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Fulltext Effectiveness of Psycho-Education Intervention Programme on Coping Strategies Among Jordanian Women Diagnosed with Breast Cancer: A Randomised Controlled Trial

Younis M, Norsa'adah B, Othman A

Breast Cancer (Dove Med Press), 2021;13:285-297.
PMID: 34007208 DOI: 10.2147/BCTT.S299584

Objective: This study aimed to assess the effectiveness of a psycho-education intervention programme in improving the coping strategies of Jordanian breast cancer patients.
Methods: A double-blinded randomised control trial involving 200 participants between the ages of 20 to 65 years old breast cancer patients was performed. Apart from those who refused participation, patients with chronic diseases and extreme baseline depression scores were also excluded. The control group received standard care twice a week from the social welfare services team facilitator compared to the intervention group that received additional psycho-education intervention programme (PEIP). The coping strategies were measured using the Brief-COPE inventory consisting of 28 items. It was administered on the second and 12th week of trial. The primary end point was compared between pre- and post-intervention. The effect of the intervention between groups, time, and covariates was measured using the generalised linear mixed model (GLMM) analysis.
Results: The mean (SD) of adaptive coping score among the intervention group increased from 5.63 (1.3) at baseline to 6.42 (1.3) at post-intervention. The mean avoidant coping score was 3.87 (1.1) at baseline but reduced to 3.69 (0.8) post-intervention. GLMM showed that women who received the intervention reported significantly higher usage of the adaptive coping strategies after attending the programme (B=0.921, p <0.001).
Conclusion: PEIP significantly improved knowledge of breast cancer patients. Thus, this programme may be considered as a part of the healthcare services in Jordan towards improving the adaptive coping strategies among breast cancer patients, which may point towards the potential for these services to increase adaptive coping strategies among patients in Jordan.
Implications for Public Health: PEIP may be considered as psychosocial intervention in public health and healthcare setting to address rising concerns on quality of care among breast cancer patients.

Matched MeSH terms: Public Health
Fulltext Review article : hepatitis A virus – a general overview

Yong HT, Son R

International Food Research Journal, 2009;16(4):455-467.
MyJurnal

Hepatitis A virus infection occurs globally and is causing a public health concern, primarily in developing countries due to its persistent circulation in the environment. The improved sanitary condition and increase in awareness of personal hygiene have led to the marked reduction of HAV prevalence in industrialized countries during childhood and to a shift of the infection towards adulthood. HAV is an environmentally stable, positive single stranded RNA virus that is primarily transmitted by the fecal-oral route, person to person contact or ingestion of contaminated food and drink. One of the main causes leading to HAV infection is epidemiologically linked to the consumption of raw or undercooked shellfish particularly oysters and clams. Due to their filter-feeding style, these shellfishes readily concentrate viruses from the surrounding water containing municipal sewage, and as a consequence pose a health threat to consumers. Therefore, development of detection techniques possessing the requisite sensitivity and specificity for the practical routine monitoring purposes is of great importance necessary for the protection of shellfish-consuming public. Nucleic acid based method such as reverse transcription PCR has emerged as the popular method of choice in view of its rapidity, accuracy and
sensitivity in contrary of the time-consuming conventional cell culture and hybridization techniques. However, detection of hepatitis A virus is firstly hampered by the non-cytophatic effect of wild type HAV strain, secondly, the low concentration of viral genome present in the environmental sample which requires effective isolation and concentration of virions and lastly the labor-extensive purification and thorough removal of the abundance of the PCR inhibitors which will unfavorably reduce the efficiency of PCR detection.

Matched MeSH terms: Public Health
Evaluation of the Seventh Malaysian Health Plan: a new approach

Yon RB, Hamidy MA, Lin CY

Asia Pac J Public Health, 2001;13(1):54-8.
PMID: 12109263

Since the First Malaysia Plan (1966-1970) many reviews have been done on the five-year health plans of the Ministry of Health (MOH). These included the Mid-Term Reviews and the review done at the end of the respective five-year plan period. There was no structured evaluation method carried out until the Seventh Malaysia Plan (7MP) period (1996-2000), among others because of the complexity of the MOH health plans. The evaluation of the 7MP was the first one conducted using a better-structured process. The findings and recommendations of the evaluation were used and incorporated in the subsequent 5-year health plan, under the Eighth Malaysia Plan (2001-2005).

Matched MeSH terms: Public Health Administration/standards*
Fulltext Examining depressive symptoms and their predictors in Malaysia: stress, locus of control, and occupation

Yeoh SH, Tam CL, Wong CP, Bonn G

Front Psychol, 2017;8:1411.
PMID: 28878710 DOI: 10.3389/fpsyg.2017.01411

The 2015 National Health and Morbidity Survey estimated that over 29% of the adult population of Malaysia suffers from mental distress, a nearly 3-fold increase from the 10.7% estimated by the NHMS in 1996 pointing to the potential beginnings of a public health crisis. This study aimed to better understand this trend by assessing depressive symptoms and their correlates in a cross-section of Malaysians. Specifically, it assesses stress, perceived locus of control, and various socio-demographic variables as possible predictors of depressive symptoms in the Malaysian context. A total of 728 adults from three Malaysian states (Selangor, Penang, Terengganu) completed Beck's depression inventory as well as several other measures: 10% of respondents reported experiencing severe levels of depressive symptoms, 11% reported moderate and 15% reported mild depressive symptoms indicating that Malaysians are experiencing high levels of emotional distress. When controlling for the influence of other variables, depressive symptoms were predictably related to higher levels of stress and lower levels of internal locus of control. Ethnic Chinese Malaysians, housewives and those engaged in professional-type occupations reported less depressive symptoms. Business owners reported more depressive symptoms. Further research should look more into Malaysians' subjective experience of stress and depression as well as explore environmental factors that may be contributing to mental health issues. It is argued that future policies can be designed to better balance individual mental health needs with economic growth.

Matched MeSH terms: Public Health
Shiftwork Association with Cardiovascular Diseases and Cancers Among Healthcare Workers: A Literature Review

Yau A, Haque M

Medeni Med J, 2019;34(4):387-395.
PMID: 32821466 DOI: 10.5222/MMJ.2019.54775

The round-the-clock demands of healthcare services, coupled with the shortage of healthcare providers in many parts of the world, have made shiftwork widespread among healthcare workers. Understanding how to mitigate unfavourable effects of shiftwork on well-being is essential to improve health promotion, to prevent disease prevention, and to increase quality of life. This comprehensive review aims to present evidence linking shiftwork with cardiovascular diseases and cancers among healthcare workers. Several studies have demonstrated evidence indicating the relationship between long-term exposure to shiftwork tempo and a higher risk of cardiovascular diseases. Health workers are increasingly witnesing unfavourable effects of shiftwork on their health state. Shiftwork disturbs circadian rhythm and cardiopulmonary processes, leading to adverse health outcomes. Increasing prevalence of shiftwork in healthcare industries due to population expansion and public health threat of cancers call for investigation towards a better understanding of the underlying mechanism of shiftwork-induced diseases. The shift work period has been considered in different studies using various criteria, resulting in inconsistent definition of measurement criteria leading to misclassification of the study population. There is a need for a more considerable and holistic effort towards standardization of shiftwork definition and conduct an assessment to establish a more conveniently appliacable framework for intervention strategies.

Matched MeSH terms: Public Health
Fulltext Global MLST of Salmonella Typhi Revisited in Post-genomic Era: Genetic Conservation, Population Structure, and Comparative Genomics of Rare Sequence Types

Yap KP, Ho WS, Gan HM, Chai LC, Thong KL

Front Microbiol, 2016;7:270.
PMID: 26973639 DOI: 10.3389/fmicb.2016.00270

Typhoid fever, caused by Salmonella enterica serovar Typhi, remains an important public health burden in Southeast Asia and other endemic countries. Various genotyping methods have been applied to study the genetic variations of this human-restricted pathogen. Multilocus sequence typing (MLST) is one of the widely accepted methods, and recently, there is a growing interest in the re-application of MLST in the post-genomic era. In this study, we provide the global MLST distribution of S. Typhi utilizing both publicly available 1,826 S. Typhi genome sequences in addition to performing conventional MLST on S. Typhi strains isolated from various endemic regions spanning over a century. Our global MLST analysis confirms the predominance of two sequence types (ST1 and ST2) co-existing in the endemic regions. Interestingly, S. Typhi strains with ST8 are currently confined within the African continent. Comparative genomic analyses of ST8 and other rare STs with genomes of ST1/ST2 revealed unique mutations in important virulence genes such as flhB, sipC, and tviD that may explain the variations that differentiate between seemingly successful (widespread) and unsuccessful (poor dissemination) S. Typhi populations. Large scale whole-genome phylogeny demonstrated evidence of phylogeographical structuring and showed that ST8 may have diverged from the earlier ancestral population of ST1 and ST2, which later lost some of its fitness advantages, leading to poor worldwide dissemination. In response to the unprecedented increase in genomic data, this study demonstrates and highlights the utility of large-scale genome-based MLST as a quick and effective approach to narrow the scope of in-depth comparative genomic analysis and consequently provide new insights into the fine scale of pathogen evolution and population structure.

Matched MeSH terms: Public Health
Fulltext Comment on Peycheva et al. Trace Elements and Omega-3 Fatty Acids of Wild and Farmed Mussels (Mytilus galloprovincialis) Consumed in Bulgaria: Human Health Risks. Int. J. Environ. Res. Public Health 2021, 18, 10023

Yap CK, Ong MC

Int J Environ Res Public Health, 2023 Jul 19;20(14).
PMID: 37510626 DOI: 10.3390/ijerph20146393

First of all, the interesting paper by Peycheva et al. [...].

Matched MeSH terms: Public Health
Evidence and potential risk factors of tuberculosis among captive Asian elephants and wildlife staff in Peninsular Malaysia

Yakubu Y, Ong BL, Zakaria Z, Hassan L, Mutalib AR, Ngeow YF, et al.

Prev Vet Med, 2016 Mar 1;125:147-53.
PMID: 26775804 DOI: 10.1016/j.prevetmed.2016.01.008

Elephant tuberculosis (TB) caused by Mycobacterium tuberculosis is an important re-emerging zoonosis with considerable conservation and public health risk. We conducted prospective cohort and cross-sectional studies in elephants and wildlife staff respectively in order to identify potential risk factors associated with TB in captive Asian elephants and their handlers in Peninsular Malaysia. Sixty elephants in six different facilities were screened for TB longitudinally using the ElephantTB STAT-PAK and DPP VetTB assays from February 2012 to May 2014, and 149 wildlife staff were examined for tuberculosis infection using the QuantiFERON-TB Gold In-tube (QFT) assay from January to April, 2012. Information on potential risk factors associated with infection in both elephants and staff were collected using questionnaires and facility records. The overall seroprevalence of TB amongst the elephants was 23.3% (95% CI: 13.8-36.3) and the risk of seroconversion was significantly higher among elephants with assigned mahouts [p=0.022, OR=4.9 (95% CI: 1.3-18.2)]. The percentage of QFT responders among wildlife staff was 24.8% (95% CI: 18.3-32.7) and the risk of infection was observed to be significantly associated with being a zoo employee [p=0.018, OR=2.7 (95% CI: 1.2-6.3)] or elephant handler [p=0.035, OR=4.1 (95% CI: 1.1-15.5)]. These findings revealed a potential risk of TB infection in captive elephants and handlers in Malaysia, and emphasize the need for TB screening of newly acquired elephants, isolating sero-positive elephants and performing further diagnostic tests to determine their infection status, and screening elephant handlers for TB, pre- and post-employment.

Matched MeSH terms: Public Health
Sociology & social medicine

YEANG CH

Med J Malaya, 1960 Jun;14:250-1.
PMID: 13787286
Matched MeSH terms: Public Health*
Risk Management of Negative Online Public Opinion in a Tertiary Hospital Based on the Kaiser Model

Xiong J, Domnic Jacob GA, Xiong JG

Am J Health Behav, 2023 Feb 28;47(1):165-172.
PMID: 36945091 DOI: 10.5993/AJHB.47.1.17

Objectives: In this study, we analyzed negative online public opinion in tertiary hospitals and evaluated corresponding risk by applying the Kaiser Model. Methods: Through data and expert group discussion, combined with the hospital's actual negative online public opinion management, we determined the opinions posing higher risk. The hospital's risk questionnaire for negative opinion was designed based on the Kaiser Model. The whole hospital staff was then trained and investigated. An Excel worksheet was used for statistical analysis and risk calculation.Results: According to the ranking of risk value, the top 5 negative online public opinions were drug supply and demand, in-hospital parking, handling of public health emergencies, the service attitude of hospital guidance staff, and interpretation of medical insurance policies. Conclusion: The hospital needs to revise and improve the emergency response plan for negative online public opinion based on the analysis results and reports of opinion risks. This is helpful for strengthening hospital-level emergency training, improving the hospital's ability to manage negative opinion risks, and promoting the hospital to become passive about negative online public opinion.

Matched MeSH terms: Public Health
Fulltext Zika virus infection in Malaysia: an epidemiological, clinical and virological analysis

Woon YL, Lim MF, Tg Abd Rashid TR, Thayan R, Chidambaram SK, Syed Abdul Rahim SS, et al.

BMC Infect Dis, 2019 Feb 13;19(1):152.
PMID: 30760239 DOI: 10.1186/s12879-019-3786-9

BACKGROUND: A major outbreak of the Zika virus (ZIKV) has been reported in Brazil in 2015. Since then, it spread further to other countries in the Americas and resulted in declaration of the Public Health Emergency of International Concern (PHEIC) by World Health Organization. In 2016, Singapore reported its first minor ZIKV epidemic. Malaysia shares similar ecological environment as Brazil and Singapore which may also favor ZIKV transmission. However, no ZIKV outbreak has been reported in Malaysia to date. This study aimed to discuss all confirmed ZIKV cases captured under Malaysia ZIKV surveillance system after declaration of the PHEIC; and explore why Malaysia did not suffer a similar ZIKV outbreak as the other two countries.
METHODS: This was an observational study reviewing all confirmed ZIKV cases detected in Malaysia through the ZIKV clinical surveillance and Flavivirus laboratory surveillance between June 2015 and December 2017. All basic demographic characteristics, co-morbidities, clinical, laboratory and outcome data of the confirmed ZIKV cases were collected from the source documents.
RESULTS: Only eight out of 4043 cases tested positive for ZIKV infection during that period. The median age of infected patients was 48.6 years and majority was Chinese. Two of the subjects were pregnant. The median interval between the onset of disease and the first detection of ZIKV Ribonucleic Acid (RNA) in body fluid was 3 days. Six cases had ZIKV RNA detected in both serum and urine samples. Phylogenetic analysis suggests that isolates from the 7 cases of ZIKV infection came from two clusters, both of which were local circulating strains.
CONCLUSION: Despite similar ecological background characteristics, Malaysia was not as affected by the recent ZIKV outbreak compared to Brazil and Singapore. This could be related to pre-existing immunity against ZIKV in this population, which developed after the first introduction of the ZIKV in Malaysia decades ago. A serosurvey to determine the seroprevalence of ZIKV in Malaysia was carried out in 2017. The differences in circulating ZIKV strains could be another reason as to why Malaysia seemed to be protected from an outbreak.

Matched MeSH terms: Public Health
Fulltext Maurice KH Yap: academic, administrator, innovator in myopia research and public health

Woo GC

Clin Exp Optom, 2018 07;101(4):616-617.
PMID: 28714215 DOI: 10.1111/cxo.12569
Matched MeSH terms: Public Health/history*
Fulltext A survey of knowledge and perceptions of menopause among young to middle-aged women in Federal Territory, Kuala Lumpur, Malaysia

Wong, L.P., Nur Liyana, A.H.

JUMMEC, 2007;10(2):22-30.
MyJurnal

Prevalence and signs and symptoms of menopause have been extensively studied among Malaysian women but no one had investigated the level of knowledge and perception of menopause. This study aimed to examine the knowledge and perception of menopause among young to middle aged women (15 to 49 years old). A cross-sectional survey using 20-items questionnaire was conducted in three randomly chosen districts in Federal Territory, Kuala Lumpur. Women in this survey were aware of the meaning of the term menopause and its symptoms. However, the majority lacked comprehensive understanding about the health risks associated with menopause. Commonly cited sources of knowledge were magazines and family members. Lack of official sources for accurate information on menopause was reported. Communication with health care personnel regarding menopause was uncommon. An exploration into respondents' perceptions on menopause revealed that the majority displayed positive thinking towards menopause. Young respondents seemed to have better perception regarding menopause compared to middle aged women. Although the women had good knowledge about menopause, they expressed feelings of sadness and nervousness upon the approach of their own menopause. Our data provides insight on the knowledge and perception of menopause that will guide future public health initiatives for premenopausal women in order for them to cope better when approaching this stage of life cycle.

