Non-communicable diseases a major burden in rural and urban areas alike

Health Care, Heart Care Foundation of India, Medicine Comments Off

Alcohol and tobacco consumption and unhealthy lifestyles form the root cause

New Delhi, 29 January 2019: According to recent reports by the WHO, non-communicable diseases (NCDs) continue to be the top killers in the South-East Asia Region, claiming 8.5 million lives each year. The categories include cardiovascular and chronic respiratory diseases, as well as diabetes and cancer. These are collectively responsible for over 70% of all deaths worldwide, or 41 million people. These include 15 million people dying prematurely, aged between 30 and 69.

The WHO indicated tobacco use, unhealthy diet, insufficient physical activity and harmful use of alcohol as the modifiable risk factors for these diseases. The NCDs disproportionately affect the poor, impoverish families, and place a growing burden on health care systems. Containing the NCDs has been listed by the WHO as its health goal for this year along with reducing mortality related to air pollution and climate change, global influenza pandemic etc.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “NCDs are not only a health problem but also a development challenge in a country like India. Apart from forcing people into poverty, they also have a large impact on undercutting productivity. While non-communicable diseases have traditionally been thought of as affecting only the urban population, research indicates that there has been an increase in their prevalence in the tribal areas as well. This is largely due to an early epidemiologic transition. There is a lack of access to affordable and quality public health systems in these areas, which further exacerbates the situation. The need of the hour, therefore, is to strengthen the public health system in these areas and integrate the tribal medical system with modern systems of medicine for providing best possible care.”

According to the National Health Systems Resource Centre, there is an overall deficit of 20% sub-centres, 30% PHCs and 22% CHCs in ten major states with tribal populations.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “The need of the hour is an urgently integrated action on health care to make it universally accessible and affordable at the same time. This will not only help address the health needs but also have a positive effect on poverty and growth levels. A strategy that makes citizens more competitive and act as an asset to the country’s growth is what is required at this juncture.”

Some tips from HCFI

·       Develop healthy habits including eating, sleeping, and exercising right.

·       Do not overdo anything. From drinking to using the cell phone, everything must be in moderation.

·       Follow ancient wisdom. Do Yoga and Meditation for your mental and spiritual wellbeing and maintain equilibrium. Allow your body to heal itself.

·       Get periodic check-ups done. Early detection of most health problems can help in correcting lifestyles to slow the degeneration process and lead a longer and healthier life.

·       Both active and passive smoking are harmful for the body.

·       Manage your blood cholesterol, blood pressure as well as blood sugar.

·       Maintain optimum body weight. Limit your salt intake.

Will leprosy be eliminated from the country this year?

Health Care Comments Off

Leprosy was eliminated from India in 2005, yet leprosy continues to be prevalent in the country as is evident from the NLEP Annual data for the year 2017-18 on the status of leprosy in India. Elimination means a prevalence rate of less than 1 case per 10,000 population at national level.

As on March 2018, at least seven states had more than 5000 cases. With 14,338 cases, Bihar had the highest no. of cases followed by UP with 12, 583 cases; Maharashtra (9836 cases), West Bengal (9175 cases), Chattisgarh (6499 cases), Odisha (6325 cases) came next (Source: National Leprosy Eradication Programme website).

Three states still have a prevalence rate exceeding the required less than 1 case per 10,000 population: Chattisgarh (2.25), Bihar (1.18) and Odisha (1.38).

Leprosy is now being detected from parts of the country not known to be prevalent for leprosy. Also, cases of multibacillary leprosy(>5 lesions with involvement of≥2 nerves) as well as cases with deformities are being detected indicating advanced stage of the disease. This means late diagnosis or failure of early leprosy detection. Early detection is crucial to its elimination.

The special Leprosy Case Detection 15-day Campaign for early detection of leprosy cases in high endemic districts conducted in 2016 had identified more than 32,000 confirmed cases.

Leprosy: At a glance

• Leprosy, also known Hansens disease is an infectious disease caused by mycobacteria of the Mycobacterium leprae complex that involve the skin and peripheral nerves.

• Leprosy, also known Hansens disease is an infectious disease caused by mycobacteria of the Mycobacterium leprae complex that involve the skin and peripheral nerves.

• Early diagnosis and a full course of treatment are critical for preventing lifelong neuropathy and disability.

• Leprosy is probably spread by the respiratory route. In the US, it is also a zoonosis; contact with armadillos has been documented in some cases.

• Leprosy is classified using the following categories: tuberculoid (TT), borderline tuberculoid (BT), mid-borderline (BB), borderline lepromatous (BL), lepromatous (LL), and indeterminate (I).

• Early physical exam findings include hypopigmented/reddish skin patches, diminished/loss of sensation in involved areas, paresthesias, painless wounds or burns and tender, enlarged peripheral nerves.

• The diagnosis is established when at least one of these physical findings is present and a skin biopsy obtained from the leading edge of the skin lesion confirms the presence of acid-fast bacilli in a cutaneous nerve.Achieving and maintaining elimination status of Leprosy by 2018 was one of the targets under the National Health Policy 2017 (Source: Press Information Bureau, March 23, 2018).

A nationwide post-exposure prophylaxis was also launched last year with single-dose rifampicin for all contacts of leprosy cases detected as per the 2018 WHO guidelines on the diagnosis, treatment & prevention of leprosy.

The WHO guidelines recommend the “use of single-dose rifampicin (SDR) as preventive treatment for adult and child (2 years of age and above) contacts of leprosy patients, after excluding leprosy and tuberculosis (TB) disease and in the absence of other contraindications”.

Now the Govt. has planned elimination of leprosy under Sparsh leprosy Awareness Campaign (SLEC) by 2nd Oct, 2019 to commemorate the 150th Birth Anniversary of Mahatma Gandhi vide a letter from Dr Anil Kumar, Deputy Director General (Leprosy) DO No. X-11016/07/2015-Lep, dated 14th Sept. 2018 (Source: National Leprosy Eradication Programme website).

Will leprosy be eliminated from the country this year?

We hope for the best, but this target appears elusive for now.

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA