Non Communicable Diseases List And Prevention PdfBy Gifford G. In and pdf 13.05.2021 at 08:54 9 min read
File Name: non communicable diseases list and prevention .zip
According to the definition of WHO, NCDs are preventable diseases through lifestyle modification of the common causes such as unhealthy diet, physical inactivity, tobacco use and excessive alcohol use. For a narrow definition, it consists of cancer, diabetes, cardiovascular disease and chronic respiratory disease. There is yet to be a formal agreement if mental illness and trauma should be added into the group of NCDs although the issues have been widely discussed.
A noncommunicable disease is a noninfectious health condition that cannot be spread from person to person. It also lasts for a long period of time.
Most Common Noncommunicable Diseases
Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct.
Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work.
Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding. Introduction to prevention and control of non-communicable diseases. It was clear from the political resolution adopted at the summit that the NCDs were being recognized as a similar grave threat to global health and development, warranting concerted global action for prevention and control UN General Assembly The transition between and , in the framing of global development goals, also illustrates how NCDs have finally emerged on the radar screen of global health priorities.
This was despite the fact that NCDs had already become the leading cause of death globally towards the end of the twentieth century and tobacco had claimed about million lives in that century.
The descriptor emerged initially to indicate diseases which were considered to be non-infectious in origin and spread, at a time when global health was mainly concerned about infectious diseases. For the purpose of the UN high-level meeting, the World Health Organization WHO proposed to restrict the term to four major disease groups: cardiovascular diseases CVDs, which include stroke , diabetes, cancers, and chronic respiratory diseases such as asthma, emphysema, and chronic bronchitis.
These four groups of disorders, though very different in their clinical profile, are linked by four common risk factors: tobacco, unhealthy diet, physical inactivity, and alcohol. First, some of the cancers e. Behaviours too are vulnerable to change under the influence of cultural and commercial messages that are communicated to people. Third, where do mental illness, vision and hearing disorders, haemoglobinopathies like thalassaemia, musculoskeletal and gynaecological disorders, and some renal diseases fit in, if the term is restricted to four groups of diseases?
These too are unsatisfactory. Would it be better to choose a descriptor that is more directly linked to the common risk factors than to a disparate group of diseases? However, it must be recognized that the UN summit has now legitimized the term NCDs in the global health parlance.
The nomenclature has finally been registered on the consciousness of national policymakers across the world and, therefore, has come to stay. Global public health must accept the term as indicative of four major disease groups which are partly but not wholly linked by four risk factors and their determinants, and not quibble about which diseases are in or out. Conditions like mental illness will surely need attention and action, as will injuries and disabilities, p. Even when deaths under 70 years of age are considered, 48 per cent of the NCD related deaths in LMICs occurred below that age in , in comparison to 26 per cent in high-income countries HICs.
Comparisons of NCD mortality, across countries or regions, provide varying profiles, depending on which statistical measure is used. When absolute numbers of NCD-attributable deaths are considered, the LMICs account for the largest fraction because of their cumulative population size.
In every region of the world, other than sub-Saharan Africa, NCDs account for a higher proportion of deaths than the combined contribution of communicable diseases, pregnancy-related events, and nutritional deficiency.
This group features two dominant disorders, coronary heart disease CHD and cerebrovascular disease stroke. In addition, there are several other cardiovascular disorders like rheumatic heart disease, cardiomyopathies, hypertensive heart disease, and peripheral vascular disease.
Cancers contributed to 21 per cent of NCD deaths, chronic respiratory diseases to 12 per cent, and diabetes to 3.
Since deaths in people with diabetes are often due to CHD or stroke, its contribution to NCD mortality is larger than the directly attributed fraction suggests. Apart from mortality, disease burdens are also estimated in terms of disability-adjusted life years DALYs. There are considerable variations across the world in the profile of NCDs. In others, both forms are co-dominant. In general, the early stages of the CVD epidemic are marked by haemorrhagic stroke and hypertensive heart disease as the major manifestations of high blood pressure.
