A clinical trial using four different oral refeeding regimes was conducted in 100 patients following acute gastro-enteritis. There was no difference in terms of the diarrhoea-relapse rates among the four groups of patients. However, a better weight gain was recorded in the groups using a lactose-free soy formula and a low-lactose low-fat cow's milk formula.

Introduction The epidemiology of hepatitis, which is apparently endemic in Asia, is still poorly documented in Malaysia. Available statistics are modelled estimates based on expert input or estimated from small studies on special populations. We therefore determined the prevalence of chronic hepatitis B and C in Malaysia based on a large sample data from a screening campaign. Methods A total of 10,914 subjects participated in the hepatitis screening campaign in 2018 and 2019. A low-cost Point-of-care test, which has previously been validated, was used to screen for HBsAg and anti-HCV. All screen positive subjects were recalled to undergo confirmatory serology tests and nucleic acid tests. Results We estimated 1.17% or 238,971 Malaysian adults aged 20 or older had chronic HBV, while only 0.74% or 151,144 adults had chronic HCV. Young adults below age 30 years had very low prevalence of HBV (0.09%). Women had lower prevalence of HBV and HCV, Chinese had the highest prevalence of HBV while Malay had the highest prevalence of HCV. Conclusion Young adults seems to be protected from HBV perhaps owing to the introduction of universal HBV vaccination since 1989. Chronic HBV however remains prevalent in older adults especially among the Chinese. Chronic HCV is uncommon in Malaysia.

A study of the immunological status of hepatitis A and B infections was carried out among the residents of eight social welfare homes in Singapore. The sample population consisted of 440 individuals of whom 55% were Chinese, 21% were Malays and 24% were Indians. The mean age of the study population was 14 years and 4 months. The immunological markers studied included specific IgM antibody and total antibody against hepatitis A virus (anti‐HAV‐IgM and total anti‐HAV respectively); hepatitis B surface antigen (HBsAg), surface antibody (anti‐HBs), core antibody (anti‐HBc) and e antigen (HBeAg), all tested by the enzyme immunoassay (EIA) technique. While none of the subjects had detectable anti‐HAV‐IgM (HAVAB‐M‐EIA), 12% were positive for total anti‐HAV (HAVAB‐EIA) indicating evidence of past infection. HBsAg was detected (Auszyme II) in 4.5% and of these, half had HBeAg (Abbott‐HBe EIA). Anti‐HBs positivity (AUSAB‐EIA) occurred in 11.6% and the majority (88%) of these had anti‐HBc positivity (CORZYME) as well. The positive rate for anti‐HBc alone was 3.6% reflecting the ‘window’ period after the fall of HBsAg and before the rise of anti‐HBs. At least one of the hepatitis B markers was present in 19.1% of the study population. The endemic nature of both hepatitis A and B infections in the local population is evident, with infection occurring in all ethnic groups at an early age.

Introduction In 2016 the World Health Organization (WHO) had adopted a global strategy to eliminate Hepatitis B (HBV) by 2030 through five core interventions, the first four were preventive while the fifth is the cascade of care, the continuum of services that persons with chronic HBV should receive as they progress from screening to diagnosis to treatment to chronic care. We determined the prevalence of the awareness and treatment of chronic HBV in Malaysia based on a large sample data from a screening campaign. Methods A total of 10,436 subjects participated in the HBV screening campaign organized by the Hepatitis Free Pahang Malaysia (HFPM) in 2018 and 2019. All screen-positive subjects were recalled to undergo laboratory-based HBsAg and HBV DNA tests. Patients with confirmed chronic HBV were referred to local health services, while continued being monitored by HFPM. Results We estimated 13.1% of Malaysian adults aged 20 or older with chronic HBV were aware of their HBV status, and of those only 0.7% had received prior anti-viral treatment, but among those with baseline HBV DNA level>20,000 IU/ml, 15.6% were subsequently treated. Tenofovir disoproxil fumarate was the only medicine used on all treated patients. The linkage to care post-screening was broken in substantial number of patients, only 108 (54%) subjects had returned to have their HBV DNA measured and only 115 (58%) patients had subsequently sought care and were on still follow-up. Conclusion Few Malaysian adults with HBV were aware of their infection and even less received anti-viral therapy. Concerted public health efforts are urgently needed to improve HBV screening and care cascade in order to meet WHO targets for HBV elimination. Keywords Cascade of care, Awareness, Treatment, Hepatitis B, Malaysia