Disability and communicable disease pdf
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- Burden of Disease
- Magnitude and scope of non-communicable disease-related disability: a systematic review protocol
- Disease burden
- Tools & Resources
This is a remarkable success story, reflecting declines in mortality and improvements in longevity resulting from major health-care efforts in low- and middle-income countries LMICs.
Jump to navigation Skip to main content. When children and teens are together in group settings such as schools, child care facilities, camps, and sporting activities, some disease-causing germs are easily spread among them. Communicable diseases are those diseases caused by bacteria, viruses, parasites, and protozoa that are passed from one person to another. It is important to recognize when someone in a group setting is sick with a communicable disease so steps can be taken to obtain medical care and prevent the spread of disease to others. The complete wall chart is a color-coded, quick disease reference for those responsible for the care of children and teens in group settings.
Burden of Disease
Metrics details. Even though migraine and other primary headache disorders are common and debilitating, major health surveys in Brazil have not included them. The purpose is to rank migraine and its impact on public healthh among NCDs in order to support public-health policy toward better care for migraine in Brazil. Data from PNS, a cross-sectional population-based study, were merged with estimates made by the Brazilian Headache Epidemiology Study BHES of migraine prevalence numbers of people affected and of candidates for migraine preventative therapy and migraine-attributed disability.
Migraine ranked second in prevalence among the NCDs, and as the highest cause of disability among adults in Brazil. Probable migraine accounted for substantial additional disability. An estimated total of 5. On this evidence, migraine should be included in the next health surveys in Brazil. Public-health policy should recognize the burden of migraine expressed in public ill health, and promote health services offering better diagnosis and treatment.
Chronic non-communicable diseases NCDs are a principal concern in public health. This is as true in Brazil [ 1 ] as elsewhere [ 2 ]. Among NCDs, neuropsychiatric neurological and mental health disorders have been identified as the single largest group of contributors to public ill health [ 2 , 3 ], while pain conditions also play a important role [ 4 ].
The economic burdens on individuals and society are expressed in heavy direct and indirect costs [ 1 , 6 ]. Brazil has implemented public-health policies to reduce the burden of NCDs, but the targets are restricted to hypertension, diabetes, cardiovascular diseases including stroke and mental health disorders. The last do not include neurological conditions, which remain low-priority.
The purpose was to support better preventative measures [ 7 ]. Primary headache disorders, in particular migraine, are common and debilitating conditions [ 8 ].
In Brazil, migraine has been found in Nevertheless, PNS, the most comprehensive survey on health and its determinants ever held in the country, did not encompass headache disorders [ 7 ], and public-health policies based on PNS do not target them. Headache management in the population is suboptimal, with limited access to preventative treatments: 7. Yet a recent study showed promising results with non-pharmachological interventions in a low-income, underserved community in Brazil [ 15 ].
The purpose was to rank migraine and its attributed disability among NCDs, so supporting public-health policy toward better care for migraine in Brazil. Conducted between and , it is the most complete survey on health in Brazil. Interviews were completed by trained professionals with the aid of handheld computers.
Full details of the sampling design and methods have been described elsewhere [ 7 , 16 , 17 ]. All participants were informed and gave signed consent. Participants in PNS were asked about past physician-diagnoses with regard to a range of NCDs, about self-reported spine or lung disorders, and about mental-health professional diagnoses of depression and other mental-health disorders Table 1.
Previous publications showed the validity of a self-reported history of doctor diagnosed NCD in other surveys [ 18 , 19 ] and in PNS [ 20 , 21 ]. Proportions reporting high or very high degrees of limitation in activities of daily living due to each of these conditions were also captured.
This was a population-based cross-sectional study interviewing randomly selected individuals by telephone. The estimated number of 1, was inflated by 2. Trained lay interviewers followed a structured questionnaire validated for the diagnosis of primary headache disorders according to the International Classification of Headache Disorders ICHD-II [ 22 ]. The headache questionnaire has been validated previously [ 23 ], additional validation was performed in 50 individuals in BHES showing that lay interviews were satisfactory [ 11 ].
Migraine was diagnosed when all diagnostic criteria were met, and probable migraine when all criteria were met but one. One-year prevalence of each was estimated. For each diagnosis, we applied two thresholds of impact. Table 2 shows the proportions of individuals who reported each NCD, sub-proportions with high disability, and derived population prevalences of those disabled with each NCD, according to PNS.
It also shows prevalences of migraine, probable migraine and all migraine according to BHES. Hypertension was highest in prevalence However, all migraine Other mental health disorders were, relatively, the most disabling of the NCDs, with All other NCDs came well below these.
Migraine In terms of population prevalence and absolute number with high or very high disability, spine disorders meaning back pain, neck pain, low back pain or sciatica, vertebrae or disc problems far exceeded all other NCDs: prevalence 3.
Hypertension was next, with only one third of these levels Table 2. Migraine, however, clearly exceeded spine disorders: 3. All migraine almost doubled these: 6. Including probable migraine all migraine would have substantially inflated the migraine estimates but not altered the rankings. An estimated 5. Migraine is among the most prevalent NCDs in Brazil, and the most disabling in terms of numbers reporting impact equated with severe disability.
Probable migraine is a substantial contributor to the disability burden. Probable migraine has often been neglected in epidemiological studies but, at least in those concerned with public health, it should not be [ 25 ].
The burden of migraine is greatly underestimated if probable migraine is ignored [ 25 ]. Although the methodology used here was imperfect, combining data from two very different surveys and extrapolating numbers, the findings mirror those obtained in the Global Burden of Disease GBD studies: migraine is among the most prevalent disorders worldwide, and the second most disabling behind low back pain [ 2 , 9 ].
