Transcript ROLE OF MEDICAL WOMEN ASSOCIATION OF NIGERIA IN …

ROLE OF MEDICAL WOMEN
ASSOCIATION OF NIGERIA IN NONCOMMUNICABLE DISEASES
BY
PROF. G.C. ONYEMELUKWE (MON)
CHAIRMAN, NATIONAL EXPERT
COMMITTEE ON NON-COMMUNICABLE
DISEASES
AREWA HOUSE KADUNA
23RD NOVEMBER 2004
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LIST OF NON COMMUNICABLE
DISEASES
1.
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3.
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9.
Hypertension
Diabetes Mellitus
Sickle Cell Disease
Mental ILL Health &
drug abuse
Asthma
Violence (Road traffic
accident, domestic,
conflict
Blindness
Oral Health
Rheumatic
fever/rheumatic heart
disease
10. Coronary heart disease
11. Cerebrovascular disease
(stroke)
12 Heart Disease
a. Cardiomyopathies
b. Endomyocardial fibrosis
c. Peripartum Cardiac
failure (PPCF)
13. Cancers
a. Hepatoma
b. Prostate
c. Cervix
d. Breast
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MORTALITY STATISTICS (1999-2001) ABUTH, ZARIA
(Source: Community Medicine)
1.
Road traffic Accidents
14.25%
2.
Infections and Septicaemia
10.80%
3.
Hypertension
9.32%
4.
Protein calorie malnutrition
8.53%
5.
Tuberculosis
5.09%
6.
HIV/AIDS
4.75%
7.
Cancers
4.07%
8.
Mellitus
3.29%
9.
Cerebrovascular Accidents
(Stroke)
2.35%
*44% of deaths are due to NCDs
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*2003 SURVEILLANCE DATA LAGOS (SW
ZONE)
BP systolic
=>140mmHg
Female
: 22.6%
Male
: 22.1%
BP diastolic
=>90mmHg
Female: 29.5%
Male : 30%
Rural (all) : 13.7%
Urban (all): 28.7%
Rural :
Urban :
20.6%
36.9%
* Risk of CVS damage doubles for every 10
point increase in diastolic and 20 point
systolic increase.
* ¼ to 1/3 of women in rural and urban areas
are hypertensive.
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NATIONAL MENTAL HEALTH
SURVEY
•
•
DEPRESSION SYMPTOMS HIGH
(Female>male)
ANXIETY SYMPTOMS
HIGH
NB: Severe depression can lead
to violence and suicide
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BURDEN OF NON COMMUNICABLE DISEASE (DALYs)
%DISTRIBUTION IN SUB SAHARAN AFRICA
70
60
50
40
NCDs
Communicable
Injuries
30
20
10
0
1990
2000
2010
2020
Source: Murray & Lopez: Global burden of Disease
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WHAT IS RISK FACTOR?
• A risk factor is a condition that
places an individual at risk of
developing a health related problem.
• A risk factor can be genetic or
acquired. It may be identified as a
single measurement (e.g. a physical
feature such as weight), a disease
(e.g. Hypertension) or a lifestyle
characteristics (e.g. smoking)
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WHAT IS RISK FACTOR? Cont.
• In order to be considered a risk
factor for a disease, the condition
must be associated with that
disease in a manner which is beyond
chance alone.
• A casual link is therefore implied
• A risk factor will however not
necessarily lead to the development
of the disease
• Risk factors/habits begin in youth/in
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womb.
RISK FACTORS IN NCD’s I
Risk Factors
Hypertension
Diabetes
Mellitus
Strokes
Cancer
Physical
inactivity
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Alcohol Excess
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Psychological
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Low Economic
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Unsafe Sex
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Age
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Drug Abuse/Use
Tobacco
Use/Smoking
Salt Excess
Unhealthy Diets
Obesity
Abnormal Blood
Lipids
Family
History/Heredity
Gender
CAD
Mental
Illness
Violence
Heart
Disease/
PPCF
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RISK FACTORS IN NCD’s II
Risk Factors
Physical inactivity
Alcohol Excess
Drug Abuse/Use
Tobacco
Use/Smoking
Salt Excess
Unhealthy Diets
Obesity
Abnormal Blood
Lipids
Psychological Stress
Low Economic
Status
Unsafe Sex
Age
Family
History/Heredity
Gender
Asthma/COPD
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Sickle Cell Blindness
Disease
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Oral
Health
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Osteoporosis/
Nutrition
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REASONS FOR EXPLOSION OF
NCDs
1. Western Lifestyle
Leading to
INSULIN RESISTANCE
2. ROLE OF INFECTIONS
Cancer Liver
HBV, HBC (25-40%
CARRIERS)
Cervix – Papilloma/Herpes genitalis
Bladder – Schistosomiasis
Coronary artey disease – Chlamydia
Rheumatic heart disease – streptococci
Blindness – filaria/chlamydia.
