Browsing by Author "Rosmawati Mohamed"
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- PublicationCascade of care, awareness and treatment of Chronic Hepatitis B in Malaysia- findings from a community-based screening campaign(2020)
;ZZ Lim ;JS Teo ;AC Tan ;Tan Soek Siam ;Rosmawati Mohamed ;KL Goh ;YY Lee ;WH LaiTO LimIntroduction: 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’s targets for HBV elimination. - PublicationHepatitis C virus core antigen as alternative diagnostic algorithm for active hepatitis C virus infection among haemodialysis population: Cost implications(2021)
;Xue Z. Wong ;Azzeri Amirah ;Chye C. Gan ;Shabaruddin Fatiha ;Dahlui Maznah ;Rosnawati Yahya ;Shubash Ganapathy ;Soek S. Tan ;Rosmawati MohamedSoo K. LimAims: In Malaysia, majority anti‐HCV positive haemodialysis patients do not undergo hepatitis C confirmation due to the high cost of HCV RNA. HCV Core Antigen might be a cost‐effective diagnostic test to identify HD patients who have active HCV infection eligible for Direct Acting Anti‐viral therapy. Methods: A cross‐sectional study was conducted to assess the correlation between HCV Ag and HCV RNA and the cost implications of different diagnostic algorithms to diagnose active HCV infection using Anti‐HCV, HCV Ag, and HCV RNA. Pre‐dialysis blood was tested for both HCV Ag and HCV RNA. HCV Ag was tested with Abbott ARCHITECT HCV Ag test. Results: Two‐hundred twenty‐seven haemodialysis patients were recruited from 20 centres with mean age of 57.68 ± 12.48 years, and male constitutes 56.8% (129) of the study population. HCV Ag correlated well with HCV RNA (Spearman test coefficient 0.943, p. 001) with sensitivity of 93.9%, specificity 99.3%, and the accuracy was 97.36%. Cost analysis indicated that a sequential test involving Anti‐HCV antibody as initial screening, followed by HCV Ag on Anti‐HCV positive and HCV RNA on HCV Ag negative cases translated to a modest cost‐saving algorithm compared to standard diagnostic algorithm. Conclusion: HCV Ag correlated well with HCV RNA and can potentially be fused in an alternative diagnostic algorithm to generate cost savings methods to diagnose active HCV infection among haemodialysis patients. This alternative algorithm is especially relevant in low to middle‐income countries such as Malaysia to optimize the use of the healthcare resource and gains in clinical outcomes.