Seminar on Communicable and Non-Communicable Diseases - Dr. Strange

Level (3) - Semester (6) COMMUNITY MEDICINE SEMINAR 1 COMMUNICABLE & NON-COMMUNICABLE DISEASES DR STRANGE  Communicable & Non-Communicable Diseases Epidemiologic Triad See Next Page Dr....

Level (3) - Semester (6) COMMUNITY MEDICINE SEMINAR 1 COMMUNICABLE & NON-COMMUNICABLE DISEASES DR STRANGE  Communicable & Non-Communicable Diseases Epidemiologic Triad See Next Page Dr. Page 1 Strange  COMMUNITY Seminar (1) – CDs & NCDs c ❶ Communicable Diseases (CDs) ❷ Non-Communicable Diseases (NCDs) ▪ Infectious diseases ▪ Chronic Non-infectious diseases, ▪ Caused by microorganisms ▪ Not caused by infectious agents but are instead the result of DEFINITION ▪ Transmitted from one individual to another various non-infectious factors such as: through direct or indirect contact. A. Lifestyle choices. B. Heredity. C. Environmental factors. ⎚ Some common examples of communicable A) The 4 Main Types: diseases include: 1. Cardiovascular diseases (CVDs) 3. Cancer 1. Tuberculosis 6. COVID-19 2. Chronic respiratory diseases 4. Diabetes 2. Malaria 7. Common cold B) Other Types: 3. HIV/AIDS 8. Influenza (Flu) 1. Hypertension 7. Osteopenia/osteoporosis EXAMPLES 4. Hepatitis 9. Poliomyelitis (Polio) 2. Dyslipidemia 8. Degenerative disc disease 5. Measles 10. Chickenpox 3. Obesity 9. Sarcopenia and frailty 4. Metabolic syndrome 10. Depression 5. Rheumatoid arthritis (RA) 11. Cognitive impairment 6. Cerebrovascular disease 12. Neurodegenerative disease ⎚ Causes include: 1. Allergies. 4. Changes in lifestyle and Highly infectious pathogens & carriers spread these CAUSES 2. Malnutrition. surroundings. diseases 3. Illness brought on by 5. Abnormal cell growth. internal factors TRANSMITTING Viruses, bacteria … etc. Nil AGENT ROLE OF Cannot be passed down Can be inherited through generations INHERITANCE from one generation to another Dr. Strange Page 2  COMMUNITY Seminar (1) – CDs & NCDs c DISEASE TYPE Develop immediately and is acute Develops over a period of time and lasts longer, it is fatal TREATMENT Traditional methods may work Surgically or specialized treatments ⎚ Risk factors of noncommunicable diseases (NCDs): ▪ Family diseases history ▪ Genetic inheritance ▪ Epigenetic changes Genetic factors ▪ Environment exposure-based (e. g. radiation) ▪ Toxic material-based mutations ▪ Air pollution Environmental ▪ Weather changes factors ▪ Sunlight (UV radiation) NB ▪ Age ▪ Ethnicity Sociodemographic ▪ Gender ▪ Education factors ▪ Race ▪ Income ▪ Tobacco use ▪ Person's weight Factors of self- ▪ Alcohol use ▪ Food choice management ▪ Physical activity ▪ Dental health care ▪ Medications ▪ Viruses Factors of medical ▪ Blood pressure ▪ Obesity conditions ▪ Lipids ▪ Stress ▪ Glucose Dr. Strange Page 3  COMMUNITY Seminar (1) – CDs & NCDs 1 NCDs and Risk of Infection A. Many NCDs have now been associated with an infectious risk factor. B. NCDs →  susceptibility for being infected by reducing immunity 2 The Term “chronic diseases” In many ways we feel that the most appropriate advice would be to start widely to use the conventional term “chronic diseases” A. Infections may play a part in certain “chronic diseases” (E.g., gastric ulcer & heart diseases) B. Many infectious diseases are “chronic” (E.g., Tuberculosis & AIDS). 3 COVID-19 Pandemic The recent COVID-19 pandemic has drawn considerable attention to the disproportionate burden among patients living with chronic medical illness A. Those living with NCDs → are at increased risk of becoming severely ill from the virus. B. The proportion of: ① Patients with the 4 most common NCDs is considerably higher among all ② Patients with NCD-related risk factors types of COVID-19 patients (E.g., tobacco use, obesity, alcohol use) Dr. Strange Page 4  COMMUNITY Seminar (1) – CDs & NCDs 4 The infection–NCD pairs ⎚ The infection–NCD pairs with the largest burden: NCD The Causing Infection ① Gastric cancer H pylori The Commonest ② Cirrhosis & other chronic liver diseases Hepatitis B Virus & Hepatitis C Virus Pair ③ Liver Cancer Hepatitis B Virus ④ Rheumatic Heart Disease Streptococcal Infection ⑤ Cervical Cancer HPV ⑥ Endemic Burkitt's lymphoma (BL) Epstein-Barr Virus (EBV) & Malaria 5 NCDs ↔ CDs A higher risk of NCD may perhaps put the population at elevated risk for common CDs & vice versa ▪ Type 2 diabetes mellitus → can interact with & complicate numerous CDs of public health importance like: A. Human Immunodeficiency Virus (HIV). B. TB. C. Malaria. ▪ Patients with type 2 diabetes mellitus → have three-times more risk of active TB infection compared to those without non-diabetes. ① ▪ Patients with HIV on antiretroviral treatments → Due to adverse effects of the drugs, They: ② A. Can present with type 2 diabetes mellitus & lipid disorders. B. Are at more risk of experiencing cardiovascular events. Dr. Strange Page 5  COMMUNITY Seminar (1) – CDs & NCDs 6 Patterns of CD & NCD multimorbidity ⎚ A systematic review study conducted in 2022 found combinations of: A. Two concurrent communicable & non-communicable diseases. B. Three concurrent communicable and non-communicable diseases. (A) Most frequently occurring DYADS (B) Most frequently occurring TRIADS ① HIV & Hypertension. ① HIV, Hypertension, & Diabetes ② Acid Peptic Disease & Hypertension ② HIV, TB, & Diabetes 7 Factors associated with CD & NCD multimorbidity ① The older population (>50 years of age) (The Most Frequent) ② Female participants ③ Those with low physical activity ④ Uneducated ⑤ Obese and overweight ⑥ Alcohol consumption 8 Prenatal infections & Non-communicable disease NCD causation can be attributed to an insult before & after birth that may subsequently promote the development of NCDs A. Infections such as (Malaria – Toxoplasmosis – Rubella - Cytomegalovirus - Herpes virus) → are all known causes of fetal malnutrition. B. Infections, in genetically predisposed individuals, can indirectly serve as risk factors in development of NCD like: - Type 2 DM. - Hypertension. - IHD. Dr. Strange Page 6  COMMUNITY Seminar (1) – CDs & NCDs ⎚ Design of prevention and control strategies for both CDs and NCDs: ▪ While focusing on preventing known risk factors for NCDs, there is a need to identify all emerging risk factors for NCD control. ▪ As evidence suggest role of infections in many NCDs, there is a need to re-design NCD control strategies to also include infection control. ▪ Integrating health systems to collectively address NCDs & infectious diseases through a wide range of services in a comprehensive manner → A.  the economic burden of healthcare. B. Strengthens the healthcare system. ▪ Understanding that infections can contribute to NCD causation from fetal life to adulthood including: A. Prevention of infection in pregnancy (Particularly malaria) B. Prevention of childhood infections (By routine immunization) As integral elements of NCDs control strategy. ⎚ Prevention & Control of NCD: ▪ Design national policies & plans Global Level ▪ Support & encourage research for NCDs prevention and control (WHO, UN) ▪ Monitor NCDs ▪ Support national & international partnerships for NCD prevention & control ▪ Improve budgetary allocations to support primary health care systems ▪ Engage: A. Nongovernmental organizations. B. Research institutions. Country Level C. The private sector in collaborative partnerships for implementation of an action plan against NCDs ▪ Develop continuous quality improvement systems focused on primary health care for the prevention & management of NCDs Society Level ▪ Offer healthy food in the workplace (Schools, Universities, ▪ Offer opportunities for physical activity in the workplace for all ages Non- ▪ Offer new resources from health-related non-governmental organizations to governmental support the services for prevention & control, treatment, and care of NCDs agencies) Individual Level ▪ Follow a healthy lifestyle Dr. Strange Page 7  COMMUNITY Seminar (1) – CDs & NCDs Package of Essential Noncommunicable (PEN) ▪ The Package of Essential Noncommunicable (PEN) disease interventions for primary health care: ▪ The WHO PEN defines a minimum set of interventions to address major NCDs in primary care. ▪ The interventions are for: ① The detection, diagnosis, treatment and care of: A. Cardiovascular diseases. B. Diabetes. C. Chronic respiratory diseases. ② A section for cancer early diagnosis is also included. ③ Components of healthy lifestyle, self-care and palliative care also feature in the package. Dr. Strange Page 8