Showing posts with label Selangor. Show all posts
Showing posts with label Selangor. Show all posts

Friday, November 6, 2015

Pain, Instability & Familial Discord: A Qualitative Study into Women Who Use Drugs in Malaysia

Out of 20,887 persons who use drugs that came into contact with the National Anti-Drugs Agency (NADA) officials in the year 2013, 3.2 % were women. Because women who use drugs (WWUD) are often a hidden population, this may be an underestimate. International literature shows that women who use drugs face increased risk of HIV, intimate partner violence, and mental health issues. Similar literature in Malaysia is lacking, and thus, the objective of our study was exploratory in nature.

Thirty-eight women who use drugs were interviewed using a semi-structured topic guide in Kelantan, Penang, Johor, Kuala Lumpur, and Selangor. Locations were chosen purposively. Nineteen women were interviewed individually and the remaining 19 were in focus group discussions (FGDs). All interviews were transcribed verbatim, translated to English, and analyzed with NVivo.

Median age of respondents was 35.5 years old, 89.5 % ethnic Malays, majority having married below the age of 20, and were of low socioeconomic backgrounds. Youngest age of initiation into drug use was 9 years old. Most reported is inhalation of amphetamine-type substances. Seven reported ever injecting. Three themes emerged: (a) repeating patterns of fluid family structures and instability; (b) “pain” and “difficulty” as features of home life; and (c) seeking marriage as a source of stabilization and practices of power within those marriages. Respondents often came from very fluid family environments and married to find stability, only to be drawn into a similar cycle. None of the women who had been separated from their children either institutionally, by family members, or by third parties, had accessed legal recourse for the loss of their parental rights.

Unstable familial relationships or environments contributed to earlier initiation of drug use which raised questions about support services for WWUD and children who use drugs. Respondents were drawn into unstable and/or abusive relationships, perpetuating social inequalities that marked their own familial environments during childhood. These findings support the need for additional services to support the unique needs of WWUD, including domestic violence services, financial and life skills, parental rights assistance, and empowerment programs.

Full article at: http://goo.gl/ZWPVAw

By: Fifa Rahman1*, Priya Lall2, Sarah Iqbal1 and B. Vicknasingam3
1Malaysian AIDS Council, No. 12, Jalan 13/48A, Sentul Raya Boulevard, Kuala Lumpur, 51000, Malaysia
2University of Malaya, Medical Faculty, Kuala Lumpur, 50603, Malaysia
3Centre for Drug Research, Universiti Sains Malaysia, Penang, 11800, Malaysia
  



Thursday, October 29, 2015

Determining Intestinal Parasitic Infections (IPIs) in Inmates from Kajang Prison, Selangor, Malaysia for Improved Prison Management

The prison management in Malaysia is proactively seeking to improve the health status of the prison inmates. Intestinal parasitic infections (IPIs) are widely distributed throughout the world and are still gaining great concern due to their significant morbidity and mortality among infected humans. In Malaysia, there is a paucity of information on IPIs among prison inmates. In order to further enhance the current health strategies employed, the present study aims to establish firm data on the prevalence and diversity of IPIs among HIV-infected and non-HIV-infected individuals in a prison, an area in which informed knowledge is still very limited.

Samples were subjected to microscopy examination and serological test (only for Strongyloides). Speciation for parasites on microscopy-positive samples and seropositive samples forStrongyloides were further determined via polymerase chain reaction. SPSS was used for statistical analysis.

A total of 294 stool and blood samples each were successfully collected, involving 131 HIV positive and 163 HIV negative adult male inmates whose age ranged from 21 to 69-years-old. Overall prevalence showed 26.5 % was positive for various IPIs. The IPIs detected included Blastocystissp., Strongyloides stercoralis, Entamoeba spp., Cryptosporidium spp., Giardia spp., and Trichuris trichiura. Comparatively, the rate of IPIs was slightly higher among the HIV positive inmates (27.5 %) than HIV negative inmates (25.8 %). Interestingly, seropositivity for S. stercoralis was more predominant in HIV negative inmates (10.4 %) compared to HIV-infected inmates (6.9 %), however these findings were not statistically significant. Polymerase chain reaction (PCR) confirmed the presence of Blastocystis, Strongyloides, Entamoeba histolytica and E. dispar.

These data will enable the health care providers and prison management staff to understand the trend and epidemiological situations in HIV/parasitic co-infections in a prison. This information will further assist in providing evidence-based guidance to improve prevention, control and management strategies of IPIs co-infections among both HIV positive and HIV negative inmates in a prison environment.

Table 4

Risk factors of intestinal parasitic infections among participating prison inmates according to HIV status (n = 294)
CharacteristicsOverall (n = 294)HIV positive (n = 131)HIV negative (n = 163)
No. infected (%)OR (95 % CI)pNo. infected (%)OR a (95 % CI)pNo. infected (%)OR (95 % CI)p
Age group (years)
 ≥4031 (27.7)1.10 (0.65-1.87)0.72716 (27.1)0.97 (0.45-2.09)0.93315 (28.3)1.21 (0.58-2.54)0.607
 <4047 (25.8)120 (27.8)b27 (24.5)1
Education attainment
 Primary school and below20 (24.4)0.86 (0.48-1.54)0.6057 (20.0)0.58 (0.23-1.47)0.24713 (27.7)1.15 (0.53-2.47)0.725
 Secondary school and below58 (27.4)129 (30.2)129 (25.0)1
Tuberculosis
 Yes8 (42.1)2.13 (0.82-5.51)0.1128 (44.4)2.43 (0.87-6.76)0.094e0NA f0.535e
 No70 (25.5)128 (24.8)142 (25.9)
Hepatitis B or C
 Yes4 (18.2)0.60 (0.20-1.82)0.3562 (11.1)0.29 (0.06-1.33)0.153e2 (50.0)2.98 (0.41-21.82)0.274e
 No74 (27.2)134 (30.1)140 (25.2)1
CD4 count c (cells/mm3 )
 ≤2008 (33.3)1.32 (0.48-3.58)0.590
 >20019 (27.5)1
Duration of having HIV (years)
 ≤1026 (29.9)1.43 (0.63-3.36)0.386
 >1010 (22.7)1
HAART d
 No32 (26.9)0.74 (0.21-2.61)0.736e
 Yes4 (33.3)1
aOR Odd ratio
b Reference group marked as OR = 1
cn = 93
dHAART Highly active antiretroviral therapy
e Fisher’s exact value
fNA Not available
Angal et al.
Angal et al. BMC Infectious Diseases 2015 15:467   doi:10.1186/s12879-015-1178-3

Full article at: http://goo.gl/o7do8w

By: Lorainne Angal1, Rohela Mahmud1, Sajideh Samin2, Nan-Jiun Yap1, Romano Ngui1,Amirah Amir1, Init Ithoi1, Adeeba Kamarulzaman3 and Yvonne AL Lim1*
1Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
2Penjara Utama Kajang, Kajang, Selangor, Malaysia
3Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia