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Penyakit NCD di Malaysia

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Health talk on NCD in Malaysia

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Penyakit NCD di Malaysia

  1. 1. PENYAKIT TIDAK BERJANGKIT (NCD)
  2. 2. Types of NCDs • Cardiovascular disease (e.g., Coronary heart disease, Stroke) Diabetes Cancer Chronic respiratory disease • • •
  3. 3. Risk Factor: Definition “An 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.” Principles of Epidemiology, CDC, 2006
  4. 4. Modifiable Risk Factor • A behavioral risk factor that can be reduced or controlled by intervention, thereby reducing the probability of disease. • WHO has prioritized the following four: I. Physical inactivity, II. Tobacco use, III.Alcohol use, and IV.Unhealthy diets (increased fat and sodium, with low fruit and vegetable intake).
  5. 5. Non-Modifiable Risk Factor A risk factor that cannot be reduced or controlled by intervention; for example: • • • • Age, Gender, Race, and Family history (genetics).
  6. 6. Common Risk Factors
  7. 7. Global Trends Causes of Deaths Projected Deaths in 2015 and 2030 0 5 10 15 20 25 30 2004 2015 2030 2004 2015 2030 2004 2015 2030 Deaths(millions) High income Middle income Low income Other infectious HIV, TB, malaria Mat//peri/nutritional CVDT Cancers Other NCDs Intentional injuries Other unintentional Road traffic accidents http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_part2.pdf
  8. 8. NCD IN MALAYSIA  Ancaman kesihatan baru  Jumlah pesakit meningkat setiap tahun.  10 penyebab utama penyakit negara  60% ( ~ 35 juta) jumlah kematian di dunia disumbang oleh NCD (WHO) NHMS 2015 adults 18 years and above  17.5% (3.5 m) have diabetes  30.3% (6.1 m) have hypertension  47.7% (9.6 m) have hypercholesterolemia
  9. 9. NCD RISK FACTORS  Common, preventable risk factors underlie most NCDs.  These risk factors are a leading cause of the death and disability burden in nearly all countries, regardless of economic development.
  10. 10. 1.Tobacco Use • Tobacco kills nearly 6 million people each year. http://www.who.int/mediacentre/factsheets/fs339/en/index.html
  11. 11. MALAYSIA : PREVALENCE OF SMOKING BY SEX (1996, 2006, 2011 & 2015) % • 1996 &2006 – adult 18 & above
  12. 12. Malaysia : Prevalence of smoking by states, ≥ 15 years (2015) %
  13. 13. Tobacco Use: Health Effects Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Medicine, 2006, 3(11): e442.
  14. 14. Tobacco Use: Health Effects (cont.) Among smokers: • • • • Cancer Coronary heart disease Diseases of the lungs Peripheral vascular disease Stroke Fetal complications and stillbirth • • • Second-hand smoke causes: • Heart disease, including heart attack • Lung cancer
  15. 15. 2. UNHEALTHY DIET
  16. 16. Global Changes in Diet http://www.pitt.edu/~super4/41011-42001/41171.pdf • Most countries have increased overall daily consumption of: • Daily calories, • Fat and meats, and • Energy dense and nutrient-poor foods such as: ‒ Starches ‒ Refined sugars ‒ Trans-fats
  17. 17. Unhealthy Diet: Health Effects • • • • • • • Coronary heart disease Stroke Cancer Type 2 diabetes Hypertension Diseases of the liver and gallbladder Obesity
  18. 18. 3.PHYSICAL INACTIVITY
  19. 19. Global Changes in Physical Activity • 31% of the world’s population does not get enough physical activity. • Many social and economic changes contribute to this trend: • • • Aging populations, Transportation, and Communication technology. 1. http://www.cdc.gov/physicalactivity/everyone/guidelines/adults.html 2. http://www.sciencedirect.com/science/article/pii/S0140673612608988
  20. 20. Global Changes in Physical Activity (cont.) Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT; Lancet Physical Activity Series Working Group. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012 Jul 21;380(9838):219-29
  21. 21. Physical Activity: Health Effects Reduces: •  High blood pressure • Adverse lipid profile • Arthritis pain Reduces risk of: • Type 2 diabetes • Certain cancers • Heart attacks • Stroke • Falls http://www.health.gov/paguidelines/factsheetprof.aspx
  22. 22. 4.HARMFUL USE OF ALCOHOL
  23. 23. Harmful Use of Alcohol: Effects Immediate effects: • Diminished brain function • • • Loss of body heat Fetal damage Risk for unintentional injuries • • Risk for violence Coma and death Long-term effects: • • • • Liver diseases Cancers Hypertension Gastrointestinal disorders • Neurological issues • Psychiatric issues
