Non-Communicable Diseases (NCDs) During Adolescent

 Major Non communicable disease 

Cardio-vascular diseases (CVDs), 

Diabetes, 

Cancer and Chronic respiratory diseases 

Globally, Every 2 seconds someone aged 30 to 70 years dies prematurely from NCDs

In Ethiopia, NCDs are an emerging health problem accounting for 39% of deaths (WHO 2018)

Global NCD burden 


Communicable, maternal, perinatal & nutritional conditions
injuries
CVDs
Other NCDs
Diabetes
Cancers




NCD Burden in Ethiopia: WHO Estimates


Risk factors of NCDs

Behavioral risk factors: Tobacco use, physical inactivity, unhealthy diet, and harmful use of alcohol
Metabolic/physiological risk factors: Raised blood pressure, overweight/obesity, high blood glucose level, and hyperlipidemia
Biological risk factors: actually the result of those behavioral risk factors
Infectious causes: Hepatitis B & C, HPV, HIV, Helicobacter pylori, Schistosomiasis, and the Liver Fluke are  prevalent  in developing countries

Why focus on NCDs in AYH?
The 70% of premature deaths in adults are associated with AY behaviors
Adolescence and youth is a time to adopt  risk and protective  behavior like
 physical inactivity,
 unhealthy diet,
 tobacco use and
 harmful use of alcohol

Global burden of cervical cancer 
Cervical cancer is the 2rd most common cancer in women
In 2020, an estimated 604 000 women were diagnosed with cervical cancer worldwide and about 342 000 women died from the disease.  Cervical cancer is the most commonly diagnosed cancer in 23 countries and is the leading cause of cancer death in 36 countries (sub-Saharan Africa, Melanesia, South America, and South-Eastern Asia) Nearly 90% of deaths occurring in low- and middle-income countries. 

National burden of cervical cancer 

In Ethiopia cervical cancer is the second most frequent form of cancer and the leading cause of cancer deaths among women.
 Cervical cancer causes an estimated 7445 new cases and about 5338 deaths every year (Globocan 2020)
Majority of cancer cases (over 80%) are detected at a late stage, predominantly due to lack of information about cervical cancer and lack of prevention services

Risk factors of cervical cancer 

Common factors for cancer development in adolescents and youths are  Early initiation of sex, 
Practicing risky sexual behaviors including multiple sexual partners, 
STI including HIV
Smoking 

Prevention 

Primary prevention: Mainly but not limited to HPV vaccination for girls 
Secondary prevention: Screening for and treating precancerous lesions
Tertiary prevention :Focuses on treating advanced cancer stages 
The primary prevention interventions for cervical cancer focus on reducing exposure to the modifiable risk factors


Global and national burden of Breast cancer 

Globally, 
number one leading cause of cancer  2.5 million women were newly diagnosed with breast cancer 685,000 women were died 
Nationally 
16,000 women were diagnosed with breast cancer  9061 women were died (Globocan 2020)


Risk factor for breast cancer 

Modifiable risk factors
Lifestyle factors: 
Drinking alcohol 
Lack of exercise
Diet especially high fat diet
Obesity
Estrogen exposure
Radiation
Non-modifiable risk factors
Age- risk increases above 50
Race
Gender
Individual or family history of breast cancer


Methods of early detection 


Breast self-exam (BSE)- monthly
Clinical Breast Exam (CBE) by nurse or doctor
Mammography

Injury during Adolescence and Youth


Injury is any physical harm or damage to someone's body caused by an accident or an attack 
Injuries are defined as damage to a person caused by an acute transfer of mechanical, thermal, electrical, chemical, or radiation energy or by the sudden absence of heat or oxygen.

Types of Injury

Unintentional injuries:  
No evidence of predetermined intent;  include motor vehicle injuries, suffocation, drowning, poisoning, burns, falls, sports 
Intentional Injuries : 
Inflected purposefully by someone else or oneself such as: Interpersonal violence (homicide, sexual violence), self-harm (e.g. attempted suicide, self-mutilation) and war, civil insurrection

Consequences of Injuries
Physical and/or cognitive limitations due to neuro-trauma Paralysis due to spinal cord trauma
Physical limb deformation or/and Partial or complete amputation Psychological trauma: Depression, post traumatic syndrome Economic crisis Sensory disability such as blindness and deafness Death.

Preventing injuries and violence

Require the involvement of a range of sectors – addressing underlying 
Economic, 
Social, 
Legal and environmental factors.  Setting and enforcing laws on a range of issues
Community (community mobilization ), schools (awareness raising activities, life skill programs ) and health facility-led prevention interventions

Prevention at the health facility

Should lead prevention through various approaches Conduct health education and SBCC activities
Conduct screening of adolescents at risk of injury such as those with mental illness, with disabilities etc.  
Provision of appropriate care and support Conduct referral services to the next tier as necessary
Provide pre- hospital and emergency care before referral.


Summary

Cardio-vascular diseases (CVDs), diabetes, cancer, chronic respiratory diseases and mental health problems are NCDs worldwide
Cervical cancer is a preventable disease and it prevalent cancer in Ethiopia
Cervical cancer is caused  STI, HPV, which is common viral infection 
HPV vaccination program is cost-effective in developing countries
Injury is one of the public health problems among adolescents and youth
Unintentional injury specially, road traffic accident are major causes of disability, psychological problem and mortality in AY
The role of the health system in preventing injury among adolescents and youth is to take a lead, advocate and bring the other stakeholder together to act up on








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