Chronic Non Communicable
Diseases Control in Guyana
Dr. Shamdeo Persaud
Chief Medical Officer
Chronic Non Communicable
Diseases

Diseases that are cause mainly due to 4 behavioral risk
factors:





Tobacco Use
Harmful Use of Alcohol
Unhealthy Diet
Physical Inactivity
Examples of main chronic diseases that cause death
and disability: Cardiovascular diseases, Cancers,
Diabetes, Hypertension and Chronic Lung Diseases
Ministry of Health, GUYANA
Risk Factors for Chronic Diseases:
Un-modifiable
 Family
History
 Age
 Ethnicity
 Gender
Ministry of Health, GUYANA
Risk Factors - Modifiable
 Tobacco



Use
Risk from direct consumption
Risk from exposure to second hand smoke
Causes deaths and diseases
 Lung
cancers
 Other cancers
 Infections such as Tuberculosis
 Cardiovascular diseases
Ministry of Health, GUYANA
Risk Factors: Modifiable

Physical Inactivity



Insufficient physical activity is the leading cause of disease
related mortality
20-30% increased risk of death
Physical activity: 30 minutes of moderate physical
activity on most days of the week


Key in energy expenditure and weight balance
Decreases the risk of
Ischaemic heart disease by 30%
 Diabetes by 27%
 Breast and colon cancers by 21-25%
 Stroke and hypertension
 Depression

Ministry of Health, GUYANA
Risk Factors: Modifiable
Harmful use of alcohol
 Major risk factor for premature death and disability
 Causing:






Cancer
Liver Disease
Cardivascular disease
Alcohol related road traffic deaths
Violence
Mental illness
Ministry of Health, GUYANA
Situation

Population: 768,000
Diverse ethnicity
Growing Economy

Developed habits







Fast Foods
Less walking
Increased use of vehicles
Conveniences
Television etc.
Ministry of Health, GUYANA
Situation
Tobacco:
 Current adult smoking prevalence: 16%


Men = 30%
Women = 3%
Current youth tobacco use: 18%
Alcohol
 Current adult prevalence: Estimated 36%
 Proportion of students who drank at least one drink in
the past 30 days: 39.2%
 Proportion of students who had their first drink before
age 14 years: 79%

Ministry of Health, GUYANA
Situation
Physical activity

Over 60 percent of the population is sedentary

Percentage of students who were physically active for 1
hour on five or more days during the past week: 21.3%

Percentage of students who spent more than 3 hours
per day doing sitting activities: 35.6%
Ministry of Health, GUYANA
Cancer – Number of Deaths due
to Cancer from 2004 – 2010
Year
No. of
2004 2005 2006 2007 2008 2009 2010
Deaths by
*
Neoplasm 426 453 406 453 469 511 536
Ministry of Health, GUYANA
Cancer deaths by Gender
No. of
deaths
by
2004
Neoplas
ms by
gender
Year
2005
2006
2007
2008
2009
2010
Male
207
223
197
198
221
247
-
Female
219
230
209
255
248
265
-
Total
426
453
406
453
536**
469
Ministry of511*
Health, GUYANA
Cancer Types
Ranking of top cancers

Prostate (male) 38%

Breast (female) 23%

Cervical (female) 21%

Stomach, Colon, other bowel (both sex) 9%

Liver - 3%

Lung - 2 %

All Other – 4%
Ministry of Health, GUYANA
Diabetes
 Diabetes





–
Estimated Prevalence – 6.2% of population
Approximately 47,000 persons living with
diabetes
Average of 11 % (31,000) of population over
30 years
Incidence – 2,000 new cases annually
Types of Diabetes
 Type
1 (Insulin Dependant) – 8%
 Type 2 (non-Insulin Dependant) - 92 %
Ministry of Health, GUYANA
Hypertensive Disorders



Prevalence – 18% of the Population over 30
years – 52,000
Incidence – 9,000 new cases reported
annually
Major contributing cause of





Strokes in persons over 40
Heart Attacks
Disability and under productivity
Together with Diabetes – 64,000 persons
13% (99,000) with either or both
Ministry of Health, GUYANA
Cardiovascular and heart
diseases
 Strokes


Hemorrhagic – 1,901 cases annually
Thrombo-embolism (Clots) – 896 cases
annually
 Heart
Attacks – 2,012 cases
 Blood vessel disease


