NON COMMUNICABLE DISEASES
I. Integrated community-based non-communicable diseases (NCD) prevention and control program aimed at preventing the 4 major NCD or chronic diseases or lifestyle-related disease
FOUR MAJOR NCD
a. Cardiovascular diseases
b. Cancer
c. Chronic Obstructive Pulmonary disease d. Diabetes mellitus
II. Prevention and control of other NCD particularly mental disorders, blindness, renal disease and programs for persons with disabilities
NON COMMUNICABLE DISEASES
NON COMMUNICABLE DISEASES
NON COMMUNICABLE DISEASES
3 MAJOR RISK
1. Tobacco smoking 2. Physical inactivity 3. Unhealthy diet
4. Alcohol consumption
GOAL
Reduce the toll of morbidity, disability and premature deaths due to chronic, NCD, lifestyle related disease
NON COMMUNICABLE DISEASES
OBJECTIVES:
1. Analyze the social, economic, political and behavioral determinants of NCD that will serve as bases for:
a. Developing policy guidelines
b. Providing financial measures to support NCD
2. Reduce exposure of individuals and population to major determinants of NCD
3. Strengthen health care for people with NCD through health sector reforms and cost effective interventions
NON COMMUNICABLE DISEASES
HEALTH EDUCATOR
• Essential toll to achieve community health
• Concern with promoting health as well as reducing behavior induced diseases
Health educator aims to:
a. Inform the people
b. Motivate the people
c. Guide the people into action
4 NON COMMUNICABLE DISEASES
1. CARDIOVASCULAR DISEASES
A. Hypertension (HPN)
B. Coronary Artery Disease (CAD)
C. Cerebrovascular Disease / Stroke
2. CANCER
3. CHRONIC OBSTRUCTIVE PULMONARY DISEASE
4. DIABETES MELLITUS
1. CARDIOVASCULAR DISEASES
CARDIOVASCULAR DISEASE – diseases of the heart and blood vessels
A. HYPERTENSION (HPN)
- HPN or high blood pressure is defined as
sustained elevation in mean arterial pressure. It is not a single disease state but a disorder with many causes, a variety of symptoms
and a range of responses to therapy
1. CARDIOVASCULAR DISEASES
ETIOLOGY/CAUSES:
There is no single cause for HPN but several risk factors have been implicated in its development:
a. Family History- people with positive family history of HPN are twice at risk than those with no history
b. Age- older person are at greater risk
c. High salt intake
d. Obesity- risk is twice greater among overweight/obese
e. Excessive alcohol intake- regular consumption of 3 or more drinks per day increase risk of HPN.
1. CARDIOVASCULAR DISEASES
KEY AREAS FOR PREVENTION OF HPN: a. Encourage proper nutrition
b. Prevent becoming overweight/obese c. Smoking cessation
d. Identify people at risk and encourage regular check-up
1. CARDIOVASCULAR DISEASES
B. CORONARY ARTERY DISEASE (CAD)
- It is a
- It is known as Ischemic Heart disease
- When the
.
- When there is decreased oxygen supply to the heart muscle, chest pain occurs (angina)
- CAD can cause myocardial infarction (heart attack), arrhythmias, heart failure and sudden death.
heart disease caused by impaired coronary
blood flow
coronary arteries become narrowed or
clogged, supply of blood and oxygen to the heart
muscle is affected
1. CARDIOVASCULAR DISEASES
ETIOLOGY/CAUSE:
- The most common cause is the
(atherosclerosis). It usually occurs when a person has high levels of cholesterol in the
blood.
thickening of the inside wall of the
arteries due to deposition of fat-like substance
CORONARY ARTERY DISEASE
CORONARY ARTERY DISEASE
1. CARDIOVASCULAR DISEASES
MODIFIABLE RISK FACTORS
• High lipid and cholesterol level in the blood = high HDL
• Smoking • Obesity
• Physical inactivity or sedentary lifestyle
• Stress
NON MODIFIABLE RISK FACTORS • Hereditary or family history
• Gender
• Age
HDL = GOOD cholesterol LDL = BAD cholesterol
1. CARDIOVASCULAR DISEASES
KEY AREAS FOR PREVENTION OF CAD
a. Promote regular physical activity and exercise
b. Encourage proper nutrition by limiting intake of saturated fats that increase LDL, limiting salt intake and increasing intake of dietary fibers
c. Prevent becoming overweight
HDL – GOOD cholesterol LDL – BAD cholesterol
1. CARDIOVASCULAR DISEASES
C. CEREBROVASCULAR DISEASE / STROKE
- Loss of alteration of bodily function that results from
.
