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

Scott A McDonald, Rosmawati Mohamed, Maznah Dahlui, Herlianna Naning, Adeeba Kamarulzaman

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Abstract

Abstract
Background: Collecting 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.
Methods: Multi-parameter evidence synthesis methods were applied to combine all available relevant data sources - both direct and indirect - that inform the epidemiological parameters of interest.
Results: An 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.
Conclusions: The 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.
Original languageEnglish
Number of pages8
JournalBMC Infectious Diseases
Volume14
Issue number564
DOIs
Publication statusPublished - 7 Nov 2014

Keywords

  • hepatitis C virus
  • prevalence
  • Bayesian evidence synthesis
  • Malaysia

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