To address the growing burden of non-communicable diseases (NCD) in Karnataka, the State’s Health Vision Group has recommended a comprehensive action plan involving prevention, screening, early diagnosis, referral, and rehabilitation in every district.
During 1990 to 2016, disability-adjusted life years (DALYS) due to ischemic heart diseases in Karnataka moved from fourth to first position, stroke from 12th to 4th position, and diabetes mellitus from 23rd to 7th position. The burden of NCDs begins to increase from age 25 and moves upwards progressively.
According to the Karnataka Health Vision Report, 2021, that was released earlier this week, the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular diseases and Stroke (NPCDCS) should be given the highest importance to address the situation through multi-pronged approaches.
Characterised by common risk factors, NCDs (also known as chronic diseases or lifestyle-related disorders) include Cardiovascular Diseases (CVDs), stroke, cancers, diabetes mellitus, chronic lung diseases, neurological disorders, and mental health conditions among others.
“In the recent Non-Communicable Diseases and Injuries (NCDI) Lancet Commission report, the earlier 4x4 NCD agenda of four diseases (cardiovascular disease, diabetes, chronic respiratory disease, and cancer) and four risk factors (unhealthy diet, physical inactivity, tobacco use, and harmful use of alcohol) has now been extended to include mental health and air pollution, thus making it 5x5 agenda for policy and programme purposes. This, in no way, undermines the importance of many other NCDs,” stated the Vision Report.
Former director of NIMHANS G. Gururaj, who is the chairman of the Vision Group as well as the Technical Committee on NCDs, said the Lancet Commission report has identified about 20 conditions in less than five years age group, 52 causes in l5 – 40 years, about 40 causes in those aged beyond 40 years that contribute to nearly 75% of disease burden, especially among poorer sections of society.
“The most predominant modifiable risk factors include biological factors like elevated levels of systolic blood pressure, fasting plasma glucose and total cholesterol. In contrast, behavioural risk factors like obesity, physical inactivity due to sedentary lifestyles, unhealthy diet, tobacco use, alcohol use, stress, and others play an equally important role,” he said.
“Most of these risk factors develop during the adolescence, or young adult phase of an individual, which, when timely intervened, can significantly reduce the burden of NCDs in later life. For NCDs there is no permanent cure but only care,” Dr. Gururaj said.
Data issues
The Vision Report has pointed out that valid, reliable, representative and real-time data with regard to NCDs and their risk factors is extremely limited at the State-level due to lack of systematic surveillance, disease registries, and research.
“Even though the State partakes in many national and international studies/surveys, State-specific disaggregated data (as per age, gender, residence, education, and income, and other characteristics) is not available as it is combined with national data,” the report stated.
Epidemiological transition
“Karnataka, being in the Higher Middle Epidemiological transition level category, has undergone major epidemiological and socio demographic transition since 2000 with an increasing burden of NCDs, surpassing the burden due to communicable and infectious diseases. There is no clear data for NCD burden in Karnataka from official agencies,” the report pointed out.
