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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. - PublicationUsing a crowdsourcing open call, hackathon and a modified Delphi method to develop a consensus statement and sexual health survey instrument(Medxriv org, 2020)
;Eneyi E. Kpokiri ;Dan Wu ;Megan L. Srinivas ;Juliana Anderson ;Lale Say ;Osmo Kontula ;Noor Ani Ahmad ;Chelsea Morroni ;Chimaraoke Izugbara ;Richard de Visser ;Georgina Yaa-Oduro ;Evelyn Gitau ;Alice Welbourn ;Michele Andrasik ;Wendy V. Norman ;Soazig Clifton ;Amanda Gabster ;Amanda Gesselman ;Chantal Smith ;Nicole Prause ;Adesola Olumide ;Jennifer T. Erausquin ;Peter Muriuki ;Ariane van der Straten ;Martha Nicholson ;Kathryn A. O’Connell ;Meggie Mwoka ;Nathalie Bajos ;Catherine H Mercer ;Lianne Marie GonsalvesJoseph D. TuckerPopulation health surveys are rarely comprehensive in addressing sexual health, and population-representative surveys often lack standardized measures for collecting comparable data across countries. We present a sexual health survey instrument and implementation considerations for population-level sexual health research. The brief, comprehensive sexual health survey and consensus statement was developed via a multi-step process (an open call, a hackathon, and a modified Delphi process). The survey items, domains, entire instruments, and implementation considerations to develop a sexual health survey were solicited via a global crowdsourcing open call. The open call received 175 contributions from 49 countries. Following review of submissions from the open call, 18 finalists and eight facilitators with expertise in sexual health research, especially in low and middle-income countries (LMICs), were invited to a 3-day hackathon to harmonize a survey instrument. Consensus was achieved through an iterative, modified Delphi process that included three rounds of online surveys. The entire process resulted in a 19-item consensus statement and a 10-minute sexual health survey instrument. This is the first global consensus on a sexual and reproductive health survey instrument that can be used to generate cross-national comparative data in both high-income and LMICs. The inclusive process identified priority domains for improvement and can inform the design of sexual and reproductive health programs and contextually relevant data for comparable research across countries.