There is an increasing prevalence of mental disorders in Malaysia, with a growing need to improve access to timely and efficient mental healthcare to address this burden. This review outlines the current legislative framework and the challenges of delivering mental healthcare and treating mental disorders in Malaysia.
Strongyloides stercoralis infection, a neglected tropical disease, poses a significant public health threat, especially in immunocompromised individuals. This parasitic nematode can establish chronic infections, potentially progressing to life-threatening conditions such as hyperinfection syndrome and disseminated disease. Timely and accurate diagnosis is critical for effective treatment and the prevention of severe complications. Traditional diagnostic methods, such as stool microscopy, are limited by low sensitivity, particularly for detecting low-intensity infections. Advances in molecular diagnostics, particularly Polymerase Chain Reaction (PCR), have significantly improved sensitivity and specificity, marking a pivotal shift in detection capabilities. However, critical barriers persist, including inconsistencies in sample collection and handling, geographic variations in parasite strains, and the impact of genetic diversity on assay performance. Emerging molecular technologies, such as real-time PCR, loop-mediated isothermal amplification (LAMP), and droplet digital PCR (ddPCR) hold significant promise for further enhancing diagnostic precision. These advanced methods provide opportunities for more robust and accessible diagnostics, particularly in resource-limited settings. To maximize their potential, it is imperative to address existing challenges through the standardization of protocols, optimization of sample handling procedures, and the development of high-quality, reliable reagents. By overcoming these obstacles, molecular diagnostics can be more effectively integrated into clinical and public health frameworks, facilitating improved management and control of S. stercoralis infection, ultimately reducing the morbidity and mitigating the global burden of this neglected tropical disease.
Older adults exhibit heterogeneous immune responses to COVID-19 vaccination, yet the relative contributions of age, comorbidity, vaccine platform, and infection history to antibody durability remain incompletely defined. Understanding these determinants is essential to inform booster strategies in ageing populations. We conducted a longitudinal observational study of 300 participants (250 aged ≥60 years and 50 younger controls) followed for up to 15 months. Anti-spike (anti-S) antibody responses were assessed at four event-anchored timepoints: ≤ 3 months post-primary vaccination (TP1), ~ 3 months post-first booster (TP2), 6-9 months post-first booster capturing waning immunity (TP3), and ≤3 months post-second booster where available (TP4). Multivariable log-linear regression models were used to identify independent determinants of antibody levels, with additional analyses stratified by infection status and vaccine platform. Among older adults, 78.8% had moderate-to-severe comorbidity burden, 40.0% were pre-frail, and only 16.8% received a second booster. At TP3, older age was associated with lower antibody levels in univariable analysis (GMR 0.81, 95% CI 0.68-0.97) but not after adjustment (aGMR 0.78, 95% CI 0.51-1.22, p = 0.279). Independent predictors of higher TP3 antibody levels included female sex (aGMR 1.24, 95% CI 1.02-1.51, p = 0.028), prior SARS-CoV-2 infection (aGMR 1.39, 95% CI 1.14-1.71, p = 0.001), and mRNA (aGMR 5.16, 95% CI 3.57-7.47, p=<0.001) or viral vector boosters (aGMR 6.05, 95% CI 4.03-9.08, p=<0.001), while renal disease was associated with lower responses (aGMR 0.71, 95% CI 0.54-0.94, p = 0.017). Similar associations were observed at TP4. Frailty and sarcopenia were not independently associated with antibody levels. Neutralising antibodies against Omicron were absent after primary vaccination and detected in only 25.9% of infection-naïve older adults after the first booster. Sustained humoral immunity following COVID-19 vaccination is driven primarily by vaccine platform and immune history rather than chronological age or geriatric syndromes alone. Waning immunity unmasks vulnerability in older adults, while low uptake of second boosters highlights a critical gap between immunological risk and vaccine utilisation. These findings support targeted, equity-focused booster strategies prioritising highly immunogenic platforms and high-risk older adults.
Maternal mental health problems are widespread worldwide, especially against the backdrop of population growth. There is an increasing prevalence of perinatal mental illness in low- and middle-income countries, and Malaysia is no exception. Despite significant improvements in the Malaysian mental health system over the past decade, there are substantial gaps in the delivery of perinatal health services in Malaysia. This article seeks to give a general overview of perinatal mental health in Malaysia and provide recommendations for the development of Malaysia's perinatal mental health services.