Period Poverty: A Neglected Public Health Issue / 가정의학회지

Period poverty is a global community health dilemma that has long been overlooked. This condition is described as having insufficient access to menstrual products, education, and sanitation facilities. Briefly, period poverty means that millions of women are subjected to injustice and inequity due to menstruation. This review aimed to explore the definition, challenges, and effects of period poverty on the community, especially among women at their productive ages. In addition, suggestions to minimize the impact of period poverty are discussed. A search strategy was applied using the keywords “period poverty,” “period equity,” “period poverty,” and “menstrual hygiene” in Google Scholar, ScienceDirect, SpringerLink, MEDLINE, and PubMed electronic databases, journals, and articles on relevant topics. Trained researchers conducted a keyword search from January 2021 to June 2022. Based on the reviewed studies, it has been proven that many countries are still affected by the period stigma and taboo, inadequate exposure to menstrual health and its management, lack of education about menstruation, and shortage of access to menstrual products and facilities. The next step is to reduce and slowly eliminate the period poverty issue by conducting more research to increase clinical evidence and future references. This narrative review could inform policymakers of the magnitude of the burden related to this issue and guide them to develop effective strategies to minimize the impact of poverty, especially during the challenging years of the post-coronavirus disease 2019 era.

Hepatitis C virus core antigen as alternative diagnostic algorithm for active hepatitis C virus infection among haemodialysis population: Cost implications.

AIMS: In Malaysia, majority anti-HCV positive haemodialysis patients do not undergo hepatitis C confirmation due to the high cost of HCV RNA. HCV Core Antigen might be a cost-effective diagnostic test to identify HD patients who have active HCV infection eligible for Direct Acting Anti-viral therapy. METHODS: A cross-sectional study was conducted to assess the correlation between HCV Ag and HCV RNA and the cost implications of different diagnostic algorithms to diagnose active HCV infection using Anti-HCV, HCV Ag, and HCV RNA. Pre-dialysis blood was tested for both HCV Ag and HCV RNA. HCV Ag was tested with Abbott ARCHITECT HCV Ag test. RESULTS: Two-hundred twenty-seven haemodialysis patients were recruited from 20 centres with mean age of 57.68 ± 12.48 years, and male constitutes 56.8% (129) of the study population. HCV Ag correlated well with HCV RNA (Spearman test coefficient 0.943, p < .001) with sensitivity of 93.9%, specificity 99.3%, and the accuracy was 97.36%. Cost analysis indicated that a sequential test involving Anti-HCV antibody as initial screening, followed by HCV Ag on Anti-HCV positive and HCV RNA on HCV Ag negative cases translated to a modest cost-saving algorithm compared to standard diagnostic algorithm. CONCLUSION: HCV Ag correlated well with HCV RNA and can potentially be fused in an alternative diagnostic algorithm to generate cost savings methods to diagnose active HCV infection among haemodialysis patients. This alternative algorithm is especially relevant in low to middle-income countries such as Malaysia to optimize the use of the healthcare resource and gains in clinical outcomes.

Winning The War Against Covid-19 In Malaysia: An Achievable Goal?

@#The World Health Organization (WHO) has initially categorised COVID-19 infection as a Public Health Emergency of International Concern (PHEIC) in late January 2020 and later on declared the outbreak as a pandemic on March 11, 2020. On February 4, 2020 the first Malaysian positive COVID-19 patients was detected. It was estimated through a thorough decision tree technique, cumulatively 22,000 positive patients were expected to be infected nationwide. At the current rate of disease detection, screening yield and clinical capacity in Malaysia, the identification of the positive patients will have to be continuously done until middle of May 2020. In addition, a prediction with the forecasted testing capacity was also conducted. In contrast with the earlier estimation, massive testing causes the number of positive patients to be saturated earlier, by the end of April 2020. Based on the projection, 346, 307 cumulative tests will be conducted with 225,100 cumulative positive cases will be identified. Of the numbers, the cumulative number of patients in care would be 17,631 with 705 cumulative number of admission to intensive care unit and 353 cumulative patients required for ventilator. The cumulative death and cumulative discharge are expected to be 394 and 6008 respectively. Currently, it is challenging for Malaysia to flatten the epidemic curve due to the constraints of healthcare resources. These challenges potentially highlight the need for realistic strategies with regard to the country’s capacity.