「Non-Communicable Diseases」の版間の差分

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==definition==
 
==definition==
 
*IDs vertical program ⇔ NCDs horizontal program
 
*IDs vertical program ⇔ NCDs horizontal program
29行目: 31行目:
 
*[https://www.who.int/ncds/management/pen_tools/en/ PEN]
 
*[https://www.who.int/ncds/management/pen_tools/en/ PEN]
  
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==diabetes and insulin treatment in LMIC==
 
*[https://www.behance.net/gallery/87623813/Insulin-Zeer Insulin Zeer]
 
*[https://www.behance.net/gallery/87623813/Insulin-Zeer Insulin Zeer]
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*cool wallet (ex. Frio)
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*DOT (directly observed treatment) like in a refugee camp
 +
 +
*Malnutrition-modulated diabetes mellitus (MMDM)
 +
**Protein-deficient DM in West Africa
 +
**Fibrocalculus pancreatic DM
 +
**onset 10-30 y/o
 +
**rural origin, poor economic status
 +
**history of inadequate nutrition since in mother's uterus
 +
**more severe DM
 +
 +
*tropical diabetic hand syndrome
 +
**usually after minor trauma
 +
**seems not due to peripheral angiopathy/neuropathy
 +
**localised cellulitis confined to hands, often progressive to amputation
 +
 +
==stroke==
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*2/3 of worldwide stroke occur in developing countries
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*40% occur in <70y/o
 +
*ethnic differences
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**caucasian
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**80% ischemic stroke
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*South Asian
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**20-30% hemorrhagic stroke
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*Africa
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**26-33% cerebral hemorrhage
 +
*Head CT
 +
**&asymp;100% in HICs
 +
**90% in LMICs, but confined to a certain size of hospitals to which many residents have difficulty in access
 +
*antiplatelet
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**92% in HICs
 +
**78% in LMICs
 +
*rtPA
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**30% in HICs
 +
**3% in LMICs
 +
 +
==NCDs among children and adolescent==
 +
*WHO definition for NCD deaths exclude that in < 30 y/o
 +
*insufficient data
 +
*rheumatic heart disease
 +
**15.6 mil. per year
 +
*Sickle cell anemia
 +
**70% of world cases in Sub-Sahara
 +
*pediatric and adolescent malignancy
 +
**cure rate 80% in HICs, 20% in LMICs
 +
*bronchial asthma
 +
**high risk factor is solid fuel burned inside house
 +
*suicide
 +
**third leading deaths in 15-19 y/o
 +
**risk
 +
***sexual violence
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***bullying
 +
***discrimination
 +
***in conflict or disaster zone
 +
***
 +
*injuries and violence
 +
**intentional
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***self
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***by others
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**unintentional 90%
 +
***1st deaths in 10-19 y/o
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***road traffic accidents 93% in LMIs
 +
***drowning
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***burns, death rate in LMIC 11 times higher than in HIC
 +
***fall
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***poisoning
 +
 +
==cancer and palliative care==
 +
*cancer 2nd deaths worldwide
 +
*9.6 mil. deaths in 2018
 +
**1 in 6 deaths
 +
*incidence in both sexes
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**1 lung, 2 breast, 3 colon, 4 prostate
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*mortality in both sexes
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**1 lung, 2 colon, 3 stomach, 4 liver
 +
 +
*only 26% of LMICs have pathology service available
 +
*only 20% of LMICs have cancer data
 +
 +
*1/3 of death by cancer are potentially preventable
 +
**obesity reduction
 +
**smoking cessation
 +
**alcohol reduction
 +
**infection control for HPV, HepB, HepC, ''H. pyroli''
 +
**occupational exposures to environmental carcinogenic agents
 +
 +
===HPV===
 +
*90% of HPV infection spontaneously regress within 24 months
 +
*risk factors of infection
 +
**early sexual activity
 +
**young age at first birth
 +
**multiple pregnancies
 +
**multiple
 +
*risk factors of cervical cancers
 +
**HPV type
 +
**immune status
 +
**coinfections with other STIs including HIV
 +
**multiparity and young age at first birth
 +
**tobacco
 +
**OC > 5 years, but it is confounding with sexual activity

