Bridging the data gaps in the epidemiology of hepatitis C virus infection in Malaysia using multi-parameter evidence synthesisReport as inadecuate

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BMC Infectious Diseases

, 14:564

Hepatitis and co-infections


BackgroundCollecting adequate information on key epidemiological indicators is a prerequisite to informing a public health response to reduce the impact of hepatitis C virus HCV infection in Malaysia. Our goal was to overcome the acute data shortage typical of low-middle income countries using statistical modelling to estimate the national HCV prevalence and the distribution over transmission pathways as of the end of 2009.

MethodsMulti-parameter evidence synthesis methods were applied to combine all available relevant data sources - both direct and indirect - that inform the epidemiological parameters of interest.

ResultsAn estimated 454,000 95% credible interval CrI: 392,000 to 535,000 HCV antibody-positive individuals were living in Malaysia in 2009; this represents 2.5% 95% CrI: 2.2-3.0% of the population aged 15-64 years. Among males of Malay ethnicity, for 77% 95% CrI: 69-85% the route of probable transmission was active or a previous history of injecting drugs. The corresponding proportions were smaller for male Chinese and Indian-other ethnic groups 40% and 71%, respectively. The estimated prevalence in females of all ethnicities was 1% 95% CrI: 0.6 to 1.4%; 92% 95% CrI: 88 to 95% of infections were attributable to non-drug injecting routes of transmission.

ConclusionsThe prevalent number of persons living with HCV infection in Malaysia is estimated to be very high. Low-middle income countries often lack a comprehensive evidence base; however, evidence synthesis methods can assist in filling the data gaps required for the development of effective policy to address the future public health and economic burden due to HCV.

KeywordsHepatitis C virus Prevalence Bayesian evidence synthesis People who inject drugs Malaysia Electronic supplementary materialThe online version of this article doi:10.1186-s12879-014-0564-6 contains supplementary material, which is available to authorized users.

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Author: Scott A McDonald - Rosmawati Mohamed - Maznah Dahlui - Herlianna Naning - Adeeba Kamarulzaman


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