The killer diseases…Not to neglect

WHO has warned: Prevention and treatment services for noncommunicable diseases (NCDs) have been severely disrupted since the actual pandemic began. The impact is global, but low-income countries are most affected. This is of significant concern because people living with NCDs are at higher risk of severe COVID-19-related illness and death. This virus could indirectly result in many more victims as the fight against “classic” infectious diseases, like measles, TB, HIV and malaria, is in danger of falling behind and these dangerous infections are currently on the rise again.

Many people who need treatment for diseases like cancer, cardiovascular disease and diabetes are not having the health services they should.

Service disruptions are widespread
Health services have been partially or completely disrupted in many countries. More than half (53%) of the countries surveyed have disrupted services for hypertension treatment; 49% for diabetes and related complications; 42% for cancer treatment and 31% for cardiovascular emergencies.
Rehabilitation services have been disrupted in almost two-thirds of countries, even though rehabilitation is key to a healthy recovery following severe illness from COVID-19.

Alternative strategies for continuing care being implemented
Alternative strategies have been established in most countries to support the people at highest risk to continue receiving treatment for NCDs. Globally, 58% of countries are now using telemedicine (advice by telephone or online means) to replace in-person consultations; in low-income countries this figure is 42%. Triage to determine priorities has also been widely used, in two-thirds of the reporting countries.

Noncommunicable diseases kill 41 million people each year, equivalent to 71% of all deaths globally. Each year, 15 million people die from an NCD between the ages of 30 and 69; more than 85% of these “premature” deaths occur in low and middle-income countries.

If you have an underlying medical condition, continue to follow your treatment plan:
■ Continue your medicines: Do not change your treatment without talking to your doctor.
■ Have at least a 30-day supply of your medicines: Reduce trips to the pharmacy.
■ Do not delay getting emergency care for an underlying medical condition: Emergency departments have contingency infection prevention plans.
■ Call your doctor if you are concerned: Any doubts about underlying medical conditions or others should be monitored.

The most relevant neglected killers
Cardiovascular disease
The number of people in the world dying from cardiovascular disease (CVD) continues to rise. Whilst genetic factors do play a role in whether people develop CVD, lifestyle choices over time have the most devastating cumulative effects.

It has been said that the best way we should think about CVD is to picture an onion. The outermost layer represents the most visible outcomes of CVD, primarily heart attack and stroke. Peelling back that layer we find coronary heart disease, cerebrovascular disease and other diseases and conditions that lead to those outcomes. Removing another layer, we will find contributing conditions like obesity, diabetes, clogged arteries and high blood pressure. In the deeper layers, you get to the key root causes of CVD: lifestyle choices that contribute to those conditions, even those based in genetic predisposition.
Preventing and managing CVD requires risk factor awareness, lifestyle changes and access to adequate health care.

The deadliest disease in the world is coronary artery disease (CAD). Although it is still the leading cause of death, mortality rates have declined in many European countries. Also called ischemic heart disease, CAD occurs when the blood vessels that supply blood to the heart become narrowed.

In fact, strokes are the leading cause of long-term disabilities. People who receive treatment within three hours of having a stroke are less likely to have disabilities.
Stroke prevention methods include controlling high blood pressure and maintaining a healthy lifestyle, with regular exercise and a healthy diet, low in sodium. Avoid smoking, and drink only in moderation.

Chronic Obstructive Pulmonary Disease
COPD is a long-term, progressive lung disease that makes breathing difficult. Chronic bronchitis and emphysema are types of COPD. It is mainly caused by long-term exposure to smoke or dust pollution. Damage to the lungs is irreversible, there is no cure, but medication can slow progression. The resulting reduction in the supply of oxygen to the body has wide-ranging effects on the individual’s general health and mobility, and impacts upon all aspects of life including work, family and social participation.
The best way to prevent COPD is to stop smoking and to avoid secondhand smoke and other lung irritants.

Lower respiratory infections
A lower respiratory infection is an infection in the airways and lungs, mostly viral but can also be caused by bacteria. Coughing is the main symptom, ill people may also feel breathlessness, wheezing and a tight feeling in the chest. Untreated lower respiratory infections can lead to breathing failure and death.
Pneumonia is still responsible, worldwide, for a large number of deaths in adults and children.

Diabetes mellitus
Diabetes affects insulin production and use. It is not always preventable but there are a number of factors, including poor diet, lack of exercise and being overweight, that need to be controlled.
People in low to middle-income countries are more likely to die of complications from diabetes.

Take care
When people think of the deadliest diseases in the world, their minds probably jump to the fast-acting, incurable ones that grab headlines from time to time. In fact, many of these diseases do not rank in the top causes of worldwide deaths. Perhaps more surprising is that several of the deadliest diseases are partially preventable. Non-preventable factors include where a person lives, access to preventive care, and quality of healthcare. These all accumulate to increase risk but there are steps everyone can take to lower their risk.

Do not forget there is more than one life-threatening disease!

Best health wishes,
Maria Alice

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Dr Maria Alice is a consultant in General and Family Medicine. General Manager/Medical Director – Luzdoc International Medical Service. Medical Director – Grupo Hospital Particular do Algarve/ Hospital S. Gonçalo de Lagos