Health

Prevention of non-communicable disease

On 7th April, we observe World Health Day. Over centuries our planet has become polluted leading to an increase in diseases like cancer, asthma, and heart diseases. The WHO estimates that more than 13 million deaths around the world each year are due to avoidable environmental causes and the climate crisis. Every part of our planet, from the deep oceans to the highest peaks of a mountain is polluted. Processed and unhealthy food is driving a wave of obesity, cancer, and heart diseases. Mosquitoes have become more powerful than ever. The theme of World Health Day 2022 is “Our Planet, Our Health”, to work on a world where clean air, water, and food are available to all.

 

We have done significant progress to handle communicable diseases by driving vaccination programmes. Yet, we are not able to provide safe drinking water to all, more so during the flood. However, the most unattended area is non-communicable diseases- diabetes, hypertension, strokes, heart diseases, lung diseases, and kidney diseases claiming millions of lives every year in India.

 

There are an estimated 72.96 million cases of diabetes in the adult population of India. The prevalence in urban areas ranges between 10.9% and 14.2% and prevalence in rural India was 3.0-7.8% among the population aged 20 years and above with a much higher prevalence among individuals aged over 50 years. (INDIAB Study- 2019).

 

The overall prevalence of hypertension in India was 29.8% and significant differences in hypertension prevalence were noted between rural and urban parts, 27.6% and 33.8% respectively (2. Hypertension in India: a systematic review and meta-analysis of prevalence, awareness, and control of hypertension, J Hypertens. 2014 Jun; 32(6): 1170–1177.) Both of these two factors play a major role in death from heart diseases, strokes, and kidney diseases. International Society of Nephrology’s Kidney Disease Data Center Study has reported a prevalence of Chronic Kidney diseases at 17%. It appears that even in India, diabetes and hypertension are responsible for 40% to 50% of all cases of chronic renal failure.

 

As a nephrologist, let me focus on the prevention of Chronic Kidney diseases. The treatment of chronic kidney disease when it reaches its end-stage (ESRD) is very costly. ESRD has very high mortality and morbidity. The disease ruins a family. Hence prevention of kidney disease is the only long-term option, more so in a country like India. Diseases like diabetes and hypertension and Chronic Kidney Diseases need regular and long-term treatment. Early detection, sustained and monitored treatment to ensure strict and sustained control of both diabetes and hypertension can prevent the menace of heart diseases, strokes, and Chronic Kidney disease. To achieve these, we need to initiate programmes like vaccinations programmes driven at the grassroots levels. Awareness and compliance of the general population about such non-communicable diseases are poor. However, in the end, States are funding huge money to provide health care, like dialysis with little success in terms of long-term mortality benefits. We need to ensure active participation of the general public by spreading awareness.

 

I have formed an organization, “Kolkata Kidney and Medicolegal Support Society”, that works actively for the prevention of communicable diseases more focussing on Chronic Kidney Disease. We have chosen 17 villages under Purandarpur Gram Panchayat in the Bankura district, covering a population of almost 25 thousand. Our Community Health Workers (CHWs) visit door to door, and screen for diabetes, hypertension, and chronic kidney disease in any individual above the age of 20 years. Those who are found positive for such diseases are then treated by our doctors or referred to the nearest BPHC.  Our CHWs then monitor their treatment to ensure dropout or failed treatment which brings strokes, heart, and kidney diseases leading to early death.

Partha Karmakar, Consultant Nephrology, Fortis Hospital, Anandapur

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