Eye Care Community Interventions Quiz

Non-Communicable Diseases

• Non-communicable diseases (NCDs) are diseases that cannot spread from person to person. Examples include cancer, heart disease, and cirrhosis.
• NCDs are not infectious.
• NCDs have a long duration and progress relatively slowly.
• Often, a person is unaware of the disease until examined. This is sometimes referred to as a "silent killer."

NCD Distribution by Age

• Younger age group: Accidents and injuries, Rheumatic Heart Disease, Diabetes, Blindness, Psychiatric disorders
• Elderly: Hypertension, Coronary Heart Disease, Diabetes Mellitus, Stroke, Malignancies, Obesity, Blindness, Psychiatric disorders, Respiratory Diseases, and others

Common Risk Factors

Non-Modifiable

• Age
• Sex
• Family History
• Genetic Factors
• Personality

Modifiable

• Cigarette Smoking
• Alcohol Abuse
• Dyslipidemia
• Sedentary Lifestyle
• Stress
• Environmental Risk Factors
• Inability to Access Preventative Healthcare Services

Causes/Risk Factors for Non-Communicable Diseases

• Unhealthy diet
• Tobacco use
• Physical inactivity
• Stress factors
• Overweight (obesity)
• Genetics
• Harmful alcohol use
• Environmental factors

Risk Factor Classification

• Background risk factors: Age, sex, education level, and genetic composition. These cannot be changed.
• Behavioral risk factors: Tobacco and alcohol use, unhealthy diet, and physical inactivity. These can be modified.
• Intermediate risk factors: Elevated blood lipids, diabetes, high blood pressure, and overweight/obesity. These can be controlled.

Cardiovascular Diseases

• Cardiovascular disease (CVD) is caused by disorders of the heart and blood vessels.
• CVD includes coronary heart disease (heart attacks), cerebrovascular disease (stroke), raised blood pressure (hypertension), peripheral artery disease, rheumatic heart disease, congenital heart disease, and heart failure.
• 80% of premature deaths from CVD could be avoided by controlling risk factors such as tobacco use, unhealthy diet and physical inactivity.

Cardiovascular Diseases: Contributing Factors

• Genetic makeup
• Lifestyle habits at a young age
• Socioeconomic status
• Mental health
• Diet
• Overweight and obesity
• Occupation
• Smoking
• Alcohol abuse
• Diabetes
• Urbanization

Cardiovascular Diseases: Prevention

• Maintaining healthy lifestyles
• Focusing on a combination of risk factors for CVD
• Providing regular medical screening to individuals at risk
• Providing effective and affordable treatment

Cancer

• Cancer is abnormal cell growth and spread originating from a single cell.
• Changes can be triggered by external factors or inherited genes.
• Cancer affects almost any part of the body.
• Its development is a multistage process in which the cell transforms into a tumor, and the growth invades surrounding tissues and metastasizes to other sites.

Cancer: Causes

• Physical carcinogens (e.g., UV radiation, asbestos)
• Chemical carcinogens (e.g., vinyl chloride, beta-napthylamine, components of tobacco smoke, aflatoxin, arsenic)
• Biological carcinogens (e.g., infections from certain viruses, bacteria, or parasites)
• Note: Most chemicals people encounter daily haven't been tested regarding long-term impact.

Cancer: Major Organs Affected

• Lung, breast, colorectal, stomach and liver cancers
• In high-income countries, lung cancer in men and breast cancer in women are leading causes of cancer death
• In low- and middle-income countries, cancer prevalence varies by underlying risks. Cervical cancer is a leading cause of death in Sub-Saharan Africa

Cancer: Risk Factors

• Tobacco use
• Unhealthy diet
• Insufficient physical activity
• Harmful alcohol use
• Infections (hepatitis B, hepatitis C, HPV, Helicobacter pylori)
• Radiation
• Environmental and occupational exposures

Chronic Respiratory Diseases

• Chronic respiratory diseases (e.g., asthma, COPD, lung cancer) can stem from exposure to tobacco, impacting the lungs.
• Second-hand smoke leads to severe respiratory health problems (e.g., asthma and reduced lung function) in children, becoming a prevalent chronic condition.
• Children are vulnerable to damp-related respiratory health issues, which include respiratory tract irritation, allergies, and asthma exacerbation. Poor housing, social conditions, and hygiene contribute to damp-related issues.

