A Stepwise Approach to a National Hepatitis C Screening Strategy in Malaysia to Meet the WHO 2030 Targets: Proposed Strategy, Coverage, and Costs

Hiebert, Lindsey; Hecht, Robert; Soe-Lin, Shan; Mohamed, Rosmawati; Shabaruddin, Fatiha Hana; Mansor, Syed Mukhtar Syed; Dahlui, Maznah; Azzeri, Amirah; McDonald, Scott

doi:10.1016/j.vhri.2018.12.005

Cited by 21 publications

(19 citation statements)

References 9 publications

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“…For instance, although sofosbuvir and daclatasvir are available in 25 public hospitals in Malaysia, the high cost of these direct-acting antivirals has imposed a financial burden on the public health care system and limited access to HCV treatment in Malaysia [9]. As of 2017, more than 12,000 HCV-infected patients in Malaysia were awaiting access to direct-acting antivirals [10].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for hepatitis C infection among adult patients in Kedah state, Malaysia: A case–control study

et al. 2019

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Hepatitis C infection is a global public health problem. This study was designed to identify the risk factors associated with hepatitis C infection among adult patients in Kedah state, Malaysia. A matched, hospital-based, case–control study was conducted at a tertiary hospital. Cases were adult (aged ≥ 18 years) patients with positive serology test results for hepatitis C virus antibody and detectable hepatitis C virus RNA from January 2015 to December 2018, and controls were age-, sex- and ethnicity-matched patients who were not infected with hepatitis C virus. Self-administered questionnaires were used to collect data on demographic characteristics and previous exposure to selected risk factors among the study participants. Associations between hepatitis C and demographic and risk factors were assessed using univariable and multivariable logistic regression analyses. A total of 255 case–control patient pairs were enrolled. The multivariable analysis indicated that having a history of blood or blood product transfusion before 1992 (adjusted odds ratio [AOR] = 6.99, 95% confidence interval [CI]: 3.73–13.81), injection drug use (AOR = 6.60, 95% CI: 3.66–12.43), imprisonment (AOR = 4.58, 95% CI: 1.62–16.40), tattooing (AOR = 3.73, 95% CI: 1.37–12.00), having more than one sexual partner (AOR = 2.06, 95% CI: 1.16–3.69), piercing (AOR = 1.71, 95% CI: 1.04–2.80), and having only secondary education (AOR = 1.92, 95% CI: 1.06–3.57) were independently associated with hepatitis C. No associations were found between health care occupation, needle-prick injury, surgical procedures, haemodialysis, acupuncture, cupping, or contact sports and hepatitis C infection. These findings demonstrate that hepatitis C risk is multifactorial. Having a history of blood or blood product transfusion before 1992, injection drug use, imprisonment, tattooing, having more than one sexual partner, piercing, and having only secondary education were associated with increased odds of hepatitis C.

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Section: Introductionmentioning

confidence: 99%

Risk factors for hepatitis C infection among adult patients in Kedah state, Malaysia: A case–control study

et al. 2019

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“…If there is commitment to further scale-up and effort leading to elimination beyond 2022, then next to treatment costs, the largest cost-driver of an HCV elimination program is likely to be screening (Hecht et al, 2018;Lim et al, 2018;World Bank, 2017). A national-level screening program design has been recently proposed to address the WHO elimination treatment goals in Malaysia using a targeted approach to limit costs during the initial phase of the programme (Hiebert et al, 2019). This step-wise screening programme initially sequentially targets various HCV high-risk sub-populations (including active PWID); after these groups are exhausted, screening in the general population would then be scaled up.…”

Section: Importance Of Population Size Estimationmentioning

confidence: 99%

Estimating the Population Size of People Who Inject Drugs in Malaysia for 2014 and 2017 Using the Benchmark-Multiplier Method

Hiebert

Azzeri

Dahlui

et al. 2020

Substance Use & Misuse

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Background. As hepatitis C elimination efforts are launched, national strategies for screening and treatment scale-up in countries, such as Malaysia, must be designed and implemented. Strategic information, including estimates of the total number of patients chronically-infected with hepatitis C virus (HCV) and the size of key populations, such as people who inject drugs (PWID), is critical to informing these efforts. For Malaysia, the estimate of the PWID population size most frequently reported in global systematic reviews is for the year 2009.Objectives. To support ongoing national HCV planning efforts, we aimed to estimate the national population size of active PWID in Malaysia, for the years 2014 and 2017. Methods. To estimate the PWID population size, we applied standard benchmark-multiplier methodology, frequently used for PWID population size estimation, and extended it by adjusting for cessation of injecting drug use within the benchmark and calculating statistical uncertainty intervals.Results. The estimated active PWID population size was 153,000 (95% uncertainty interval (UI):

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“…The model estimated screening of < 1 million PWID per year between 2018-2026, before expanding to the general population, with a total of 6 million people screened between 2018-2030. The total cost of screening was estimated at $58 million[ 41 ]. Zuckerman et al[ 42 ], suggested that there should be established recommendations for screening and diagnosis of HCV to help overcome disparities in diagnosis and linkages to care.…”

Section: Recommendations To Eliminate Hcv Burden In Kuwaitmentioning

confidence: 99%

Accelerating the elimination of hepatitis C in Kuwait: An expert opinion

Hasan

Alfadhli

Al-Gharabally

et al. 2020

WJG

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The hepatitis C virus (HCV) is estimated to affect 71 million people worldwide. In 2016, the World Health Organization adopted the first global health sector strategy to eliminate viral hepatitis as a public health threat by 2030. In December 2018, the European Association for the Study of the Liver, International Liver Foundation convened an expert panel to address the elimination of HCV in Kuwait. Several steps have already been taken to eliminate HCV in Kuwait, including free HCV treatment for Kuwait’s citizens, high blood safety standards, and the implementation of screening and awareness programs. The expert panel made several recommendations aimed at accelerating the elimination of HCV in Kuwait: The development of a national strategy and action plan to guide all HCV elimination activities; the formation of a coordination mechanism to support collaboration between hepatitis working committees; the prioritization of micro-elimination at primary, secondary or tertiary facilities, in prisons and rehabilitation centers; and ensuring the involvement of multiple stakeholders – including relevant civil society groups – in all activities. Enhanced screening and linkage to care should be prioritized in Kuwait, with the expansion of the prescriber base to primary healthcare providers and nurse practitioners to be considered. Raising awareness and educating people about HCV infection also remain essential to achieve the goal of HCV elimination. Lastly, a national HCV registry should be developed to help monitor the implementation of viral hepatitis plans and progress towards achieving national and international targets.

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A Stepwise Approach to a National Hepatitis C Screening Strategy in Malaysia to Meet the WHO 2030 Targets: Proposed Strategy, Coverage, and Costs

Cited by 21 publications

References 9 publications

Risk factors for hepatitis C infection among adult patients in Kedah state, Malaysia: A case–control study

Risk factors for hepatitis C infection among adult patients in Kedah state, Malaysia: A case–control study

Estimating the Population Size of People Who Inject Drugs in Malaysia for 2014 and 2017 Using the Benchmark-Multiplier Method

Accelerating the elimination of hepatitis C in Kuwait: An expert opinion

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