EPIDEMIOLOGY OF CHRONIC DISEASES

Dr. H. Ari Udijono, M.Kes

Master of Epidemiology – Postgraduate Program
Department of Epidemiology, Faculty of Public Health
Diponegoro University Semarang
World’s Problems
News
World’s Problems
 Global Deaths, 2005
17.528.000

Cardio-
Vascular
Disease

7.586.000

Cancer

4.057.000

2.830.000
Chronic
1.607.000 Respiratory 1.125.000
HIV/ 883.000
Disease
AIDS Tbc DM
Malaria

*NCD are the mayor of deaths in the world

**Sumber: WHO dan WorldBank 2005
Epidemiologic Transition
40
35
30
25
PM
20
INJURI
15 PTM
10
5
0
1990 2000 2010 2020
WHO, 2005

The Projection of Deaths trends by general causes at Developing Countries

 Epidemiologic Transition
70
59.5
60
49.9
50 44.2
41.7
SKRT 1995
40
31.2 SKRT 2001
28.1
30
Riskesdas 2007
20
10.1
10 6 6 5.9 7.3 6.5

0
Gangguan Penyakit Penyakit Tidak Cedera
Perinatal Menular Menular

Trends of main cause of deaths in Indonesia, SKRT 1995, 2001, Riskesdas 2007
Double Burden of Diseases

Communicable Diseases

Indonesia

Non-Communicable Diseases
 Indonesia
International Estimation WHO Perspective

• 2000  8.4 milions people with DM (1.9%)

• 2030  21.3 milions people with DM (2.8%)

World 4th largest prevalence!!!

Wild, et al.
2004
 DM Prevalence in Indonesia

1982
1982
6.1 %

5.1%
1.6 % 1991
2005 1.5 % 1981
1.1% 1.4%
1998
1995 1992 2004
3.5 %
Padang Surabaya
5.7 % 7.2% Jakarta Bali
Singaparn Makassar
2001 9.2% 12.5 % a
Pekajanga Manado
14.7 % 2003 n
2005
Risk Factors
 Risk Factors
Risk Factors CVD DM Ca COPD
Smoking + + + +

Alcohol + + +

Unhealthy Diet + + + +

Physical Inactivity + + + +

Obesity + + + +

Raised Blood Pressure + + + +

Blood Lipid + + + +

Blood Glucose + + + +
Leading Cause of Death, 2000
Blood pressure

Tobacco

Cholesterol

Underweight High Mortality Developing Countries

Unsafe sex Low Mortality Developing Countries
Fruit and vegetable intake Developed Countries
High Body Mass Index

Physical inactivity

Alcohol

Unsafe water, sanitation, and hygiene

Indoor smoke from solid fuels

Iron deficiency

Urban air pollution

Zinc deficiency

Vitamin A deficiency

Unsafe health care injections

0 1000 2000 3000 4000 5000 6000 7000 8000

Number of deaths (000s) Source: WHR 2002
Life Style
 Unhealthy Diet

• Opened since 1991 in Jakarta

• After 15 years : > 108 McDonald’s outlets across
Indonesia (54  in Jakarta & Jakarta’s sub urban)

Consumers growth 10 % per year

2005 : 3 millions customers / month
Physical Activities
 High Technologies
HP dan remote TV  menghindarkan
kita dari BERJALAN KAKI

20 x sehari x 20 m = 400 m

Jarak tempuh yang hilang / tahun

400 x 365 = 146,000 m

146 km = 25 jam berjalan kaki

1 jam jalan kaki = 113-226 kcal

Energi yang tersimpan =2800-6000 kcal

 0.4-0.8 kg jaringan adiposa/ lemak

Rössner, 2002 BB
Daily Activities
Overweight
Global Problem
Developing Countries’ smokers
Epidemic of Tobacco
Invisible Diseases
Invisible Diseases
 i o n
n t
e ve
P r
n &
t i o
m o
Pr o
 Penyakit Tidak Menular
 Penyakit Kardiovaskuler
 Penyakit Jantung Koroner
 Stroke
 Hipertensi
 Penyakit Metabolik
 Diabetes mellitus
 Penyakit Keganasan
 Ca Mammae
 Ca cervix uteri
 Penyakit Paru Obstuktif Menahun (Asma, PPOM)