Kuliah 1: Epidemiology Of NCDjknj.moh.gov.my/ncd/latihanpengurusan/kuliah/Kuliah 1... ·...

PENGENDALIAN PERKHIDMATAN PENYAKIT TIDAK

BERJANGKIT (NCD) UNTUK PARAMEDIK

KEMENTERIAN KESIHATAN MALAYSIA

ANJURAN : BAHAGIAN PEMBANGUNAN KESIHATAN

KELUARGA DAN BAHAGIAN KAWALAN PENYAKIT

Modul Latihan Perkhidmatan NCD Untuk Paramedik KKM

Kuliah 1: Epidemiology Of NCD

Penyakit-Penyakit

Tidak Berjangkit ?

• Penyakit Kronik yang tidak berjangkit semakin meningkat diseluruh dunia

• Juga dikenali sebagai penyakit-penyakit kronik yang mana pergerakan penyakit adalah perlahan

• Termasuklah

- Diabetes

- Hipertensi

- Hypercholestrolaemia

- Penyakit jantung

- Strok (Angin Ahmar)

- Kanser

- Penyakit sistem pernafasan kronik

- Mental

• Menyerang semua golongan umur, kelas dan bangsa.


10 Sebab Utama Kematian Di Dunia


4


60 % Kematian

didunia adalah

disebabkan

oleh penyakit

kronik


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80 %

Kematian akibat

penyakit kronik

berlaku di negara-

negara mundur

dan sedang

membangun


10 Sebab-Sebab Kemasukan Ke Hospital Kerajaan & Swasta, 2013

1. Pregnancy, childbirth and the puerperium 20.77%

2. Diseases of the respiratory system 12.41%

3. Certain infectious and parasitic diseases 9.40%

4. Injury, poisoning and certain other consequences of external causes 8.29%

5. Diseases of the circulatory system 7.53%

6. Diseases of the digestive system 6.37%

7. Certain conditions originating in the perinatal period 5.39%

8. Diseases of the genitourinary system 5.22%

9. Neoplasms 4.10%

10. Factors influencing health status and contact with health services 3.73%

• Penyakit NCD termasuk didalam 10 sebab-sebab kemasukan pesakit

ke hospital kerajaan & swasta


1. Diseases of the circulatory system 24.71%

2. Diseases of the respiratory system 21.70%

3. Certain infectious and parasitic diseases 13.66%

4. Neoplasms 13.62%

5. Diseases of the digestive system 4.93%

6. Injury, poisoning and certain other consequences of external causes 4.75%

7. Diseases of the genitourinary system 4.07%

8. Certain conditions originating in the perinatal period 2.47%

9. Endocrine, nutritional & metabolic diseases 2.05%

10. Diseases of the nervous system 1.83%

10 Sebab-Sebab Kematian Pesakit Di Hospital Kerajaan & Swasta, 2013

• Penyakit NCD termasuk didalam 10 sebab-sebab kematian pesakit di

hospital kerajaan & swasta


Kadar Kematian, Malaysia (% jumlah kematian, semua peringkat umur, kedua-dua jantina)

Kemungkinan meninggal dunia antara umur 30 dan 70 tahun daripada

4 NCD utama ialah 20%


19.4%

15.7%

8.5%

7.3%

7.0%

5.0%

2.3%

0.2%

0.1%

22.8%

1.2%

9.1%

8.1%

8.2%

7.1%

0.3%

0.2%

0.1%

25% 20% 15% 10% 5% 0% 5% 10% 15% 20% 25%

High BP

Tobacco

Diabetes Mellitus

High Cholesterol

High BMI

Physical Inactivity

Alcohol

Underweight

Poor Water & Sanitation

Male Female

Kematian Mengikut Faktor Risiko

Burden of Disease Study Malaysia, 2014, slide courtesy of Dr Mohd. Azahadi Omar, Institute for Public Health


Penyakit Tidak Berjangkit (NCDs)

• Berkongsi faktor risiko

Faktor Risiko Penyakit NCD • Penggunaan tembakau

• Pemakanan Tidak Sihat

• Kurang Aktif Fizikal

• Alkohol


Faktor Tidak

Langsung

•Globalisasi

•Urbanisasi

• Penduduk Tua

Faktor Risiko yg

Umum

i. Boleh Diubah

•Pemakanan Tak

Sihat

• Kurang Aktiviti

Fizikal

•Tembakau & Arak

ii. Tidak Boleh

diubah

•Umur

•Keturunan

Fakto Risiko

Pertengahan

•Lebih Berat Badan

/obes

• Paras Glukosa

Darah Naik

•Tekanan Darah Naik

•Paras Cholesterol

Naik

PTB

•Sakit Jantung

•Diabetes

•Hipertensi

•Stroke/ Angin Ahmar

•Kanser

•Penyakit Paru2

•Kronik

Kesan Melalui Saringan

Intervensi Rawatan

Faktor Risiko dan Proses Berlaku Penyakit NCDs


Diabetes


11.6

15.2

17.5

7.0 7.2 8.3

4.5

8.0

9.2

4.2 4.9 4.7

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

16.0

18.0

20.0

NHMS III (2006) NHMS 2011 NHMS 2015

Pre

va

len

ce (

%)

