chronic non communicable diseases control in guyana

Chronic Non Communicable Diseases Control in Guyana

Dr. Shamdeo PersaudChief Medical Officer

Ministry of Health, GUYANA

Chronic Non Communicable Diseases Diseases that are cause mainly due to 4 behavioral

risk factors: Tobacco Use Harmful Use of Alcohol Unhealthy Diet Physical Inactivity

Examples of main chronic diseases that cause death and disability: Cardiovascular diseases, Cancers, Diabetes, Hypertension and Chronic Lung Diseases


Risk Factors for Chronic Diseases: Un-modifiable

Family History Age Ethnicity Gender


Risk Factors - Modifiable Tobacco Use

Risk from direct consumption Risk from exposure to second hand smoke Causes deaths and diseases

Lung cancers Other cancers Infections such as Tuberculosis Cardiovascular diseases


Risk Factors: Modifiable

Physical Inactivity Insufficient physical activity is the leading cause of

disease related mortality 20-30% increased risk of death

Physical activity: 30 minutes of moderate physical activity on most days of the week Key in energy expenditure and weight balance Decreases the risk of

Ischaemic heart disease by 30% Diabetes by 27% Breast and colon cancers by 21-25% Stroke and hypertension Depression


Risk Factors: Modifiable

Harmful use of alcohol Major risk factor for premature death and

disability Causing:

Cancer Liver Disease Cardivascular disease Alcohol related road traffic deaths Violence Mental illness

Situation Population: 768,000 Diverse ethnicity Growing Economy

Developed habits Fast Foods Less walking Increased use of vehicles Conveniences Television etc.


SituationTobacco: Current adult smoking prevalence: 16%

Men = 30% Women = 3%

Current youth tobacco use: 18%Alcohol Current adult prevalence: Estimated 36% Proportion of students who drank at least one drink

in the past 30 days: 39.2% Proportion of students who had their first drink

before age 14 years: 79%


SituationPhysical activity

Over 60 percent of the population is sedentary

Percentage of students who were physically active for 1 hour on five or more days during the past week: 21.3%

Percentage of students who spent more than 3 hours per day doing sitting activities: 35.6%



Cancer – Number of Deaths due to Cancer from 2004 – 2010

No. of Deaths

by Neoplas

m

Year2004

2005 2006 2007 2008 200

92010

*426

453 406 453 469 511 536


Cancer deaths by GenderNo. of deaths

by Neoplasms by gender

Year

2004 2005 2006 2007 2008 2009 2010

Male

207 223 197 198 221 247 -

Female

219 230 209 255 248 265 -

Total

426 453 406 453 469 511* 536**


Cancer TypesRanking of top cancers Prostate (male) 38% Breast (female) 23% Cervical (female) 21% Stomach, Colon, other bowel (both sex)

9% Liver - 3% Lung - 2 % All Other – 4%


Diabetes Diabetes –

Estimated Prevalence – 6.2% of population Approximately 47,000 persons living with

diabetes Average of 11 % (31,000) of population

over 30 years Incidence – 2,000 new cases annually Types of Diabetes

Type 1 (Insulin Dependant) – 8% Type 2 (non-Insulin Dependant) - 92 %


Hypertensive Disorders Prevalence – 18% of the Population over 30

years – 52,000 Incidence – 9,000 new cases reported annually Major contributing cause of

Strokes in persons over 40 Heart Attacks Disability and under productivity

Together with Diabetes – 64,000 persons 13% (99,000) with either or both


Cardiovascular and heart diseases Strokes

Hemorrhagic – 1,901 cases annually Thrombo-embolism (Clots) – 896 cases

annually Heart Attacks – 2,012 cases Blood vessel disease

Atherosclerosis – 3,129 reported Aneurysms - 0.7 %


Priorities for Action and Response Multi-sectoral response

Chronic Non Communicable Disease Commission Comprising stakeholders

International agencies: PAHO, UN Agencies Line Ministries and other Governmental Agencies Non Governmental Organizations

Chaired by Minister of Health Meets quarterly Develop a multi-year work plan and Strategy


Priorities for Action and Response Mass Media

Television shows: “Pulse Beat” on NCN channel 11 “Your Health the Nation’s Wealth” on NCN channel 11 “Changing Course” on Drug Demand Reduction,

every Radio programme: Doctor on Call, Let’s Talk about

DAT (Drugs, Alcohol and Tobacco) Radio series Merundoi incorporated CNCDs Advertisement Print, TV and Radio Social media??


Priorities for Action and Response Promotion of Healthy Lifestyle Changes

Weight No More Tracking 12 overweight and obese women over 12

weeks as they modified their lifestyles to be healthier Health Walks Health Fairs Interpersonal communication and direct

education at all health facilities, workplace, school and community groups


Priorities for Action and Response Screening

VIA for cervical cancer Breast Self Examination education Prostate and other cancers Body Mass Index (BMI) Waist circumference Blood pressure Blood glucose Lipids and cholesterol

1. Risk Reduction: Screening in community and workplace


Priorities for Action and Response Information, Education and Communication

on CNCDs

Television and print advertisements Posters Pamphlets Brochures Fliers


Priorities for Action and Response Disease Management

Integrated PHC clinics Standardized clinical guidelines for Heart Disease,

Hypertension, Diabetes, Cancers and Asthma Diabetes, cancer and other Registers Foot, eye, kidney and heart care programs Testing: glucometers for blood glucose

measurements, HbA1c, lipid, PSA, Renal Function, heart scans, angiogram, CT, MRI

Nutrition and Lifestyle counseling

You are an equal partner with your health care team

Prepare yourself for each clinic visit by writing any important information you need to share with your doctor or any questions you may have to ask.

Know what health goals you and your team have set


Priorities for Action and Response

Surveillance Introduction of NCD Morbidity Reporting system (S3) Data Base development (MIS) Mortality Data system Registries Monitoring and Evaluation Indicators

Core Data and periodic surveillance Minimum data set (CHRPHA) Steps Surveys


Priorities for Action and Response

Surveys: Demographic Health Survey 2009 Global School Health Survey 2004, 2010 Global Youth Tobacco Survey 2000, 2004, 2010 Global School Personnel Survey 2010 Global Health Professional Student Survey 2009 GENACIS Survey on Alcohol 2009 Emergency Room Survey on Alcohol and Injuries

2011 Behavioural Surveillance Survey 2004 and 2008 BMI Registers Food Consumption Survey Physical Activity Survey


Priorities for Action and Response Training

Pre service training: Health care workers: Doctors, nurses and medex Screening and Brief Intervention for Alcohol Motivational Interviewing for Substance Use Mental Health – anxiety, depression, suicide

University of Guyana and Teacher’s Training College Drug Demand Reduction, including alcohol Tobacco control CNCDs


Priorities for Action and Response Policies, Legislation and Regulation

Draft legislation for tobacco control Smoke Free spaces Labeling and advertizing

Regulation of “fast food” (Salt, Sugar, Fats) Policy on school canteen, Dorms, feeding

programs Health Family Basket of foods – Zero Rated Safe open spaces for physical activities Other Health Public Policies


Thank You Questions?Comments!

chronic non communicable diseases control in guyana

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