As societies move to high-fat diets and increased rates of smoking, thrombotic CVDs CHD and thrombotic stroke become prominent. In cancer too, there is considerable geographic variation in the types of cancers that are most frequent. This is related to variations in patterns of diet, tobacco consumption, alcohol use, and exposure to cancer-causing viruses. Based on models of demographic and developmental transitions expected to occur over the coming two decades, the WHO estimates that the number of deaths attributable to NCDs would rise to 55 million by , if urgent measures are not taken to contain the threat of these diseases.
This will amount to 70 per cent of all global deaths that year. Action would be needed not only on timely diagnosis and treatment of manifest disease but, more importantly, on the prevention and control of risk factors before they result in disease. NCDs also have an adverse impact on the economy, at national and global levels. This is due to the combined burden of healthcare costs and productivity losses resulting from deaths in working age and disease-related disability that curtails the ability to engage in fully productive work.
NCDs also result in catastrophic health expenditure and can push families into poverty because of unaffordable costs of technology-intensive medical care Heeley et al. Among the several risk factors associated with NCDs, three categories can be identified: biological, behavioural, and socioeconomic.
Of these, the four behavioural risk factors identified by the WHO unhealthy diet, physical inactivity, tobacco consumption, and harmful use of alcohol are positioned centrally. They are influenced upstream by socioeconomic determinants like education and income that operate at the individual level, and societal factors like trade policies, urban design and transport, media and cultural influences that operate at the population level.
Behaviours in turn have a substantial impact on biological risk factors like blood pressure, body weight, body shape central obesity , blood lipids, and blood sugar which are the downstream mediators of risk. While the four behavioural risk factors are indeed the main contributors to NCDs, becoming the critical link between social determinants and biological causes, there are other risk factors p.
These vary from viruses causing cancer, to indoor and outdoor air pollution causing respiratory diseases and CVDs. Family history plays a role too, but the focus of a public health strategy must be on modifiable risk factors. The role that genetic factors play has not been sufficiently well defined to predict risk in many NCDs.
Disorders like CHD and maturity-onset diabetes are polygenic and the variability explained by the identified genes so far is low. Study of gene—environmental interactions in NCDs suggests that the environment is the dominant determinant in the development of these conditions Florez et al. However, genetic markers are more prominently associated with some cancers and help in risk prediction and targeted therapy.
The role of epigenetics, wherein gene expression is altered by environmental exposures such as tobacco, diet, and chemical pollutants, is now coming to the fore. Similarly, the role of early life influences, of fetal and childhood nutrition and growth, is being invoked to explain adult susceptibility to NCDs Barker et al. Further research in these areas may help to better identify population groups and individuals at a high risk of one or more of the NCDs.
The GBD supports this approach by revealing that the four major behavioural risk factors and high blood pressure account for the largest fraction of global deaths and disability Lim et al. Similarly the population mean of systolic blood pressure has declined or stabilized in HICs but has risen and is now the highest in LMICs Danaei et al. Overweight and obesity are continuing to rise in prevalence across all regions of the world.
Diabetes too is escalating as a global epidemic, with LMICs dominating the league table of countries with the largest numbers of people with diabetes International Diabetes Federation Alongside the global transition, where NCD mortality rates are stabilizing or declining in HICs but rising in LMICs, there is also evidence of a progressive reversal of the social gradient as the epidemics mature.
In the early stages of the NCD epidemics, harmful behaviours are more often associated with the higher disposable incomes of the rich, placing them in the high-risk category. However, as the epidemics advance, mediators of risk are mass produced for mass consumption and the ubiquitous presence of tobacco, alcohol, processed foods, labour saving devices, and motorized transport systems writes the prescription for mass epidemics.
At a later stage, the affluent and educated sections benefit from their greater access to information, health services, healthy foods, and leisure time exercise to avoid or reduce the risk of NCDs. On the other hand, the poor and less educated sections have inadequate knowledge of NCDs and their risk factors, cannot afford regular purchase and consumption of fruit, vegetables, healthy oils, and fish, which are often costlier than unhealthy processed foods, and usually lead more stressful lives.
In such a mature epidemic, the poor will be the most vulnerable victims and experience the highest burden of NCDs Reddy et al. Across the world, different stages of this transition are evident in different regions, based on the level of economic and social development.
Health services are frequently confronted by the challenge of balancing a broad public health response focusing on the determinants which operate at the population level and a medical response which places emphasis on providing clinical care to individuals with manifest disease or at a high risk of developing it.