Total diabetes Known Undiagnosed IFG

Malaysia : Prevale e of Dia etes, ≥ 8 years (2006, 2011, 2015)

NHMS II

(1996)

NHMS III

(2006) NHMS 2011 NHMS 2015

Age group years years years Est. Population ≥ 8 years Prevalence 8.3% 11.6% 15.2% 2,622,284 17.5%

Known diabetes 6.5% 7.0% 7.2% 1,247,366 8.3%

Undiagnosed 1.8% 4.5% 8.0% 1,374,918 9.2%

IGT* / IFG** 4.3% * 4.2% ** 4.9% ** 481,477


Malaysia : Prevalence of Diabetes, ≥ 30 Years, NHMS (1996, 2006, 2011 and 2015)


0.0 0.7

1.4

3.4 3.4

6.9

10.5

14.8

20.6

26.5

24.4

27.9

24.4

5.5 5.2

7.4 7.2

9.5

11.0 11.5 12.2 12.4

11.8

13.6

11.2 12.6

5.5 5.9

8.9

10.6

12.9

17.6

22.0

27.0

32.9

38.3 38.0 39.1

37.0

3.6 3.6 3.9 3.9 4.6

6.0 5.8 5.8 5.9 5.5 4.8

5.4 6.0

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

Pre

va

len

ce (

%)

Prevalence of Diabetes, ≥ 8 years, by age groups (2015)

Known Undiagnosed Total diabetes IFG

Prevalence of Diabetes, ≥ 8 years, by Ethnicity (2015)

%


19.8

25.4

18.5

16.7

19.3

14.8

18.1

19.4 20.6

15.5

18.6

14.2 14.8

17.4

19.2

0.0

5.0

10.0

15.0

20.0

25.0

30.0

Pre

va

len

ce (

%)

Prevalence of Diabetes, ≥ 8 years, by States (2006, 2011 & 2015)

NHMS III (2006) NHMS 2011 NHMS 2015


NHMS 2015

Hypertension


Malaysia : Prevale e of Hyperte sio , ≥ Years, NHMS (1996, 2006, 2011 and 2015)

Pre

va

len

ce (

%)

Modul Latihan Perkhidmatan NCD Untuk

Paramedik KKM

0.7 1.9 2.8

3.9 5.8

11.9

15.0

23.1

29.3

37.1 39.1

50.4

46.1

6.0 7.5

10.4 12.0

18.1 20.3

23.8 26.2 26.2

27.9 28.7

25.0 27.3

6.7

9.4

13.2

15.9

23.9

32.2

38.8

49.3

55.5

65.0

67.8

75.4 73.4

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

Prevalence of Hypertension by Age Groups,

≥18 years (2015)

Known Undiagnosed Total HPT

Pre

va

len

ce (

%)

36.4

38.2

27.9

32.8 34.1

29.9 28.4

42.9

41.1

28.7

26.8

29.1

40.5

27.1

22.5

27.4

37.5

33.8

25.8

32.5

28.5 29.8

36.4 35.4

25.5 26.9 26.8

37.3

33.8

24.1

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

Pre

vale

nce

(%

)

Malaysia : Prevalence of Hypertension by State,

≥18 years (2011 & 2015)

2011 2015

29.3

13.2

16.1

33.5

12.8

20.7

0

5

10

15

20

25

30

35

Total hypertension Known Undiagnosed

Prevalence of Hypertension by Strata,

≥18 years (2015)

Urban Rural

Pre

va

len

ce (

%)


Hypercholesterolaemia


Paramedik KKM

Prevale e of Hyper holesterole ia, ≥ Years, NHMS (1996, 2006, 2011 and 2015)

Pre

va

len

ce (

%)


22.0

26.5

33.7

44.0

49.7

57.2

60.1

65.5

68.8

65.3

61.6 62.7

58.3

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

Prevalence of Hypercholesterolemia by age groups,

≥ 8 years 5

Known Undiagnosed Total Hchol

Pre

va

len

ce (

%)

50.1

8.7

41.4

47.5

11.0

36.5

50.1

12.3

37.8

45.4

11.2

34.2

37.4

2.2

35.2

0.0

10.0

20.0

30.0

40.0

50.0

60.0

Overall Chol Known Undiagnosed

Pre

va

len

ce (

%)

