Targeted

Chronic diseases, Prevalence & Treatment
# Targeted disease Disease prevalence Treatment
1 Metabolic diseases:
  • Hypercholesterolemia
  • Hypertension,
  • Diabetes mellitus,
  • Obesity
  • Fatty Liver disease
Hypercholesterolemia (HC) 48% [7],
Familial HC 0.3% [8]
Hypertension 35% [9]
Diabetes 21% [10]
Obesity 18% [11]
Abdominal obesity 55% [12,13]
Fatty Liver disease 32% [14]
Lifestyle modification
Anti-Hypertensive drugs
Anti-Diabetic drugs
Statins
Treatment for Familial HC
2. Chronic Hepatitis B (HBV) 1.2% [3] Anti-virals: Tenofovir, Entecavir
3. Chronic Liver disease No data, likely common given HBV & NAFLD prevalence Treat primary liver disease
4. Chronic Kidney disease Year 2011 9% [15]
Year 2018 15% [16]
Treat primary kidney disease, ACEi/ARB, SGLT2 inhibitor
5. Sight threatening Eye diseases (Diabetic retinopathy (DR), Age related Macular Degeneration (AMD), Glaucoma (GLC)) Low vision (Visual acuity <6/18) age 50+ 12.7%
Blindness 2% [17].
DR, AMD & GLC contributed 7.4% of all low vision [18]
Bevaci/Ranibizumab, Aflibercept, Faricimab
GLC: topical eye drops, Prostaglandin, Laser, Surgery
6. Vascular diseases
  • Carotid artery disease
Prevalence carotid plaque 21%, stenosis 1.5% [19,20] Surgery, angioplasty
  • Abdominal Aortic Aneurysm
Prevalence 0.5%, patients for angiography with risk factors 1.6%, age 65+ 2.9% [21,22] Surgery
7. Cancer
  • Prostate
  • Liver
  • Gastric (Stomach)
  • Cervix
  • Naso-pharynx (nose)
Ranking by incidence among top 10 cancers in Malaysia [23]:
Prostate (rank #4), Liver (#5), Naso-pharynx (#6), Cervix (#9), Stomach (#10),
Various treatments including surgery, chemo-radiation, targeted and immunotherapies.

References

  1. RP Kaur, GF Ho, et al. The elephant in the room- Universal coverage for Costly treatments in an upper middle income country. Preprint at BioRxivdoi: https://doi.org/10.1101/214296(2017
  2. Muhammad Radzi AH, et al. Hepatitis Screening and Treatment campaign in Malaysia- Validation of low cost Point of Care screening tests and Nucleic Acid Tests for Hepatitis B and C. Euroasian J Hepato-Gastroenetrology2018; 8:101-107
  3. Lim ZZ, Teo JS, Tan AC, Lim TO. Prevalence of Chronic Hepatitis B and C in Malaysia- results from a community-based screening campaign. Preprint at medRxivhttps://medrxiv.org/cgi/content/short/2020.04.30.20085944v1 (2020).
  4. Lim ZZ, et al. Cascade of care, awareness and treatment of Chronic Hepatitis B in Malaysia- findings from a community based screening campaign. Preprint at medRxivhttps://www.medrxiv.org/content/10.1101/2020.06.15.20131409v1 (2020)
  5. Bhuyan KK. Health promotion through self-care and community participation: elements of a proposed programme in the developing countries. BMC Public Health. 2004 Apr 16;4:11. doi: 10.1186/1471-2458-4-11.
  6. Vashist SK, Luppa PB, Yeo LY, Ozcan A, Luong JHT. Emerging Technologies for Next-Generation Point-of-Care Testing. Trends Biotechnol. 2015;33(11):692-705. doi:10.1016/j.tibtech.2015.09.001
  7. [Lipid] Halizah MR, et al Hypercholesterolemia Prevalence, Awareness, Treatment and Control Among Adults in Malaysia: The 2015 National Health and Morbidity Survey, Malaysia. Global Journal of Health Science 2018; 10; 11-23
  8. [FH] Shi, Z. et al. Familial hypercholesterolemia in China: prevalence and evidence of under-detection and under-treatment in a community population. Intl J. Cardiol. 174, 834-836 (2014)
  9. [HT] Ab Majid, et al. Prevalence, Awareness, Treatment and Control of hypertension in the Malaysian population: findings from the National Health and Morbidity Survey 2006-2015. J Hum Hypertens 32, 617-624 (2018).
  10. [DM] 2. Letchuman GR, Wan Nazaimoon WM, Wan Mohamad WB, et al. Prevalence of diabetes in the Malaysian National Health Morbidity Survey III 2006. Med J Malaysia 2010;65:180e6.
  11. [Obesity] Mohamad Nor, N., Ambak, R., Mohd Zaki, N. et al. An update on obesity research pattern among adults in Malaysia: a scoping review. BMC Women's Health 18, 114 (2018). https://doi.org/10.1186/s12905-018-0590-4
  12. [Abdo obesity] Mohamud WN, Ismail AA, Sharifuddin A, et al. Prevalence of metabolic syndrome and its risk factors in adult Malaysians: results of a nationwide survey. Diabetes Res ClinPract 2012;96:91e7.
  13. [Abdo obesity] Zaki M, Robaayah Z, Chan SP, et al. Malaysia Shape of the Nation (MySoN): a primary care based study of abdominal obesity in Malaysia. Med J Malaysia 2010;65: 143e9.
  14. [NAFLD] Goh SC, Ho ELM, Goh KL. Prevalence and risk factors of non-alcoholic fatty liver disease in a multiracial suburban Asian population in Malaysia. HepatolInt 2012;7:548-554
  15. [CKD] Hooi LS, Ong LM, Ahmad G, et al. A population-based study measuring the prevalence of chronic kidney disease among adults in West Malaysia. Kidney Int. 2013;84:1034-40
  16. [CKD] Saminathan, T.A., Hooi, L.S., Mohd Yusoff, M. et al. Prevalence of chronic kidney disease and its associated factors in Malaysia; findings from a nationwide population-based cross-sectional study. BMC Nephrol 21, 344 (2020). https://doi.org/10.1186/s12882-020-01966-8
  17. [Eye] Bourne RRA, et al. Magnitude, temporal trends, and projections of the global prevalence of blindness and vision impairment: a systematic review and meta-analysis. Lancet Glob Health 2017; published online Aug 2.
  18. [Eye] Source: Flaxman SR, et al. Vision Loss Expert Group of the Global Burden of Disease Study. Global causes of blindness and distance vision impairment 1990-2020: a systematic review and meta-analysis. Lancet Glob Health. 2017;5:e1221-e1234
  19. [Carotid] Song P, Fang Z, Wang H, et al. Global and regional prevalence, burden, and risk factors for carotid atherosclerosis: a systematic review, meta-analysis, and modelling study. Lancet Glob Health 2020; 8: e721-29.
  20. [Carotid] Song P Xia W Zhu Y et al. Prevalence of carotid atherosclerosis and carotid plaque in Chinese adults: a systematic review and meta-regression analysis. Atherosclerosis. 2018; 276: 67-73
  21. [AAA] Li X, Zhao G, Zhang J, Duan Z, Xin S. Prevalence and trends of the abdominal aortic aneurysms epidemic in general population--a meta-analysis. PLoS One. 2013 Dec 2;8(12):e81260. doi: 10.1371/journal.pone.0081260.
  22. [AAA] Li W, et al. Predictors Associated With Increased Prevalence of Abdominal Aortic Aneurysm in Chinese Patients with Atherosclerotic Risk Factors. Eur J VascEndovasc Surg. 2017 Jul;54(1):43-49. doi: 10.1016/j.ejvs.2017.04.004.
  23. Ferlay J, Colombet M, Soerjomataram I et al. Global and Regional Estimates of the Incidence and Mortality for 38 Cancers: GLOBOCAN 2018. Lyon: International Agency for Research on Cancer/World Health Organization; 2018