1. Prof. Wasantha Gunathunga

2.  Primary  Secondary  Tertiary

3.  To know approaches to prevention of NCD  To know the control measures of NCDs

5.  Physical  Mental  Social  Spiritual  Combined

6.  Central obesity  BMI  Exercise  Stamina

7.  Managing stress  Work place  Marital  Social

8. Train mind

9.  Teaching to relax

11.  NIRIGI lanka project (ministry of health website)  Walking tracks  Relaxation programs  MO NCD, MO mental health, MO (MCH)

13.  Secondary prevention

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17.  Test asymptomatic people to classify them as likely or unlikely to have a particular disease eg. Pap smear  Leads to further investigations to reach a final diagnosis eg. Biopsy  Goal is to reduce morbidity or mortality from the disease being screened for by early treatment of cases  Screening is the major form of secondary prevention 17

18. A. The disease  Should be an important health problem in terms of impact on the individual and society  Natural history should be known  The disease or condition should be common ( P&I)  There should be a recognisable latent or early detectable preclinical phase B. The screening test  Suitable test should be available ie. sensitivity, specificity, PPV  Screening should be repeated at intervals determined by natural history  Accurate % acceptable C. The treatment  Should have an effective treatment for early stage disease D. The screening program  Benefit should be greater than harm  Costs  Case finding should be a continuous process and not a “once and for all” project 18

19.  Diagnostic tests are usually performed in people with signs or symptoms of disease  Screening tests are performed in asymptomatic persons  Population vs individual perspective  Benefits of testing must outweigh any negative effects that may arise including physical, psychological and monetary 19

20.  Mass screening  Individualized screening  Routine screening 20

21. 21 Examples of screening Breast cancer: Mammography for women >50yrs Cervical cancer: Pap smears Colon cancer: Faecal occult blood tests and sigmoidoscopy Cardiovascular disease: Blood pressure, Cholesterol Neonatal screening - PKU (Phenylketonuria) Antenatal screening - HBsAg, VDRL

22.  Diabetic clinics  Ncd clinics  Routine screening

23.  Rehabilitation units  Community based rehabilitation  Other treatment forms