Country Level Aging and Disease Burden(cont...)

Nepal

Nepal is in the early stages of the demographic transition, which is expected to advance in the future (Figure 2.6). The proportion of the population 65 years and older will move from 4.2 percent in 2000 to 5.8 percent in 2025.

Figure 2.6 Age structure in Nepal, 2000 and 2025

Source: U.S Census Bureau. www.census.gov/ipc, accessed July 1, 2010.

In 2004, NCDs accounted for 60.1 percent of the total age-standardized burden of forgone DALYs with the remainder from communicable diseases and MCH issues. Of the total DALY burden, CVD accounts for 13.1 percent, mental health 11.0 percent, cancer 4.2 percent, respiratory diseases 3.6 percent, diabetes 1.2 percent, and injuries 11.6 percent. NCDs account for 65.7 percent of all deaths with CVD the leading cause (31.1 percent) followed by cancer (8.6 percent), respiratory diseases (6.7 percent), diabetes (2.2 percent), and mental illness (1.5 percent). Injuries account for 8.8 percent of total deaths.

Key NCD trends include:

* Service utilization for NCD:

In the public sector, NCDs accounted for 81.5 percent of outpatient department cases and 88 percent of inpatient morbidity.

* CVD:

Of all deaths, those from CVD are expected to increase to 34.9 percent by 2030.

* Cancer:

Of all deaths, those from cancer are expected to increase to 12 percent by 2030.

* Diabetes:

Prevalence is 10.8 percent among adults.

* Hypertension:

Prevalence is 21.5 percent among adults.

* Obesity:

The prevalence of overweight and obesity is highest in the 25–34 year age group

among males, while among women the prevalence of overweight and obesity is highest in the

45–54 year age group.

* Alcohol:

The prevalence of hazardous and harmful drinking12 (combined) in the last seven days

among current drinkers is more common among males (38.9 percent) than females (30.3 percent).

* Smoking:

Overall prevalence is in the regional midrange for males but is highest in women

among South Asian countries (males 36 percent, females 28 percent) while smoking prevalence

among youth is among the highest (boys 13 percent, girls 5 percent). Tobacco use increases with

age, with the highest rates at age 45–54 (approximately 85 percent among men and 45 percent

among women).