EPIDEMIOLOGY OF

NONCOMMUNICABLE
DISEASE

GROUP 1
Noncommunicable Diseases
➔ also known as chronic diseases, are not passed from person to person. They are
of long duration and generally have slow progression

Chronic conditions are characterized by the following:

➔ Do not result from an (acute) infectious process

➔ Are “not communicable”
➔ Cause premature morbidity, dysfunction, and reduced quality of life
➔ Usually develop and progress over long periods
➔ Often initially insidious
➔ Once manifested there is usually a protracted period of impaired health
Noncommunicable Diseases
Non-Communicable Disease (NCD) Characteristics

➔ Complex etiology (causes)

➔ Multiple risk factors
➔ Long latency period
➔ Non-contagious origin (non-communicable)
➔ Prolonged course of illness
➔ Functional impairment or disability
➔ Incurability
➔ Insidious onset
Noncommunicable Diseases
Risk Factors
➔ Any aspect of personal behavior or lifestyle, an environmental exposure, or a
hereditary characteristic that is associated with an increase in the occurrence of a
particular disease, injury, or other health condition
Modifiable Risk Factors
➔ The WHO has prioritized the following four:
❏ Physical inactivity
❏ Tobacco use
❏ Alcohol use
❏ Unhealthy diets
Noncommunicable Diseases
Risk Factors

Non-Modifiable Risk Factors

❏ Age
❏ Gender
❏ Race
❏ Family history
(genetics)
Noncommunicable Diseases
Noncommunicable Diseases
➔ NCDs also include:
❏ Chronic mental illness
❏ Injuries, which have an acute onset, but may be followed by prolonged
convalescence and impaired function
Types:
❏ Cardiovascular disease (Coronary heart disease, Stroke)
❏ Cancer
❏ Chronic lung disease
❏ Diabetes
❏ Chronic neurologic disorders (Alzheimer’s, Dementias)
❏ Arthritis/Musculoskeletal diseases
Noncommunicable Diseases
Cardiovascular Diseases
➔ include diseases of the heart, vascular diseases of the brain and diseases of blood
vessels
➔ CVDs are responsible for over 17.3 million deaths per year and are the
leading causes of death in the world
Noncommunicable Diseases
Tumors
➔ In general, neoplasms are irreversible, and their growth is for the most part,
autonomous

❏ Benign Tumors
➔ do not penetrate (invade) adjacent tissue borders, nor do they spread
(metastasize) to distant sites
➔ remain localize overgrowths in the area in which they arise
➔ are more differentiated than malignant tumors, that is, they closely
resemble their tissue of origin
Noncommunicable Diseases
Tumors

❏ Malignant Tumors
➔ are capable of invasion (spread of the neoplasms into adjacent
structures) and metastasis (implantation of the neoplasms into non-
contiguous sites)
Noncommunicable Diseases
Chronic Obstructive Pulmonary Disease
➔ is a life-threatening lung disease that interferes with normal breathing
➔ “smoker’s cough”
➔ almost 90% of COPD deaths occur in low- and middle-income countries
➔ the primary cause of COPD is tobacco smoke (through tobacco use or second-
hand smoke).
➔ the disease now affects men and women almost equally, due in part to
increased tobacco use among women in high-income countries
➔ COPD is not curable, but treatment can slow the progress of the disease
➔ Total deaths from COPD are projected to increase by more than 30% in the next
10 years without interventions to cut risks, particularly exposure to tobacco smoke
Noncommunicable Diseases
Chronic Obstructive Pulmonary Disease
➔ characterized by persistent respiratory symptoms and airflow limitation that is
not fully reversible
➔ requires the presence of chronic airflow obstruction, determined by
spirometry
➔ Persistent reduction in forced expiratory flow rates is the most typical
finding in COPD.
➔ Increases in the residual volume and the residual volume/total lung capacity ratio,
non-uniform distribution of ventilation, and ventilation-perfusion mismatching.
Noncommunicable Diseases
Chronic Obstructive Pulmonary Disease
Risk Factors:
❏ Cigarette smoking
➔ Packs/year of cigarette smoking is the most highly significant predictor
❏ Respiratory Infections
➔ important causes of COPD exacerbation
❏ Occupational exposures
➔ coal mining, gold mining, and cotton textile dust, have been implicated as
risk factors for chronic airflow obstruction
❏ Ambient air pollution
➔ prolonged exposure to smoke produced by biomass combustion, a
common mode of cooking in some countries
Noncommunicable Diseases
Chronic Obstructive Pulmonary Disease

