NCDs: Answer lies in early screening, prevention

Last week, a Health Week was launched in Gahengeri Sector, Rwamagana District, with the aim of looking at different ways to help the community access healthcare services better. The week was also launched with the purpose of raising awareness about non-communicable diseases (NCDs). The activities of the day involved doing sports, and messages about the dangers of smoking and drug abuse. People were also screened for NCDs such as hypertension, diabetes and obesity, among others. People from the area were encouraged to engage in sports at least once a week as a strategy to fight NCDs. According to Gerald Kaberuka, the head of Gahengeri Health Centre, most people do not have a proper understanding of NCDs. “We are educating the community on different diseases and what they can do to prevent them,” he said. The sensitisation comes through community meetings on behaviour change, mobilising people and teaching them about non-communicable diseases and how to prevent them, Kaberuka said. Kaberuka noted that they have been receiving about six persons seeking consultation about NCDs at the health centre daily, which shows need for concern. Through earlier community outreach programmes, about 80 people per month were targeted. But because the community has a big challenge of geographical inaccessibility, health experts from the area are trying to personally move out to the field to reach more people for screening. “We want to do this kind of screening to reach every single person in this community,” he said. Over 500 people turned up on the first day of screening for NCDs while the target was 2,000 people by the end of the week. What are NCDs? According to the World Health Organisation, A non-communicable disease (NCD) is a medical condition or disease that is not caused by infectious agents (non-infectious or non-transmissible). NCDs can refer to chronic diseases which last for long periods of time and progress slowly. NCDs, also known as chronic diseases, tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behavioural factors. The main types of NCDs are cardiovascular diseases (like heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) and diabetes. NCDs are the leading cause of death globally. Globally, it’s estimated that 36 million deaths, or 63 per cent of the 57 million deaths that occurred, 60 per cent of all deaths, were due to non-communicable diseases, most of them in the low and middle income countries. Data from Health Management Information System Rwanda shows that 3,650 cases of chronic kidney diseases were registered between 2013 and 2015. Hypertension, diabetes and HIV are the leading causes of chronic kidney diseases. However, the Rwanda 2015 Steps Survey shows that 2.7 per cent of the population is obese. Obesity of women in Rwanda is 4.7 per cent against 0.8 percent of men. Prevalence of obesity in urban areas is 10.2 percent. Hypertension accounts for 15.9 per cent and diabetes 3 percent, according to the survey. Challenges in NCDs control/prevention According to Dr Everiste Ntaganda, the in-charge of cardiovascular disease in the Division of NCDs at Rwanda Biomedical Centre, a lot needs to be done to address the challenges posed by NCDs. He says key among them is that people need to go for screening and maintain a healthy lifestyle. Ntaganda explains that the major reason why controlling and preventing NCDs remains hard is that people are not going for screening, and to make it worse they only appear at the health facility when the condition has reached its late stages. “People are reluctant to come for screening early enough, even after the government has made it easier for them. For instance, the screening for any disease is all covered with mutuelle de santé and other medical insurance packages. “When screened early enough, and found out to be having any type of NCD, the patient is able to get treatment immediately,” he adds. Ntaganda further notes that the importance of screening is that even if one is found not to have any disease, such a person is advised to continue maintaining preventive measures and on how to stay healthy. “When one is found to have or is close to developing NCDs, they are put on medication immediately to avoid further complications,” he says. Another challenge, Ntaganda says, is the exposure to risk factors of NCDs. For example, he says many people are exposed to drinking alcohol, smoking and bad eating habits. All these are factors that expose one to develop NCDs. “It is easy for one to start drinking with one bottle and increase the number. Before they know it, they have already become addicted to alcohol. This is very risky especially when it has become a habit already,” he says. Another challenge, he says, is the treatment of chronic diseases being expensive. “When people are not screened, they are at risk of developing diseases that could have been avoided when identified early. They wait until the disease is in its late stage (chronic), where treatment may not be effective,” he says Similarly, Kaberuka advises people to go for screening always, eat a balanced diet, do sports as well as avoid risk factors if they want to stay away from NCDs. The way forward According to Prof. Joseph Mucumbisti, a pediatrician, cardiologist and president of Rwanda Heart Foundation, the only way to evade all the above cases is through prevention. He notes that if people focus on strategies of reducing the impact of risk factors, they can go a long way in reducing the number of deaths attributed to NCDs. “Prevention lies in changing of our lifestyle, for instance, cutting down the eating of processed and pre-packaged foods which are often high in sugar and salt. Swap sugary treats for fresh fruits as a healthy alternative,” he says. Mucumbisti adds that, one should also cut down on the amount of alcohol intake, and stay active to reduce the risk of heart diseases. Kaberuka also notes that in order to stay away from NCDs, people should focus on minimising the risk factors such as smoking, drinking and a bad lifestyle. He says that this is because they are the factors that lead to chronic disases, especially if one is not going for screening, at least once every year. “Women above the age of 35 should always go for screening for cancer, hypertention, diabetes and heart diseases, among others. The same case should also apply to men above the age of 40,” he says. Ntaganda urges the population to always go for screening. “All sectors, including media, Ministry of Education and all others should come in and help fight NCDs by raising awareness in the public. “This is an enormous problem that can’t be handled by the Ministry of Health only. For instance, in the education sector, including the prevention measures in the curriculum can be a good start in the fight against NCDs at an early stage. “Addressing issues of alcohol intake, smoking, drug use among the students and youth is vital and can ensure early NCDs prevention and control,” he says.