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Meghalaya looks to integrate non-alcoholic fatty liver disease in NCD population screening

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Shillong, Aug 30: With an aim to integrate the screening of population for Non Alcoholic Fatty Liver Disease (NAFLD) with the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), a meeting was held on Wednesday between the National Health Mission, Meghalaya officials and the State NCD Nodal Officers, where Dr. Kanika Kaushal, Assistant Professor of Clinical Research and Epidemiology at the Institute of Liver & Biliary Sciences (ILBS), Delhi, gave a presentation on the guidelines for the integration of NAFLD into NPCDCS.

Meghalaya looks to integrate non-alcoholic fatty liver disease in NCD population screening

The highlight of the meeting was the alignment of existing NCD programme’s strategies to prevent and control NAFLD with the following: behaviour and lifestyle changes; early diagnosis and management of NAFLD; building of capacity at various levels of healthcare for prevention; and, diagnosis and treatment of NAFLD.

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Dr. Kaushal’s presentation threw light on NAFLD, its implications and preventive practices. It was highlighted that NAFLD is the abnormal accumulation of fat in the liver in the absence of secondary causes of fatty liver, such as harmful alcohol use, viral hepatitis, or medications. According to research, it is a serious health concern as it encompasses a spectrum of liver abnormalities, from a simple non-alcoholic fatty liver (NAFL, simple fatty liver disease) to more advanced ones like non-alcoholic steatohepatitis (NASH), cirrhosis and even liver cancer.

Following the presentation, the Principal Secretary, Health & Family Welfare Department, Sampath Kumar stated that liver health can play an important role for managing various other NCDs. In this context, he highlighted the important support that the Mid Level Health Providers (MLHPs) can provide. The need to close the gap between research and implementation was stressed upon, as was the need for effective public communication and sensitisation about the issue.

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Globally, NASH caused 40 lakh prevalent cases of compensated cirrhosis in 1990, which increased to 94 lakh cases in 2017. NAFLD is emerging as an important cause of liver disease in India. Researchers have found NAFLD in about 40% to 80 % of people who have type 2 diabetes and in about 30% to 90% of people who are obese. Studies also suggest that people with NAFLD have a greater chance of developing cardiovascular disease.

The State plans to expand the existing program to curb deaths due to NCDs linked with the condition as NAFLD is an independent predictor of future risk of cardiovascular diseases, type 2 diabetes and other metabolic syndromes like hypertension, abdominal obesity, dyslipidemia, and glucose intolerance.

The meeting also highlighted a critical role that the Village Health Councils (VHCs) in Meghalaya can play in terms of community empowerment as well as prevention of diabetic cases.

It may be recalled that in February 2021, India pioneered the need for action for NAFLD whereby Dr Harsh Vardhan, Union Minister, Health & Family Welfare, launched the operational guidelines for integration of NAFLD (Non-Alcoholic Fatty Liver Disease) with NPCDCS (National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke) in the same year.

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