Year : 2013 | Volume
: 10 | Issue : 1 | Page : 1--2
Challenges with the control of non-communicable disease burden
Department of Medicine, Bayero University/ Aminun Kano Teaching Hospital, Kano, Nigeria
M M Borodo
Department of Medicine, Bayero University/ Aminun Kano Teaching Hospital, Kano
|How to cite this article:|
Borodo M M. Challenges with the control of non-communicable disease burden.Niger J Basic Clin Sci 2013;10:1-2
|How to cite this URL:|
Borodo M M. Challenges with the control of non-communicable disease burden. Niger J Basic Clin Sci [serial online] 2013 [cited 2022 Jan 25 ];10:1-2
Available from: https://www.njbcs.net/text.asp?2013/10/1/1/117228
While the manifestations of non-communicable disease (NCD) is bread and butter in the developed world, the rising profile of this group of health problems is yet to reach its peak in the less developed parts of the world as its predicted global epidemic in the next two decades promises to unleash most of its venom in that region with expected devastating consequences in morbidity and mortality figures of the population, unless appropriate strategies are put in place.
Copied unhealthy life-styles, low level of health education, poor resources and inappropriate use of modern technology as well as misdirected leadership styles are important catalysts of the brewing epidemic of NCDs in the developing world requiring redress in order to put control strategies to address the menace. Although NCDs such as hypertension, diabetes, hyperlipedemia and non-alcoholic fatty liver run a chronic course with prolonged incubation period before they cause devastating mortality through cardiovascular diseases such as stroke and ischemic heart disease, others like cancers and obstructive airways diseases lead to death through other multiple path ways also after a long siege on patients. There is yet another group with short incubation period with often fatal consequences such as traumatic illnesses notably road traffic accident and pregnancy related mortality affecting mother and fetus/neonate alike.
Arising from these highlighted varied characteristics of the NCDs, appropriate control measures require to be deployed to address them. Notable among these is improved level of health education of the populace about risk factors/behaviors for acquiring the conditions as well as knowledge of their early clinical manifestations and treatment/control measures.
An example of an interventional scheme targeting pregnant women for control of NCDs is the article in this edition by Malik et al. on utilization of financial assistance under Janani Shuraksha Yojna scheme in rural India, which draws attention to a commendable government sponsored program of cash inducement for pregnant women to deliver in hospital under standard medical care to stem the high maternal and neonatal mortality in India. As the authors said "every year more than 500,000 women die from causes related to pregnancy and child-birth. More than 99% of these deaths take place in developing countries. India alone has 22% of the global total.'' This scheme, which covers 9.5 million women (36%) of the 26 million women who deliver annually in India engulfs $342 million annually and exemplify appropriate leadership style that should be copied by others. The case report by Hauwa M Abdullahi and others from Nigeria on a case of intra-abdominal pregnancy presenting late to expert health-care manifests the paucity of health education that often fuels the scourge of the NCDs. The case for further health education in the control of NCDs is further highlighted by the article on Assessing the severity of injury using the revised trauma score by Gwaram and co-authors where the authors drew attention to the very high mortality (67%) associated with serious injuries mainly from transport related accidents. The study further identified avoidable risk factors such as non-use of seat belt or helmet and driving under the influence of alcohol as correctable traits via diligent health education programs.
Chronicity of NCDs such as hypertension and diabetes has implication for long term treatment using life-style changes, dietary control as well as pharmacologic agents that have their cost implications and side-effects that may not be palatable, all of which contribute to patient exhaustion and predispose to treatment failure with dire consequences. There are also non pharmacologic treatments such as exercise, weight control and maintenance of normal blood lipids, which are often not expensive but require motivation but have the huge advantages of cutting down the cost of care as well as providing independent protection against cardiovascular disease risk. The article by Sikiru Lamina and others in this edition on the effects of interval training program on rate - pressure product in the management of hypertension in black male subjects, which shows statistically significant beneficial reduction in both blood pressure and myocardial oxygen demand after interval exercise in mild to moderate male black hypertensive, illustrates this point. Of further significance is the proven role of these life-style changes in the delay in the occurrence or even the prevention of hypertension and diabetes in those with other risk factors for the conditions.
This edition also draws attention to the problem of self-medication reported by Hauwa Abdullahi and Jamilu Tukur in the form of traditional medications for sexual stimulation in over half of a population of predominantly young females interviewed raising concern about possible untoward effects of drugs. There are also other case reports and communications to the editor to complete your reading of this edition!