DISEASE PATTERN IN DEVELOPING COUNTRY

BY : MBA (HM)

1st semester

INTRODUCTION

Developing country”

nation with a low level of material well-being.

Developing countries are in general countries which have not

achieved a degree of industrialization relative to their population.

LIST OF DEVELOPING COUNTRIES

INDIA CHINA

BANGLADESH SOUTHAFRICA

ARGENTINA BRAZIL

INDONESIA MALAYSIA

GHANA PAKISTAN

TURKEY THIALAND

IN A TYPICAL DEVELOPING COUNTRY ABOUT 40%OF DEATH ARE FROM INFECTIOUS ,PARASITE,AND RESPIRATORY DISEASES COMPARED WITH ABOUT 8%IN DEVELOPED COUNTRIES

IN INDIA ,AS IN OTHER DEVEOPING COUNTRIES ,MOST DEATH RESULT FROM INFECTIOUS AND PARASITE DISEASE,ABETTED BY MALNUTRITION.

-> DIARRHOEAL DISEASES ARE WIDESPREAD.

-> CHOLERA HAS SHOWN DECLINE TREND.

Non communicable diseases (NCD) are the major health burden in the industrialized countries, and are increasing rapidly in the developing countries owing to demographic transitions and changing lifestyles among the people.

  Disease

Annual mortality rate

Annual infection rate

1. Lower respiratory infections

4 million —

2. HIV/AIDS 3 million 39.4 million1

3. Malaria 1–5 million 300–515 million

4. Diarrhea 2.2 million 4 billion

5. Tuberculosis 2 million 8 million

6. Measles 530,000 30 million

7. Whooping cough 200,000–300,000 20–40 million

8. Tetanus 214,000 500,000

9. Meningitis 174,000 1 million +

10. Syphilis 157,000 12.2 million1

Top Deadly Diseases of the Developing World

ON THE OTHER HAND ,AN INCREASE IN FREQUENCY OF NEW HEALTH PROBLEMS SUCH AS CORONARY HEART DISEASE ,HYPERTENSION ,CANCER,DIABETES,AND ACCIDENT HAVE BEEN NOTED.

ALONG WITH THE DEVELOPMENT OF INDUSTRIES ,VARIOUS OCCUPATION D/S EG.PNEUMOCONIOSIS IS ON INCREASE.

THE EMERGING PICTURE IS A MIXTURE OF THE OLD AND MODERN DISEASE.

MEANING OF DISEASE PATTERN

• Factors determining and influencing frequency and distribution of disease.

• Cause , distribution and control of diseases in a population.

Reason for shift

Sudden and stark increase in population growth rate.

Medical innovation in diseases.

Development in healthcare system.

Reduced infant mortality and fertility rate.

Growing industrialisation, gobalisation, and urbanization.

Social and lifestyle changes.

DISEASES FOUND IN DEVELOPING COUNTRIES.

COMMUNICABLE / INFECTIOUS DISEASE S

NON COMMUNICABLE/CHRONIC DISEASES

NON-COMMUNICABLE DISEASES

Medical condition or disease which is in non-infectious

Disease that is not transmissible from infected host to another

Disease of long duration and slow progression

Include many environmental diseases ,covering avoidable & unavoidable human health conditions caused by external factors such as :

Sunlight

Food

Pollution

Life style choices

Examples: Cardiovascular diseases (CVD)

Chronic obstructive pulmonary diseases (COPD)

Cancer

Stroke

Diabetes mellitus

Genetic disorders

Chronic kidney diseases

Allergies

COMMUNICABLE DISEASES

Infectious disease.

Transmissible disease.

Disease that is contagious.

Agent of disease is transmitted from infected host to another.

Comprise clinically evident illness resulting from infection, presence & growth of pathogenic biological agents in an individual host organism.

Transmitted through :

Fluid exchange (e.g. blood) or

Vector (e.g. mosquitoes)

Examples: HIV/AIDS

Tuberculosis

Malaria

meningitis

Hepatitis

Anthrax

Chicken pox

Cholera

Dengue fever

Gonorrhea

Leprosy

Measles

Tetanus

DISEASE PATTERN

The rapidity of the changes in developing countries is such that a double burden of disease may often exist.

Hunger and malnutrition

It includes death, disability, stunted mental and physical growth, and as a result, retarded national socioeconomic development.

Some 60% of the 10.9 million deaths each year among children aged under five years in the developing world are associated with malnutrition.

Traditional diets and lifestyles are changing, thus food insecurity and undernutrition persist along with chronic diseases.

The epidemic of obesity exists along with heart disease, hypertension, stroke, and diabetes.

Increasing prevalence of obesity indicates that physical inactivity is an increasing problem .

On a global basis, 60 % of the burden of chronic diseases will occur in developing countries, and by 2020, 70% of deaths will occur due to diabetes.

Cardiovascular diseases are even now more numerous in India and China than in all the economically developed countries in the world put together.

As for obesity, current prevalence has reached unprecedented levels, and is increasing at a substantial rate annually.

The public health implications of this phenomenon are staggering, and already becoming apparent.

DOUBLE BURDEN OF DISEASE

The rapidity of the changes in developing countries is such that a double burden of disease may often exist.

Hunger and malnutrition

It includes death, disability, stunted mental and physical growth, and as a result, retarded national socioeconomic development.

Some 60% of the 10.9 million deaths each year among children aged under five years in the developing world are associated with malnutrition.

Traditional diets and lifestyles are changing, thus food insecurity and undernutrition persist along with chronic diseases.

The epidemic of obesity exists along with heart disease, hypertension, stroke, and diabetes.

Increasing prevalence of obesity indicates that physical inactivity is an increasing problem .