- If blood is obstructed for more than several minutes, injury to the brain cells becomes permanent and tissue dies in the affected region resulting in cerebral infarction.
an insufficient supply of blood to some
parts of the brain
1. CARDIOVASCULAR DISEASES
3 TYPES OF STROKE
1. Thrombolytic stroke/Transient Ischemic Attack - usually occurs in
atherosclerotic blood vessel commonly seen in older people.
2. Embolic stroke/Ischemic stroke - caused by a moving blood clot usually from a thrombus in the left heart that becomes lodged in a small artery through which it cannot pass
3. Hemorrhagic stroke - most fatal type of stroke, rupture of intracerebral blood vessel
CEREBROVASCULAR DISEASE / STROKE
1. CARDIOVASCULAR DISEASES
RISK FACTORS:
a. Increasing age
b. Heredity and race
c. Hypertension
d. Cigarette smoking
e. Diabetes mellitus
f. heart disease
g. High RBC count –thicken the blood and make clots more likely
h. Season and climate
i. Socio-economic factors
j. Certain kind of drug abuse
KEY AREAS FOR PREVENTION OF STROKE:
a. Treatment and control HPN b. Smoking cessation
c. Limit alcohol consumption
d. Avoid intravenous drug abuse
e. Prevent all other risk factors of atherosclerosis
2. CANCER
There are many types of cancers as there are three types of tissues in the body
- Cancer develops when cells in a part of the body begin to grow out of control.
- Cancer cells continue to grow and divide even when there is no need to do so.
- Instead of dying they outlive normal cells and continue from new abnormal cells.
- They compete with normal cells for the blood supply and nutrients.
- Cancer cells often travel to other parts of the body where they begin to grow and replace normal tissue- “metastasis”
2. CANCER
There are many types of cancers as there are three types of tissues in the body
• Second leading cause of mortality in developed countries
• 2.7 million deaths annually •
and spreads to other areas of the body.
• Tumorigenesis: formation of tumors
• Metastasis: spreading of tumors
Uncontrolled growth of cells that often forms a solid mass or tumor
(neoplasm)
2. CANCER
CANCER PROGRESSION
2. CANCER
CAUSES OF CANCER:
1. Hereditary/family history
2. Carcinogens - agent capable of causing cancer, maybe chemical, environmental agent, radiation
a. Polycyclic hydrocarbon - are chemicals found in cigarette smoke, industrial agents and in smoked foods.
b. Benzopyrene - produced when meat and fish are charcoal broiled or smoked, also produced when food is fried in fat that has been reused repeatedly
c. Nitrosamines - powerful carcinogens used as preservatives in foods like tocino, longganisa, bacon, hotdogs
d. Radiation - UV rays from sunlight, x-rays
e. Viruses
f. Aflatoxin - found in peanuts and peanut butter
2. CANCER
KEY AREAS FOR PRIMARY PREVENTION OF CANCERS a. smoking cessation
b. encourage proper nutrition
- increase intake of dietary fibers
- limit consumption if smoked, charcoal-broiled, salt cured foods. c. drink alcohol beverages in moderation
d. control obesity
e. early diagnosis and prompt treatment
3. CHRONIC OBSTRUCTIVE PULMONARY DISEASE
- Major cause of chronic morbidity and mortality world wide (4TH leading cause of mortality).
- It is a disease characterized by
The
airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases.
airflow
limitation that is not fully reversible.
