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Nigeria's free digital learning hub. Videos, lecture notes, practice questions and leaderboards aligned with CCMAS, NBTE, NCCE, WAEC, NECO, IJMB and JAMB curricula.
This is the complete lecture note for COM503 Epidemiology and Principle of Control of Non-communicable Diseases, Chronic Diseases and Cancers of Global Importance. You can read it online below, open it in the full viewer, or download the PDF for offline study. It pairs with the course's video lectures, so you can read and watch together.
la-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS
la-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS Course code: COM 503 Course title: Epidemiology and Principle of Control of Non-communicable Diseases, Chronic Diseases and Cancers of Global Importance Course credit load: 2 Units Series 1: Principles and Concepts of Non-Communicable Disease Prevention and Control • Part 1.1: Basic Concepts in Non-Communicable Disease Epidemiology o Sub Part 1.1.1: Definition and characteristics of non-communicable diseases o Sub Part 1.1.2: The burden of non-communicable diseases in Nigeria o Sub Part 1.1.3: Distinguishing non-communicable from communicable diseases • Part 1.2: Natural History and Multifactorial Origin of Non-Communicable Diseases o Sub Part 1.2.1: Stages in the natural history of a non-communicable disease o Sub Part 1.2.2: The multifactorial causation of non-communicable diseases o Sub Part 1.2.3: Chronic disease progression and cumulative exposure • Part 1.3: Levels of Prevention for Non-Communicable Diseases o Sub Part 1.3.1: Primary prevention of non-communicable diseases o Sub Part 1.3.2: Secondary prevention of non-communicable diseases o Sub Part 1.3.3: Tertiary prevention of non-communicable diseases • Part 1.4: Principles of Non-Communicable Disease Control Programmes o Sub Part 1.4.1: Population-based versus high-risk approaches to control o Sub Part 1.4.2: Integration of non-communicable disease control into primary health care o Sub Part 1.4.3: The role of health promotion in non-communicable disease control
la-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS Introduction Non-communicable diseases, sometimes called chronic diseases, now account for a growing share of illness and death in Nigeria, encompassing conditions such as hypertension, diabetes mellitus, and cancer, which, unlike the communicable diseases addressed in an earlier course, are not transmitted from one person to another. Picture a busy urban clinic where, alongside patients with infections, an increasing number now attend for long-term management of raised blood pressure or blood sugar, often first detected only after years of silent progression. Understanding the distinct epidemiological principles that govern such diseases, and the levels at which they can be prevented, is essential, and it is this foundation that forms the subject of this opening Series. The aim of this Series is to equip you with the core concepts and principles that underpin the prevention and control of non-communicable diseases, providing the conceptual toolkit on which every later Series in this course will build. This Series begins with basic concepts in non-communicable disease epidemiology, before turning to the natural history and multifactorial origin of these diseases. Next, we examine the levels of prevention, before concluding with the broader principles of non-communicable disease control programmes. Series Learning Outcomes At the end of this Series, you should be able to: • SLO 1.1: define a non-communicable disease and describe its key characteristics • SLO 1.2: distinguish non-communicable diseases from communicable diseases • SLO 1.3: describe the stages in the natural history of a non-communicable disease • SLO 1.4: describe the multifactorial causation of non-communicable diseases • SLO 1.5: describe primary, secondary, and tertiary prevention as applied to non-communicable diseases • SLO 1.6: distinguish the population-based approach from the high-risk approach to non-communicable disease control • SLO 1.7: describe the integration of non-communicable disease control into primary health care, and • SLO 1.8: describe the role of health promotion in non-communicable disease control.
