CHRONmate

ASTHMA, WHAT YOU SHOULD KNOW

By Omodolapo Shobowale, CHRONmate NCD Champion

Asthma is a major noncommunicable disease which is a clinical syndrome of chronic airway inflammation characterized by recurrent, reversible, airway obstruction. Airway inflammation also leads to airway hyperreactivity, which causes airways to narrow in response to various stimuli.

According to WHO in 2016, It was estimated that more than 339 million people suffer from asthma of which majority were among children. Asthma remains a leading cause of missed workdays. It is also responsible for 1.5 million emergency department visits annually and up to 500,000 hospitalizations.

Also, the advent of asthma in an individual can be attributed to either or both of these two factors: genetic predisposition and environmental factors. These factors are known as allergens.

Asthma is the most common noncommunicable disease among children. Most deaths occur in older adults. However, the classic signs and symptoms of asthma are shortness of breath, cough (often worse at night), and wheezing (high-pitched whistling sound produced by turbulent airflow through narrow airways, typically with exhalation). Many patients also report chest tightness. Although asthma cannot be cured, It is important to note that these symptoms are episodic, and individuals with asthma can go long periods without any symptoms.

What are Allergens?

Allergens are substances that provoke allergic reactions which irritate the airways and causes it to be inflamed.
Examples are; dust, mites, chemical irritants, smoke, pollens, moulds, air pollution, cold air, others are extreme emotional arousal such as anger or fear, and physical exercise. Certain medications can also trigger asthma e.g. aspirin and other non-steroid anti-inflammatory drugs, and beta-blockers (which are used to treat high blood pressure, heart conditions and migraine).

First Aid Treatment for an Asthma Attack

In case of an asthmatic attack at home, at work, an event, or anywhere at all, these are the procedures to take before rushing the victim to the nearest hospital for further attention:

The victim should be reassured to avoid panic
The victim should be moved to an open space where there is adequate ventilation,
The victim should be assisted to sit upright (cardiac position),
If the victim is conscious, he would be asked where to get his medications e.g inhaler,
The victim should be helped to a nearby healthcare facility to immediately seek medical attention.

Although, asthma does not kill on the scale of other chronic diseases like chronic obstructive pulmonary disease (COPD), but failure to take appropriate medications or adhere to treatment can lead to death.

So, it is necessary for asthmatic patients to take appropriate medications and at all cost avoid an environment with triggers (factors) that pose the occurrence of another asthmatic attack so as that the disease can be well controlled and they can enjoy a good quality of life.

Act On NCDs

By Daniel Odeyemi, CHRONmate NCD Champion

Many times, we have people around us having one health related challenge or the other. How we respond or cater for such people goes a long way in their recovery process. Our focus here is on Non-Communicable Diseases (NCDs).

Living with people having such diseases does not mean you are also going to contract it, so relax and read through.

What are Non-communicable Diseases ?

These are diseases that cannot be transmitted from person to person, meaning you can’t contract them from another person. They often last for a long period of time also.

Four major non communicable diseases include:
1. Cardiovascular disease (involving the heart or blood vessels)
2. Diabetes
3. Cancers
4. Chronic respiratory diseases e.g. Asthma, chronic obstructive pulmonary disease, cystic fibrosis.

Risk factors for Non-communicable Diseases

Environmental factors (these are factors due to the environment in which we live, grow and also what we are exposed to.
Tobacco use
Harmful use of alcohol
Physical inactivity
Eating habits.

Non communicable diseases kill about 41 million people each year, accounting for about 71% of all deaths globally with cardiovascular diseases responsible for the largest percentage.

Proportions of NCDs distribution globally

In Nigeria, Non communicable diseases account for an estimated percentage of 29% in 2016 according to world bank collection of development indicators. According to WHO, evidence shows that 15 million of death attributed to NCDs occur between the ages of 30-69 years. Of these deaths, over 85% are estimated to occur in low and middle income countries. Therefore, Poverty contributes to the prevalence of NCDs and this poses a very great challenge.

Let’s take a look at the figure below;

Prevention and Control of NCDs

Tobacco control interventions
Improvement measures towards healthy dietary and physical activity patterns
Early detection and treatment of cancers
-Treatment of hypertension, diabetes
Treatment of heart disease and stroke
Increase of poverty alleviation schemes

Objectives of CHRONmate in the tackling of NCDs

Sensitization of various communities across the country on NCDs
Prioritizing research on prevention and health care
Strengthening partnerships with various fellowships towards acting on NCDs
More enlightment programs to the public on the harmful effects of alcohol and tobacco use
Monitoring NCD trends and assessing progress made at various state levels through her volunteers.

ALWAYS REMEMBER TO STAY SAFE AND CHECK YOUR HEALTH STATUS REGULARLY. PREVENTION IS BETTER THAN CURE.

