DPC - LE 3 Prevention and Control of Non-Communicable Disease PDF

DISEASE PREVENTION AND CONTROL: LE 3 | TRANS 2 AILA EDZMIER DIANSUY-DE TORRES, LPT, MD, MMHoA, CSHSP, FPAFP & CHIARA MARIE M. DIMLA, MD, MSPH, DPPS | (11/07/2024) sti OUTLINE ✔...

DISEASE PREVENTION AND CONTROL: LE 3 | TRANS 2 AILA EDZMIER DIANSUY-DE TORRES, LPT, MD, MMHoA, CSHSP, FPAFP & CHIARA MARIE M. DIMLA, MD, MSPH, DPPS | (11/07/2024) sti OUTLINE ✔ Enumerate public health interventions (Globally and I. Non-Communicable IV. What is the DOH Locally-Philippines) Diseases (NCDs) Doing? ✔ To understand the overview on the epidemiology, A. What are A. DOH A0 2011-0003 control and prevention of non-communicable diseases, Non-Communicabl B. DOH A0 2012-0029 particularly diabetes mellitus e Diseases C. PhilHealth Circular ✔ To know current preventive and control measures B. Burden of NCDs No. 0020 s. 2013 against diabetes mellitus, global and national C. Risk Factors for V. Summary initiatives/programs NCD VI. Review Questions ✔ To understand key items in the following: II. Major Types of VII. References o DOH AO 2011-0003: National Policy on Non-Communicable Strengthening the Prevention and Control of Diseases Chronic Lifestyle Related Non-Communicable A. Cardiovascular Diseases Diseases o DOH AO 2012- 0029: Implementing Guidelines on B. Diabetes Mellitus the Institutionalization of Philippine Package of III. Prevention & Control Essential NCD Interventions (Phil Pen) On The of NCDs in the Integrated Management Of Hypertension And Philippines: The Case Diabetes For Primary Health Care Facilities for Investment o PhilHealth Circular No. 0020 s. 2013: Adoption of A. Main Findings the Philippine Package of Essential Regarding the 5 Non-communicable Disease (NCD) Interventions Packages (PhilPEN) in the Implementation of PhilHealth’s B. 5 Steps the Primary Care Benefit Package Government Can I. NON-COMMUNICABLE DISEASES (NCDs) Take to Strengthen NCD A. WHAT ARE NON-COMMUNICABLE DISEASES Prevention and Also known as chronic diseases Control Multifactorial: Result of a combination of genetic, C. WHO “Best Buy” - physiological, environmental and behavioral risk - - ④ Interventions for factors NCDs They tend to run a course of long duration Characteristics of NCDs: SUMMARY OF ABBREVIATIONS → Not Caused by injury or extraneous physical factors NCDs Non-Communicable Diseases → Sometimes share common risk factors, hence, share CVD Cardiovascular Diseases common preventative strategies DM Diabetes Mellitus The main types of NCDs are cardiovascular diseases T2DM Type 2 Diabetes Mellitus (such as heart attacks and stroke), cancers, chronic FBS Fasting Blood Sugar respiratory diseases (such as chronic obstructive HbA1c Hemoglobin A1c pulmonary disease and asthma) and diabetes. OGTT Oral Glucose Tolerance Test NCDs disproportionately affect people in low- and PEN Package of essential noncommunicable middle-income countries, where more than three quarters (disease) of global NCD deaths (31.4 million) occur. ACE Angiotensin-converting enzyme WHO ARE AT RISK RCT Randomized controlled trial. People of all age groups, regions and countries are Must know Lecturer Book Previous Trans affected by NCDs. NCDs are often linked to older age, yet 40% of NCD deaths (17 million) occur before age 70. LEARNING OBJECTIVES → 86% of these premature deaths happen in low- and Define Non-Communicable Diseases (NCDs) middle-income countries like the Philippines. ✔ Describe the global and local burden of NCDs → All age groups—children, adults, and the elderly—are ✔ Enumerate risk factors (metabolic, modifiable, and non vulnerable to NCD risk factors, including unhealthy modifiable) diets, inactivity, tobacco smoke, alcohol use, and air ✔ Identify the four major NCDs, focus on Cardiovascular pollution. Diseases and Diabetes Mellitus NCDs are driven by forces that include rapid unplanned o Discuss screening, diagnosis, treatment and urbanization, globalization of unhealthy lifestyles and preventive strategies population aging. LE 3 TRANS 2 TG-C22: *S. Yambot, J. Yanzon, R. Yumang, G. Zacate, B. TE: S. Yambot & G. Zacate AVPAA: A. Rejuso Page 1 of 15 Zafra, G. Zenarosa, J. Zipagan  Unhealthy diets and lack of physical activity can lead to metabolic risk factors, such as high blood pressure, blood glucose, elevated blood lipids, and obesity, which increase the risk of cardiovascular disease—the leading cause of premature NCD deaths. B. BURDEN OF NCDs KEY FACTS OF NCDs NCDs kill 41 million people each year, equivalent to 08 74% or 71% of all deaths globally. NOTE: Different percentages are stated in PPT (74%) and manual (71%). Cardiovascular diseases account for most NCD deaths, or 17.9 million people annually, followed by cancers (9.3 million), chronic respiratory diseases (4.1 million), and diabetes (2.0 million including kidney disease deaths Figure 2. Graph of the Total disease burden by cause, caused by diabetes). World [Lecturer’s PPT] These four groups of diseases account for over 80% of all premature NCD deaths. Tobacco use, physical inactivity, the harmful use of alcohol, unhealthy diets and air pollution all increase the risk of dying from an NCD. Physical inactivity and unhealthy diets increase the risk of dying from NCD like diabetes. Key responses to the control of NCDs → Detection → Screening → Treatment → Primary health care Figure 3. Top 10 causes of total number of deaths in 2019 → Palliative Care and percent change 2009-2019, all ages combined (IHME) [Lecturer’s PPT] GLOBAL BURDEN OF NCDs Based on the data provided by the Institute for Health SOCIO-ECONOMIC IMPACT OF NCDs Metrics and Evaluation (IHME) on Global Burden of NCDs threaten progress toward the 2030 Agenda for Diseases (2024), Cardiovascular diseases ranks 1st on Sustainable Development, which aims to reduce deaths the data provided while Diabetes ranks 9th. from any of the four main NCDs among people aged WHO advocates the detection, treatment, and 30-70 by one-third by 2030. prevention of NCDs Poverty is closely linked with NCDs. → The rapid rise in NCDs is expected to hinder poverty reduction in low-income countries by increasing household costs associated with healthcare. → Vulnerable, socially disadvantaged people tend to get sicker and die sooner than those of higher social status due to greater exposure to harmful products, like tobacco, or unhealthy dietary practices, and limited access to health services. → The expensive healthcare cost of NCDs takes away resources from basic needs like education, nutrition, clothing and housing. Figure 1. Graph of the Share of total disease burden by → Out of pocket expenses further drive families into cause, World, 2021 [Lecturer’s PPT] poverty In low-resource settings, health-care costs for NCDs Based on the data provided by the Institute for Health quickly drain household resources. Metrics and Evaluation (IHME) on Global Burden of The high costs of NCD treatment and income loss push Diseases (2024), NCDs is the leading cause of disease millions into poverty each year, hindering development. burden, having 60% of the total ratio from the graph IMPORTANT WAYS TO CONTROL AND PREVENT NCDs Controlling NCDs requires reducing associated risk factors. Low-cost solutions can help governments address common modifiable risks. Monitoring NCD trends and their risk is essential for guiding policy and priorities. a A comprehensive approach is needed to reduce NCD impact, requiring collaboration across sectors—health, finance, transport, education, agriculture, planning and DISEASE PREVENTION AND CONTROL Prevention & Control of Non-Communicable Disease: Control of CVD & DM Page 2 of 15  others—to lower risks and promote prevention and Figure 4. Top Burden of Disease [Lecturer’s PPT] control. Investing in better management of NCDs is critical. Management of NCDs includes-- detecting, screening and &treating these diseases, and providing access to= palliative care for people in need. → Early