بسم الله الرحمن الرحيمبسم الله الرحمن الرحيم

والسالم والصالة العالمين رب لله والسالم الحمد والصالة العالمين رب لله الحمد، سيدناسيدناعلي علي األمين الوعد الصادق ، محمد األمين الوعد الصادق محمد

، والوهم الجهل ظلمات من أخرجنا ، اللهم والوهم الجهل ظلمات من أخرجنا اللهم

والعلم المعرفة نور والعلم إلى المعرفة نور ....إلى

Non-Communicable DiseasesNon-Communicable Diseases

Chronic degenerative diseases Chronic degenerative diseases

Importance of NCDImportance of NCD

Non communicable diseases are the leading Non communicable diseases are the leading cause of functionary impairment and death cause of functionary impairment and death worldwide. These conditions have been the worldwide. These conditions have been the leading cause of death in the United States leading cause of death in the United States and other high-income countries over the and other high-income countries over the last fifty years, and they are emerging as a last fifty years, and they are emerging as a leading cause of death in low-to middle-leading cause of death in low-to middle-income countries. income countries.

Deaths across the globe: an Deaths across the globe: an overviewoverview

Imagine a diverse international group of Imagine a diverse international group of 1000 individuals representative of the 1000 individuals representative of the women, men and children from all over the women, men and children from all over the globe who died in 2004. Of those 1000 globe who died in 2004. Of those 1000 people, 138 would have come from high-people, 138 would have come from high-income countries, 415 from middle-income income countries, 415 from middle-income countries and 447 from low-income countries and 447 from low-income countries.countries.

What would be the top 10 causes of What would be the top 10 causes of their deaths? their deaths?

The major non communicable The major non communicable diseases are :diseases are :

Cardiovascular Diseases.Cardiovascular Diseases. Chronic Obstructive Pulmonary DiseaseChronic Obstructive Pulmonary Disease DiabetesDiabetes HypertensionHypertension CancersCancers Accidents in its different typesAccidents in its different types Psychiatric and Mental DiseasesPsychiatric and Mental Diseases

Non communicable diseases also include Non communicable diseases also include injuries, which have an acute onset, but may injuries, which have an acute onset, but may be followed by prolonged convalescence be followed by prolonged convalescence and impaired function, as well as chronic and impaired function, as well as chronic mental diseases.mental diseases.

Chronic diseases have been defined Chronic diseases have been defined as :as :

Chronic illnesses. Chronic illnesses. Non-Communicable. Non-Communicable. Degenerative. Degenerative.

Characteristics: Characteristics:

Uncertain etiology.Uncertain etiology. multiple risk factors.multiple risk factors. long latency period .long latency period . Prolonged course of illness.Prolonged course of illness. non- contagious origin.non- contagious origin. functional disability and sometimes functional disability and sometimes

incurability . incurability .

Latency periodLatency period is the period between contact of is the period between contact of the causative agent with susceptible host to the the causative agent with susceptible host to the onset of first sign a symptoms.onset of first sign a symptoms.

The cause of many chronic diseases remains The cause of many chronic diseases remains obscure, but risk factors identified for some of the obscure, but risk factors identified for some of the leading chronic diseases. The most important leading chronic diseases. The most important among these risk factor is Tobacco use especially among these risk factor is Tobacco use especially in COPD .in COPD .

Strategies for the preventionStrategies for the prevention

Approach to prevention of chronic Approach to prevention of chronic diseases can be considered under diseases can be considered under three headings :three headings :

1-Primordial prevention:1-Primordial prevention:

prevention or avoiding the development prevention or avoiding the development of risk factors in the community to prevent of risk factors in the community to prevent the disease in the population and as such the disease in the population and as such protects the individuals. This involves the protects the individuals. This involves the avoidance of risk behaviors.avoidance of risk behaviors.

prevention of disease occurrence by prevention of disease occurrence by altering susceptibility of the host or altering susceptibility of the host or reducing exposure of susceptible persons reducing exposure of susceptible persons to the risk factors to the risk factors

Examples : immunization , good Examples : immunization , good nutrition , health education , nutrition , health education ,

counseling, environmental sanitation, counseling, environmental sanitation, purification of water , protection against purification of water , protection against accidents at work place and seat belts.accidents at work place and seat belts.