Chronic Diseases; The Silent Epidemic

By Paul Yiran Ntasin, CHRONmate NCD Champion

Background

Advances in technology and healthcare has reduced the prevalence of communicable diseases especially in developed countries but another silent epidemic has emerged (which has proved far more difficult to control, not scared of lockdowns, isolation, vaccines and antibiotics) known as Chronic diseases.

Introduction

Non-communicable diseases (NCDs) or chronic diseases are long-term illnesses that require long term care. They have serious impact on the quality of life and can cause premature death. There has been a worrying trend of increasing prevalence and deaths from chronic diseases. The NCDs with the highest prevalence and death rates are; cardiovascular diseases, chronic respiratory syndrome, diabetes, cancer and stroke.

Why the sudden increase?

Increased NCDs diagnosis alone cannot account for the swift increase in chronic disease. Rapid changes in lifestyle, associated new behavior patterns, globalization, intensive urbanization and an aging population all contribute to the widespread increase in the four risk factors of NCDs; smoking, sedentary lifestyle, excessive alcohol consumption and poor diet.

Statistics

Cardiovascular diseases are the leading cause of death in the world, followed by cancers and respiratory diseases. Collectively, NCDs are responsible for more than 73% of all deaths. About 80% of chronic disease are driven by lifestyle factors. 41 million deaths are attributed to NCDs each year.

Easier life, bigger problems

Modern dietary patterns and physical activity patterns are risk behaviors that travel across countries and are transferable from one population to another like an infectious disease. Traditional plant-based diets have been swiftly replaced by processed high-fat energy-dense diets in developed countries and more recently in developing countries. Urbanization has led to increased physical inactivity.

Urbanization: A blessing and a ‘curse’

Urbanization and technology have made life easier, but it has also indirectly caused an increase in the prevalence of chronic disease through lifestyle change. We cannot go back to life in the 15th century, but we can adopt a healthy lifestyle especially in our diet and physical activity frequencies that will lead to a decreased risk of NCDs.

Don’t be deceived

There has been an increase in the prevalence of NCDs among young adults, which has led to reduction in the quality of life and decreased productivity. Half of NCD-related deaths each year are associated with behaviors beginning in adolescence.

Target the vulnerable

Poorer people show lower rates in acceptancing health-promoting behaviors compared to other sectors of society. Thus policies need to favor the poor, as they are most at risk of NCDs and have the least power to effect change.

A fatal misconception

NCDs have often been seen as a problem of developed nations, while communicable diseases are considered the primary health concern in developing nations. However, NCDs and communicable diseases are increasing in developing countries placing a great burden on rising economies and fragile healthcare systems. Nearly 4 out of 5 deaths in developing countries result from chronic diseases.

Ignorance: A barrier

Diagnosis of chronic diseases in developing countries is still below the expected standard and the causes of death is sometimes not investigated in some developing countries. This has led to a wrong conception of the underlying damage caused by NCDs. It has also hampered the effectiveness of awareness campaigns in certain communities.

Way forward

According to the WHO, millions of lives could be saved and healthcare expenditure considerably reduced by national campaigns such as; consistent measures to improve healthcare, increase screening and provision of early-stage treatment of NCDs, initiatives designed to reduce exposure to the risk factors. Evidence readressing pervasive NCDs myths such as “inevitable consequences of aging” and “diseases of affluence” must be disseminated.

Governments must act

Implementing policies that increase early diagnosis of chronic diseases, subsidizing NCDs management and treatment, banning, controlling or discouraging the use of substances & chemicals like tobacco that increase the risk of NCDs, supporting and equipping healthcare systems to better handle NCDs are some of the measures governments in developing countries can take to curtail the increasing tide of NCDs.

Collaboration for progress

There has to be cross-disciplinary collaboration of the academic world with economists, sociologists and political scientists to understand the social transformation at the population levels that are driving NCDs and to develop feasible and effective strategies to reverse them.

Advocating for the Prevention of Hypertension in Low and Middle Income Countries

By Mary Abraham-Alowonle, CHRONmate NCD Champion

Hypertension or elevated blood pressure is a leading cause of heart, brain and kidney diseases. The American College of Cardiology/American Heart Association(ACC/AHA, 2017), defined hypertension as “blood pressure that is consistently higher than 130 over 80 millimetres of mercury(130/80mmHg)”.

According to the World Health Organization (WHO,2019), “an estimated 1.13billion people worldwide have hypertension, most(two-thirds) living in low and middle-income countries”. The increased prevalence of hypertension in low and middle-income countries can be attributed to inadequate awareness and prevention of the risk factors of hypertension, poor access to health care facilities among others.

The poor health-seeking practices in these countries have also led to the increased mortality rates from complications of hypertension when compared with high-income countries.

In a study conducted on the prevalence of hypertension in low and middle-income countries, it was observed that “Persons without formal education, overweight/obese and urban settlers were more likely to be hypertensive, compared with those who were educated, normal weight and rural setters respectively” [Sarki, Nduka, Stranges, Kandala, Uthman, 2015].

