Are you aware not only adults come down with non-communicable diseases(NCDs)? Do you know that your lifestyle patterns determine the kind of NCD you develop? Have you ever cared to know the disease entities that constitute NCDs and how much havoc they have caused?
Then, you need to read this article👇
NON-COMMUNICABLE DISEASES (NCDs): ONE DEATH, TOO MANY!
INTRODUCTION
40 million people die each year from NCDs, an estimated 70% of all deaths worldwide according to World Health Organization (WHO). The burden of these diseases is alarming in low- and middle-income countries, with over 80% of premature deaths from these diseases occurring in these countries, Nigeria being one of them. Cardiovascular Diseases (like heart attack and stroke), Cancers, Respiratory Diseases (like Asthma) and Diabetes Mellitus which are the leading NCDs have claimed the lives of so many. These deaths stem from inadequate sensitization and awareness about these diseases, poor healthcare infrastructure, critical shortage of specialists and more importantly poverty. These impede access to quality and timely healthcare. Poverty, which is closely linked with NCDs, makes these diseases continue to threaten progress towards the 2030 Agenda for Sustainable Development.
WHAT ARE THEY?
NCDs, also known as chronic diseases, are not passed from person to person. Though, some communicable diseases are also chronic, such as HIV/AIDS, they are contagious or transferable from one human to another unlike NCDs which are not caused by infectious agents (non-infectious or non-transmissible). They are usually of long duration, slow progression and are the result of a combination of genetic, physiological, environmental and behavioural factors.
The four major types of NCDs are cardiovascular diseases (accounting for 55.3%), cancers (accounting for 27.5%), respiratory diseases (accounting for 12.2) and diabetes mellitus (accounting for 5%). The other disease entities that constitute NCDs are sickle cell disease, chronic kidney disease, cataract, fibromyalgia, Alzheimer’s disease, osteoporosis, amongst others.
It is pertinent to note that not only diseases that develop in adulthood constitute NCDs. Some diseases that are mostly detected in childhood like sickle cell disease and congenital heart defects (‘hole in the heart’) are also NCDs.
WHAT RISK IS INVOLVED?
NCDs affect people of all age groups, regions and countries. Of the 40 million deaths attributed to NCDs each year, 15 million occur between the ages of 30 and 69 years constituting a significant proportion of premature deaths. Around the world, NCDs affect men and women almost equally.
Children, adults and the elderly are all vulnerable to the risk factors predisposing to NCDs with the shared risk factors for most NCDs being tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol. These risk factors reflect the lifestyle patterns of individuals affected with these diseases and are modifiable behaviours. They usually lead to four key metabolic/physiological changes- overweight/obesity, elevated blood pressure, raised blood glucose and elevated cholesterol. Of these, elevated blood pressure takes the lead as 19% of global deaths are attributed to it.
Tobacco use kills over 7.2 million people each year. By 2020, this number is expected to increase to 7.5 million, accounting for 10% of all deaths. Excess salt consumption is responsible for 4.1 million annual deaths. More than half of the 3.3 million deaths attributable to alcohol use are from NCDs, including cancer. Physical inactivity accounts for 1.6 million deaths every year.
It is worthy of note that individuals with family history of some NCDs like hypertension, diabetes mellitus, amongst others are at increased risk of coming down with these diseases. In addition, although not always the case, infections can be precursors of some cancers. Human papilloma virus (HPV) infection which can be a precursor of cervical cancer being a classical example.
HOW SERIOUS IS IT?
NCDs are not only a health problem, they are also a challenge to development as they largely undercut productivity. As a result of catastrophic expenditures on treatment, those living these diseases are forced into or entrenched in poverty. This has a downward spiral effect on long term care and eventual outcome of these diseases leading to myriads of complications and ultimately death.
More than 9 billion deaths attributed to NCDs occur before the age of 60. Cardiovascular diseases are responsible for most NCD deaths accounting for 17.9 million deaths. This is followed by cancers contributing 9 million deaths. Next are respiratory diseases responsible for 3.9 million deaths and then diabetes mellitus which accounts for 1.6 million deaths. 10 million people die each year due to high blood pressure.
It is saddening to note that these diseases that are responsible for deaths of such a significant proportion of the populace are preventable and usually due to low access to quality and timely health care especially in low-resource settings like Nigeria where health-care costs for NCDs quickly drain household resources, force a handful of people into poverty annually and stifle development.
HOW CAN THEY BE PREVENTED?
Lifestyle modification is pivotal in the prevention of NCDs. Effective interventions that tackle shared risk factors cannot be over emphasized. Eliminating major risk factors could prevent most NCDs-around three-quarters of heart diseases, stroke, type 2 diabetes mellitus and 40% of cancers would be prevented.
Eating a balanced diet and reduction of salt and fat consumption will reduce the risk for some NCDs. Abstaining from tobacco consumption, including second-hand smoking will keep the incidence of cancers to the barest minimum. Avoiding excessive alcohol intake and engaging in regular physical activity are essential ways of preventing majority of NCDs.
To lessen the impact of NCDs on individuals and the society at large, a comprehensive approach is needed requiring all sectors, including health, agriculture, finance, education and others, to collaborate to reduce the risks associated with NCDs, and promote interventions to prevent and control them. Evidence shows that such interventions are excellent economic interventions that will reduce the burden of and deaths from NCDs. The role of civil society organizations is also indispensable in the prevention and control of these diseases with WHO taking the lead by developing a global action plan for the prevention and control of NCDs 2013-2020.
CONCLUSION
The devastating consequences of NCDs are innumerable. To achieve one of the targets of 2030 Agenda for Sustainable Development which is to reduce premature deaths from NCDs by one-third through prevention and treatment, all hands must be on deck to achieve the key components of the response to NCDs which are detection, screening, treatment and palliative care.
More efforts must be channelled towards sensitization and creation of awareness about NCDs with emphasis on risk factors, prevention and right approach to care. The populace should be screened for NCDs with a focus on early detection and immediate institution of treatment. Those living with NCDs must be supported to ensure their accessibility to and affordability of quality health care services. It is when all these are put in place that we can tame the scourge of NCDs which has eaten deep into the fabrics of the society. It’s high time we said ENOUGH TO NCDs!
REFERENCES
www.who.int/en/news-room/fact-sheets/detail/noncommunicable-diseases, 2017.
www.who.int/gho/ncd/risk_factors/en/, 2018
GBD 2015 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet, 2016; 388 (10053): 1659-1724
Dr. Olanrewaju Adams Amusat MB; BS(Ibadan)
Director, SmileBuilders Initiative
July 2018