detection, and timely treatment High impact essential NCD interventions can be delivered through a primary health care approach to strengthen early detection and timely treatment. Early interventions for NCDs are economically beneficial, reducing costly treatments, but countries with limited healthcare access struggle to meet essential NCD management and SDG targets. W.H.O. RESPONSE TO THE ACCELERATED RISE IN NCDs The 2030 Agenda for Sustainable Development recognizes NCDs as a major challenge for sustainable Figure 5. All Causes of mortality (Top 20), Philippines: development. January to December, 2022 and 2023 As part of the Agenda, heads of state and government [Lecturer’s PPT] committed to develop ambitious national responses, by 2030, to reduce by one third premature mortality from NCDs through prevention and treatment (SDG target 3.4). SGD Target 3.4: Call to action…to reduce by one-third premature mortality from NCDs by the year 2030, through prevention and treatment. WHO plays a key leadership role in the coordination and promotion of the global fight against NCDs and the achievement of the SDG target 3.4. In 2019, the World Health Assembly extended the WHO Global action plan for the prevention and control of NCDs 2013-2020 to 2030 and called for the development of an Implementation Roadmap 2023 to 2030 to accelerate progress on preventing and controlling NCDs. Figure 6. Health Sector Performance Report (2017-2022) The Roadmap supports actions to achieve a set of nine & [Lecturer’s PPT] global targets with the greatest impact towards prevention and management of NCDs.. Figure 7. Strategy Map for the 8-Point Action Agenda [Lecturer’s PPT] Figure 4. WHO's 9 Voluntary Global Targets [Lecturer’s PPT] NCD STATUS IN THE PHILIPPINES (NATIONAL) DISEASE PREVENTION AND CONTROL Prevention & Control of Non-Communicable Disease: Control of CVD & DM Page 3 of 15  Figure 8. DOH Strategic Focus on Primary Care [Lecturer’s PPT] Figure 11. NCD caused by behavioral risk factors [Lecturer’s PPT] C. RISK FACTORS FOR NCD TOBACCO USE CAUSATION PATHWAY FOR NCD Responsible for 6 million preventable deaths worldwide, and 8 million deaths every year (including from the effects of exposure to second-hand smoke). Annually, 87,600 Filipinos die from tobacco-related diseases. Mood Char → 1 in every 4 Filipino adults are current smokers (GATS, 2015) → 3 out of 10 adolescents aged 13-15 years old are current tobacco user (GYTS, 2019) → More common in urban areas among middle class to richest → More common among males than females. Figure 9. The causation pathway for chronic diseases There is a total of 70 estimated number of carcinogens, [Lecturer’s PPT] cancer causing ingredients, contained in a cigarette stick. There is no safe level of secondhand smoke exposure. MODIFIABLE BEHAVIORAL RISK FACTORS Part of air pollution These are factors in which the individuals has some Successful smoking cessation restores the risk of control ischemic heart disease (IHD) or coronary artery disease Modifiable behaviors like tobacco use, inactivity, (CAD) to that of a non-smoker within approximately 3 unhealthy diets, and alcohol abuse significantly years. increase NCD risk. → tobacco causes over 8 million deaths (including from UNHEALTHY DIET the effects of exposure to second-hand smoke) Low daily consumption per person of fruits and → excess salt/sodium intake causes 1.8 million deaths vegetables (90 mmHg → Rank 2: hyperglycemia (high blood glucose levels); ANTHROPOMETRIC MEASURE: WHR fasting blood sugar level of 100-125 mg/dl → Rank 3: overweight/obesity; BMI of ≥ 23.0 → Rank 4: hyperlipidemia (high levels of fat in the blood); blood cholesterol level of 200-239 mg/100 ml - In terms of attributable deaths, the leading metabolic - -> risk factor globally is elevated blood pressure (to which 19% of global deaths are attributed), followed by raised blood glucose and overweight - and obesity. DYSLIPIDEMIA Ideal Lipid Profile → Total Cholesterol: