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==definition==
*IDs vertical program ⇔ NCDs horizontal program
*DALY
*QALY
**[[file:DALY_and_QALY.jpg|500px]] ===WHO Package of Essential NCDs intervention (PEN)===*[https://www.who.int/ncds/management/pen_tools/en/ PEN] ==diabetes and insulin treatment in LMIC==*[https://www.behance.net/gallery/87623813/Insulin-Zeer 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
