Non-communicable

Diseases (NCDs)
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NON-COMMUNICABLE DISEASE

I. Integrated community-based non-communicable diseases (NCD)

prevention and control program aimed at preventing the 4 major NCD
or chronic diseases or lifestyle-related disease

a. Cardiovascular diseases
b. Cancer
c. Chronic Obstructive Pulmonary disease
d. Diabetes mellitus

II. Prevention and control of other NCD particularly mental disorders,

blindness, renal disease and programs for persons with disabilities
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INTEGRATED COMMUNITY-BASED NCD PREVENTION AND
CONTROL PROGRAM

• 4 Major NCD

• In Philippines, urbanization and lifestyle changes have

brought about a considerable change on the health status

• Globalization and social change influenced the spread of NCD

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HEALTH EDUCATOR

• Essential toll to achieve community health

• Concern with promoting health as well as reducing behavior-
induced diseases

Health educator aims to:

a. Inform the people
b. Motivate the people
c. Guide the people into action
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CAUSES AND RISK FACTORS OF MAJOR NON-COMMUNICABLE DISEASES

I. CARDIOVASCULAR DISEASES

• Disease of the heart and blood vessels

A. Hypertension (HPN)

Description:

• HPN or high blood pressure is defined as sustained elevation in mean

arterial pressure. It is not a single disease state but a disorder with
many causes, a variety of symptoms and a range of responses to
therapy
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B. Coronary Artery Disease (CAD)

Description:

• It is a heart disease caused by impaired coronary blood flow

• It is known as Ischemic Heart disease
• When the coronary arteries become narrowed or clogged, supply of blood and oxygen to the
heart muscle is affected.
• When there is decreased oxygen supply to the heart muscle, chest pain occurs (angina)
• CAD can cause myocardial infarction (heart attack), arrhythmias, heart failure and sudden
death.

Etiology/Cause:

• The most common cause is the thickening of the inside wall of the arteries due to
deposition of fat-like substance (atherosclerosis). It usually occurs when a person has high
levels of cholesterol in the blood.
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Modifiable risk factors

• High lipid and cholesterol level in the blood=high HDL

• Smoking
• Obesity
• Physical inactivity or sedentary lifestyle
• Stress

Non Modifiable risk factors

• Hereditary or family history

• Gender
• Age

Key areas for prevention of CAD

• a. Promote regular physical activity and exercise

• b. Encourage proper nutrition by limiting intake of saturated fats that increase LDL, limiting
salt intake and increasing intake of dietary fibers
• c. Prevent becoming overweight
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c. Cerebrovascular Disease or Stroke

Description:

• Loss of alteration of bodily function that results from an insufficient supply of blood to some
parts of the brain.
• If blood is obstructed for more than several minutes, injury to the brain cells becomes
permanent and tissue dies in the affected region resulting in cerebral infarction.

Etiology/cause:

Three types of stroke

1. Thrombolytic stroke- usually occurs in atherosclerotic blood vessel commonly seen in older
people.
2. Embolic stroke- caused by a moving blood clot usually from a thrombus in the left heart that
becomes lodged in a small artery through which it cannot pass
3. Hemorrhagic stroke- most fatal type of stroke, rupture of intracerebral blood vessel
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II. CANCER

• There are many types of cancers as there are three types of tissues in the body
• Cancer develops when cells in a part of the body begin to grow out of control.
Cancer cells continue to grow and divide even when there is no need to do so.
• Instead of dying they outlive normal cells and continue from new abnormal
cells.
• They compete with normal cells for the blood supply and nutrients.
• Cancer cells often travel to other parts of the body where they begin to grow
and replace normal tissue- “metastasis”
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Causes of Cancer:

1. Hereditary/family history
2. Carcinogens- agent capable of causing cancer, maybe chemical, environmental agent, radiation
a. Polycyclic hydrocarbon- are chemicals found in cigarette smoke, industrial agents and in
smoked foods.
b. Benzopyrene- produced when meat and fish are charcoal broiled or smoked, also
produced when food is fried in fat that has been reused repeatedly
c. Nitrosamines- powerful carcinogens used as preservatives in foods like tocino ,longanisa,
bacon, hotdogs
d. Radiation- UV rays from sunlight, x-rays
e. Viruses
f. Aflatoxin- found in peanuts and peanut butter

Key areas for primary prevention of cancers

a. smoking cessation
b. encourage proper nutrition
- increase intake of dietary fibers
- limit consumption if smoked, charcoal-broiled, salt cured foods.
c. drink alcohol beverages in moderation
d. control obesity
e. early diagnosis and prompt treatment
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III. DIABETES MELLITUS

Description:

• Genetically and clinically heterogeneous group of metabolic disorder characterized by

glucose intolerance with hyperglycemia present at time of diagnosis

Etiology/cause:

• Depends on the type of diabetes. Two predisposing factors include genetic

predisposition and environment/lifestyle
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Types of diabetes

TYPE I- Insulin dependent Diabetes Mellitus (IDDM)

• Characterized by absolute lack of insulin due to damaged pancreas
• Dependent on insulin injections
• Genetic, environmental or maybe acquired

TYPE II- Non-insulin Dependent Diabetes Mellitus (NIDDM)

• More common, 90-95% of all person with obesity and diet
• Possible cause include impaired insulin secretion and increased hepatic glucose
production
• Usually in older and overweight persons

Risk factors of Type II DM

• Family history
• Overweight and obesity
• Sedentary lifestyle
• Hypertension
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GESTATIONAL DIABETES- develops during pregnancy and may lead to type II DM

Key areas for prevention and control of diabetes

a. encourage proper nutrition
b. maintain body weight and prevent obesity
c. promote regular exercise
d. smoking cessation- DM patients who smoke have higher risk of heart attack and stroke

SCREENING FOR DIABETES MELLITUS

• Ask the patient (for adults 20 years and above)

A. Family history of diabetes

B. Polyuria
C. Polydypsia
D. Polyphagia
E. Unexplained weight loss

Blood tests:

• Fasting blood sugar

• 2 hours post prandial test
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IV. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

Description:

• Major cause of chronic morbidity and mortality world wide- 4th leading cause of
mortality.
• It is a disease characterized by airflow limitation that is not fully reversible. The airflow
limitation is usually progressive and associated with an abnormal inflammatory
response of the lungs to noxious particles or gases.