Clinical Presentation:
➔ Three most common symptoms in COPD are cough, sputum production, and
exertional dyspnea
➔ Development of airflow obstruction is a gradual process, many patients date the
onset of their disease to an acute illness or exacerbation
➔ Development of exertional dyspnea (increased effort to breathe, heaviness, air
hunger, or gasping, can be insidious)
➔ As COPD advances, the principal feature is worsening dyspnea on exertion
Noncommunicable Diseases
Chronic Obstructive Pulmonary Disease

Physical Examination
➔ in patients with more severe disease, the physical examination of the lungs is
notable for a prolonged expiratory phase and may include expiratory wheezing
➔ Patients with severe airflow obstruction may also exhibit use of accessory
muscles of respiration, sitting in the characteristic “tripod” position to facilitate the
actions of the sternocleidomastoid, scalene, and intercostal muscles
➔ Patients may develop cyanosis, visible in the lips and nail beds
Noncommunicable Diseases
Diseases Caused by Tobacco Use

Cigarette smoking increases the risk of:

➔ Coronary heart disease

➔ Atherosclerotic peripheral vascular disease
➔ Cerebrovascular disease
➔ Cancers of the lung, larynx, mouth, esophagus, bladder, pancreas,
kidney, and cervix
➔ Chronic obstructive pulmonary disease
Noncommunicable Diseases
Diseases Caused by Tobacco Use

Cigarette smoking increases the risk of:

➔ Intrauterine growth retardation, premature rupture of membranes

➔ Low-birth weight babies, perinatal mortality
➔ Cataract, macular degeneration
➔ Peptic ulcer disease
➔ Possibly liver, stomach, and colorectal cancers and acute myelocytic
leukemia
Noncommunicable Diseases
Involuntary smoking (environmental tobacco smoke) is a cause of:

➔ Lung cancer and coronary heart disease in nonsmokers

➔ Respiratory infections and symptoms in the children of parents who smoke

Smokeless tobacco causes:

➔ Oral Cancer
➔ Oral leukoplakia
➔ Dental caries (possibly)
Noncommunicable Diseases
Diabetes

➔ more than 346 million people worldwide have diabetes

➔ there is an emerging global epidemic of diabetes that can be traced back to rapid
increases in overweight, obesity and physical inactivity
➔ Diabetes is predicted to become the seventh leading cause of death in the world
by the year 2030
➔ total deaths from diabetes are projected to rise by more than 50% in the next 10
years
Noncommunicable Diseases
Diabetes
➔ Cardiovascular disease is responsible for between 50% and 80% of deaths in people
with diabetes
➔ Diabetes has become one of the major causes of premature illness and death in most
countries, mainly through the increased risk of cardiovascular disease (CVD)
➔ Diabetes is a leading cause of blindness, amputation and kidney failure
➔ Lack of awareness about diabetes, combined with insufficient access to health
services and essential medicines, can lead to complications such as blindness,
amputation and kidney failure
Noncommunicable Diseases
Diabetes

Type 1 Diabetes Mellitus

➔ due to autoimmune B-cell destruction, usually leading to absolute insulin
deficiency
➔ characterized by a lack of insulin production
➔ much more common than type 1 diabetes
➔ accounts for around 90% of all diabetes worldwide
➔ Type 2 diabetes can be prevented - 30 minutes of moderate-intensity physical
activity on most days and a healthy diet can drastically reduce the risk of
developing type 2 diabetes
Noncommunicable Diseases
Diabetes

Type 2 Diabetes Mellitus

➔ due to progressive loss of B- cell insulin secretion frequently on the
background of insulin resistance
➔ results from the body's ineffective use of insulin
Noncommunicable Diseases
Diabetes

Diagnosis:

➔ Plasma glucose 126 mg/dL (7.0 mmol/L) after an overnight fast or

➔ Two-hour plasma glucose > 200 mg/dl (11.1 mmol/l) during a 75-gram Oral
Glucose Tolerance Test
➔ Random plasma glucose > 200 mg/dl (11.1 mmol/l) in a patient with classic
symptoms of hyperglycemia (weight loss, polyuria, polyphagia, polydipsia) or with
signs and symptoms of hyperglycemic crisis
Noncommunicable Diseases
Diabetes

Gestational Diabetes
➔ characterized by hyperglycemia, or raised blood sugar, which has first
appeared or been recognized during pregnancy
Which tests should be used to screen pregnant women for gestational diabetes?
➔ An oral glucose tolerance test (OGTT) preferably the 75g OGTT
The diagnosis is made when any of the following plasma glucose values are met or
exceeded:
Noncommunicable Diseases
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