IntroductionTo achieve the elimination of hepatitis C virus (HCV), substantial scale-up in access to testing and treatment is needed. This will require innovation and simplification of the care pathway, through decentralisation of testing and treatment to primary care settings and task-shifting to non-specialists. The objective of this study was to evaluate the feasibility and effectiveness of decentralisation of HCV testing and treatment using rapid diagnostic tests (RDTs) in primary healthcare clinics (PHCs) among high-risk populations, with referral of seropositive patients for confirmatory viral load testing and treatment.MethodsThis observational study was conducted between December 2018 and October 2019 at 25 PHCs in three regions in Malaysia. Each PHC was linked to one or more hospitals, for referral of seropositive participants for confirmatory testing and pretreatment evaluation. Treatment was provided in PHCs for non-cirrhotic patients and at hospitals for cirrhotic patients.ResultsDuring the study period, a total of 15 366 adults were screened at the 25 PHCs, using RDTs for HCV antibodies. Of the 2020 (13.2%) HCV antibody-positive participants, 1481/2020 (73.3%) had a confirmatory viral load test, 1241/1481 (83.8%) were HCV RNA-positive, 991/1241 (79.9%) completed pretreatment assessment, 632/991 (63.8%) initiated treatment, 518/632 (82.0%) completed treatment, 352/518 (68.0%) were eligible for a sustained virological response (SVR) cure assessment, 209/352 (59.4%) had an SVR cure assessment, and SVR was achieved in 202/209 (96.7%) patients. A significantly higher proportion of patients referred to PHCs initiated treatment compared with those who had treatment initiated at hospitals (71.0% vs 48.8%, p<0.001).ConclusionsThis study demonstrated the effectiveness and feasibility of a simplified decentralised HCV testing and treatment model in primary healthcare settings, targeting high-risk groups in Malaysia. There were good outcomes across most steps of the cascade of care when treatment was provided at PHCs compared with hospitals.

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Substance use disorder (SUD) has both social and public health problems with a substantial burden to society. SUD is a type of mental illness and has been described as a chronic relapsing disease. Treatments for SUD may include among others, psychosocial rehabilitation as a provision to comprehensive treatment to address the social and behavioral issues. These psychosocial components can address the issues of morality, spirituality, and religion. Religion and spirituality are believed to support SUD clients in the reduction of drug use, other associated high-risk behaviors, and criminal issues. In promoting treatment retention, it is important to reduce the drug use, maintain abstinence, and influence the self-esteem and coping ability of SUD clients. Hence, this review was conducted to determine the effects of psychosocial and spiritual support towards clients with substance abuse problem. We had followed the framework from Arksey and O&rsquo;Malley&rsquo;s scoping review in identifying published studies from specific databases to be included in this review. A total of 8560 articles from various databases were screened. After removing duplicates, two authors independently screened 244 titles and abstracts. A total of eighteen articles were included in the final review. Out of eighteen studies, seventeen studies found that psychosocial support and spiritual needs have positive effect among substance abuse clients. Psychosocial and spiritual supports are beneficial among SUD clients due to various potential factors, such as religious reasons, personal beliefs or philosophical reasons, safety concerns, and a desire for improvements from substance abuse.

RESUlTSA total of 105 patients with type 2 diabetes mellitus were enrolled. Of these, 58 and 47 were randomised to intervention and control groups, respectively. After six months, the glycated haemoglobin (HbA1c) level in the intervention group showed a statistically significant improvement of 1.3% (p = 0.001; 95% confidence interval 0.6-2.0), relative to the control group that underwent usual care. The percentages of patients that reached the HbA1c treatment target of ≤ 7% were 14.0% and 32.1% in the control and intervention groups (p = 0.036), respectively. CONClUSIONThe usage of a glucometer improved glycaemic control, possibly due to the encouragement of greater self-care in the intervention group.

INTRODUCTION: Drug addiction and drug abuse is a serious public health problem worldwide. Millions of people worldwide suffered from drug use disorders, directly and indirectly, attributable to drug use and included deaths related to HIV and hepatitis C acquired through unsafe injecting practices. Many parts of the world have a shortfall in prevention and treatment for drug use disorders, with only less than 10% of people with drug use disorders receiving treatment yearly. Medication-assisted treatment of opioid dependence like Methadone is used in maintenance therapy or detoxification helps people with drug use disorders. MATERIAL AND METHODS: Secondary data from an existing electronic dataset in Ministry of Health (MOH) from 2015 until 2019, which includes registered patients who had undergone Methadone Maintenance Therapy (MMT) either government or private facilities were included. The dataset divided into few domains namely socio-demographic, treatment modalities, clinic location and history of infection. RESULTS: A total of 37 various government and private facilities deliver MMT programme in the state of Selangor offered to a total of 5337 patients. The youngest patients were in the early twenties and oldest were in late seventies. The median age of patients was 45 years and the majority were males. Most of them were having secondary education (SPM holder) and below. Most of MMT programme takers were opioid drug users then followed by Amphetamine Type Stimulant (ATS) as the second most used. Among MMT programme takers, about 34.1% were reactive for Hepatitis C, 6.6% reactive for HIV, 4.2% reactive for Hepatitis B and 1.7% acquired tuberculosis infection. Almost 5% of MMT takers had passed away, which the three main causes of death were AIDS, alleged motor vehicle accident and septic shock. None of MMT takers was died due to methadone. CONCLUSION: It is a great concern of the nation in combating drug-related problems due to the growing number of substance abusers. This review concluded that the MMT programme that widely available had shown a positive outcome by keeping lower mortality among MMT patients.