3. CHRONIC OBSTRUCTIVE PULMONARY DISEASE
SMOKING CESSATION
• Harmful substance in tobacco • Tar
• Nicotine
• Carbon monoxide
CAUSES AND RISK FACTORS:
• Smoking is the primary cause of COPD
• It is usually due to chronic bronchitis and emphysema
• Age
COMPLICATIONS:
a. Respiratory failure
b. Cardiovascular disease
Tobacco contains 4000 chemicals, 43 have been proven carcinogenic
• Acetone- used in nail polish remover • Acetic acid- used in vinegar
• Ammonia- used in food and toilet cleaners
• Arsenic- used to make rat poison
• Butane- used in cigarette lighter fluid
• Cadmium- used on rechargeable batteries
• Carbon monoxide- found in exhaust fumes
• Formaldehyde- used to preserve dead bodies
• Hexamine- used in lighter fluid
• Hydrogen cyanide- used in gas chambers
• Methane- used like gasoline
• Naphthalene - used to make moth balls
• Nicotine- used in insecticides
• Nitrobenzene- used as gasoline additive
• Nitrous oxide- used as disinfectants • Dieldrin- used as insecticides
• Ethanol- alcohol
• Stearic acid- used in candle wax
• Toluene- Used as industrial solvent
• Vinyl chloride- used to make PVC pipe
4. DIABETES MELLITUS
- Genetically and clinically heterogeneous group of
glucose intolerance with hyperglycemia present at time of diagnosis
ETIOLOGY/CAUSE:
- Depends on the type of diabetes. Two predisposing factors include genetic predisposition and environment/lifestyle
RISK FACTORS OF TYPE II DM • Family history
• Overweight and obesity
• Sedentary lifestyle
• Hypertension
metabolic disorder characterized by
4. DIABETES MELLITUS
TYPES OF DIABETES
TYPE I- Insulin dependent Diabetes Mellitus (IDDM) / JUVENILE DIABETES • Characterized by absolute lack of insulin due to damaged pancreas
• Dependent on insulin injections
• Genetic, environmental or maybe acquired
TYPE II- Non-insulin Dependent Diabetes Mellitus (NIDDM)
• More common, 90-95% of all person with obesity and diet
• Possible cause include impaired insulin secretion and increased hepatic glucose production
• Usually in older and overweight persons
GESTATIONAL DIABETES - develops during pregnancy and may lead to type II DM
4. DIABETES MELLITUS
SCREENING FOR DIABETES MELLITUS
• Ask the patient (for adults 20 years and above) A. Family history of diabetes
3P’S
B. Polyuria – excessive urination
C. Polydipsia – excessive thirst
D. Polyphagia – excessive eating
E. Unexplained weight loss – TYPE 1 DM
Blood tests:
• Fasting blood sugar
• Oral Glucose Tolerance Test • 2 hours post prandial test
• HBA1C (Glycosylated Hemoglobin)
4. DIABETES MELLITUS
DIABETES MELLITUS
• inability of the body to produce enough or respond normally to insulin, causing blood sugar (glucose) levels to be abnormally high.
• Pancreatic disorder
• Deficiency in INSULIN
DIABETES INSIPIDUS
• rare condition in which the kidneys are unable to retain water.
• Hypothalamic disorder
• Deficiency in Anti-Diuretic Hormone (ADH)
DIFFERENCE OF DIABETES MELLITUS AND DIABETES INSIPIDUS
3. DIAB
ETES MELLITUS
4. DIABETES MELLITUS
• Kidney problems (Nephropathy) or Kidney problems
• Eye problems (Retinopathy) or blindness
• Cardiovascular diseases (atherosclerosis, heart attack, stroke)
• Lower extremity amputation
• Nerve damage (Neuropathy) - can lead to slow wound healing.
COMPLICATIONS FROM DIABETES MELLITUS
Program for the Prevention and Control of other Non-Communicable Diseases
NATIONAL PREVENTION OF BLINDNESS PROGRAM I. Background
• VISION 2020: The right to sight, is a global initiative to eliminate avoidable blindness by the year 2020.
