Non communicable disease and risk factors inthe context of nepal

1. Presented By:
Rabin Dani

2. CONTENT
• Introduction
• Characteristics of NCDs
• Risk factors and NCDs
• Status of NCDs in Nepal
• WHO global NCDs target
• References
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3. Introduction
Non-communicable disease:
• Impairment of bodily structure or functions that
necessitates a modification of the patient’s normal life
and has persisted over extended life period of time.1
1–
EURO symposium, 1957
• Non communicable diseases are the leading cause of
death today and are on the increase.
• Nearly 80% of these deaths occurred in low- and
middle-income countries.
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4. • More 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.
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5. Characteristics of NCD’S :
• Caused by non- reversible pathological alteration
• They require a long term systemic approach to treatment.
• Have long latent period between the exposure and
causes.
• Are permanent
• Mostly irreversible.
• Disability and fatality rate is high
• Require special training of the patient rehabilitation
• NCDs have emerged as the major causes of morbidity
and mortality worldwide.
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6. What are the main noncommunicable diseases?
Heart disease and strokeHeart disease and stroke
DiabetesDiabetes
CancerCancer
Chronic respiratory diseaseChronic respiratory disease
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eg:
Chronic
bronchitis,
Emphysema,
Asthma
Eg: Coronary Heart Disease
(CHD),
Cerebrovascular disease,
Hypertension,
Heart failure,
Stroke

7.  Nervous and mental diseases
 Musculoskeletal condition such as arthritis and allied
diseases
 Permanent results of accidents
 Renal diseases
 Blindness
 Obesity and various other metabolic and degenerative
disease
 Chronic result of communicable diseases
Other Non communicable diseases (NCDs)
include:
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8. Why is tackling NCDs a priority?
"Among both men and women,
most deaths globally are due to
noncommunicable conditions"
Out of every 10 deaths:
-6 are due to noncommunicable
conditions
-3 to communicable,
reproductive or nutritional
conditions
-1 is due to injuries
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9. Source: WHO Global Health Estimates 2014 (Year: 2012), Deaths by age group
NCD deaths as a proportion of all deaths, 2012
NCDs and nutritional
conditions
Infectious and parasitic diseases,
respiratory infections
Maternal and neonatal
conditions Injuries
Ages 0 – 29
11 million deaths
2 million NCD deaths
Ages 30 – 69
20 million deaths
14 million NCD deaths
Ages 70+
25 million deaths
22 million NCD deaths
Largely
preventable
deaths
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10. Risk factors:
• The risk factors for many of the NCDs are associated
with lifestyle related choices, environmental and genetic
factors. Tobacco use, harmful use of alcohol, unhealthy
diets (high in salt, sugar and fat and low in fruits and
vegetables) and physical inactivity are some of the
established behavioral risk factors of NCDs.
• These risk factors have 80% contribution in the
development of NCDs.
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11. Risk factors and NCDs
“Lifestyle diseases” caused by “Behaviours”
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12. The risk factors and globally current status of
mortality by NCDs are:
1. Major behavioural risk factors:
1. Tobacco use (cigarette use and other forms of
smoking 9 % death/year)
2. Harmful alcohol consumption
3. Unhealthy diet (low fruit and vegetable
consumption)
4. physical in activity (6% death globally/year)
5. Stress factors etc.
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Source: WHO Global Report " Preventing Chronic Disease: A Vital Investment, 2005’’

13. 2. Major biological risk factors and deaths :
 Over weight (BMI) ≥25 kg/m2 and Obesity (BMI) ≥30
kg/m2.
(5% deaths globally/year)
 Raised blood pressure (responsible for 13% of deaths
globally/year),
 Raised blood glucose fasting plasma glucose value ≥ 7.0
mmol/L (126 mg/dl) (6%death /year),
 Abnormal blood lipids and its subset raised total cholesterol
(total cholesterol value ≥ 5.0 mmol/L (190 mg/dl))
3. Other risk factors
2. Failure to obtain preventive services
3. Environmental factors etc. (eg. Occupational hazards, water
pollution )
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14. Trends in risk factors
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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.
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15. Status of NCD’s in Nepal8
According to the WHO Global Report " Preventing Chronic Disease: A Vital
Investment, 2005’’
51% of total deaths are caused by NCD, of which;
 CVD holds the top most position with 21% of all deaths,
 followed by cancer (7%),
 Chronic respiratory disease (5%),
 and Diabetes (2%).
Road traffic injuries account for 9% of all deaths,
 other chronic disease and rest of the chronic diseases being 7%.
• This composition is similar to Regional scenario. WHO global info base provides
a projection for the year 2030, which suggest a 66.2% increase in deaths caused
by CVD and 71.4% by Cancer.
8-Non-communicable Diseases: Emerging Trends and Socio-economic impact ,Dr. Mahesh Maskey MBBS, MPH, DSc. ,Executive
Chair, Nepal Public Health Foundation,17 Sept, 2010.

16. WHO 9 global NCD targets to be attained by 2025:
(WHO 2010 baseline)
1.A 25% relative reduction in risk of premature mortality from
cardiovascular disease, cancer, diabetes or chronic respiratory diseases
2.At least a 10% relative reduction in the harmful use of alcohol
3.A 10% relative reduction in prevalence of insufficient physical activity
4.A 25% relative reduction in prevalence of raised blood pressure or
contain the prevalence of raised blood pressure
5.A 30% relative reduction in prevalence of current tobacco use
6.Control to rise in diabetes and obesity
7.A 30% relative reduction in mean population intake of salt/sodium
8.An 80% availability of the affordable basic technologies and essential
medicines, incl. generics, required to treat NCDs
9.At least 50% of eligible people receive drug therapy and counselling to
prevent heart attacks and strokes
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17. References:
1. EURO sumposium, 1957
2. Commission of Chronic Illness, USA
3. World Health Report 2004
4. Menzies Research Institute Tasmania. Non-communicable Diseases. [cited
2010 20 August]
5. World Health Report 2004
6. World Health Report 2005
7. Habib SH, Soma S. Burden of non communicable disease: Global overview.
Health Economics Unit, Diabetic Association of Bangaladesh, 122 Kazi Nazrul
Islam Avenue, Dhaka 1000, Bangaladesh (available online April 1, 2010)
8. WHO Global Report " Preventing Chronic Disease: A Vital Investment, 2005’’

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18Have a Nice Day……