la-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS 1.1 Basic Concepts in Non-Communicable Disease Epidemiology 1.1.1 definition and characteristics of non-communicable diseases A disease not passed from one person to another A non-communicable disease, or NCD, is a medical condition that is, by definition, not caused by an infectious agent and is not directly transmissible from one person to another, typically arising instead from a combination of genetic, physiological, environmental, and behavioural factors accumulating over a substantial period of time, in clear contrast to the transmissible communicable diseases addressed in an earlier course. Non-communicable diseases are generally characterised by long duration, often lasting many years or the remainder of a person's life, and typically slow progression, developing gradually rather than presenting with the sudden onset characteristic of many communicable diseases, features that carry major implications for how such diseases are detected, managed, and prevented at population level, themes developed throughout this Series. Fill in the blank: A non-communicable disease is, by definition, not caused by an infectious agent and is not directly ________ from one person to another. 1.1.2 the burden of non-communicable diseases in Nigeria Non-communicable diseases now account for a substantial and rising proportion of overall illness and death in Nigeria, a pattern often described as part of a broader epidemiological transition, in which the relative burden of disease within a population shifts over time from predominantly communicable conditions toward an increasing share of non-communicable conditions, frequently accompanying urbanisation and associated changes in lifestyle. This rising burden places substantial strain on health systems that have historically been organised predominantly around the management of acute, communicable conditions, and increasingly requires health systems in Nigeria to build capacity for long-term, continuous care of the kind non-communicable diseases typically demand, a structural challenge distinct from that posed by most communicable diseases. Fill in the blank: The shift in a population's disease burden over time from predominantly communicable toward non-communicable conditions is termed the epidemiological ________.
la-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS 1.1.3 distinguishing non-communicable from communicable diseases Beyond the absence of person-to-person transmission, non-communicable diseases differ from communicable diseases in several other important respects, including their typically multifactorial causation, discussed further later in this Series, in contrast to the single specific infectious agent responsible for a given communicable disease, and their generally gradual, cumulative development rather than a defined incubation period leading rapidly to clinical illness. These differences carry direct implications for control, since measures such as quarantine and isolation, central to communicable disease control, have no meaningful application to non-communicable diseases, which instead require sustained attention to individual and population-level risk factors, a central theme of the next Series of this course. Fill in the blank: Unlike communicable diseases, non-communicable diseases are generally caused by multiple factors rather than a single specific infectious ________. Figure 1.1: A nurse measuring a patient's blood pressure during a routine clinic visit. Pilot questions 1.1 1. Define a non-communicable disease and describe its key characteristics. (Linked to SLO 1.1)
la-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS 2. Explain why non-communicable diseases are generally of long duration and slow progression. (Linked to SLO 1.1) 3. Define the epidemiological transition. (Linked to SLO 1.1) 4. Explain why the rising burden of NCDs strains health systems organised around acute care. (Linked to SLO 1.2) 5. Distinguish non-communicable diseases from communicable diseases in terms of causation. (Linked to SLO 1.2) 1.2 Natural History and Multifactorial Origin of Non-Communicable Diseases 1.2.1 stages in the natural history of a non-communicable disease A gradual progression from exposure to established disease The natural history of a non-communicable disease typically begins with a prolonged pre-clinical stage, during which underlying biological changes accumulate silently, with no apparent symptoms, sometimes over many years, before progressing to an early symptomatic stage, in which subtle or intermittent symptoms may begin to appear, though these are often mild enough to be overlooked or attributed to other causes. This is followed by a stage of established clinical disease, with clearly recognisable signs and symptoms, and, in the absence of effective management, a final stage of complications or disability, such as heart failure following long-standing hypertension, a pattern of gradual, cumulative progression that stands in notable contrast to the more compressed natural history typical of many communicable diseases, discussed in an earlier course. Fill in the blank: The natural history of a non-communicable disease typically begins with a prolonged pre-clinical stage during which changes accumulate ________. 1.2.2 the multifactorial causation of non-communicable diseases Unlike most communicable diseases, which arise from a single identifiable infectious agent, non-communicable diseases are generally the product of multiple interacting causes, encompassing genetic predisposition, behavioural factors such as diet and physical activity, environmental exposures, and broader socioeconomic determinants, no single one of which is typically both necessary and sufficient to produce disease on its own. This multifactorial causation means that a given individual's overall risk of developing a non-communicable disease reflects the cumulative influence of several contributing factors acting together, a concept explored in greater depth in the next Series of this course, and it also means
la-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS that effective prevention typically requires addressing several contributing factors simultaneously rather than a single intervention targeting one cause alone. Fill in the blank: Non-communicable diseases are generally the product of multiple interacting causes, a pattern termed ________ causation. 1.2.3 chronic disease progression and cumulative exposure A defining feature of many non-communicable diseases is that disease risk accumulates with cumulative exposure over time, meaning the total risk to an individual often depends not merely on whether a given risk factor is present, but on its intensity and, importantly, the
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