Matched MeSH terms: Public Health
Gender issues in medical and public health education

Wong YL

Asia Pac J Public Health, 2000;12 Suppl:S74-7.
PMID: 11338745

There is no doubt that gender bias has been inherent in medical and public health education, research, and clinical practice. This paper discusses the central question for medical and public health educators viz. whether women's health concerns and needs could be best addressed by the conventional biomedical approach to medical and public health education, research, and practice. Gender inequalities in health and gender bias in medical and public health education are revealed. It is found that in most public health and prevention issues related to women's health, the core issue is male-female power relations, and not merely the lack of public health services, medical technology, or information. There is, thus, an urgent need to gender-sensitize public health and medical education. The paper proposes a gender analysis of health to distinguish between biological causes and social explanations for the health differentials between men and women. It also assessed some of the gender approaches to public health and medical education currently adopted in the Asia-Pacific region. It poses the pressing question of how medical and public health educators integrate the gender perspective into medical and public health education. The paper exhorts all medical and public health practitioners to explore new directions and identify innovative strategies to formulate a gender-sensitive curriculum towards the best practices in medicine and public health that will meet the health needs of women and men in the 21st century.

Matched MeSH terms: Public Health/education*
COVID-19 vaccines and herd immunity: Perspectives, challenges and prospects

Wong RSY

Malays J Pathol, 2021 Aug;43(2):203-217.
PMID: 34448786

The coronavirus disease 2019 (COVID-19) is one of the biggest public health threats in the 21st century. Nearly every country in the world has been affected by COVID-19. The magnitude of the problem, with over 179 million confirmed cases and 3.8 million deaths worldwide, has driven researchers to search for vaccines to combat the disease. The discovery and development of a new vaccine, from the initial stage to the vaccine finally reaching the patients, usually take many years. However, given the urgency of the situation, many clinical trials on the COVID-19 vaccines have been conducted at extraordinary speed, whereas several vaccines against SARS-CoV-2 are being administered worldwide. This article gives an overview of the different types of COVID-19 vaccines, with a focus on those with promising results and are commonly used worldwide. It also gives an overview of herd immunity and discusses the challenges in achieving herd immunity through the global vaccination campaigns. Last but not least, some strategies that may be used to address these challenges are discussed.

Matched MeSH terms: Public Health/statistics & numerical data*
Fulltext Physical, Psychological, and Social Health Impact of Temperature Rise Due to Urban Heat Island Phenomenon and Its Associated Factors

Wong LP, Alias H, Aghamohammadi N, Aghazadeh S, Nik Sulaiman NM

Biomed Environ Sci, 2018 Jul;31(7):545-550.
PMID: 30145991 DOI: 10.3967/bes2018.074
Matched MeSH terms: Public Health
The state of lipid control in patients with diabetes in a public health care centre

Wong JS, Tan F, Lee PY

Asia Pac J Public Health, 2007;19(3):16-21.
PMID: 18330400 DOI: 10.1177/101053950701900304

Achieving treatment targets has been difficult in treating diabetic patients. This cross-sectional study describes the lipid profiles of patients with diabetes mellitus at a public primary health care centre in Sarawak, Malaysia. The targets for lipid control were based on the International Diabetes Federation recommendation (2002). 1031 patients (98% Type 2 Diabetes) were studied. Fasting lipid profiles were available in 990 (96%) patients. The mean total cholesterol was 5.3 +/- 1.0 mmol/L, Triglycerides 1.90 +/- 1.26 mmol/L, HDL-C 1.28 +/- 0.33 mmol/L and LDL-C 3.2 +/- 0.9 mmol/L. Overall, 22% of patients achieved the treatment target for LDL-C level < 2.6mmol/L. 67% of patients had HDL-C > 1.1 mmol/L and 42% of patients had a target TG level below 1.5 mmol/L. Of the 40% of patients who received lipid-lowering drug, 17% achieved LDL-C target, 50% had LDL-C 2.6-4.4 mmol/ L and 33% have LDL-C > 4.0 mmol/L. For the remaining 60% not receiving any lipid lowering therapy, 68% had LDL-C between 2.6-4.0 mmol/L and 7% had LDL-C level > 4 mmol/L. Dyslipidemia is still under-treated despite the availability of effective pharmacological agents and the greatly increased risk of cardiovascular diseases in diabetic patients.

Matched MeSH terms: Public Health*
Fulltext Diagnostics to support elimination of lymphatic filariasis-Development of two target product profiles

Won KY, Gass K, Biamonte M, Dagne DA, Ducker C, Hanna C, et al.