The role of proper awareness and prevention of risk factors in reducing the prevalence of hypertension cannot be overemphasized. The risk factors associated with elevated blood pressure include obesity, poor nutrition, physical inactivity, excessive alcohol consumption, tobacco smoking etc. Some of these risk factors and ways they can be prevented are stated below.

1. Obesity:

Obesity is a body mass index of 30kg/m² or higher. Obesity has been associated with increased risk of hypertension as it causes hardening and increased resistance in blood vessels, thereby increasing blood pressure significantly. Maintaining a normal weight decreases the risk of hypertension greatly.

2. Poor nutrition:

Increased consumption of foods high in sodium can cause fluid retention and increase the blood pressure to unhealthy levels. Low potassium intake has also been implicated in causing the accumulation of sodium in the body. Cutting sodium intake to the required minimum reduces the risk of hypertension.

3. Physical Inactivity:

Regular exercise strengthens the heart muscle to pump blood easily against resistance. physical inactivity, on the other hand, increases peripheral resistance in blood vessels and blood pressure. A study showed that three minutes of low-intensity physical activity(e.g walking) every thirty minutes significantly lower systolic and diastolic blood pressure [Dempsey Pc et.al, 2016].

4. Excessive alcohol consumption:

Excessive intake of alcohol alters nervous activity, which causes the constriction of the blood vessels, resulting in elevated blood pressure. Moderation in alcohol intake is strongly advised.

5. Smoking:

Chewing or smoking tobacco increases blood pressure temporarily and damage the lining of blood vessels. Exposure to tobacco smoke (passively) can also increase blood pressure. Smokers are advised to quit, to reduce the risk of having elevated blood pressure.

6. Stress:

It has been observed that psychosocial stress contributes to elevated blood pressure via the release of certain substances in the blood that causes blood vessels to constrict. Certain activities people indulge in to relieve stress, such as drinking, smoking, eating excessively, have also been implicated in increasing blood pressure. Elimination of ‘stress triggers’, as well as seeking medical help is important to effectively manage stress.

Others:

Long term use of Non-Steroidal Anti-inflammatory Drugs (NSAIDs) can also elevate the blood pressure. Indiscriminate use of drugs should be discouraged and proper medical advice sought when the need arises.

It is Time to Act On NCDs

By David Orji, CHRONmate NCD Champion

Addressing non-communicable diseases (NCDs) and their risk-factors is one of the most powerful ways of improving longevity and healthy life expectancy for the foreseeable future – especially in low- and middle-income countries.

According to the WHO, Non-communicable or chronic disease (NCD) is a medical condition or disease that is non-infectious or non-transmissible. The 4 main types of NCDs are cardiovascular diseases (like heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructed pulmonary disease and asthma) and diabetes.

Noncommunicable diseases (NCDs) kill 41 million people each year, equivalent to 71% of all deaths globally. Tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diets all trigger and increases the risk of dying from a NCD. Early detection, screening and treatment of NCDs, as well as palliative care, are key components of the response to NCDs.

For this year’s Global Week for Action on NCDs, together we’re drawing on inspiration, determination and optimism to focus efforts on ensuring that NCD prevention and control get the much needed attention and action they deserve.

Good governance plays an important role in strengthening the components of the primary health care system. Government, supported by various NGOs, stakeholders, development agencies, organizations, etc should invest more in health care systems – including infrastructure and the health workforce – together with monitoring, reporting and accountability mechanisms, and political leadership at the highest level, as these are critical elements for successful national approaches.

Attempts by governments to “spend their way out” of the NCD crisis by investing in treatment services alone will be futile unless matched by policies that target the whole population, address the shared risk factors for the leading NCDs, and empower individuals and communities to lead healthier lives. Prevention is also vital to the control of NCDs, and law is an important tool for achieving this goal.

Action on all three fronts – prevention of key risk factors, treatment for NCDs, and addressing the social impacts of illness – makes sense in policy terms by reducing future expenditures, improving productivity, and reducing suffering. An effective response to NCDs requires governments to adopt cost-effective and mutually reinforcing measures for both prevention and treatment, while also addressing discrimination and the social impacts of illness.

Leadership and accountability are vital requirements for the success of national efforts to prevent and control NCDs. Globally, the emerging governance structures rely fundamentally on national governments to assume leadership and to implement effective laws and policies. The proposed global monitoring framework for NCDs must be strengthened to include comprehensive monitoring, reporting and accountability for legal and policy action by governments.

Together, through Accountability, Investment, Leadership, Community Engagement and Care, we can overcome NCDs. It is time to ACT on NCDs.

References

1. Globalization and Health: https://globalizationandhealth.biomedcentral.com/articles/10.1186/1744-8603-10-44

2 World Health Organization – Non-communicable Diseases: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases

3. The Global Week for Action on NCDs: https://actonncds.org/en