This challenge is often exacerbated by the limited resources available to the health system, especially in LMICs. For example, abundant evidence, gathered from both observational epidemiology and clinical trials, enables us to state the following principles of risk for CVD:.
Risk operates in a continuous manner, and not across arbitrary thresholds. This is true of biological variables like blood pressure, blood cholesterol, blood sugar, body mass index, and even to the number of cigarettes smoked per day.
Most adverse events arise in a population in people in the mid-range of a risk factor distribution—while high levels of any risk factor place individuals at higher relative risk, the majority of people in a population have risk factor levels in the mid-range and, therefore, contribute to the largest number of events.
When multiple risk factors coexist, the overall risk is additive. In all populations, the majority of the CVD events arise in people with concurrent elevation of many risk factors rather than in individuals with a high level of a single risk factor. Based on this, we can derive the principles of prevention:. Small reductions in risk factor levels, when achieved across the whole population, result in a large reduction of CVD events.
Non-drug measures prevent risk across the whole population and reduce it in people who have already acquired a high-risk profile. Drug therapy to reduce risk is most cost-effective in people who are at high risk of adverse events in the next 10 years. Best results are achieved through a combination of population-based prevention and high-risk individual management approaches.
Healthy diet, regular physical activity, and avoiding harm from alcohol can not only help individuals to lower blood pressure, but can shift the population distribution of blood pressure to the left, with a lower mean. This will substantially reduce the burden of CHD and stroke in that population. For further discussion, see Chapter 8. While these principles are derived from CVD epidemiology, they are also applicable to other NCDs where behavioural risk factors translate into biological risk.
They would hold true for the relationship of body mass index, central obesity, and physical inactivity to diabetes or the relationship of air pollution to chronic respiratory diseases. Similarly, the risk of cancer with tobacco exposure has a continuous relationship. This makes a strong case p. The fact that many biological risk factors are driven by a clustering of behaviours also provides the rationale for a strategy that focuses on the four behavioural risk factors identified by the WHO.
Blood lipids, blood sugar, blood pressure, and obesity are influenced by diet, physical activity, and alcohol. Tobacco interactively amplifies the risk of each of these biological risk factors for NCDs. Action on these risk behaviours, therefore, will provide great benefits to populations as well as individuals by reducing the levels and effects of several biological risk factors. In relation to the risk factors for NCDs, changing the behaviours of individuals is essential but is difficult and will take a concerted effort over a long time.
More research is also required to ascertain the most effective ways in which this could be achieved, especially in the current global context where so much health-related information, and misinformation, is transmitted and shared through the Internet and social media networks, often on a peer-to-peer basis. It is critical, in parallel, to change environmental factors so as to create settings and environments that actively promote healthy behaviours and activities.
A comprehensive and integrated strategy should therefore encompass effective public health interventions to minimize risk factor exposure in the whole population and to reduce the risk of disease-related events in individuals at high risk. As this combination of the population approach and the high-risk approach is synergistically complementary, cost-effective, and sustainable, such an approach provides the strategic basis for early, medium-term, and long-term impact on NCDs.
The response to NCDs, therefore, requires concerted action at the level of policy, health systems, community action, and individual behaviours. Since the determinants of risk are driven by many social forces, including social inequalities that expose vulnerable segments of society to greater risks and reduced access to health promoting programmes, screening, and medical care, a comprehensive policy response is necessary, involving several sectors such as agriculture, food processing, urban design and transport, commerce, education, and communication.
Tobacco control, for example, requires higher taxes on all tobacco products, a ban on tobacco advertising, effective health warnings, and smoke-free public and work places. Promotion of healthy diets would need availability of fruit, vegetables, and healthy oils at affordable prices and reduction of salt, sugar, and trans and saturated fats, in processed foods.
Communicable Disease Control Manual
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Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding. Introduction to prevention and control of non-communicable diseases.
ANNEX 2: LIST OF COUNTRIES BY WORLD BANK INCOME GROUPS in strengthening NCD prevention and control pdf, accessed 9 June ). 4.