  24. 24. Metabolic Risk Factors http://www.who.int/nmh/events/2012/discussion_paper3.pdf • “Metabolic" refers to the biochemical processes involved in the body's normal functioning Behaviors (modifiable risk factors) can lead to metabolic/physiologic changes. WHO has prioritized the following four metabolic risk factors: • • ‒ ‒ ‒ ‒ Raised blood pressure Raised total cholesterol Elevated glucose Overweight and obesity
  25. 25. 1.OBESITY
  26. 26. KADAR OBESITI DI SELURUH DUNIA 17.7% MALAYSIA
  27. 27. 1.Puberty 2.Men above 30 3.Pregnancy 4.The freshman year of college 5.Injury 6.Depression 7.Menopause and peri-menopause (Women in their 50’s ) LIFE STAGE: CRITICAL PERIODS FOR WEIGHT GAIN
  28. 28. OBESITI
  29. 29. COMPLICATIONS OF OBESITY
  30. 30. 2.HIPERTENSI / TEKANAN DARAH TINGGI
  31. 31. Overview of NCD’s and Risk Factors Raised Blood Pressure Measurement Normal Pre-Hypertensive Hypertensive Systolic mmHg Diastolic mmHg <120 120-139 140+ <80 80-89 90+
  32. 32. 36.4 27.9 32.8 34.1 29.9 28.4 42.9 41.1 28.7 29.1 40.5 27.1 22.5 27.4 38.327.5 33.8 25.8 32.5 28.5 29.8 36.4 35.4 25.5 26.286.9 26.8 37.3 33.8 24.1 20.0 15.0 10.0 5.0 0.0 25.0 30.0 35.0 40.0 45.0 Prevalence(%) MALAYSIA : PREVALENCE OF HYPERTENSION BY STATE, ≥18 YEARS (2011 & 2015) 2011 2015
  33. 33. FAKTOR RISIKO HIPERTENSI
  34. 34. Raised Blood Pressure: Health Effects • • • Leading risk factor for stroke Major risk factor for coronary heart disease Risk of CVD doubles for each increment of 20/10 mmHg of blood pressure Other complications of raised blood pressure:• ‒ Heart failure ‒ Peripheral vascular disease ‒ Renal impairment ‒ Retinal hemorrhage ‒ Visual impairment
  35. 35. Hypertension and Excessive Sodium Intake • Sodium, through hypertension, is a major cause of cardiovascular disease deaths and disability. • About 10% of cardiovascular disease is caused by excess sodium intake. • 8.5 million deaths could be prevented over 10 years if sodium intake were reduced by 15%.
  36. 36. Sources of Sodium • People are unaware of how much dietary sodium they are eating. • In the U.S. 75% of sodium consumed comes from processed and restaurant foods. • In China and Japan, 75% of sodium consumed comes from cooking with high sodium products.
  37. 37. Recommendations and Actual Intakes WHO/PAHO • Recommendations • A population salt intake of less than 5 grams or approximately 2,000 milligrams of sodium, per person per day is recommended to reach national targets or in their absence. This level was recommended for the prevention of cardiovascular diseases. • Actual Intake • Latest global estimates show that average sodium intake varies from 2,000 to 7,200 milligrams of sodium per person per day.
  38. 38. 3.DIABETES MELLITUS Diabetes : keadaan di mana paras gula dalam darah adalah tinggi dari normal. Bila paras gula dalam badan meningkat:  Merosakkan sel yang memerlukan glukosa untuk bahan bakar dan
  39. 39. Diabetes: Burden of Disease 1. http://www.who.int/mediacentre/factsheets/en/ 2.http://www.idf.org/regions • 347 million people worldwide have diabetes. • In 2004, an estimated 3.4 million people died from consequences of high blood sugar. • Healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use can prevent or delay the onset of type 2 diabetes.
  40. 40. GOLONGAN RISIKO TINGGI UNTUK MENDAPAT DIABETES Berat badan berlebihan atau obesiti. Semakin berat >> semakin tinggi risiko diabetes. Faktor pemakanan Lebih makanan bergoreng/lemak tinggi dan kurang pengambilan makanan berserat
  41. 41. 11.6 15.2 17.5 7.2 8.3 47.50 8.0 9.2 4.2 4.9 4.7 20.0 18.0 16.0 14.0 12.0 10.0 8.0 6.0 4.0 2.0 0.0 NHMS 2011 Prevalence(%) NHMS III (2006) Total diabetes Known Undiagnosed NHMS 2015 IFG MALAYSIA : PREVALENCE OF DIABETES, ≥18 YEARS (2006, 2011, 2015) NHMS II (1996) NHMS III (2006) NHMS 2011 NHMS 2015 Age group S30 years S18 years S18 years Est. Population ≥18 years Prevalence 8.3% 11.6% 15.2% 2,622,284 17.5% Known diabetes 6.5% 7.0% 7.2% 1,247,366 8.3% Undiagnosed 1.8% 4.5% 8.0% 1,374,918 9.2% IGT* / IFG** 4.3% * 4.2% ** 4.9% ** 481,477
  42. 42. 19.8 25.4 18.5 16.7 19.3 14.8 18.1 19.4 20.6 15.5 18.6 14.2 14.8 17.4 19.2 0.0 5.0 10.0 15.0 20.0 25.0 30.0 Prevalence(%) PREVALENCE OF DIABETES, ≥18 YEARS, BY STATES (2006, 2011 & 2015) NHMS 2015NHMS III (2006) NHMS 2011
  43. 43. Berita baik adalah jika seorang DM dapat mengawal diabetes dengan baik, ia membantu mengelakkan atau melambatkan komplikasi
  44. 44. 22.8% (5 m) currently smoked tobacco ( NHMS 2015)
  45. 45. Pencegahan COPD Berhenti Merokok - Terapi gentian nikotin/pengurangan keinginan merokok.
  46. 46. NCD BOLEH DICEGAH Hampir 80% penyakit jantung, stroke dan diabetes jenis II boleh di cegah daripada berlaku Dengan menyingkirkan faktor risiko NCD Penggunaan tembakau, pemakanan tidak sihat, tidak aktif fizikal dan pengambilan alcohol.

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