MovingMoving forwardforward withwith SurveillanceSurveillance ofof NCDsNCDs inin thethe EnglishEnglish--speakingspeaking CaribbeanCaribbean
Dr.Dr. GlennisGlennis AndallAndall--BreretonBrereton CaribbeanCaribbean EpidemiologyEpidemiology CentreCentre (CAREC/PAHO/WHO)(CAREC/PAHO/WHO)
CARMEN BIENNIAL MEETING, PERU October 27, 2009
(CAREC/PAHO/WHO) OutlineOutline ofof PresentationPresentation
¾¾ ImplementingImplementing riskrisk factorfactor surveillancesurveillance
z PrevailingPrevailing riskrisk factorsfactors ¾¾ ImplementingImplementing NCDNCD surveillancesurveillance ¾¾ PlanPlan forfor providingproviding feedbackfeedback forfor preventionprevention andand controlcontrol ofof chronicchronic diseasesdiseases inin thethe subsub-- regionregion
(CAREC/PAHO/WHO) (CAREC/PAHO/WHO) CommitmentCommitment toto SurveillanceSurveillance ofof NCDsNCDs
¾¾DeclarationDeclaration ofof PortPort ofof Spain,Spain, SeptemberSeptember 20072007
z ““ThatThat wewe willwill establish,establish, asas aa mattermatter ofof urgency,urgency, thethe programmesprogrammes necessarynecessary forfor researchresearch andand surveillancesurveillance ofof thethe riskrisk factorsfactors forfor NCDsNCDs withwith thethe supportsupport ofof ourour UniversitiesUniversities andand thethe CaribbeanCaribbean EpidemiologyEpidemiology Centre/PanCentre/Pan AmericanAmerican HealthHealth OrganizationOrganization (CAREC/PAHO);(CAREC/PAHO);””
(CAREC/PAHO/WHO) RiskRisk FactorFactor SurveillanceSurveillance
(CAREC/PAHO/WHO) ImplementingImplementing RiskRisk FactorFactor SurveillanceSurveillance inin thethe CaribbeanCaribbean
¾¾ 66 countriescountries completedcompleted NationalNational RiskRisk FactorFactor SurveysSurveys usingusing thethe PanPan AmAm STEPSSTEPS methodologymethodology asas aa startingstarting pointpoint forfor surveillancesurveillance ofof RFsRFs forfor chronicchronic diseases:diseases:
z 20052005 BahamasBahamas
z 20072007 ArubaAruba
z 20082008 Barbados,Barbados, Dominica,Dominica, St.St. KittsKitts • Survey Reports Outstanding
z 20092009 BritishBritish VirginVirgin IslandsIslands • First country to use Electronic Methodology (E-STEPS)
(CAREC/PAHO/WHO) ImplementingImplementing RiskRisk FactorFactor SurveillanceSurveillance inin thethe CaribbeanCaribbean contd..contd..
¾¾ TwoTwo countriescountries completedcompleted NationalNational RFRF surveyssurveys usingusing differentdifferent methodologiesmethodologies andand questionnairesquestionnaires
z JamaicaJamaica (2001(2001 && 2008)2008) LifestyleLifestyle SurveySurvey-- TropicalTropical MedicineMedicine ResearchResearch Inst.Inst.
z BelizeBelize (2007)(2007) CAMDICAMDI ProjectProject
(CAREC/PAHO/WHO) ImplementingImplementing RiskRisk FactorFactor SurveillanceSurveillance inin thethe CaribbeanCaribbean contd..contd..
¾ EightEight otherother countriescountries trainedtrained inin implementingimplementing RFRF surveyssurveys usingusing PanPan AmAm STEPSSTEPS methodologymethodology andand involvedinvolved atat variousvarious stagesstages ofof thethe planningplanning processprocess z Anguilla z Bermuda z Curacao z Grenada z St. Lucia z St. Vincent and the Grenadines z Trinidad and Tobago z Turks and Caicos Islands
¾ 22nd NationalNational RFRF SurveySurvey z Bahamas
(CAREC/PAHO/WHO) RiskRisk FactorsFactors forfor ChronicChronic DiseasesDiseases
(CAREC/PAHO/WHO) OverweightOverweight
2 Overweight BMI ≥ 25kg/m
Females St. Kitts
Males Dominic a
BVI
Barbados
0 102030405060708090 % Prevalence
(CAREC/PAHO/WHO) SedentarySedentary LifestylesLifestyles
Physical Activity Levels
High levels of physical activity
St. Kitts Low levels of physical activity Dominica
No vigourous activity BVI
Barbados
% 0 1020304050607080
(CAREC/PAHO/WHO) AlcoholAlcohol UseUse
Current Drinkers
St. Kitts
Females Dominica Males BVI
Barbados
0 10203040506070 %
(CAREC/PAHO/WHO) AlcoholAlcohol AbuseAbuse
Harmful Alcohol Use- Binge Drinking
Females (having ≥ 4 drinks on any day St. Kitts in last w eek)
Dominic a Males (having ≥ 5 drinks on any day in last w eek)
BVI
Barbados
0 5 10 15 20 25 30 % Current Drinkers
