Displaying publications 61 - 80 of 471 in total

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  1. Impact of the Expanded Program of Immunization against hepatitis B infection in school children in Malaysia
    Ng KP, Saw TL, Baki A, Rozainah K, Pang KW, Ramanathan M
    Med Microbiol Immunol, 2005 May;194(3):163-8.
    PMID: 15834754
    The implementation of the Expanded Program of Immunization (EPI) in 1989 has dramatic impact on hepatitis B virus (HBV) infection in school children in Malaysia. A cross-sectional seroprevalence study of HBV infection in 190,077 school children aged 7-12 years from 1997 to 2003 showed a steady decline of HBV surface antigen (HBsAg) prevalence rate from 2.5% for children born in 1985 to 0.4% among school children born in 1996. The overall prevalence of HBsAg was 0.6%, 0.7% in males and 0.6% in females. Over 92.7% of school children had been vaccinated with HBV vaccine, in which 93.7% were vaccinated under the EPI and 6.3% on voluntary basis. The school children vaccinated under EPI had a 0.4% HBsAg carrier rate, which was significantly lower than school children vaccinated on a voluntary basis (HBsAg carrier rate 1.3%) and non-vaccinated school children (HBsAg carrier rate 2.7%), suggesting that HBV vaccination of infants was the most effective measure in preventing vertical transmission of HBV in the hyperendemic region.
    Matched MeSH terms: Mass Vaccination*
  2. Hepatitis A vaccines
    Shahidah KN
    Med J Malaysia, 2005 Jul;60 Suppl B:112-5.
    PMID: 16108190
    Hepatitis A, an acute usually self limiting infection of the liver is one of the most common vaccine-preventable infectious disease in the world. Effective vaccines which provide long term immunity against hepatitis A have been available since 1992. They are of known good quality, well tolerated with no serious adverse events and have been successfully used to protect different populations from infection as well as interrupt outbreak in closed communities. Mathematical models estimate the long term persistence of antiHAV antibodies to be more than 25 years. Vaccination efforts should be supplemented by health education and improved sanitation. Planning for large scale immunization programmes against hepatitis A should take into consideration epidemiological and cost benefit studies.
    Matched MeSH terms: Vaccination
  3. Risk factors for under-immunisation in hospitalised preschool children
    Mariana, D., Quah, B.S., Mazidah, A.R.
    Malaysian Journal of Paediatrics and Child Health, 2005;14(1):33-40.
    MyJurnal
    Even though vaccines are effective for prevention of diseases, compliance with recommended schedules of immunisation in early childhood is not always complete. Identification of potential risk factors associated with under-immunisation may help increase vaccination uptake. The objectives of this study were to determine the prevalence and risk factors of under-immunisation in hospitalised preschool children in Universiti Sains Malaysia Hospital (HUSM). Children aged 1 month to 2 years admitted between December 1998 and December 2000 in medical paediatric wards at HUSM were studied. Parents/guardians were interviewed during admission regarding immunisation status and potential risk factors. Children who did not have home-based cards during admission were excluded. Among 401 children, 37.9% had complete immunisation, 43.4% had delayed immunisation and 34.9% had incomplete immunisation. The uptake of BCG, DPT/OPV 1, DPT/OPV2, Hepatitis B3, DPT/OPV3, and measles were 98.5%, 90.7%, 83.2%, 81.4%,79.2% and 72.9% respectively. Vaccines scheduled to be given at later ages were significantly less likely to be taken (p=0.002) compared with vaccines scheduled to be given at an earlier age. Significant independent risk factors for under-immunisation were elderly mothers (3 40 years old) (OR 3.0, 95% CI: 1.2-8.0), low birth weight £2.0 kg (OR 6.2; 95% CI: 1.8-21.4) and presence of chronic illness in the child (OR 4.5; 95% CI: 2.5-7.9). In children whose father's education was low (primary school or no education), low maternal education was significantly associated with lower rate of under-immunisation (p = 0.005, OR 0.11 95%CI 0.02-0.51).
    In conclusion this study showed that a large proportion of hospitalised preschool children were under-immunised, and vaccines scheduled to be given at a later age had lower uptakes. The situation can be rectified if every opportunity is taken to immunise all children, who have lapsed in their immunisation schedule.