Requires : accurate knowledge of causative Requires : accurate knowledge of causative agent and process of disease.agent and process of disease.

2-Primary prevention :2-Primary prevention :

Modifying or reducing the risk factors Modifying or reducing the risk factors associated with the development of a associated with the development of a disease in individuals with or without the use disease in individuals with or without the use of interventions, It involves modification of of interventions, It involves modification of established risk behavior and risk factors established risk behavior and risk factors with specific interventions to prevent with specific interventions to prevent clinically manifest disease clinically manifest disease

That is by early detection , screening by That is by early detection , screening by examinations altering the course of examinations altering the course of disease disease

Examples : high blood pressure , T.B. Examples : high blood pressure , T.B. Diabetes , Cancer of the breast , Cancer of Diabetes , Cancer of the breast , Cancer of the cervix colo-rectal cancers, lung cancer the cervix colo-rectal cancers, lung cancer etc. etc.

3- Secondary prevention :3- Secondary prevention :

Modifying the risk factors in the presence Modifying the risk factors in the presence of the manifested disease by changes in of the manifested disease by changes in lifestyle and/or use of drugs.lifestyle and/or use of drugs.

4- Tertiary Prevention :4- Tertiary Prevention :

alleviation and limitation of disability alleviation and limitation of disability improvement of quality of life , improvement of quality of life , RehabilitationRehabilitation and follow up. and follow up.

Out of all non-communicable illnesses, Out of all non-communicable illnesses, cardiovascular diseases stay as the leading cardiovascular diseases stay as the leading cause of morbidity and mortality , especially cause of morbidity and mortality , especially in developed and rich countries. All over the in developed and rich countries. All over the world, almost 1.5 million adults and elderly world, almost 1.5 million adults and elderly died in 1995 from heart disease, stroke or died in 1995 from heart disease, stroke or other forms of circulatory disease. other forms of circulatory disease.

Cancer is a growing health problem in Cancer is a growing health problem in developing countries, where more than half developing countries, where more than half of the global total of six million deaths occur.of the global total of six million deaths occur.

Chronic Diseases 2:Chronic Diseases 2:

Disability or chronicity may be the outcome Disability or chronicity may be the outcome of many of these chronic diseases and they of many of these chronic diseases and they will not be accounted for by using the will not be accounted for by using the mortality indicators as the only indicators for mortality indicators as the only indicators for chronic and degenerative diseases :chronic and degenerative diseases :

Examples :Examples :1- Musculo-sketelal problems1- Musculo-sketelal problems

Artihritis and osteoarthritis which may reach in old Artihritis and osteoarthritis which may reach in old age a prevalence of 600/1000 persons, and over age a prevalence of 600/1000 persons, and over 300/1000 persons in males.300/1000 persons in males.

Rheumatoid arthritisRheumatoid arthritis Low back painLow back pain Foot problems in old ageFoot problems in old age Scoliosis in childrenScoliosis in children Congenital hip dislocationCongenital hip dislocation OsteoporosisOsteoporosis

2- Neurological disorders2- Neurological disorders

Cerebral palsyCerebral palsy Mental retardationMental retardation Epilepsy and other seizure disorders Epilepsy and other seizure disorders Headache and migraineHeadache and migraine Multiple sclerosisMultiple sclerosis Alzheimer and dementiaAlzheimer and dementia Parkinson diseaseParkinson disease

3- Psychiatric disorders:3- Psychiatric disorders:

Deppression,Compulsive Obsessional Deppression,Compulsive Obsessional Neuroses and Shcizophrenia. Neuroses and Shcizophrenia.

4- Other disorders – cataract , glaucoma4- Other disorders – cataract , glaucoma 5- Vision and hearing disorders5- Vision and hearing disorders 6- Genetic disorders – Down’s 6- Genetic disorders – Down’s

syndrome,Cystic Fibrosis.syndrome,Cystic Fibrosis.