Country Level Aging and Disease Burden(cont..)

Pakistan

Pakistan is in the early stages of the demographic transition, which is expected to advance in the future (Figure 2.7). The proportion of the population 65 years and older will move from 3.9 percent in 2000 to 5.4 percent in 2025.

Figure 2.7 Age structure in Pakistan, 2000 and 2025

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

In 2004, NCDs accounted for 59 percent of the total forgone DALYs, with the remainder from communicable diseases and MCH issues. Of the total DALY burden, CVD accounts for 12.7 percent, mental health 11.9 percent, cancer 3.5 percent, respiratory diseases 3.9 percent, diabetes 1.4 percent, and injuries 9.3 percent.

* CVD:

Accounts for 34 percent of all deaths. A population-based study among persons 40 years

and older found prevalence at 25 percent (using both clinical and ECG criteria) with higher rates

in urban than rural populations. A third of the population was classified as having metabolic

syndrome—a risk factor for CVD.

* Diabetes:

Pakistan ranks sixth globally in the number of persons with diabetes. A high prevalence of diabetes was noted in all provinces especially in urban and rural Sindh (16.5 percent and 13.9 percent, respectively). Approximately half those with diabetes were unaware of their condition. Future projections indicate a two- to threefold increase in diabetes over the next decades.

* Cancers:

The most common among men are lung and oropharynx, and in women, breast and

oral cavity.

* Respiratory diseases:

Smoking is one of the most significant risk factors. Other environmental pollutants such as biomass fuel, commonly used in villages, have been associated with symptoms of COPD in rural areas. A recent survey found physician-diagnosed asthma present in 15.8 percent of school children.

* Injuries.

In Karachi, about 42 percent of vehicle crashes involved public transport or heavy

goods vehicles. About half the fatal cases were among motorbike riders. Despite a motorcycle

helmet law, only 8 percent of riders wear helmets.

* Hypertension:

During 1990–1994 the prevalence was 17.9 percent among those 15 years or above. he odds for hypertension were 20 percent lower in literates versus illiterates, indicating higher risk in those socially deprived. In 2004, in Karachi, the prevalence of hypertension was 40 percent in those aged 40 years or over.

* Mental health:

Of the general population, 10–16 percent suffer from mild to moderate psychiatric illnesses. Suicide rates have surged in recent years from a few hundred pre-1990s to almost 7,000 in 2008.

* Obesity:

In the past 10 years, a twofold increase in prevalence of overweight and obesity among

school going children in urban Pakistan has occurred.

* Smoking:

Prevalence is in the midrange among South Asian countries for adults (males 35 percent, females 7 percent) and for youth (boys 12 percent, girls 8 percent).