Causes and risk factors:

• Smoking is the primary cause of COPD
• It is usually due to chronic bronchitis and emphysema
• Age

Complications:
a. Respiratory failure
b. Cardiovascular disease
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SMOKING CESSATION

• Harmful substance in tobacco

• Tar
• Nicotine
• Carbon monoxide

Tobacco contains 4000 chemicals, 43 have been proven carcinogenic

• Acetone- used in nail polish remover

• Acetic acid- used in vinegar
• Ammonia- used in food and toilet cleaners
• Arsenic- used to make rat poison
• Butane- used in cigarette lighter fluid
• Cadmium- used on rechargeable batteries
• Carbon monoxide- found in exhaust fumes
• Formaldehyde- used to preserve dead bodies
• Hexamine- used in lighter fluid
• Hydrogen cyanide- used in gas chambers
• Methane- used like gasoline
• Napthalene- used to make moth balls
• Nicotine- used in insecticides
• Nitrobenzene- used as gasoline additive
• Nitrous oxide- used as disinfectants
• Dieldrin- used as insecticides
• Ethanol- alcohol
• Stearic acid- used in candle wax
• Toluene- Used as industrial solvent
• Vinyl chloride- used to make PVC pipe
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Program for the prevention and Control of other Non-Communicable Diseases

NATIONAL PREVENTION OF BLINDNESS PROGRAM

I. Background

• VISION 2020: The right to sight, is a global initiative to eliminate avoidable blindness by the year 2020.
• The long term aim of VISION 2030 is to develop a sustainable comprehensive health care system to ensure the
best possible vision for all people and thereby improve quality of life.
• The priority worldwide are the 5 preventable/treatable conditions
a. cataract
b. Refractive errors and low vision
c. Trachoma
D. Onchocerciasis
e. Childhood blindness

75% of blindness in the Philippines is a result of three preventable/treatable conditions:

• a. cataract
• b. Refractive errors and low vision
• c. Childhood blindness
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II. Vision/Mission/Goals

A. Vision:
• All Filipinos enjoy the right to sight by year 2020

B. Mission:
• The DOH, Local Health Units, partners stakeholders commit to:

• Strengthen partnership among and with stake holders to eliminate avoidable blindness
in the Philippines
• Empower communities to take proactive roles in the formation of eye health and
prevention of blindness
• Provide access to quality eye care services for all.

C. Goal
• Reduce the prevalence of avoidable blindness in the Philippines through provision of
quality eye care
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INTERVENTIONS BY EYE DISORDER:

1. Cataract
• Opacification of the normally clear lens of the eye
• Most common cause of blindness world wide
• Found mostly in older groups
• Surgery is the only cure for cataract blindness

2. Errors of refraction
• Common cause of visual impairment in the country
• Corrected either with spectacle glasses , contact lenses and surgery

3. Childhood blindness

• Highly specialized services that are needed to diagnose and treat

• Screening of children for any sign of visual impairment can be done by pediatricians,
school clinics and health workers.
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MENTAL HEALTH AND MENTAL DISRODERS

• Mental Health- state of well being where a person can realize his or own abilities to cope with normal
stresses of life and work productively.
• It is not just the absence of psychiatric disorder or illness but a positive state of mental well being

Mental Health Problems

1. Defined Burden

• Refers to the burden currently affecting person’s mental disorders and is measured in terms of
prevalence and other indicators such as the quality of life indicators and DAILY.
• Felt heavily by families and communities both in human and economic loss

2. Hidden burden

• Refers to the stigma and violations of human rights

• Stigma is a mark of shame, disgrace or disapproval that result in a person being shunned or rejected by
others

3. Future burden

• Refers to the burden in the future resulting from the aging of the population, increasing social problems
and unrest inherited from existing burden
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RENAL DISEASE CONTROL PROGRAM (REDCOP)

• Started as DOH- preventive Nephrology Project (PNP), with NKTI as the main implementing
agency
• The implementation of the project then was on the screening for urine abnormality among
elementary school children nationwide
• It lasted from January 1994 to December 1999
• In January 2000, the PNP was renamed REDCOP

Vision:

• Healthy and empowered Filipinos by the year 2020 with reduced mortality and morbidity from
kidney disease, in a society which has an established modern health system that can efficiently and
effectively address the current and emerging problems of the renal system

• Kidney Disease: ranks as the number 10 killer in the Philippines, causing death to about 7,000
Filipinos every year
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Kidney Diseases:

• Chronic glomerulonephritis (CGN)

• Diabetic Kidney disease
• Hypertensive Kidney disease
• Pyelonephritis
• Often lead to End-Stage Renal Disease (ESRD)

• CGN- used to be the most common cause of ESRD in the third world countries. It usually affects
children, adolescents and young adults in their protective years

• Complication in the Kidney from DM- Leading cause now of ESRD

• Some of the signs of latent Kidney Disease

• The person would look or feel normal but when the urine is examined, it will reveal abnormal
findings.