NCDs

Question 1

Non communicable diseases

Answer 1

Cannot be transmitted from 1 to another

Insidious onset

Multiple causes

Long latency period (from initiation to detection)

Prolonged treatment

Care predominates

E.g. cancer, diabetes, stroke, heart disease

Question 2

Epidemiological transition

Answer 2

Pandemics of infection replaced by degenerative and man made diseases —> increased life span due to improved health care and disease prevention

Shift associated with demographic and socioeconomic transitions

Question 3

Age of pestilence and famine

Answer 3

Increase in infectious diseases

Nutritional deficiencies

Short average life expectancy

Increased mortality

Question 4

Age of receding pandemics

Answer 4

Transitional stage

Mortality starts to decline —> no longer die of infection at young ages, but of chronic disease at older ages

Improved sanitation, nutrition, personal hygiene and medical interventions

Lower fertility and longer birth intervals with better infant and child survival

Increasing lifespan

Question 5

Age of Degenerative and Man made Diseases

Answer 5

Further advancements — vaccines, antibiotics

Declines in mortality and fertility rates

Fertility more impt to popn growth

Longer periods of morbidity —> live longer to develop NCDs

Question 6

Age of delayed degenerative diseases

Answer 6

Extension of 3rd stage

Delayed due to operations, medicine, better diets

Risk of dying redistributed to older ages

Ageing popn

Question 7

Years of life lost (YLL)

Answer 7

Years of life lost due to premature mortality

YLL = N x L ; N=no of deaths , L = standard life expectancy at age of death in years

Question 8

Years lived with disability (YLD)

Answer 8

Years of healthy life lost due to living in states of less than full health

Disability weight —> reflects severity of disease

YLD = prevalence x disability weight

Question 9

Disability adjusted life year (DALY)

Answer 9

Overall disease burden

1 DALY = 1 lost year of healthy life

DALY = YLD + YLL

Question 10

Quality adjusted life year (QALY)

Answer 10

1 QALY = 1 year of life in perfect health OR 2 years lived in 50% of perfect health

QALY = years of life remaining for patient following treatment x QOL score (0-1)

Persons ability to carry out activities of daily life and freedom from pain and mental disturbance