Due to epidemiological transition, the global disease profile is changing at an astonishingly fast rate with a special pace in low and middle income countries like Bangladesh. This is resulting in the changing pattern of mortality and morbidity causes, which are shifting towards more death and disabilities due to chronic and Non Communicable Diseases (NCDs) than that of communicable and infectious diseases. Along with high death toll, NCDs are also identified as major cause of disability, resulting in disability adjusted life years (DALYs) and quality adjusted life years (QALYs).
There are many risk factors for developing NCDs, some of which are modifiable and some are non-modifiable. The most important modifiable risk factors for developing NCDs are: unhealthy diet and excessive energy intake, physical inactivity and tobacco use. All these causes are expressed through the intermediate risk factors i.e. raised blood pressure, raised level of blood glucose, abnormal blood lipids, overweight and obesity. All NCDs, combined with its intermediate risk factors, have direct costs of health-care resources and non-medical goods and the services consumed in the treatment of NCDs are enormous for even developing countries let alone developing countries like Bangladesh.
Now if we look at the status of NCDs in Bangladesh, among the top 25 cause of death, 12 are directly due to NCDs. A hospital based registry yields the fact that yearly 84,074 people get admitted by various types of cancer of which 53,710 dies. Among all cancer patients about 24.1% male suffers from lung cancer while 23.7% and 22.8% female suffers from breast cancer and cervical cancer respectively. The prevalence for diabetes (≥ 20 years) is 7% rurally and 14.2% in urban areas. One precursor for developing diabetes is metabolic syndrome and around 3% rural female suffers from metabolic syndrome. On the other hand cardio vascular diseases, hypertension and stroke cause around 12.5% (2.4% heart attack/MI, 3.6% stroke and 6.5% other cardio vascular complications) of the total death. Among rural population (≥ 18 year) 13% (9.8% male and 15.6% female) suffers from hypertension (140/90 mm hg). And annually around 5.9% population gets admitted to hospitals due to various COPD’s (except Asthma) and these various COPD’s causes around 3% of the total death. In case of risk factors, the percentage of sedentary lifestyle is 43% rurally and 90% in urban areas. Among total population (>15 year), 43% uses any kind of tobacco (either smoking or chewing or both) and in rural areas 6.5% females and in urban areas 50% female and 31% male are obese.
Even though maternal mortality declined from 322 in 2001 to 194 in 2010, a 40% decline in 9 years in our country, yet 21% maternal deaths occur as a result of cancer – another non communicable disease.
Within the aforementioned context, Eminence has taken NCDs as its one of core thematic areas and works for the prevention, control and management of NCDs.