In Brazil, migraine prevalence was Probable migraine affected another In Brazil, other studies showed high numbers of probable migraine prevalence in different populations [ 30 , 31 , 32 ], therefore, a high global burden of migraine is trully substantial in Brazil. The need for prevention is another key topic for health care policy planning in headache disorders [ 33 ]. In Brazil, 3. Quite clearly, migraine and other headache disorders should be prioritized in health-care policies.
This message has already been clearly sounded by the World Health Organization [ 35 ], and reiterated multiple times by the Global Campaign against Headache [ 9 ], and here we present striking evidence from Brazil to support it. For better estimates to inform policy, migraine should be included in the next health surveys in Brazil. Spine disorders should probably be studied in more detail, since there are probable overlaps between pain disorders, not to mention comorbidities with sleep and mental health disorders.
One study limitation has been mentioned: we merged two studies with different methodologies. In PNS, there were considerable diagnostic uncertainties, likely to have had some impact on prevalence estimates in either direction. BHES, on the other hand, used a validated diagnostic instrument.
We made assumptions about the relationship between disability and MIDAS scores, but this was, probably, more reliable than the self-reporting of high or very high degrees of limitation in activities of daily living used in PNS. Since migraine is under-diagnosed, PNS numbers regarding migraine are probably under-estimated. It is illogical that health policy ignores it. Migraine should be part of the next health surveys in Brazil, to inform public-health strategies promoting better diagnosis and treatment.
Rev Bras Epidemiol 18 suppl 2 :3— Vos T, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F et al Global, regional, and national incidence, prevalence, and years lived with disability for diseases and injuries for countries, — a systematic analysis for the global burden of disease study Lancet — Lancet Neurol — Pain — Rev Saude Publica 51 suppl 1 :4s. Cephalalgia — J Headache Pain Headache — Arq Neuropsiquiatr — Headache Med — Google Scholar. Fernando Prieto Peres M, Prieto Peres Mercante J, Belitardo de Oliveira A Non-pharmacological treatment for primary headaches prevention and lifestyle changes in a low-income community of brazil: a randomized clinical trial.
Headache J Head Face Pain — Lampe F Validity of a self-reported history of doctor-diagnosed angina. J Clin Epidemiol — Rev Bras Epidemiol — Cad Saude Publica — Cad Saude Publica S Cephalalgia 24 suppl 1 :1— 2nd edition. Brazil Cephalalgia — Neurology — WHO, Geneva. Download references. MFPP conceived the original idea. All authors discussed the results and contributed to the final version of the manuscript. All authors read and approved the final manuscript.
Correspondence to Mario Fernando Prieto Peres. All participants were informed and gave consent.
Magnitude and scope of non-communicable disease-related disability: a systematic review protocol
An ambitious global target established by the United Nations Sustainable Development Goals — indicator 3. Achieving the target is possible — there has already been progress in some areas, particularly related to CVD reduction — but only if there is faster, more concerted action. CVD kills more people than any other cause, but most CVD deaths are preventable with currently available interventions. Many opportunities to prevent disease, disability, and death are being missed, and, in the US and some other high-income countries, the decrease in CVD that has driven the increase in life expectancy has stalled or begun to reverse in recent years [ 3 ]. In some low- and middle-income countries, death rates from NCDs are twice those of high-income countries [ 4 ], and, with population growth and aging, the number of cases in these countries is increasing [ 5 ].
heart disease are fast replacing the traditional enemies, such as infectious diseases and malnutrition, as the leading causes of disability and premature death.
Disease burden is the impact of a health problem as measured by financial cost , mortality , morbidity , or other indicators. The World Health Organization WHO has provided a set of detailed guidelines for measuring disease burden at the local or national level. In , the World Health Organization calculated that 1.
Tools & Resources
Dotted lines: a leading cause has decreased in rank between and ; solid lines, a cause has maintained or ascended to a higher ranking. Causes in white boxes were not among the top 25 in either or in COPD, indicates chronic obstructive pulmonary disease. States are listed in descending order according to probability of death in Data for Washington, DC, were not included in this analysis. See Appendix Table 2 in Supplement 2 for explanation of terms. See Figure 7 caption for details.
August 11, — January 10, RS Generally, individuals with serious contagious diseases would most likely be considered individuals with disabilities. However, this does not mean that an individual with a serious contagious disease would have to be hired or given access to a place of public accommodation if such an action would place other individuals at a significant risk. Such determinations are highly fact specific and the differences between the contagious diseases may give rise to differing conclusions since each contagious disease has specific patterns of transmission that affect the magnitude and duration of a potential threat to others. As stated in the act, its purpose is "to provide a clear and comprehensive national mandate for the elimination of discrimination against individuals with disabilities. The Americans with Disabilities Act, often described as the most sweeping nondiscrimination legislation since the Civil Rights Act of , provides protections against discrimination for individuals with disabilities. The threshold issue when discussing the applicability of the ADA is whether the individual in question is a person with a disability.
Non-communicable diseases (NCD) and disability are both common, and increasing in magnitude, as a result of population ageing and a shift in disease burden.
Metrics details. Even though migraine and other primary headache disorders are common and debilitating, major health surveys in Brazil have not included them. The purpose is to rank migraine and its impact on public healthh among NCDs in order to support public-health policy toward better care for migraine in Brazil. Data from PNS, a cross-sectional population-based study, were merged with estimates made by the Brazilian Headache Epidemiology Study BHES of migraine prevalence numbers of people affected and of candidates for migraine preventative therapy and migraine-attributed disability. Migraine ranked second in prevalence among the NCDs, and as the highest cause of disability among adults in Brazil. Probable migraine accounted for substantial additional disability.