Non-Communicable Diseases

Non-Communicable Diseases (NCDs)

• Chronic diseases of long duration and slow progression
• Types of chronic diseases:
• Cardiovascular diseases
• Cancers
• Chronic respiratory diseases
• Metabolic disorders

Epidemiology of NCDs

• Increasing prevalence worldwide due to:
• Demographic transition (increased life expectancy and aging population)
• Epidemiologic transition (decreased mortality from communicable diseases due to immunizations and antibiotics)
• Nutrition transition (changes in dietary patterns and sedentary lifestyle)
• Multifactorial nature of risk factors (difficult to determine causes and prevent)
• Migration of population across different cultures (high risk cultures)
• International communication (modernization, international business, and new food technologies)
• Environmental changes (air pollution)
• Different epidemiology of NCDs across countries (presence of well-developed surveillance systems)
• Changing epidemiology over time (novel risk factors emerge)
• Limited use of scientific progress in management of NCDs due to high cost (especially in developing countries)

Risk Factors of NCDs

• Modifiable factors:
• Unhealthy diet
• Tobacco and alcohol use
• Sedentary life
• Non-modifiable factors:
• Age
• Sex
• Genetics
• Ethnicity and personality type
• Metabolic and psychological factors:
• Raised blood pressure
• Overweight and obesity
• Hyperglycemia
• Hyperlipidemia

Burden of NCDs in Egypt

• NCDs morbidity:
• Two-thirds are overweight
• One-third are obese
• 40% are hypertensive
• 37% have high cholesterol levels
• Risk factors for NCDs in Egypt:
• Dietary pattern: 95% eat less than five servings of fruits and vegetables per day
• Tobacco use: one-quarter are smoking
• Sedentary life: three-quarters don't engage in vigorous activity or sports, and only one-third of adults perform low-level physical activity
• Mortality from NCDs:
• NCDs account for 82% of all deaths in Egypt and 67% of premature deaths (WHO 2022)
• Risk factors for mortality from NCDs in Egypt:
• 24% prevalence of smoking and growing use of shisha tobacco
• One of the most overweight populations in the world (66% of women overweight and 42% obese)
• Almost three-quarters of the population not involved in vigorous activity
• 17% prevalence of diabetes
• 40% prevalence of hypertension
• Egyptians have an average daily salt intake of 9 grams, nearly double the recommended allowance

Prevention and Control of NCDs

• Primordial prevention: health education
• Primary prevention: health promotion and specific protection
• Secondary prevention: early detection and treatment
• Tertiary prevention: disability limitation and rehabilitation
• Quaternary prevention: set of activities to mitigate or avoid the consequences of unnecessary intervention of health system

Egypt Strategies to Mitigate NCDs

• Establishment of an NCD Unit within the MoHP
• Raising tobacco taxes and reducing salt and replacing trans fat in the Egyptian diet
• Integrating NCD prevention, early detection, and management services to the primary health care level

Role of Primary Health Care

• Health education to improve lifestyle
• Nutrition education
• Identify high-risk groups
• Health screening of risk groups for early detection of NCDs
• Referral to specialist for treatment
• Follow-up to ensure compliance

Non-Communicable Diseases (NCDs)

• Chronic diseases of long duration and slow progression
• Types of chronic diseases:
• Cardiovascular diseases
• Cancers
• Chronic respiratory diseases
• Metabolic disorders

Epidemiology of NCDs

• Increasing prevalence worldwide due to:
• Demographic transition (increased life expectancy and aging population)
• Epidemiologic transition (decreased mortality from communicable diseases due to immunizations and antibiotics)
• Nutrition transition (changes in dietary patterns and sedentary lifestyle)
• Multifactorial nature of risk factors (difficult to determine causes and prevent)
• Migration of population across different cultures (high risk cultures)
• International communication (modernization, international business, and new food technologies)
• Environmental changes (air pollution)
• Different epidemiology of NCDs across countries (presence of well-developed surveillance systems)
• Changing epidemiology over time (novel risk factors emerge)
• Limited use of scientific progress in management of NCDs due to high cost (especially in developing countries)

Risk Factors of NCDs

• Modifiable factors:
• Unhealthy diet
• Tobacco and alcohol use
• Sedentary life
• Non-modifiable factors:
• Age
• Sex
• Genetics
• Ethnicity and personality type
• Metabolic and psychological factors:
• Raised blood pressure
• Overweight and obesity
• Hyperglycemia
• Hyperlipidemia

Burden of NCDs in Egypt

• NCDs morbidity:
• Two-thirds are overweight
• One-third are obese
• 40% are hypertensive
• 37% have high cholesterol levels
• Risk factors for NCDs in Egypt:
• Dietary pattern: 95% eat less than five servings of fruits and vegetables per day
• Tobacco use: one-quarter are smoking
• Sedentary life: three-quarters don't engage in vigorous activity or sports, and only one-third of adults perform low-level physical activity
• Mortality from NCDs:
• NCDs account for 82% of all deaths in Egypt and 67% of premature deaths (WHO 2022)
• Risk factors for mortality from NCDs in Egypt:
• 24% prevalence of smoking and growing use of shisha tobacco
• One of the most overweight populations in the world (66% of women overweight and 42% obese)
• Almost three-quarters of the population not involved in vigorous activity
• 17% prevalence of diabetes
• 40% prevalence of hypertension
• Egyptians have an average daily salt intake of 9 grams, nearly double the recommended allowance

Prevention and Control of NCDs

• Primordial prevention: health education
• Primary prevention: health promotion and specific protection
• Secondary prevention: early detection and treatment
• Tertiary prevention: disability limitation and rehabilitation
• Quaternary prevention: set of activities to mitigate or avoid the consequences of unnecessary intervention of health system

Egypt Strategies to Mitigate NCDs

• Establishment of an NCD Unit within the MoHP
• Raising tobacco taxes and reducing salt and replacing trans fat in the Egyptian diet
• Integrating NCD prevention, early detection, and management services to the primary health care level

Role of Primary Health Care

• Health education to improve lifestyle
• Nutrition education
• Identify high-risk groups
• Health screening of risk groups for early detection of NCDs
• Referral to specialist for treatment
• Follow-up to ensure compliance