) among those at high risk of having
one.
B u t many such interventions are not being
implemented, and about half of coronary patients
in the world still require more intensive blood
pressure management.
Cancer
Cancer is the uncontrolled 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.
Cancer: Interaction between a person’s
genetic factors and any of three
categories of external agents
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.
Cancer: the majority of cancer deaths
Lung , breast, colorectal, stomach and liver cancers
I n high-income countries, the leading causes of
cancer deaths are lung cancer among men and
breast cancer among women.
I n 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.
Cancer: risk factors for cancer
tobacco use unhealthy diet insufficient physical activity t h e 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
Cancer: policy
WHO’s approach to cancer has four pillars:
prevention,
early detection,
screening,
treatment
palliative care.
Cancer: policy
A t least one third of the 10 million new cases of
cancer each year are preventable through reducing
tobacco and alcohol use, moderating diet and
immunizing against viral hepatitis B.
Early detection and prompt treatment where
resources allow can reduce incidence by a further
one third.
Effective techniques are sufficiently well
established to permit comprehensive palliative care
for the remaining more advanced cases.
Cancer: national cancer control programme
W H O has consolidated tools for countries in a
framework known as the national cancer control programme, which focuses government attention and services on all facets of the fight.
A national cancer control programme is a public health programme designed to reduce cancer incidence and mortality and improve cancer patients’ quality of life, through the systematic and equitable implementation of evidence-based strategies for prevention, early detection, diagnosis, treatment and palliation, making the best use of available resources.
Chronic respiratory diseases: Quick facts and figures
According to the WHO Global Status Report on NCDs
2010, smoking is estimated to cause about 71% of all lung
cancer deaths and 42% of chronic respiratory disease
worldwide. Of the six WHO regions, the highest overall
prevalence for smoking in 2008 was estimated to be the
in the European Region, at nearly 29%.
Chronic respiratory diseases:
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Quick facts and figures
Sur vey data from 2002–2007 indicate that over half of all
children aged 13–15 years in many countries in the
European Region are exposed to second-hand tobacco
smoke at home. 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.
Chronic respiratory diseases: Quick facts and figures
According to the latest available data for 1997–2006, over 12% of infant deaths in the world are due to respiratory diseases.
Indoor air pollution from biological agents related to damp and mould increases the risk of respiratory disease in children and adults. 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.
Chronic respiratory diseases: Quick facts and figures
Increasing evidence suggests that allergic sensitization,
which is the most common precursor to the
development of asthma, can already occur antenatally.
Emphasis on the health, nutrition and environment of
the pregnant woman and the unborn child are therefore
essential.
Ozone pollution causes breathing difficulties, triggers
asthma symptoms, causes lung and heart diseases, and is
associated with about 21 000 premature deaths per year
in 25 countries in the WHO European Region.
Chronic respiratory diseases: Quick facts and figures
M o s t countries in the world and the European Region
have introduced a wide range of comprehensive policies
to reduce and eliminate tobacco smoke. For example,
the advertising of cigarettes and the sale of tobacco
products to minors have been banned in more than 80%
of the countries in the Region. Smoking in restaurants
and bars continues to be regulated less strictly, however.
Ireland, Turkey and the United Kingdom are the first
countries to make public places 100% smoke free.
Diabetes
Diabetes is a chronic disease 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.
Diabetes: Quick facts and figures
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.
Diabetes: Quick facts and figures
Diabetes is predicted
to become the seventh
leading cause of death
in the world by the
year 2030.
Total deaths from
diabetes are projected
to rise by more than 50%
in the next 10 years.
Diabetes: Quick facts and figures
8 0 % of diabetes deaths occur in low- and middle-income countries.
I n 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.
Diabetes: Health implications
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).
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.
B e 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.
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 F o o t 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.
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.
I n 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.
T h e risk of developing more than one of these diseases (co-morbidity) also increases with increasing body weight.
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.
Obesity: Quick facts and figures
More than 1.4 billion adults were overweight in 2008, and more than half a billion obese
In 2008, more than 1.4 billion
adults were overweight and more than half a billion were obese. At least 2.8 million people each year die as a result of being overweight or obese. The prevalence of obesity has nearly doubled between 1980 and 2008. Once associated with high-income countries, obesity is now also prevalent in low- and middle-income countries.
Obesity: Quick facts and figures
Globally, over 40 million preschool children were overweight in 2008
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.
Obesity: Quick facts and figures
Overweight and obesity are linked to more deaths worldwide than underweight
65% of the world's population
live in a country where overweight and obesity kills more people than underweight. This includes all high-income and middle-income countries. Globally, 44% of diabetes, 23% of ischaemic heart disease and 7–41% of certain cancers are attributable to overweight and obesity.
Obesity: Quick facts and figures
Supportive environments and communities are fundamental in shaping people’s choices and preventing 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.
Obesity: Quick facts and figures
The global obesity epidemic requires a population-based multisectoral, multi- disciplinary, and culturally relevant approach
WHO's Action Plan for the
Global Strategy for the Prevention and Control of Noncommunicable Diseases provides a roadmap to establish and strengthen initiatives for the surveillance, prevention and management of noncommunicable diseases, including obesity.
Noncommunicable diseases:
country income
About 30% of people dying from NCDs in low- and middle-income countries are aged under 60 years and are in their most productive period of life.
T h e prevalence of NCDs is rising rapidly and is projected to cause almost three-quarters as many deaths as communicable, maternal, perinatal, and nutritional diseases by 2020, and to exceed them as the most common causes of death by 2030.
I n most middle- and high-income countries NCDs were responsible for more deaths than all other causes of death combined, with almost all high- income countries reporting the proportion of NCD deaths to total deaths to be more than 70%.
Noncommunicable diseases: Current status and trends in risk
factors
Common, preventable risk factors underlie most NCDs.
These risk factors are a leading cause of the death and
disability burden in nearly all countries, regardless of
economic development.
T h e leading risk factor globally for mortality is:
1. raised blood pressure (responsible for 13% of deaths
globally),
2. followed by tobacco use (9%),
3. raised blood glucose (6%),
4. physical inactivity (6%),
5. overweight and obesity (5%).
Noncommunicable diseases: Current status and trends in risk
factors
The prevalence of these risk factors varied between country
income groups, with the pattern of variation differing between risk factors and with gender. High-, middle- and low- income countries had differing risk profiles.
Several risk factors have the highest prevalence in high- income countries. These include:
1. physical inactivity among women,
2. total fat consumption,
3. raised total cholesterol.
Some risk factors have become more common in middle- income countries. These include:
1. tobacco use among men,
2. overweight and obesity.
Noncommunicable diseases: parameters for estimation of behavioural
and metabolic risk factors
current daily tobacco smoking: the percentage of the
population aged 15 or older who smoke tobacco on a daily
basis.
physical inactivity: the percentage of the population aged
15 or older engaging in less than 30 minutes of moderate
activity per week or less than 20 minutes of vigorous
activity three times per week, or the equivalent.
raised blood pressure: the percentage of the population
aged 25 or older having systolic blood pressure ≥ 140 mmHg
and/or diastolic blood pressure ≥90 mmHg or on
medication to lower blood pressure.
Noncommunicable diseases:
parameters for estimation of behavioural and metabolic risk factors
raised blood glucose: the percentage of the population aged
25 or older having a fasting plasma glucose value ≥ 7.0
mmol/L (126 mg/dl) or on medication for raised blood
glucose.
overweight: the percentage of the population aged 20 or
older having a body mass index (BMI) ≥ 25 kg/m2.
obesity: the percentage of the population aged 20 or older
having a body mass index (BMI) ≥30 kg/m2.
raised cholesterol: the percentage of the population aged 25
or older having a total cholesterol value ≥ 5.0 mmol/L (190
mg/dl).
Noncommunicable diseases:
Prevention and Control of NCDs
Millions of deaths can be prevented by stronger
implementation of measures that exist today.
These include policies that promote government-wide
action against NCDs:
1. stronger anti-tobacco controls
2. promoting healthier diets,
3. physical activity,
4. reducing harmful use of alcohol;
5. along with improving people's access to essential health
care.
Noncommunicable diseases: Prevention and Control of
Noncommunicable Diseases
There is the 2008-2013 Action Plan for the
implementation of the WHO Global Strategy on the
Prevention and Control of Noncommunicable Diseases.
This Action Plan was endorsed by the 2008 World Health
Assembly.
I t provides countries a roadmap for taking action
against NCDs, including raising the priority of NCD
control, improving disease surveillance, enabling
governments to take comprehensive action against the
diseases, and protecting countries, particularly
developing, from the burden of the epidemic.
Noncommunicable diseases: The six objectives of the 2008-2013 Action
Plan are:
To raise the priority accorded to noncommunicable
disease in development work at global and national
levels, and to integrate prevention and control of such
diseases into policies across all government departments
To establish and strengthen national policies and plans
for the revention and control of noncommunicable
diseases
To promote interventions to reduce the main shared
modifiable risk factors for noncommunicable diseases :
tobacco use, unhealthy diets, physical inactivity and
harmful use of alcohol
Noncommunicable diseases: The six objectives of the 2008-2013 Action
Plan are:
To promote research for the prevention and control of
noncommunicable diseases
To promote partnerships for the prevention and control
of noncommunicable diseases
To monitor noncommunicable diseases and their
determinants
Evaluate progress at the national, regional and global
levels
First global ministerial conference on healthy lifestyles and noncommunicable disease control 28-29 April 2011, Moscow, the Russian Federation
The aim of the conference was to support Member States
develop and strengthen policies and programmes on healthy lifestyles and NCD prevention.
The conference had three main goals:
to highlight the magnitude and socio-economic impact of NCDs;
to review international experience on NCD prevention and control;
to provide evidence on the pressing need to strengthen global and national initiatives to prevent NCDs as part of national health plans and sustainable development frameworks
UN General Assembly ’s commitment
to fight noncommunicable diseases
U N General Assembly adopt of the political declaration
on the prevention and control of noncommunicable
diseases. For the first time, global leaders have reached
consensus in the General Assembly on concrete actions
to tackle these diseases.
Governments agreed on the need for global targets to
monitor these diseases and their risk factors like
tobacco use, unhealthy diet, physical inactivity and the
harmful use of alcohol.
UN General Assembly ’s commitment
to fight noncommunicable diseases Global leaders committed to greater efforts to prevent
and treat noncommunicable diseases and improve health care including better access to vital medicines.
Success will depend on the engagement of non-health sectors such as finance, agriculture, transportation, urban development, and trade.
Governments will integrate policies to reduce noncommunicable diseases into health planning processes and national development agendas.
T h e declaration is a clear signal that global leaders acknowledge the devastating impact of noncommunicable diseases worldwide and that they are committed to reducing it. The next step is to act on those commitments.