Diabetes

• Diabetes is a chronic metabolic disorder resulting from insufficient insulin production by the pancreas or from the body's inability to effectively utilize insulin.
• Approximately 347 million people worldwide have diabetes.
• Rapid increases in overweight, obesity, and physical inactivity are contributing to increasing numbers of diabetes cases.
• 80% of diabetes-related deaths happen in low- and middle-income countries.

Diabetes: Complications

• Elevated blood sugar damages blood vessels, heart, eyes, kidneys, and nerves.
• Diabetic retinopathy, neuropathy, are complications from uncontrolled diabetes.
• Diabetes is a leading cause of kidney failure.
• 10-20% of people with diabetes die of kidney failure.
• 50% of people with diabetes die of cardiovascular disease (mostly heart disease and stroke).

Diabetes: Prevention

• Achieve and maintain a healthy body weight.
• Regular moderate physical activity.
• Early diagnosis via inexpensive blood testing.
• Lower blood sugar and address other known risk factors that damage blood vessels.
• Quitting tobacco use.

Diabetes: Control

• Type 1 diabetes requires insulin, type 2 may be controlled with oral medications or insulin.
• Control blood pressure
• Foot care
• Screening and treatment for retinopathy (potentially leading to blindness)
• Control blood lipids
• Screening for and treatment of early signs of kidney disease

Obesity

• Obesity is a significant public health challenge. Its prevalence has tripled in many regions since the 1980s.
• Obesity is related to several physical and psychological complications.
• Obesity sharply increases the chances of developing non-communicable diseases (NCDs), including cardiovascular disease, cancer, and diabetes.
• The risk of developing multiple diseases (co-morbidity) increases with increasing body weight.
• Childhood obesity is a serious public health issue with children at high risk of becoming obese adults, often developing diabetes and CVDs early in life.
• Environmental support is crucial to shaping healthier lifestyle choices.

Obesity: Definition

• Overweight and obesity are defined as abnormal/excessive fat accumulation that affects health.
• Body mass index (BMI) measures weight relative to height is a common tool for classifying overweight and obesity.
• WHO defines overweight as BMI 25 or greater, and obesity as BMI 30 or greater.

Obesity: Prevention

• Individual responsibility is critical, paired with access to healthy lifestyles and support.
• WHO supports stakeholders for shaping environments to make healthy foods affordable.

Non-Communicable Diseases: Prevention and Control

• Preventing millions of deaths from NCDs requires strengthening existing measures and policies.
• This can involve government-wide actions such as enforcing anti-tobacco policies, improving dietary choices, encouraging physical activity, reducing harmful alcohol use, and improving accessibility to healthcare.

Other Preventative Measures

• Non-infectious diseases require avoiding triggers (e.g., allergies and asthma), eating healthy, exercising, and managing chronic conditions.
• Regular check-ups and testing for family-history conditions are recommended.

Preventing Blindness

• Strategies to prevent blindness can be grouped into primary (preventing onset), secondary (detecting and treating early), and tertiary (reducing the impact) prevention.
• Primary Prevention: Awareness programs, promoting protective measures (e.g., sunglasses), encouraging good hygiene, vaccination (e.g., measles) and improving nutrition.
• Secondary Prevention: Early screening for refractive errors, amblyopia, cataracts, glaucoma, and diabetic retinopathy, providing affordable and accessible treatment options.
• Tertiary Prevention: Conducting surgeries to restore affected vision, rehabilitating individuals with blindness, and offering social and psychological support.

Preventing Psychiatric Illnesses

• Individual strategies: Maintain a balanced lifestyle (diet, exercise, sleep), avoiding substance abuse and practicing stress management (mindfulness, meditation, or yoga), enhance resilience (coping skills, problem-solving skills, support network).
• Community strategies: Organize mental health education programs in schools, workplaces, and communities to reduce mental health stigma.
• Policy-level strategies: Integrate mental health services into primary healthcare; promote workplace wellness; address poverty, unemployment, housing insecurity; implement crisis helplines; establish screening programs in schools, workplaces, and clinics; enact anti-discrimination laws.

Further Prevention Considerations

• Childhood interventions: support parenting programs, early childhood education, identify and assist children with trauma or neglect; school based programs: promote social-emotional learning, anti-bullying initiatives, trauma-informed care.