Objective Proper foot assessment is important for early detection and treatment of diabetic peripheral neuropathy (DPN), the main cause of diabetic foot ulcers (DFUs). This study aimed to determine the accuracy and cost-effectiveness of the locally developed Diabetic Foot Screen (DFS) proforma in detecting DPN among diabetic patients at 10 selected clinics in Yangon, Myanmar. Methodology The study included 625 type 2 diabetics from 10 primary care clinics who participated in the diagnostic accuracy and cost-effectiveness analysis. They were assessed with DFS proforma and biothesiometry by two examiners independently. The cost-effectiveness analysis was conducted based on available data in the local primary care setting. Results The overall accuracy of the DFS proforma assessment was 74.76% (95% CI: 70.46%- 79.06%). The optimal cut-off DFS score was ≥1.5 (sensitivity 62%; specificity 76%) in detecting DPN. Compared to biothesiometry, the cost-effectiveness of DFS proforma assessment in DPN detection was 41.79 USD per DPN case detected. Conclusion This study supported the use of DFS proforma for DPN detection in primary care clinics. It also provided new information on the estimated costs per patient with DPN detected in Myanmar.

INTRODUCTIONStrong primary health care (PHC) is the cornerstone for universal health coverage (UHC), reinforced by the Astana Declaration of 2018 1 as the best means to achieve an inclusive, effective, and efficient approach to enhance people's physical and mental health and social wellbeing.PHC includes both public health (PH) and primary care (PC). A highly performing PC system provides access to first-contact, patient-centred care that is comprehensive, and continuous over time while coordinating services. 2 The World Health Organization (WHO) resolution on the primary health care draft operational framework, approved by the WHO Executive Board in January 2020, notes that a key lever is 'Models of care that promote high-quality, people-centred primary care and essential public health functions as the core of integrated health services throughout the course of life.' 3 Effective PHC therefore requires a coherent integration of PH and PC services, which involves a number of actions that include comprehensive PC services to a defined population, improved communication between PH and PC providers, knowledge sharing between individual-and population-focused health services, and strengthened and coordinated PC and PH surveillance functions. 4 The year 2020 saw the advent of the COVID-19 pandemic, and now more than ever PH and PC measures are needed to form the foundation of the crisis response and provide continued health care to all those suffering the ongoing direct and indirect effects of this health crisis. There is a need for adaptation, flexibility, and innovation, with task shifting in the workforce to mount the response, and a move to telehealth where possible for provision of non-COVID-19 care. 5 We report on the PHC approaches of six different countries in the Asia-Pacific region (Fiji, Japan, Macao (a Special Administrative Region of China), New Zealand (NZ), Philippines, and Thailand) and describe the degree to which their PH and PC systems have mounted an integrated response to the spread of COVID-19 in their country. Our analysis is based on the data provided by expert academic family doctors, using PHC framework developed by the World Organization of Family Doctors (WONCA) Working Party on Research. Our aim is to identify the relative strength of PHC and integration of PH and PC in each country, and relate this to their response to COVID-19. CHARACTERISTICS OF PRIMARY CARE IN THE SIX COUNTRIES BEFORE COVID-19Key characteristics of PHC in the six countries are outlined in Table 1. Gatekeeping was well established in NZ, Macao, Thailand, and Fiji. In Thailand and Macao, this was largely through the public sector, whereas private GP clinics generally provided this role in NZ and Fiji. In all countries, governments funded PH, but there were different funding arrangements for PC services that range from out-of-pocket through blended to government-funded models. PC services were largely delivered by interdisciplinary teams in coordination with other community-based providers in Thailand, Macao, NZ, Philippi...

BACKGROUND: Osteoarthritis is one of the most common complaints consulted in the outpatient department. The management of osteoarthritis includes both pharmacologic and nonpharmacologic measures, which aim to reduce pain, improve quality of life, diminish morbidities and delay the progression of physiologic deterioration. OBJECTIVE: patient-reportedTo determine patient-related outcomes of adult Filipinos with knee osteoarthritis enrolled in the Osteoarthritis Multidisciplinary Clinic of the University of the Philippines – Philippine General Hospital. METHODS: This was a cross-sectional study involving adults with knee osteoarthritis enrolled at Osteoarthritis Multidisciplinary Clinic (OAMDC). Participants recruited were interviewed using the Knee Injury and Osteoarthritis Outcome Score questionnaire (KOOS) on the day of recruitment, on the 3rd month and on the 6th month of follow-up.  RESULTS: Eighty-six percent of the recruited patients completed the 6th-month follow-up whose mean age is 52 (SD± 6.0). Results showed that there was a significant decline in the mean score between baseline and 3 months (p-value <0.05). However, the 6th-month follow-up showed significant improvement in all of the KOOS components (KOOS Pain, KOOS Symptoms, KOOS Function in Sports and Recreational Activities, KOOS Quality of life and KOOS Activities of Daily Living) (p-value <0.05).  CONCLUSION: This study showed that patients enrolled in OAMDC have been observed to have significant improvement in their pain, symptoms, function in sports and recreation, activities of daily living and quality of life.