DISEASE TRENDS IN INDIA

Initial burden -> infectious diseases, maternal and child mortality.

Present status -> non communicable diseases, injuries and geriatric

problems.

Communicable diseases pattern in India :

Small pox and guinea worm are eradicated.

Yaws and plague are under control.

Cholera : 1,76,307 with 86,997 death in 1950

now total cases are 5,000 and mortality is also low.

Tuberculosis is not controled because of poor management, unavailability of drugs and incomplete treatment.

AIDS /HIV increases from the past one and half decade.

Non communicable disease pattern in India : As a result of industrilization , socio economic

development, urbanization and changing life styles, India is facing growing burden of Non communicable diseases.

32% of deaths are due to NCDs.

13% due to cardiovascular diseases.

8.7% injuries.

6.7% chronic respiratory diseases

3.4% cancer

0.2% diabetes

10 – 15% hypertension

DISEASE PATTERN IN BANGLADESH

Communicable diseases were the major health hazardsPoor nutrition and sanitation Infectious diseases--cholera, dysentery, diarrhea,

measles, diphtheria, helminthiasis-- were responsible for widespread illness and numerous deaths

Noncommunicable diseases such as diabetes, cardiovascular diseases, mental illness, gastrointestinal disorders, cancer, respiratory disease, and urogenital diseases were increasing in frequency in the 1980s.

COMMUNICABLE DISEASE IMPACT

Mortality due to infectious d/s

Morbidty(daly’s)lost

World poorest 20%

59% 64%

World richest 20%

8% 11%

World total 34% 44%

Causes of Death 1998 (WHO)

Communicable Disease Control, Global and Local: Methods

Immunization (measles and many more)

Chemotherapy (STD’s, TB)

Water, sanitation & washing (many)

Vector control (malaria, yellow fever etc.)

Education/behaviour change (HIV etc. etc.)

Regulatory measures (pasteurization, quarantine etc.)

**Socioeconomic development

Objectives

A global perspective on the frequency and impact of communicable diseases

Appreciation of the distribution of various representative communicable diseases

An introduction to the principles and practice of communicable disease control

An introduction to the idea that International Health can be fascinating and rewarding

NOTE: To teach the pathophysiology or life cycle of various tropical and communicable diseases

DISEASE PATTERN IN THAILAND

• In Thailand dramatic change in the disease pattern have occurred as non-communicable diseases were on the rise but burden from HIV/AIDS resulting from the epidemic in the 1990s remains high and injuries show negligent change.

• Total disease burden in 2004 amounts to 5.7 million DALYs in men and 4.2 million DALYs in women were a little higher than those in 1999.

• The proportion of burden from premature deaths in 2004 decreased among men, from 75% to 69% and from 65% to 62% among women, indicating increasing proportion of non fatality conditions for which people lived in disabilities.

• HIV/AIDS burden considerably reduced from 32.3 to 21.1 DALYS per 1,000 population in men but moderately reduced in women (12.2 to 9.3). This indicates second wave of epidemic spread by sexual relation with long-term female partners.

• Apart from non-fatal diseases, DM, COPD, and Asthma had lower share of burden from premature deaths ranging from 49 to 68 per cent.

Leading causes of DALY’S(000’s) in thailand, 1999 and 2004

Diseases Total %

In 1999

Total %

In 2004

Men Women

Men Women

HIV/AIDS 17.2 9.4 11.5 7.1

Stroke 4.8 7.1 5.9 7.6

Ischemic Heart Disease 2.9 2.8 3.2 4.6

Diabetes 4.8 7.1 5.9 7.6

Traffic accidents 9.2 2.9 10.4 3.0

Liver cancer 4.4 3.0 4.9 3.0

COPD 2.8 2.4 3.2 2.6Lower Respiratory tract infection 1.5 2.1 1.8 2.2

Asthma 0.9 1.1 1.5 2.3

Depression 1.7 3.7 2.4 4.6

Source: Bandhamacharoen et al BMC Public Health 2011 doi 10.1186/1471-2458-11-53

Disease trend in china

The ageing of the population is the major force driving the epidemic of chronic diseases is estimated 80% of total deaths.

COMMUNICABLE DISEASES

HIV/ AIDS epidemic in china. Due to high prevalence of homosexuality, unsafe sex ,infected blood donation.

According to WHO avian influenza is a challenge for a country in recent years.

WHO global targets for detecting and treating TB cases. But still TB is common in china.

Non-Communicable diseases

It is expected that there will 200% increase in cardio vascular diseases by 2040 due to increase in ageing population.

Due changing lifestyle obesity, hypertension and diabetes are fast emerging major non communicable diseases.

Due to ageing Alzheimer is emerging as prominent chronic diseases.

Due to excess use of tobacco chronic respiratory disease and cancer are emerging as a major problem in china.

DISEASE PATTERN IN SOUTH AFRICA

Ranking of Communicable Diseases By DALYs

Disease Condition Disease Burden

HIV-AIDS 84.5 million

Neglected Tropical Diseases 56.6 million

Malaria 46.5 million

Tuberculosis 34.7 millionHotez PJ, Molyneux DH, Fenwick A, Ottesen E, Ehrlich Sachs S, Sachs JDPLoS Medicine 2006; 3: e102

The Neglected Tropical Diseases: Humanity’s Ancient Diseases of Stigma and Poverty

13 Parasitic and Bacterial Infections Rural Areas of Low-Income Countries Poverty-Promoting Conditions

Child Development & Education Pregnancy Worker Productivity

Burdened humanity for centuries “The Biblical Diseases”

Disabling and deforming Associated with intense stigma

River Blindness Guinea Worm Lymphatic Filariasis

Leprosy