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NON COMMUNICABLE DISEASE(NCDs)

PRESENTED BY:Dr Rani Komal Lata

NON COMMUNICABLE DISEASE: A MISNOMER!

A difficult group to define

Not all non-communicable• some caused by bacteria or viruses.• some diseases like cancers of the liver, stomach, and cervix

Not all chronic

• may be cured in early stage by appropriate heath interventions

Not the diseases of affluence anymore!• Shifted from being epidemic in rich countries to truly Internationally Pandemic!

‘The risk of the global transfer of infectious disease has increased’

Source:More with Less:Disasters in an Era of Diminishing Resources:By Kevin M. Cahill

Communicable Diseases/Infections With Overwhelming Evidence Of Causing NCDs

Disease AgentChronic gastritis Helicobacter pyloriPeptic ulcer Helicobacter pyloriHaemolytic—uraemic syndrome Escherichia coli 0157Hepatocellular cancer Hepatitis B Cervical cancer Human Papilloma Virus (HPVCongenital rubella syndrome Rubella virus infectionCongenital mental retardation Cytomegalovirus (CMV)Rheumatic heart disease Streptococcal infectionAcute glomerulonephritis Streptococcal infection

Source :World Health Organization 2013 ,Communicable Disease Newsletter, Volume 10 Issue 2, May 2013

Communicable diseases/infections as possible causes of NCDs

DISEASE AGENTGuillain-Barre syndrome Campylobacter jejuniBell’s palsy Herpes simplex virusInsulin dependent diabetes EnterovirusReactive arthritis Salmonella spp., Yersinia spp.,

ChlamydiaKaposi’s sarcoma Human Herpes Virus 8Castleman’s disease Human Herpes Virus 8Thrombotic thrombocytopenic purpura

Escherichia coli 0157

Atherosclerosis Chlamydia pneumoniae, CMV

Source :World Health Organization 2013 ,Communicable Disease Newsletter, Volume 10 Issue 2, May 2013

NCD: WHY TO BE STUDIED?

TRENDS

 

36 MILLION PREMATURE

DEATHS(2008)

LIKELY TO CAUSE 55 MILLION

DEATHS BY 2030

Cardiovascular Disease And Cancers :Biggest Cause Of Mortality Worldwide.

PROJECTED TO AFFECT 471 MILLION BY 2035.

Source: WHO Europe (2014), Non-communicable diseases, World Health Office Regional Office for Europe, Copenhagen, Denmark, accessed 12 September 2014.

TRENDS

SENILE

DEMENTIA Currently affects 44

million people Projected to rise to

135 million worldwide by 2050

With 96 million of them in developing

countries.

TOBACCO Accounts for almost 6 million

premature deaths a year

Projected to rise to 8

million by 2030

OBESEITY Currently 10

% of the world’s adults In 2012, more than 40 million

children under the

age of 5 were either

overweight or obese.

1. Alzheimer’s Disease International (2013), 'The Global Impact of Dementia 2013–2050', Alzheimer’s Disease International, London, UK.

3. WHO (2014), Obesity and overweight, Factsheet, World Health Organization, Geneva, Switzerland, accessed 4 September 2014.2. WHO (2013), Noncommunicable diseases, Factsheet, World Health Organization, Geneva, Switzerland, accessed 4 September 2013

Source: Database At A Glance: Non Communicable Diseases: Rachel Neill, 18 August 2014

NCD:A PUBLIC HEALTH ISSUE

Increased life expectancy

Environmental health risks

Economic inequality, pove

rty and food insecurity

Rapid technological development 

Growing antibiotic resistance

Competition for global resources

Source: Changing disease burdens and risks of pandemics (GMT 3), European Environment Agency,01 Jun 2015

Level of approach by Public Health Sector

PREVENTION

• Intersectorial planning for health promotion

• Training of health personnel

• Designing of policies

DETECTION

• Surveillance to determine prevalence of risk factors

• Evaluation of intermediate risk factors

Source:N Engl J Med 2013;369:1336-43. DOI: 10.1056/NEJMra1109345

Source: PAHO, OAS launch task force to tackle NCDs June 22, 2015 By GuyanaTimes