Preventing non-communicable diseases in children and Adolescents
| Monday October 20, 2014 16:37
Obesity is a chronic disease that affects children as well as adults. According to the World Health Organisation, it is now replacing the more traditional public health concerns, including under nutrition and infectious diseases as one of the most significant contributors to ill health. Further, obesity is a key risk factor in the natural history of other chronic and non-communicable diseases (NCDs) such as diabetes and cardiovascular ailments.
In September 2011, the United Nations General Assembly declaration on prevention and control of NCDs acknowledged the increasing impact of NCDs on children and adolescents and recognised the need to protect them.
Dr Patson Mazonde, a paediatrician at Boitekanelo Paediatric Clinic, said it is crucial to form habits that protect children from certain diseases in their childhood as this will later translate to their wellbeing as adults. He explained that children must be given the opportunity to develop socially, mentally and physically but if left unchecked, certain diseases can interrupt that development. A life course approach to preventive efforts addressing NCDs and their risk factors and behaviours will improve child and adolescent health but also decrease lifetime health care costs. This approach recognises that adult health and disease risks develop early in life and can affect disease states and risks across generations.
While most Batswana have embraced the vaccination programme that prevents certain diseases such as measles, Dr Mazonde observed that a preventive approach to NCDs in children and adolescents has not been stressed enough. He emphasised the need to educate communities on the importance of a nutritious diet as this will help children’s mental performance as well as their physical growth.
According to Dr Mazonde, “a nutritious diet may prevent obesity which has been proven to affect a child’s performance in school with the added stigma attached to it. Nutrition also has to do with changing certain mind-sets, for instance soft porridge, which is commonly used as a weaning diet, is mainly starch but a growing child needs proteins, minerals and vitamins probably more than an adult does. ”
Studies show that cases of people being overweight and obese are increasing in high income countries as well as in low and middle income countries with increased risk of diabetes and cardiovascular disease. Dr Mazonde added that children should, as a way of circumventing the problem of obesity, be encouraged to spend more time exercising instead of sitting in front of a television set for hours.
“These days we allow our children too much TV without appreciating the impact on their health. Furthermore, parents and guardians need to ensure that children consume healthy foods such as fruits and fruit juices instead of the common empty calories that are so frequently packed for those going to school,” he said. The growing prevalence of type 2 diabetes, cardiovascular diseases and some cancers is tied to excess weight. Consequently, diabetes is rapidly emerging as a global healthcare problem that threatens to reach pandemic levels by 2030. Statistics show that more than 25 percent of obese adolescents have signs of diabetes by age 15.
Dr Mazonde noted that when a child develops diabetes, the disease becomes difficult to manage as it needs the cooperation of the person affected. He said the effects of the disease on the family are far reaching as it involves prohibitive costs, sometimes interruption of studies and the parents’ way of life because of constant visits to a health centre. The onset of risk behaviours to NCDs often occurs in children and adolescents. Globally, 100,000 young people start smoking each day and over 90 percent of adults who smoke started as children or youth.
Adolescent alcohol consumption and use of illicit drugs such as glue and marijuana are common even in developing countries risking brain damage, compromised brain development, non-intentional injury and violence and dependence in adulthood.
Dr Mazonde also believes the vaccine preventing cervical cancer should be promoted for the girl child, with strategies put in place for preventable healthcare especially for adolescents who in their semi-independent state need more persuasion than small children. Strengthening child and adolescent health systems is essential if low and middle income countries are to develop comprehensive approaches to prevention and management of NCDs.
Integrating primary health care for children and youth with community youth centres is a useful model for a comprehensive multi-level approach to NCD prevention and management. In order to optimise chances of success in the prevention of NCDs of adolescents in particular, young people should also be engaged as active participants in promoting community health and social services that meet their needs.