Introductory massage about NCD

1. Non-Communicable Diseases
Introduction
Dr. Mostafa Mahtab Toaha
MBBS, MPH (CM), PGDDP

2. Non-Communicable Disease
[NCD]
These are a group of chronic diseases where the causative agents are not
clearly identified, but a set of risk factors have been identified to be
associated.

3. Common NCDs in Bangladesh
 Cardiovascular diseases (CVDs):
- Coronary Heart Disease (CHD) / Ischemic Heart Disease (IHD)
- Hypertension
- Rheumatic Heart Disease (RHD)
 Cancer
 Mental illness
 Blindness.
 Diabetes
 Chronic Respiratory diseases
 Cerebro-Vascular Diseases (Stroke, TIA)
 Accident

4. Cardinal Characteristics of NCD
The commission on Chronic illness in USA has defined NCD as “Comprising
all impairments or deviations from normal, which have one or more of the
following characteristics:
1. are permanent.
2. leave residual disability.
3. are caused by non-reversible pathological alternation.
4. require special training of the patient for rehabilitation.
5. may be expected to require a long period of supervision, observation, or
care.”

5. Risk factors (R/F) of NCD
- Cigarette and other forms of smoking.
- Alcohol abuse.
- Failure or inability to obtain preventive health services (e.g.
hypertension control, cancer detection, management of diabetes).
- Life style changes (e.g. dietary patterns, physical activity).
- Environmental risk factors (e.g. occupational hazards, air & water
pollution, and procession of destructive weapons).
- Stress factors.

6. 04 types of NCDs:
Cardiovascular diseases, Cancer, Chronic Respiratory diseases and Diabetes
make the largest contribution to Mortality and Morbidity due to NCD.
04 behavioral R/F are responsible for significant proportions of these diseases:
Tobacco, unhealthy Diet, Physical inactivity, and unethical use of Alcohol.

7. Impacts of NCDs
- Loss of life.
- Disability.
- Family hardship.
- Poverty.
- Economic loss of the country.

8. Traits Communicable disease NCD
Transmission Transmitted from person to person Not transmitted person to person
Agent / risk factor Agent responsible There are some risk factors
Causative agent Usually (Single) Multi-factorial
Disease cycle Yes No
Incubation period Usually, short Long
Cellular alteration Usually, reversible Irreversible pathological
alteration
Vaccine Some have No Vaccine
Differences between Communicable & Non-Communicable Diseases

9. WHY WE STUDY NCD
SDG have 17 goals, whereas 3rd goal is devoted specifically to the Health.
Goal 3: Ensure healthy lives and promote well-being for all at all ages
Target 3.4: By 2030, reduce by one third premature mortality from non-
communicable diseases through prevention and treatment and promote mental
health and well-being.
• Indicator 3.4.1: Mortality of Cardiovascular Disease, Cancer, Diabetes or
Chronic Respiratory disease
• Indicator 3.4.2.: Suicide Mortality Rate

10. WHY WE STUDY NCD
Target 3.5: Strengthen the prevention and treatment of substance abuse,
including narcotic drug abuse and harmful use of alcohol.
Target 3.6: By 2020, halve the number of global deaths and injuries from the
road traffic accidents.
Target 3.b: Support the research and development of vaccines and medicines
for the communicable and noncommunicable diseases that primarily affect
developing countries…(shorten)

11. Gaps about the natural history of chronic diseases
 Absence of a known agent:
- Whereas in some chronic diseases the cause is known (e.g., silica in
silicosis, asbestos in mesothelioma).
- For many chronic diseases, the causative agent is not known.
 Multifactorial causation:
- Chronic diseases appear to result from the cumulative effects of multiple
risk factors
- These factors may be both environmental and behavioral or constitutional.

12. Gaps about the natural history of chronic diseases... Contd.
 Long latent period:
- Long latent/incubation period between the first exposure to "suspected cause"
and the eventual development of disease (e.g., cervical cancer).
- This makes it difficult to link suspected causes with outcomes, e.g., the possible
relation between oral contraceptives and the occurrence of cervical cancer.
 Indefinite onset:
- Most chronic diseases are slow in onset and development, and the distinction
between diseased and non-diseased states.

13. Preventive measures for NCDs
NCDs are multifactorial in causation, so their prevention demands a
complex mix of interventions.
1. Primary Prevention:
- Identification and Elimination of risk factors
- Modification of lifestyle patterns
- Case finding through screening and health examination technique.
- Application of improved method of diagnosis and treatment
- Control of food, water and air pollution
- Influencing human behavior and life-styles through intensive education
- Developing and applying better methods of comprehensive medical
care including primary health care.

14. 2. Secondary Prevention:
- Control of HTN and Diabetes
- Cassation of smoking control
- Control of alcohol & drug abuse.
- Healthy nutrition and exercise promotion
3. Tertiary Prevention
Finally, The integrated programme for the prevention and control of non
communicable diseases.

15. Get help from…
1. RKH
2. Park
3. Communicable and Non-communicable Diseases (Health Science Series) by
Kenneth L. Jones and etc.

16. ?