Malnutrition and unhealthy diets are important risk factors for non-communicable diseases. Francesco Branca and colleagues call for changes in both what and how food is produced, marketed, and consumed. Malnutrition is a key risk factor for NCDs. It also includes excessive and imbalanced intake, leading to overweight, obesity, and diet related NCDs.
The burden and true costs of malnutrition and diet related NCDs
Она сомневалась, что Танкадо мог передать ключ какому-то человеку, который не приходился ему близким другом, и вспомнила, что в Штатах у него практически не было друзей. - Северная Дакота, - вслух произнесла она, пытаясь своим умом криптографа проникнуть в скрытый смысл этого имени. - Что говорится в его посланиях на имя Танкадо. - Понятия не имею. КОМИНТ засек лишь исходящую почту. В данный момент мы ничего не знаем про Северную Дакоту, кроме анонимного адреса.
- Сэр, мне кажется… что с ТРАНСТЕКСТОМ какая-то проблема. Стратмор закрыл дверцу холодильника и без тени волнения взглянул на Чатрукьяна. - Ты имеешь в виду работающий монитор. Чатрукьян растерялся. - Так вы обратили внимание. - Конечно. Он работает уже шестнадцать часов, если не ошибаюсь.
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Сьюзан, - сказал Стратмор, уже теряя терпение, - директор не имеет к этому никакого отношения. Он вообще не в курсе дела. Сьюзан смотрела на Стратмора, не веря своим ушам. У нее возникло ощущение, что она разговаривает с абсолютно незнакомым человеком.
Вы хотите отправить его домой.
И самый мерзкий пляж, покрытый острыми камнями. Этого и ждут от меня читатели. Больные на соседних койках начали приподниматься, чтобы разглядеть, что происходит.
Не жалуюсь. Джабба вытер губы. - Ты на месте. - А-га.
Кровь не. Выпустите меня отсюда. - Ты ранена? - Стратмор положил руку ей на плечо. Она съежилась от этого прикосновения. Он опустил руку и отвернулся, а повернувшись к ней снова, увидел, что она смотрит куда-то поверх его плеча, на стену.
Выдержав паузу, он как бы нехотя вздохнул: - Хорошо, Грег. Ты выиграл. Чего ты от меня хочешь.
На экране перед ними высветилось сообщение об ошибке: НЕДОПУСТИМЫЙ ВВОД. ТОЛЬКО В ЦИФРОВОЙ ФОРМЕ - Черт его дери! - взорвался Джабба. - Только цифровой. Нам нужно число. Он нас надул.
- Но пока этого не произошло, мы в цейтноте. Сьюзан открыла рот, желая сказать, что она все понимает, но ее слова были заглушены внезапным пронзительным звуком. Тишина шифровалки взорвалась сигналом тревоги, доносившимся из служебного помещения ТРАНСТЕКСТА.
Немедленно. Соши побежала к своему терминалу. Джабба нередко прибегал к ВР, что в компьютерных кругах означало виртуальная реальность, но в АНБ это сокращение имело несколько иной смысл - визуальная репрезентация.
Мне сказали, что вы сегодня отличились. Вы позволите поговорить с вами об. Беккер заколебался.
Справа бесконечной чередой мелькали кадры, запечатлевшие последние минуты Танкадо: выражение отчаяния на его лице, вытянутую руку, кольцо, поблескивающее на солнце. Сьюзан смотрела на эти кадры, то выходившие из фокуса, то вновь обретавшие четкость. Она вглядывалась в глаза Танкадо - и видела в них раскаяние. Он не хотел, чтобы это зашло так далеко, - говорила она .
Сьюзан открыла один из каналов. На экране высветилось предупреждение: Информация, содержащаяся в этом файле, предназначена исключительно для научного использования. Любые частные лица, которые попытаются создать описанные здесь изделия, рискуют подвергнуться смертоносному облучению и или вызвать самопроизвольный взрыв. - Самопроизвольный взрыв? - ужаснулась Соши. - Господи Иисусе.
Сьюзан услышала глухой хлопок, когда уже спустилась на несколько пролетов. Звук показался очень далеким, едва различимым в шуме генераторов. Она никогда раньше не слышала выстрелов, разве что по телевизору, но не сомневалась в том, что это был за звук.