PLoS Negl Trop Dis, 2021 11;15(11):e0009968.
PMID: 34780503 DOI: 10.1371/journal.pntd.0009968

As lymphatic filariasis (LF) programs move closer to established targets for validation elimination of LF as a public health problem, diagnostic tools capable of supporting the needs of the programs are critical for success. Known limitations of existing diagnostic tools make it challenging to have confidence that program endpoints have been achieved. In 2019, the World Health Organization (WHO) established a Diagnostic Technical Advisory Group (DTAG) for Neglected Tropical Diseases tasked with prioritizing diagnostic needs including defining use-cases and target product profiles (TPPs) for needed tools. Subsequently, disease-specific DTAG subgroups, including one focused on LF, were established to develop TPPs and use-case analyses to be used by product developers. Here, we describe the development of two priority TPPs for LF diagnostics needed for making decisions for stopping mass drug administration (MDA) of a triple drug regimen and surveillance. Utilizing the WHO core TPP development process as the framework, the LF subgroup convened to discuss and determine attributes required for each use case. TPPs considered the following parameters: product use, design, performance, product configuration and cost, and access and equity. Version 1.0 TPPs for two use cases were published by WHO on 12 March 2021 within the WHO Global Observatory on Health Research and Development. A common TPP characteristic that emerged in both use cases was the need to identify new biomarkers that would allow for greater precision in program delivery. As LF diagnostic tests are rarely used for individual clinical diagnosis, it became apparent that reliance on population-based surveys for decision making requires consideration of test performance in the context of such surveys. In low prevalence settings, the number of false positive test results may lead to unnecessary continuation or resumption of MDA, thus wasting valuable resources and time. Therefore, highly specific diagnostic tools are paramount when used to measure low thresholds. The TPP process brought to the forefront the importance of linking use case, program platform and diagnostic performance characteristics when defining required criteria for diagnostic tools.

Matched MeSH terms: Public Health
Fulltext Prevention of cervical cancer by Human papillomavirus (HPV) vaccination and early detection through effective screening: a review

Win Win Than, Tin Sabai Aung

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):74-74.
MyJurnal

Introduction: Cervical cancer remains the second commonest female malignancy worldwide and the seventh among Malaysians. Globally in 2012, an estimated 528 000 women developed cervical cancer and almost 266 000 died from this disease. Of all cervical cancers, 83% occur in the less developed world due to the absence of screening. To promote the community health awareness of cervical cancer which is preventable. Methods: By internet literature searching (Google Scholar) and textbooks. Results: The primary cause of cervical pre-cancer and cancer is persistent infection with one or more of the oncogenic types of HPV, the most common infection acquired during sexual inter-course, usually early in sexual life. Cervical cancer due to HPV can be prevented by HPV vaccination, participation in a screening program, avoidance of smoking, limitation of sex partners and use of a condom. Three HPV vaccines are available worldwide such as bivalent HPV 16/18 vaccine, quadrivalent HPV 16/18/6/11 L1 virus-like particles vaccine and 9-valent HPV 6/11/16/18/31/33/45/52/58 recombinant vaccine. The HPV test can be done on the same sample of cells collected from the Pap test and it can help to know HPV types. Conclusion: Cervical cancer due to HPV can be prevented by vaccination and the pre-cancerous phase of cervical cancer can be screened by the HPV testing with the Pap test. The community health awareness plays a major role in cervical cancer prevention.

Matched MeSH terms: Public Health
Access to pathology and laboratory medicine services: a crucial gap

Wilson ML, Fleming KA, Kuti MA, Looi LM, Lago N, Ru K

Lancet, 2018 05 12;391(10133):1927-1938.
PMID: 29550029 DOI: 10.1016/S0140-6736(18)30458-6

As global efforts accelerate to implement the Sustainable Development Goals and, in particular, universal health coverage, access to high-quality and timely pathology and laboratory medicine (PALM) services will be needed to support health-care systems that are tasked with achieving these goals. This access will be most challenging to achieve in low-income and middle-income countries (LMICs), which have a disproportionately large share of the global burden of disease but a disproportionately low share of global health-care resources, particularly PALM services. In this first in a Series of three papers on PALM in LMICs, we describe the crucial and central roles of PALM services in the accurate diagnosis and detection of disease, informing prognosis and guiding treatment, contributing to disease screening, public health surveillance and disease registries, and supporting medical-legal systems. We also describe how, even though data are sparse, these services are of both insufficient scope and inadequate quality to play their key role in health-care systems in LMICs. Lastly, we identify four key barriers to the provision of optimal PALM services in resource-limited settings: insufficient human resources or workforce capacity, inadequate education and training, inadequate infrastructure, and insufficient quality, standards, and accreditation.

Matched MeSH terms: Public Health

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