Prevalence of Hypercholesterolemia by Ethnicity,

≥ 8 years (2015)

Malay Chinese Indians Other Bumiputras Others


37.7

43.4

33.8 35.9

39.7

31.7 32.7

45.0 45.1

31.9

34.9

31.1 33.5

29.4

33.3

45.8

53.5 51.7

46.6

49.5

56.2

52.2

48.3 47.0

43.5

52.1

40.9

48.6

52.9

46.4

0.0

10.0

20.0

30.0

40.0

50.0

60.0

Malaysia : Prevalence of Hypercholesterolemia by

States, ≥ 8 years (2011, 2015)

NHMS 2011 NHMS 2015

Pre

va

len

ce (

%)


47.7

9.7

38.0

47.7

7.1

40.5

0

10

20

30

40

50

60

Overall Chol Known Undiagnosed

Pre

va

len

ce (

%)

Prevalence of Hypercholesterolemia by Strata,

≥ 8 years (2015)

Urban Rural


(Aged 18 years old)

STATUS NUTRISI


Paramedik KKM

DEFINITION

BMI STATUS (CPG 2004)

• U der eight .5

• Normal = 18.5 – 22.9

• Pre-obese = 23.0 – 27.4

• Obese .5

BMI STATUS (WHO 1998)

• U der eight .5

• Normal = 18.5 – 24.9

• Overweight = 25.0 – 29.9

• Obese


Malaysia : Prevalence of obesity and overweight, ≥ 8 years

(WHO 1998)


Malaysia : Prevalence of obesity by state (WHO 1998)

29.8 33.2

28.8

36.0 35.6 32.5

27.8 29.5

36.0 32.7 32.5

23.9

32.3 29.6

43.0

0.0

10.0

20.0

30.0

40.0

50.0

60.0

Pre

va

len

ce(%

)


Malaysia : Prevalence of obesity by sex, (WHO 1998)

24.0

26.8

0.0

5.0

10.0

15.0

20.0

25.0

30.0

Male Female

Pre

va

len

ce(%

)


Malaysia : Prevalence of obesity among adults by

ethnicity, (WHO 1998)

28.5

19.2

36.5

25.8

15.6

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

Malays Chinese Indians Other

Bumiputras

Others

Pre

va

len

ce(%

)


TOBACCO


DEFINITION

Current smoker :

• Smoker who daily or occasionally smokes any tobacco product.

(2011&2015)

• Respondent who reported to have smoked 100 or more cigarettes

in lifetime and smoked daily or some days in the past one month.

(2006)

• One who reported to be smoking at the time of the survey (1996)

Smokeless tobacco:

• Snuff, chewing tobacco, betel quid with tobacco, electronic

cigarettes, and others.


Paramedik KKM

Malaysia : Prevalence of smoking by sex

(1996, 2006, 2011 & 2015)

%

• 1996 &2006 – adult 18 & above Modul Latihan Perkhidmatan NCD Untuk Paramedik KKM

Malaysia : Prevale e of s oki g y states, ≥ 5 years 5

%


Malaysia : Prevalence of smoking

y age groups, ≥ 5 years old

Pre

va

len

ce %


Malaysia : Prevalence of smoking by ethnicity

(1996, 2006, 2011 and 2015)

Pre

va

len

ce (

%)


Malaysia : Prevalence of smoking by

strata

• 1996 & 2006 – adult 18 & above

Pre

va

len

ce (

%)


PHYSICAL ACTIVITY


• Physical activity level was measured based on the definitions of the International Physical Activity Questionnaire (IPAQ) short form

• There are 3 levels of physical activity:

1. I acti e

2. Mi i ally acti e

3. HEPA-acti e health-enhancing physical activity; a high active category)

• The volume of activity can be calculated by weighting each type of activity by its energy requirements defined as METS (Metabolic Equivalent of Task) which are multiples of the resting metabolic rate

• Respondents who achieved the minimally active level of physical activity (at least 600 MET- i / eek ere classified as acti e

• HEPA-active : more or equal to 3000 MET-min/week

Physical Activities


• NHMS 2006 – respondents aged 18 years and above

• NHMS 2011 & 2015 – respondents aged 16 years and above


Active

(66.5%)


• Rural population was significantly more active than urban population


• The prevalence of physically active adults increased from the 16-19 age group, peaking at the 40-44

age group, then decreased with increasing age Modul Latihan Perkhidmatan NCD Untuk Paramedik KKM

NCD boleh dicegah

Hampir 80% penyakit jantung, stroke dan diabetes jenis II, dan lebih 3 kes kanser boleh di cegah daripada berlaku

Penggunaan tembakau, pemakanan tidak sihat, tidak aktif fizikal dan pengambilan alkohol

Dengan menyingkirkan faktor risiko NCD


TERIMA KASIH


Paramedik KKM

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