2021年5月30日 (日) 16:37時点における最新版

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Chevron-up-blue.png

definition

  • IDs vertical program ⇔ NCDs horizontal program
  • some IDs in tropics have NCD-like characterics
    • HIV
    • lymphatic filariasis
    • Chagas disease

epidemiology

  • 41 mil. deaths per year worldwide
    • 71% of all deaths
  • 15 mil. deaths by NCDs occur between 30 and 69 y/o ... "premature" death

NCDs in LMICs

  • tobacco
  • food pricing and availability
  • food preferences
  • physical activity
  • technologies
  • social movement
  • limited research of NCDs in LMICs

measuring burdens of NCDs

  • death
  • DALY
  • QALY
    • DALY and QALY.jpg

WHO Package of Essential NCDs intervention (PEN)

diabetes and insulin treatment in LMIC

  • Insulin Zeer
  • cool wallet (ex. Frio)
  • DOT (directly observed treatment) like in a refugee camp
  • Malnutrition-modulated diabetes mellitus (MMDM)
    • Protein-deficient DM in West Africa
    • Fibrocalculus pancreatic DM
    • onset 10-30 y/o
    • rural origin, poor economic status
    • history of inadequate nutrition since in mother's uterus
    • more severe DM
  • tropical diabetic hand syndrome
    • usually after minor trauma
    • seems not due to peripheral angiopathy/neuropathy
    • localised cellulitis confined to hands, often progressive to amputation

stroke

  • 2/3 of worldwide stroke occur in developing countries
  • 40% occur in <70y/o
  • ethnic differences
    • caucasian
    • 80% ischemic stroke
  • South Asian
    • 20-30% hemorrhagic stroke
  • Africa
    • 26-33% cerebral hemorrhage
  • Head CT
    • ≈100% in HICs
    • 90% in LMICs, but confined to a certain size of hospitals to which many residents have difficulty in access
  • antiplatelet
    • 92% in HICs
    • 78% in LMICs
  • rtPA
    • 30% in HICs
    • 3% in LMICs

NCDs among children and adolescent

  • WHO definition for NCD deaths exclude that in < 30 y/o
  • insufficient data
  • rheumatic heart disease
    • 15.6 mil. per year
  • Sickle cell anemia
    • 70% of world cases in Sub-Sahara
  • pediatric and adolescent malignancy
    • cure rate 80% in HICs, 20% in LMICs
  • bronchial asthma
    • high risk factor is solid fuel burned inside house
  • suicide
    • third leading deaths in 15-19 y/o
    • risk
      • sexual violence
      • bullying
      • discrimination
      • in conflict or disaster zone
  • injuries and violence
    • intentional
      • self
      • by others
    • unintentional 90%
      • 1st deaths in 10-19 y/o
      • road traffic accidents 93% in LMIs
      • drowning
      • burns, death rate in LMIC 11 times higher than in HIC
      • fall
      • poisoning

cancer and palliative care

  • cancer 2nd deaths worldwide
  • 9.6 mil. deaths in 2018
    • 1 in 6 deaths
  • incidence in both sexes
    • 1 lung, 2 breast, 3 colon, 4 prostate
  • mortality in both sexes
    • 1 lung, 2 colon, 3 stomach, 4 liver
  • only 26% of LMICs have pathology service available
  • only 20% of LMICs have cancer data
  • 1/3 of death by cancer are potentially preventable
    • obesity reduction
    • smoking cessation
    • alcohol reduction
    • infection control for HPV, HepB, HepC, H. pyroli
    • occupational exposures to environmental carcinogenic agents

HPV

  • 90% of HPV infection spontaneously regress within 24 months
  • risk factors of infection
    • early sexual activity
    • young age at first birth
    • multiple pregnancies
    • multiple
  • risk factors of cervical cancers
    • HPV type
    • immune status
    • coinfections with other STIs including HIV
    • multiparity and young age at first birth
    • tobacco
    • OC > 5 years, but it is confounding with sexual activity