Non communicable diseases

Question 1

characteristics of NCD’s

Answer 1

complex cause
multiple risk factors 
non contagious cause
long latency period
prolonged course of illness
often curable
causes reduced quality of life
increased premature mortality and morbidity

Question 2

types of NCD’s

Answer 2

cancer
diabetes
chronic lung disease
heart disease/ stroke
other:
Mental illness
o Injuries
o Malnutrition
o Neuro-degenerative diseases
o Musculoskeletal diseases

Question 3

some risk factors

Answer 3

modifiable: alcohol, smoking, diet, physical inactivity , stress, pollution
non modifiable: age, sex, race, family history, personality

Question 4

pathway to NCD

Answer 4

environmental- national level
behavioral- PHC LEVEL
biological - PHC LEVEL
chronic NCD- TERTIARY LEVEL

Question 5

Stages of epidemiological transition

Answer 5

Stage 1:
• Stage of pestilence and famine
– Stage 2:
• Stage of receding pandemics
– Stage 3:
• Stage of degenerative and human created diseases
– Stage 4:
• Stage of delayed degenerative diseases
– (Possible) Stage 5:
• Stage of reemergence of infectious and parasitic diseases
(hypothesized)

Question 6

socio-ecological framework

Answer 6

individual, relation ,community, societal

Question 7

active case finding

Answer 7

using existing data to look for people with known risk factors

Question 8

passive case finding

Answer 8

wait for people to come to clinic

Question 9

screening tests

Answer 9

cheap
positive indicates suspicion high sensitivity 
simple and non invasive
detect potential disease indicators
asymptomatic individuals

Question 10

sensitivity

Answer 10

proportion of individuals who have the disease who test positive= a/a+c

Question 11

specificity

Answer 11

proportion of individuals who dont have the disease who test negative= d/ b+d

Question 12

positive predictive value

Answer 12

proportion of individuals who test positive who actually have the disease
a/a+b

Question 13

Quadruple burden of disease

Answer 13

maternal, child problems
HIV and TB
NCD
Trauma and violence

Question 14

what qualifies a disease for screening

Answer 14

disease- should be an important public health problem, early asymptomatic stage should exist, known to cause suffering, disability or death if detected late

test- simple, cost effective, safe, acceptable, good sensitivity, specificity and PPV(not diagnostic)
follow up- diagnosis can be confirmed, treatment is available
outcome- early treatment improves long term outcome

Question 15

challenges for screening in SA

Answer 15

Decreased access to healthcare:
Lack of equipment
Shortage of staff
Poor staff training
– E.g. inadequate smears (for TB or Pap smears)
Loss to follow-up
Long waiting lists for intervention