Health workers urged to screen and treat people with NCDs

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NON-COMMUNICABLE DISEASES

Government has urged health workers to vigilantly screen and treat people battling against non-communicable diseases. 

The director in charge of public health at the health ministry Dr Daniel Kyabayinze said as the health ministry provides prevention awareness messages to the public on NCDs, health workers must ensure that people who are sick get the services.

Dr Kyabayinze who described NCDs as a time boom said it is not enough to just tell people that they have the diseases, but to rather check and immediately treat those found to have diseases are started on treatment,” Dr. Kyabayinze said.

The director Uganda Initiative for Integrated Management of NCDs (UINCD) Dr Isaac Ssinabulya chatting with participants during a group discussion. (Photo by Agnes Kyotalengerire)

He further noted that the number of patients battling against non-communicable diseases is on the rise given that lately, people live longer.

“If we manage non-communicable diseases early with the support of specialists, we are able to save lives,” Dr Kyabayinze said.

Dr Kyabayinze was speaking during the launch of the road map for the five-year non-communicable disease strategy at the recent Uganda PEN-plus national operational strategy stakeholders’ consultative meeting at Protea Hotel Kampala on Tuesday, October 8, 2024.

The meeting was organized by the health ministry in partnership with PEN- Plus Uganda Initiative for Integrated Management of NCDs (UINCD). PEN-Plus is an integrated care delivery strategy focused on alleviating the non-communicable disease (NCD) burden among the poorest children and young adults with the support of trained health workers.

He said the strategy entails taking services for non-communicable diseases to hospitals.

The non-communicable disease (NCD) strategy also provides an opportunity to offer services for all the different NCDs that are ravaging the country.

“There are so many non-communicable diseases that people are battling against, but we are also trying to address some health conditions which are emerging such as obesity, over-weight and are causing non-communicable diseases.” Dr. Kyabayinze said.

On a good note, he said the government through the health ministry, is managing other diseases such as hypertension, sickle cell disease, and Rheumatic heart disease, among many others.

Dr Daniel Kyabayinze, the director public health at the health ministry chatting with Dr Susan Nakireka, Dr Robert Kalyesubula and Dr Isaac Ssinabulya the ED PEN plus. (Photo by Agnes Kyotalengerire)

Dr. Kyabayinze further noted that they are seeing a number of people who require preventive methods, but also, the strategy will primarily look at how to improve care in the hospitals so as to avert premature death.

The launch comes after a two-year study and pilot where non-communicable diseases (NCDs) care was taken to specific regional hospitals for example Atutur in Kumi district and Nakaseke in Nakaseke Hospital. The findings reveal that these services were easy to provide and were the most sought-after by patients.

Non-communicable diseases (NCDs) are diseases that are not transmissible directly from one person to another. Examples of no- communicable diseases include: NCDs strokes, heart diseases, cancers, diabetes and chronic kidney disease.

The national advisor for NCDS at the World Health Organization (WHO) Dr Hafisa Kasule said once the PEN-plus strategy is doing its work and the primary health care level is taken care of, then non-communicable diseases (NCDs) will be easy to eradicate.

“I am happy that there has been proof of concept that the PEN-plus strategy works, and we only need to work harder to move forward to promote and save lives,”, Dr Kasule said.

He said there is a need to strengthen the PEN-plus strategy activities at health centres III and IV to relieve and leave the district hospitals to handle severely ill patients with NCDs.

The chairman of the Parliamentary Forum for NCDS, Dr Nicholas Kamara, urged the government to focus on funding non-communicable diseases since the majority of development partners prefer to fund communicable diseases, for example, malaria and TB, among others. Kamara said the role of parliament must be an enabler and mover to make sure the money is ring-fenced for NCDS.

Spike in children with diabetes I

Dr Kyabayinze said that lately, many children are born with type 1 diabetes, and it is very hard to recognize because health workers are not trucking them.

“People do not know that even children can be born with diabetes type 1, and have to be on insulin for the rest of their lives”, he said

Type 1 diabetes is a chronic condition in which the pancreas produces little or no insulin. It typically appears in adolescence, and symptoms include increased thirst, frequent urination, hunger, fatigue and blurred vision.

Dr. Kyabayinze urged health workers to ensure that such children are identified and given treatment.

The assistant district health officer Kumi, Dr Sarah Asio, said there are challenges with treating and following up children to parents who are separated or those staying in broken homes.

Dr Asio said the health workers try to counsel and provide medicine to the children, but the problem stems from parents and caregivers who do not bring them back for treatment. “At the time of the visit to the hospital. You find the child is with the mother. After a few days, they are taken to their fathers’ home and later to their grandmother. At the end of the day, the child is all over, and it becomes difficult to follow them up,” she said.

The NCDs burden

The number of people diagnosed diabetes type II has doubled in the last eight years, according to a new report.

Preliminary results of the STEPS Survey of 2023 report about the prevalence of Non-Communicable Diseases (NCDs) in Uganda revealed that the burden of type 2 diabetes currently stands at 2.6 %, up from 1.4% (STEPS Survey 2014 report). This means that the number of people with diabetes has doubled, and the majority do not know.

Participants pose for a group photo during the Uganda PEN-plus national stakeholders meeting in Kampala recently. (Photo by Agnes Kyotalengerire)

Diabetes is a disease associated with persistent high sugar levels in the blood. If left untreated, it leads to the management of body organs such as the brain, heart, eyes, feet and reproductive organs.

Type 2 diabetes is associated with a sedentary lifestyle, which involves physical inactivity and excessive weight gain. 

The spike has been noticed more in the rural area, and the difference that was between the urban and rural has disappeared.

The same report indicates that the proportion of Ugandans who are overweight has increased from 9.2% to about 33% in the same period. This means that 33 people out of 100 are beyond the desired weight in the age category of 18 to 69.

The overall prevalence of hypertension increased significantly from 11 per 1000 in 2016 to 19 per 1,000 in 2021

Uganda records about 36,000 new cases of cancer every year, a figure slightly lower than that of neighbouring Kenya, which registers close to 54,000 new cancer cases annually.

About 8,000 access care from Uganda Cancer Institute Mulago, and of those, 20% are from other East African countries. Meanwhile Mbarara Regional Cancer Centre records about 1200 new cancer cases every year.

Among women, cancer of the cervix is top on the list of commonly diagnosed cancers, followed by breast cancer, then cancer of the stomach, cancer of the Oesophagus and lastly, cancer of the liver.

In men, prostate cancer ranks first, followed by Kaposi Sarcoma, then cancer of the liver and Lymphoma –cancer of the soft tissue.