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REASONS FOR EXPLOSION OF NCDs
Cont.
3. CULTURAL
Large body image “pot” belly/ “cash madam”
Cultural pre-matual fattening
“Kunu Kanwa” heating
postpartum heart
failure
“Mai – Shanu” consumption
lipidemia
Traditional African cooking vitamins
antioxidants destroyed
4. INTRAUTERINE LOW BIRTH WEIGHT
(BAKER’S HYPOTHESIS – Stress, infection,
under-nutrition, smoking.
5. NUTRITIONAL TRANSITION
CHILD STUNTING; REFEEDING – SHORT OBESE
ADULT
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ENVIRONMENT
GENES
VS
1.
2.
3.
PHYSICO-CHEMICAL-MICROBIAL ENVIRONMENT
PSYCHOSOCIAL ENVIRONMENT
INTRAUTERINE ENVIRONMENT
HIGH STRESS
LACK OF EXERCISE
HIGH FAT
SMOKING
HIGH SALT
ALCOHOL
HIGH RISK
BEHAVIOUR
UNSAFE SEX
DRUG ABUSE
FETAL UNDER NUTRITION
OBESITY, HYPERTENSION, DIABETES,
ASTHMA, CANCERS, MENTAL ILL-HEALTH,
CORONARY ARTERY DISEASE
OSTEOPOROSIS ETC
CHILDHOOD UNDER NUTRITION
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TEN COMMAND CIVIC DUTIES OF ALL NIGERIANS
S/N
DUTIES
BENEFITS
1.
Exercise daily (including walks)
Prevention of hypertension, diabetes,
obesity, mental ILL health, cancers etc.
2.
Know blood pressure from age 30 and above
(annually/six monthly)
Detect hypertension early (blood
pressure increases with age)
3.
Know blood sugar from age 40 years
Detect diabetes mellitus (blood sugar
increases with age)
4.
Know sickle cell genotype of all family
For counseling of family
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Monthly breast self examination by females from age 17
To detect lumps and early breast cancer
6.
Know presence of hepatitis B surface antigen in blood of
family members
Prevent liver cancer and other diseases.
7.
Know prostate specific antigen (PSA) blood level (men
50 years)
To detect prostate cancer
8.
Women screen cervical smear (PAP Smear) every 2 – 3
years
To prevent, detect early cervical cancer.
9.
Know blood cholesterol by obese or overweight people
from age 40 years
Prevent coronary heart disease
10.
Know body mass index (BMI) (weight in kg
Height x height (mtrs)
To watch nutritional excess or
deficiency
Issued by NCD Expert Committee on Non-Communicable Disease
Note: BMI >30kg/mtr2 is Obesity
BMI >25kg/mtr2 is overweight
BMI <18.5kg/mtr2 shows under-nutrition
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• POLITICAL WILL – Lack IN STATES of
NCDs,
SILENT KILLERS
CARING/COMPASSIONATE SOCIETY
• FIRM VOICE; FIRM AGENDA BY
(WOMEN)
• STRATEGIC GATES OF WOMEN AND
CONSEQUENCES
1. Gate to stomach
2. Gate into world (womb – intrauterine)
3. Gate to Child/Family Destiny –
Children risk
factors
4. Gate to Domestic Finance
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CONCLUSION
ROLES:
1. INFORMATION, EDUCATION,
COMMUNICATION – RADIO TALKS
2. SCREENING
3. LIFESTYLE RISK FACTOR
MODIFICATION (MULTIFACTOR
APPROACH)
4. RESEARCH IN WOMEN HEALTH –
BRITISH WOMEN/USA DONE
5. NATIONAL ACTION ON TOBACCO
CESSATION
6. HEPATITIS B VACCINATION OF
CHILDREN
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MAY GOD’S PUPPOSE
FOR NIGERIA BE
PERFORMED
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