• The long term aim of VISION 2030 is to develop a sustainable comprehensive health care system to ensure the
best possible vision for all people and thereby improve quality of life. • The priority worldwide are the 5 preventable/treatable conditions a. cataract
b. Refractive errors and low vision
c. Trachoma
D. Onchocerciasis
e. Childhood blindness
Program for the prevention and Control of other Non-Communicable Diseases
NATIONAL PREVENTION OF BLINDNESS PROGRAM
75% of blindness in the Philippines is a result of three preventable/treatable conditions:
• a. cataract
• b. Refractive errors and low vision • c. Childhood blindness
A. Vision:
• All Filipinos enjoy the right to sight by year 2020
Program for the prevention and Control of other Non-Communicable Diseases
NATIONAL PREVENTION OF BLINDNESS PROGRAM
B. Mission:
• The DOH, Local Health Units, partners stakeholders commit to:
• Strengthen partnership among and with stake holders to eliminate avoidable blindness in the Philippines
• Empower communities to take proactive roles in the formation of eye health and prevention of blindness
• Provide access to quality eye care services for all.
C. Goal
• Reduce the prevalence of avoidable blindness in the Philippines through provision of quality eye care
Program for the prevention and Control of other Non-Communicable Diseases
NATIONAL PREVENTION OF BLINDNESS PROGRAM INTERVENTIONS BY EYE DISORDER:
1. Cataract
• Opacification of the normally clear lens of the eye • Most common cause of blindness world wide
• Found mostly in older groups
• Surgery is the only cure for cataract blindness
2. Errors of refraction
• Common cause of visual impairment in the country
• Corrected either with spectacle glasses , contact lenses and surgery
3. Childhood blindness
• Highly specialized services that are needed to diagnose and treat
• Screening of children for any sign of visual impairment can be done by pediatricians,
school clinics and health workers.
Program for the prevention and Control of other Non-Communicable Diseases
MENTAL HEALTH AND MENTAL DISRODERS
• Mental Health- state of well being where a person can realize his or own abilities to cope with normal stresses of life and work productively.
• It is not just the absence of psychiatric disorder or illness but a positive state of mental well being
Mental Health Problems 1. Defined Burden
- Refers to the burden currently affecting person’s mental disorders and is measured in terms of prevalence and other indicators such as the quality of life indicators and DAILY.
- Felt heavily by families and communities both in human and economic loss
Program for the prevention and Control of other Non-Communicable Diseases
MENTAL HEALTH AND MENTAL DISRODERS
Mental Health Problems
2. Hidden burden
• Refers to the stigma and violations of human rights
• Stigma is a mark of shame, disgrace or disapproval that result in a person being shunned or rejected by others
3. Future burden
• Refers to the burden in the future resulting from the aging of the population, increasing social problems
and unrest inherited from existing burden
Program for the prevention and Control of other Non-Communicable Diseases
RENAL DISEASE CONTROL PROGRAM (REDCOP)
• Started as DOH- preventive Nephrology Project (PNP), with NKTI as the main implementing agency
• The implementation of the project then was on the screening for urine abnormality among elementary school children nationwide
• It lasted from January 1994 to December 1999 • In January 2000, the PNP was renamed REDCOP
Program for the prevention and Control of other Non-Communicable Diseases
RENAL DISEASE CONTROL PROGRAM (REDCOP) Vision:
• Healthy and empowered Filipinos by the year 2020 with reduced mortality and morbidity from
kidney disease, in a society which has an established modern health system that can efficiently and effectively address the current and emerging problems of the renal system
• Kidney Disease: ranks as the number 10 killer in the Philippines, causing death to about 7,000 Filipinos every year
Program for the prevention and Control of other Non-Communicable Diseases
RENAL DISEASE CONTROL PROGRAM (REDCOP) KIDNEY DISEASES:
• Chronic glomerulonephritis (CGN) • Diabetic Kidney disease
• Hypertensive Kidney disease
• Pyelonephritis
• Often lead to End-Stage Renal Disease (ESRD)
• CGN- used to be the most common cause of ESRD in the third world countries. It usually affects children, adolescents and young adults in their protective years
• Complication in the Kidney from DM- Leading cause now of ESRD
• Some of the signs of latent Kidney Disease
• The person would look or feel normal but when the urine is examined, it will reveal abnormal findings.
