By ML Mazaba
Zambia National Public Health Institute, Lusaka.
Correspondence: Mazyanga Lucy Mazaba (mazyanga.mazaba@znphi.co.zm)
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Citation style for this article:Mazaba ML. Prevention and Control is the way to go – a focus on four conditions. Health Press Zambia Bull. 2018: 2(10&11); pp 1-3.
Welcome to our combined October-November 2018 issue. Our editorial focuses on prevention and control measures for four diseases/conditions highlighted for awareness in October and November 2018: breast cancer, diabetes, mental health, and eye diseases (trachoma).
Breast Cancer
Breast cancer is the most common malignancy in women around the world, accounting for about 25% of all cancers, and there are means to reduce the risk. The global cancer project revealed that in 2015 an estimated 1.7 million new cases of breast cancer were identified and over 500,000 deaths were caused by breast cancer globally in 2012 [1]. Although 100 times more likely to happen in women, men can also get breast cancerThe WHO notes an increase in the incidence of breast cancer “in the developing world due to increase life expectancy, increase urbanization and adoption of western lifestyles” [2].
So how can we prevent and control breast cancer? Studies have been done and various recommendations have been made to prevent and control breast cancer including the following: Women should get screened for breast cancer risk as early detection has been known to improve breast cancer outcome and survival. Limiting alcohol intake reduces the risk of breast cancer as it has been proven that the more alcohol one drinks, the greater the risk of developing breast cancer. Avoiding smoking, as there is accumulating evidence that suggests a link between smoking and breast cancer risk, particularly in premenopausal women. Controlling one’s weight, as being overweight or obese increases the risk of breast cancer. Being physically active has been linked to improved well-being, including prevention of breast cancer. Breastfeeding might play a role in breast cancer prevention, and getting early access to treatment has improved outcomes in breast cancer [2,3].
Diabetes
The burden of diabetes has increased globally because of the rise in the prevalence of obesity and unhealthy lifestyles. The number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014 [4]. By 2035, up to 592 million people are expected to be affected by diabetes, including both type 1 and type 2 diabetes, with type 2 diabetes accounting for more than 85% of all diabetes cases [5].
According to the WHO, diabetes can be treated, prevented and controlled with the following measures: Correct diet avoiding sugars and saturated fats; increased physical activity with at least 30 minutes of regular, moderate intensity activity daily; medication; and regular screening and treatment for complications [4].
Mental Health
It is anticipated that one adult in four and one child in ten will have a mental health issue exacerbated by human rights violations, wars and violence in the home, schools and businesses each year [6]. Millions of lives are affected around the world, with the sufferers incapable of making it through the day, failing to sustain relationships and to maintain work, especially in the medium to low income countries which account for 80% of the global burden [7].
With 50% or more of mental illness starting around the age of 14, many cases can be prevented by seeking professional help, this following recognition and understanding of the early warning signs and symptoms of mental illness. Psychosocial support can be provided in schools and other community settings and health workers can be trained to detect and manage mental health disorders.
Trachoma
Trachoma, the leading cause of preventable blindness, is caused by a bacterium, Chlamydia trachomatis [8]. Endemic in 49 countries, mostly in Africa, trachoma causes an estimated 5.6 million people to be blind, visually impaired or at immediate risk of blindness and a further 146 million people have active trachoma in need of treatment. This high burden of eye disease is associated with deprivation of basic needs in housing, health, water and sanitation [9].
As countries strategise for elimination of trachoma, prevention and control strategies include: surgery to treat the blinding stage of the disease (trachomatous trichiasis); mass drug administration of antibiotics to clear infection; facial cleanliness; and environmental improvement, especially in areas of water and sanitation [10].
This year’s awareness themes relating to the diseases/conditions articulated above were:
For breast cancer with various national and organisational themes such as ‘Wear it pink’; ‘Defect it, Treat it, Defeat it’; ‘Her fight is my Fight’; celebrated in the month of October and highlighted on 19th October to raise awareness, increase attention and support for the awareness, early detection and treatment as well as palliative care of breast cancer.
For diabetes, the theme, ‘The Family and Diabetes’, to highlight how diabetes affects not just an individual, but spouses and children, was celebrated in the month of November and highlighted on 14th November 2018.
For mental health, the theme was, ‘Young people and mental health in a changing world’, celebrated globally on 10th October 2018 and aimed at raising awareness surrounding mental health issues around the world and mobilizing efforts in support of mental health.
World Sight Day, which is celebrated on the second Thursday of October, is an annual awareness day aimed at bringing global attention to blindness and vision impairment. World Sight Day 2018 was celebrated on 11 October 2018 with the theme ‘Eye Care Everywhere’. THP-Z focuses on trachoma in this issue.
List of References
1. Ghoncheh M, Pournamdar Z, Salehiniya H. Incidence and Mortality and Epidemiology of Breast Cancer in the World. Asian Pac J Cancer Prev. 2016;17(S3):43-6.
2. World Health Organisation. URL: https://www.who.int/cancer/detection/breastcancer/en/
4. Centers for Disease Prevention and Control. URL: https://www.cdc.gov/cancer/breast/basic_info/prevention.htm
5. World Health Organisation. URL: http://www.who.int/news-room/factsheets/detail/diabetes
6. Forouhi NG, Wareham NJ. Epidemiology of diabetes. Medicine (Abingdon). 2014;42(12):698-702.
7. World Health Organisation. URL: https://www.who.int/mental_health/world-mentalhealth-day/2018/en/
8. Thyloth M, Singh H, Subramanian V. Increasing burden of mental illnesses across the globe: Current status. Indian J Soc Psychiatry 2016;32:254-6
9. Kyaw TA, Nyunt T, Sundaresan TK, Tarizzo ML. Control of trachoma and prevention of blindness in rural communities in Burma. Bull World Health Organ. 1978;56(6):945-55.
10. World Health Organisation. Blindness: Vision 2020 – control of major blinding diseases and disorders. The Global Initiative for the Elimination of Avoidable Blindness Fact sheet N°214. URL: http://www.who.int/mediacentre/factsheets/fs214/en/
11. World Health Organisation. Trachoma. URL: http://www.who.int/news-room/factsheets/detail/trachoma