(CAREC/PAHO/WHO) FruitsFruits andand VegetablesVegetables inin thethe DietDiet
Consumption of Fruit and Vegetables
2.5
2 Mean daily servings of vegetables 1.5 Daily Servings Mean daily servings of fruit 1
0.5
0 Barbados BVI Dominica St. Kitts
(CAREC/PAHO/WHO) SmokingSmoking
Current Smokers
St. Kitts
Dominic a Exposure to Secondhand Smoke Females BVI Males
Barbados
0 5 10 15 20 35
% Prevalence 30 Dominica 25 St. Kitts 20
15
10
5
0 Home Workplace Males Females % (CAREC/PAHO/WHO) Risk for Development of Chronic Diseases in the Population
Levels of Risk
Raised risk (25-64 years)
Raised risk (45-64 years)
St. Kitts Raised risk ( 25-44 years)
Dominica Low risk
BVI
Barbados
0 20406080%
(CAREC/PAHO/WHO) Raised Risk ≥ 3 risk factors ImplementingImplementing NCDNCD SurveillanceSurveillance
(CAREC/PAHO/WHO) NCDNCD MinimumMinimum DataData SetSet BackgroundBackground ¾ 20022002
z Recommendation from CAREC Scientific Committee ¾ 20032003
z CAREC NCD Minimum Data Set Developed and Agreed (Epidemiologists Meeting) ¾ 20062006
z Regional Strategy and Plan on Action for Chronic Disease for the Americas
z PAHO HQ agreed to use NCD Minimum Data Set developed by CAREC as starting point for developing NCD Minimum Data Set for Americas
(CAREC/PAHO/WHO) DevelopmentDevelopment ofof NCDNCD MinimumMinimum DataData SetSet forfor thethe AmericasAmericas
¾ 20072007-- PAHOPAHO InterInter--programmaticprogrammatic ChronicChronic DiseaseDisease SurveillanceSurveillance WorkingWorking GroupGroup establishedestablished ¾ Representation from countries in the Americas ¾ Agencies: PAHO, WHO, CAREC, PHAC,CDC
¾ (March(March 20072007-- JuneJune 2008)2008) –– NCDNCD MinimumMinimum DataData SetSet developeddeveloped forfor thethe RegionRegion ofof thethe AmericasAmericas z Stepwise approach - core, expanded and optional z 78 indicators • 57 Core Indicators
(CAREC/PAHO/WHO) MinimumMinimum DataData SetSet forfor NCDNCD SurveillanceSurveillance ComponentsComponents
¾ Mortality from/with selected NCDs (12 core indicators)
¾ Age-standardized mortality rates per 100,000 population
¾ PYLL (potential years of life lost) per 100,000 ¾ Prevalence/incidence selected conditions (6 core indicators) ¾ Risk factors for chronic diseases :
z Adult ( 17 core indicators) & Youth (8 core indicators) ¾ Health System Performance Indicators (19 indicators - 9 core) ¾ Socioeconomic and context indicators (16 indicators – 5 core) ¾ ..\NCD Infobase\NCD Reporting Form_youth separate_Sept 25 2009.xls
(CAREC/PAHO/WHO) ImplementingImplementing MinimumMinimum DataData SetSet forfor NCDNCD SurveillanceSurveillance inin thethe CaribbeanCaribbean
¾ AugustAugust 20082008 -- TrainingTraining toto PilotPilot NCDNCD MinimumMinimum DataData SetSet z Bahamas, Barbados, Belize, Bermuda, Cayman Islands and Dominica ¾ MarchMarch 20092009 -- MeetingMeeting forfor EvaluationEvaluation ofof thethe PilotPilot ¾ MarchMarch--SeptemberSeptember 20092009 –– RevisionRevision ofof NCDNCD MinimumMinimum DataData SetSet basedbased onon outcomeoutcome ofof PilotPilot ¾ OctoberOctober 20092009 –– TrainingTraining forfor thethe ImplementationImplementation ofof thethe MinimumMinimum DataData SetSet inin CARECCAREC MemberMember CountriesCountries z 18 countries participated (Epidemiologists & Focal Point) z Agreed start date for annual country reporting: May 2010
(CAREC/PAHO/WHO) PlanPlan forfor FeedbackFeedback onon NCDNCD SurveillanceSurveillance inin thethe CaribbeanCaribbean
¾¾ IntegratedIntegrated SurveillanceSurveillance SystemSystem –– InfobaseInfobase
z CaribbeanCaribbean CHARTSCHARTS
z BeingBeing developeddeveloped toto facilitate:facilitate: • Country use of NCD information for planning and programming • Sub-Regional Reporting on POS Declaration • Advocacy
(CAREC/PAHO/WHO) OutputsOutputs
¾¾CountryCountry profilesprofiles ¾¾SubSub--RegionalRegional profilesprofiles ¾¾AgeAge--specificspecific profilesprofiles ¾¾MapsMaps ¾¾AdAd--hochoc queriesqueries
(CAREC/PAHO/WHO) ChronicChronic DiseaseDisease ProfileProfile
(CAREC/PAHO/WHO) Thank You for Your Kind Attention
(CAREC/PAHO/WHO)