Atherosclerosis – 3,129 reported
Aneurysms - 0.7 %
Ministry of Health, GUYANA
Priorities for Action and
Response
 Multi-sectoral

response
Chronic Non Communicable Disease Commission
 Comprising



stakeholders
International agencies: PAHO, UN Agencies
Line Ministries and other Governmental Agencies
Non Governmental Organizations
 Chaired
by Minister of Health
 Meets quarterly
 Develop a multi-year work plan and Strategy
Ministry of Health, GUYANA
Priorities for Action and
Response
 Mass

Media
Television shows:
 “Pulse
Beat” on NCN channel 11
 “Your Health the Nation’s Wealth” on NCN channel 11
 “Changing Course” on Drug Demand Reduction, every




Radio programme: Doctor on Call, Let’s Talk about
DAT (Drugs, Alcohol and Tobacco)
Radio series Merundoi incorporated CNCDs
Advertisement Print, TV and Radio
Social media??
Ministry of Health, GUYANA
Priorities for Action and
Response
 Promotion

of Healthy Lifestyle Changes
Weight No More
 Tracking
12 overweight and obese women over 12
weeks as they modified their lifestyles to be healthier
 Health
Walks
 Health Fairs
 Interpersonal communication and direct
education at all health facilities, workplace,
school and community groups
Ministry of Health, GUYANA
Priorities for Action and
Response
 Screening





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

VIA for cervical cancer
Breast Self Examination education
Prostate and other cancers
Body Mass Index (BMI)
Waist circumference
Blood pressure
Blood glucose
Lipids and cholesterol
Ministry of Health, GUYANA
1. Risk Reduction:
Screening in community and workplace
Priorities for Action and
Response
 Information,
CNCDs





Education and Communication on
Television and print advertisements
Posters
Pamphlets
Brochures
Fliers
Ministry of Health, GUYANA
Priorities for Action and
Response
 Disease






Management
Integrated PHC clinics
Standardized clinical guidelines for Heart Disease,
Hypertension, Diabetes, Cancers and Asthma
Diabetes, cancer and other Registers
Foot, eye, kidney and heart care programs
Testing: glucometers for blood glucose
measurements, HbA1c, lipid, PSA, Renal Function,
heart scans, angiogram, CT, MRI
Nutrition and Lifestyle counseling
Ministry of Health, GUYANA
 You
are an equal partner
with your health care team
 Prepare
yourself for each
clinic visit by writing any
important information you
need to share with your
doctor or any questions you
may have to ask.
 Know
what health goals you
and your team have set
Priorities for Action and
Response
 Surveillance
 Introduction
of NCD Morbidity Reporting system (S3)
 Data Base development (MIS)
 Mortality Data system
 Registries
 Monitoring and Evaluation Indicators

Core Data and periodic surveillance
 Minimum
data set (CHRPHA)
 Steps Surveys
Ministry of Health, GUYANA
Priorities for Action and
Response

Surveys:
 Demographic
Health Survey 2009
 Global School Health Survey 2004, 2010
 Global Youth Tobacco Survey 2000, 2004, 2010
 Global School Personnel Survey 2010
 Global Health Professional Student Survey 2009
 GENACIS Survey on Alcohol 2009
 Emergency Room Survey on Alcohol and Injuries 2011
 Behavioural Surveillance Survey 2004 and 2008
 BMI Registers
 Food Consumption Survey
Ministry of Health, GUYANA
 Physical Activity Survey
Priorities for Action and
Response
 Training

Pre service training:
 Health
care workers: Doctors, nurses and medex
 Screening and Brief Intervention for Alcohol
 Motivational Interviewing for Substance Use
 Mental Health – anxiety, depression, suicide

University of Guyana and Teacher’s Training College
 Drug
Demand Reduction, including alcohol
 Tobacco control
 CNCDs
Ministry of Health, GUYANA
Priorities for Action and
Response
 Policies,

Legislation and Regulation
Draft legislation for tobacco control
 Smoke
Free spaces
 Labeling and advertizing





Regulation of “fast food” (Salt, Sugar, Fats)
Policy on school canteen, Dorms, feeding programs
Health Family Basket of foods – Zero Rated
Safe open spaces for physical activities
Other Health Public Policies
Ministry of Health, GUYANA
Thank You
Questions?
Comments!
Ministry of Health, GUYANA