This document discusses the triple burden of disease faced by many developing countries. It describes the triple burden as the coexistence of infectious diseases, undernutrition, and emerging non-communicable diseases. Many countries now struggle with this combination of communicable diseases, malnutrition, and non-communicable diseases like heart disease and diabetes. Addressing this triple burden presents challenges for healthcare systems in developing nations. Risk factors like poverty, malnutrition, urbanization and changing lifestyles have contributed to the rise of non-communicable diseases.

1. BY
SUSHANT LUITEL
TRIPAL BURDEN OF
DISEASE

2. INTRODUCTION
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 Most of these countries suffer from a triple burden of
disease: the backlog of common infections, under
nutrition, and maternal mortality, the emerging
challenges of non-communicable diseases (NCDs),
such as cancer, diabetes, heart disease, and
mental illness.

3. Cont…
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 The triple burden of malnutrition is the coexistence of
food insecurity, under nutrition, and overweight and
obesity is a growing challenge in the Middle East and
North Africa (MENA). The triple burden of
malnutrition leads to large social and economic losses.

4. Distribution
Globally
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 Global trends on the nature and causes of different
health risks have shifted over the last century.
Countries all over the world, including developing
ones like the Philippines, are thus challenged to come
up with health systems that can address these evolving
health concerns.

5. Cont…
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The World Health Organization (2017) estimated that
about half of the 56.4 million deaths worldwide can be
attributed to just 10 causes. However, in recent years,
cases of road injuries have gradually increased to
become one of the top causes of mortality.

6. Cont…
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 This Economic Issue of the Day explains the concept
of triple burden of disease and its Implications for
public health policy.
Ortiz, Danica Aisa P.; Abrigo, Michael R.M. | July 2017

7. Nationally…
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 Non-communicable diseases, communicable diseases
and trauma are emerging as a triple burden for
healthcare system of developing countries like Nepal
thus hindering our efforts to increase life expectancy,
low economic growth and halting the global strategy
for obtaining good health for all.

8. Cont…
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NCD account for 36 million deaths (WHO, 2008) in
the world. Among them, 80 % of deaths occur in low
and middle income countries. According to WHO
every year an estimated 14 million people die
prematurely in developing countries from preventable
heart disease, stroke, diabetes, cancers and asthma,
with major negative consequences for socioeconomic
development. By 2020, these diseases are expected to
account for seven out of every ten deaths.
This article was published in Republica Daily by Dr Raja Ram Dhungana

9. Challenges
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 While low and middle-income countries have been
struggling with CD for many years, they are now stuck
with NCD and road traffic accidents putting them in
triple burden. In recent years, NCD such as
cardiovascular diseases, mental illnesses, diabetes,
COPD and cancers have become an emerging
pandemic in low and middle-income countries.

10. Cont…
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According to the estimates of the WHO, by 2020, NCD
will account for 80 percent of the global burden of
disease and 70 percent of deaths- the majority of the
burden and death being in low and middle-income
countries. The transition from CD to NCD and road
traffic accidents in low and middle-income countries is
being catalyzed by the ongoing economic
development, urbanization and changing lifestyles.
Ethiop J Health Sci. 2018 Jan; 28

11. Causes
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12. Cont…
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Both communicable and non
communicable diseases have been the primary culprits
of deaths all over the world in the last two decades or
so.
However, in recent years, cases of road injuries have
gradually increased to become one of the top causes of
mortality.

13. Etiology
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CD
NCD
CD +NCD+
OTHER
INFECTIO
US
DISEASE
POVERTY
&
MALNUTR
ITION

14. Incidence of disease
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15. Control measure
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EARLY
DIAGNOSI
S
NOTIFICATI
ON TO
HIGHER
CENTER
EPIDEMIO
LOGICAL
INVESTIG
ATION
ISOLATIO
N
TREATME
NT

16. Preventions
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1. Primordial prevention:
Prevention of emergency or development of risk
factor in countries or population group in which they
have not yet appeared.
Intervention of individual and mass education. Eg:
national programmes and polices on food and
nutrition against smoking, drugs abuse and to
promote regular physical exercise.

17. Cont…
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2. Primary prevention:
Action taken prior to onset of disease which removes
the possibility that will ever occur.
Intervention of pre-pathogenesis stages of disease.
Mode of intervention of health promotion and specific
protection.

18. Cont…
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3. Secondary prevention:
Action which halts the progress of the disease at its
incipient stage and prevents complication.
Intervention of early pathogenesis stage.
Mode of intervention of early diagnosis and adequate
prompt treatment.

19. Cont…
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4. Tertiary prevention:
All the measures available to reduce or limit
impairments and disabilities and minimize suffering
caused by existing depatures from good health and to
promote the pattern adjustment to irremediable
conditions.
Intervention of late pathogenesis stage.
Mode of intervention of disability limitations and
rehabilitation.

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