NON COMMUNICABLE DISEASES( NCDs) By NSABIMANA Olivier Philemon, B.Pharm. ASEPA / UNR From 19/4-3/5 /2014

Introduction 1 Abakorinto 6:19 ‘’ Mbese ntimuzi yuko imibiri yanyu ari insengero z’umwuka wera uri murimwe,….. I Abakorinto10: 31 ‘’ namwe iyo murya cyangwa munywa cg mukora ikindi kintu cyose mujye mukorera byose guhimbaza Imana.

NON COMMUNICABLE DISEASES ( NCDs) Non communicable diseases (NCDs), also known as chronic diseases, are not passed from person to person. They are of long duration and generally slow progression. The four main types of non communicable diseases are:  Cardiovascular diseases (like heart attacks and stroke)  Cancers  Chronic respiratory diseases (such as chronic obstructed pulmonary disease and asthma)  Diabetes

NCDs Worldwide NCDs kill more than 36 million people each year Nearly 80% of NCD deaths ( 29 million ) occur in low- and middle-income countries More than 9 million of all deaths attributed to NCDs occur before the age of 60.  Cardiovascular diseases account 17.3 million people annually.  Cancers (7.6 million people) annually  Respiratory diseases (4.2 million people) annually  Diabetes (1.3 million) annually.

5 A global problem In 2004 there were 59 million deaths world-wide Non-communicable diseases accounted for 60% of these deaths and injuries and violence 10%. By 2020 it is estimated that non- communicable disease will account for 73% of all deaths

The growing threat of NCDs to Development “World’s health challenges are more than medical. Behavior and lifestyle also contribute to ill-health. To become a healthy nation, Countries need to make decisions about what they eat, the way they use alcohol and tobacco and state of Physical activities”. World Health Development Plan 2030

7 The epidemiologic transition Change in the balance of disease in a population from communicable diseases to non-communicable disease

2012 Lancet report on Global Burden of Disease In 1990, 47% of deaths worldwide were from communicable, maternal, neonatal, and nutritional disorders, 43% from non-communicable diseases, and 10% from injuries. By 2010, this had shifted to 35%, 54%, and 11%, respectively. Thus there is a 11% relative increase in burden from NCDs within 20 years. Projections are that there will be an even steeper rise over the next 20 years with the greatest increase being in Africa.

2012 Lancet report on Global Burden of Disease (Cont’d) Thus there is a 11% relative increase in burden from NCDs within 20 years. Projections are that there will be an even steeper rise over the next 20 years with the greatest increase being in Africa. By 2030 it is estimated that NCDs will contribute 75% of global deaths. 13% of deaths from NCDs in developed countries occur in people under 60 – in Africa it is 29%

Projected global deaths for selected causes, 2004– GBD report 2004 update, 2008

NCDs Risk Factors (1) NCDs share four risk factors: Tobacco use Physical inactivity Use of alcohol Unhealthy diets

NCDs Risk Factors (Cont’d) 2 Modifiable behavioral risk factors Tobacco accounts for almost 6 million deaths every year (including over deaths from exposure to second-hand smoke). About 3.2 million deaths annually can be attributed to insufficient physical activity. 1.7 million deaths are attributable to low fruit and vegetable consumption. 2.3 million annual deaths from harmful drinking.

NCDs Risk Factors (Cont’d) 3 Metabolic/physiological risk factors These behaviors lead to four key metabolic/physiological changes that increase the risk of NCDs:  Raised blood pressure,  Overweight/Obesity,  Hyperglycemia (high blood glucose levels)  Hyperlipidemia (high levels of fat in the blood).

In terms of attributable deaths,NCDs  Blood pressure (to which 16.5% of global deaths are attributed  Tobacco use (9%)  Raised blood glucose (6%)  Physical inactivity (6%)  Overweight and obesity (5%)

Prevention and control of NCDs An important way to reduce NCDs is to focus on lessening the risk factors associated with these diseases. Low-cost solutions exist to reduce the common modifiable risk factors: (mainly tobacco use, unhealthy diet, physical inactivity, and the harmful use of alcohol) and map the epidemic of NCDs and their risk factors (1). Interventions that can be delivered through a primary health-care approach to strengthen early detection and timely treatment

Summary Non-communicable diseases are now the most common cause of death worldwide Increasing rates in low and middle income countries because of change in lifestyles (urbanisation) Key risk factors have very large effects Interventions are effective and can reduce burden 16

WEEK PROGRAM Along this week we will go though the main four NCDs such as:  Cardiovascular diseases (like heart attacks and stroke)  Cancers  Chronic respiratory diseases (such as chronic obstructed pulmonary disease and asthma)  Diabetes( Type I and Type II)

WEEK PROGRAM ( 2) We will see:  Physiopathology of disease  Signs and Symptoms of disease  Risk factors  Prevention measures