Abstract |
Like other developing countries in the South East Asian region Indonesia is undergoing an epidemiological transition. Communicable diseases tend to decrease, while non-communicable diseases and accidents tend to increase. This epidemiologic transition is strongly influenced by demographic and "life style" factors. Risk factors as smoking high calorie and fat diet, mental stress and a sedentary life style will have an important impact on the increase of non-communicable diseases like cancer, heart disease, stroke and diabetes. Cardiovascular diseases are rare before 1960, but started to increase since the 1970's. According to the health household surveys the prevalence of cardiovascular diseases increases from 1.1 per 1000 in 1972 to 5.9 per 1000 in 1980. A 5 year study (1976-1980) of hospital patients in Bali analyzed 1.339 in patients (12% of all inpatients) and found the following distribution : ischemic h.d. 32%, rheumatic h.d. 40%, pulmonic h.d. 18% hypertensive h.d. 4%, congenital h.d. 1% and other h.d. 5%. Community surveys of diabetes, found a prevalence of around 1.5% in adults. The most frequent complications of diabetes were : ischemic heart disease (20-25%), gangrene (2,4%), pulmonary tb (10-13%) and diabetic ketoacidosis (2.5-5%). Cancer incidence is estimated at 100 per 100.000 per year. A pathology based registry in 1988 recorded the following localisations : cervix (25.57%), breast (15.83%), lymphoid (12.52%), skin (11,46%), nasopharynx (7.8%), ovary (6,60%). Rectum (6.04%), connective tissue (5.82%), thyroid (4.43%), colon (3.9%). A study of cancer in 17 hospitals in Jakarta found the following cancers in men : lung liver, nasopharynx, lymphoma, rectum, leukemia, stomach, colon, larynx and pancreas in descending order of frequency. The most frequent cancers in women were located in the cervix, breast, ovary, lung, liver, nasopharynx, rectum, leukemia, lymphglands and colon. Hospital data showed that 60-80% of patients treated in mental hospitals are suffering from schizophrenia. A study of patients seeking treatment from health centres from that around 20% were experiencing psychological or mental problems. Several dental surveys found carries and periodental diseases in 60% of population surveyed. The highest frequency were found in the 35-44 year age group. According to the health household survey in 1980, accidents have caused 3,5% of all deaths. It is estimated that around 2.5 million accidents each year and around 10% of all hospital admissions are caused by accidents. About 40% of all accidents treated in hospitals are caused by traffic accidents, 35% of which are head trauma. Research on non-communicable diseases have to be undertaken to know the magnitude of the problems and develop methodologies to control the diseases, emphasizing behaviour change, environmental improvement and the use of appropriate technology. Diseases which require attention are cancer, cardiovascular diseases, endocrine diseases (diabetes, thyroid diseases, etc), dental and oral diseases, accidents and occupational diseases, mental diseases, neurological diseases, chronic respitory diseases, joint and rheumatic diseases, congenital/hereditary diseases, and diseases caused by radiation. |