    Matched MeSH terms: Vaccination
  4. Fulltext Chronic hepatitis B infection and liver cancer
    Wong Ch, Goh K
    Biomed Imaging Interv J, 2006 Jul;2(3):e7.
    PMID: 21614253 MyJurnal DOI: 10.2349/biij.2.3.e7
    Hepatitis B virus (HBV) is one of the most well recognised human carcinogens. Since its discovery about 40 years ago, HBV has been studied extensively. This article summarises the evidence derived from various studies including epidemiological, animal model, histopathology studies and molecular genetics studies leading to the establishment of HBV as the main aetiological agent for hepatocellular carcinoma (HCC). The reduction in the incidence of childhood HCC due to mass hepatitis B vaccination in Taiwan is a dramatic demonstration of the critical aetiological role of hepatitis B in HCC. Thus it is essential for interventionalists to understand the epidemiological and pathogenesis of HCC to ensure optimal patient care.
    Matched MeSH terms: Vaccination
  5. Fulltext CT appearances of Marjolin's ulcer in the left gluteal region of a young man
    Mohamed S, Abdullah B, Singh DA, Heng KS
    Biomed Imaging Interv J, 2006 Jul;2(3):e26.
    PMID: 21614240 DOI: 10.2349/biij.2.3.e26
    Chronic wounds and scar tissues are prone to skin cancer. In 1828, Jean-Nicholas Marjolin described the occurrence of tumours in post-traumatic scar tissue. He did not, however, identify the warty ulcers he described as malignant. It was Dupuytren, who about two years later, noted that these lesions were cancerous. The eponym was bestowed by Da Costa in 1903. Marjolin's ulcer no longer refers only to carcinomas secondary to burns and is classified as a malignancy that arises from previously traumatised, chronically inflamed, or scarred skin. It has been reported in relation to osteomyelitis, venous stasis ulcer, tropical ulcers, chronic decubitus ulcer, frostbite, pilonidal sinus, vaccination site, urinary fistula, hidradenitis suppurativa, skin graft donor site, gunshot wounds, puncture wounds, dog bites, and lupus rash. Early arising Marjolin's ulcer has rarely been described in literature. In this case report, we present the CT appearances of Marjolin's ulcer in the left gluteal region of a young man.
    Matched MeSH terms: Vaccination
  6. Fulltext Hepatitis B infection: what the primary care doctors should know
    Kew ST, Loh KY
    Malays Fam Physician, 2006;1(1):8-10.
    MyJurnal
    Hepatitis B virus infection is a global public health problem. The prevalence of hepatitis B infection is higher in Asia. The rate of HBsAg carriage in the general population ranges from 2-20%. The WHO has recommended that by the end of 21st century hepatitis B vaccination should be incorporated into routine childhood immunisation programmes for all nations. Vaccination against hepatitis B remains the most important aspect of preventive care. Most importantly hepatitis B vaccination can protect individual from fulminant hepatitis, liver cirrhosis and hepatocellular carcinoma. Primary care physicians must be familiar with the pathology, epidemiological and clinical presentations of this disease and be able to refer patients for appropriate treatment at the tertiary centre.
    Matched MeSH terms: Vaccination
  7. Fulltext Current Issues Facing The Introduction Of Human Papillomavirus Vaccine In Malaysia
    Wong LP, Sam IC
    Malays Fam Physician, 2007;2(2):47-53.
    PMID: 25606080 MyJurnal
    Certain human papillomavirus (HPV) types are strongly associated with cervical cancer. Recently-described effective vaccines against these HPV types represent a great medical breakthrough in preventing cervical cancer. In Malaysia, the vaccine has just received regulatory approval. We are likely to face similar barriers to implementing HPV vaccination as reported by countries where vaccination has been introduced. Most women have poor understanding of HPV and its link to cervical cancer. Physicians who will be recommending HPV vaccines may not have extensive knowledge or experience with HPV-related disease. Furthermore, a vaccine against a sexually-transmitted infection may elicit negative reactions from potential recipients or their carers, particularly in a conservative society. Given the high cost of the vaccine, reaching the most vulnerable women is a concern. To foster broad acceptance of HPV vaccine, education must be provided to health care providers, parents and young women about the risks of HPV infection and the benefits of vaccination.
    Matched MeSH terms: Vaccination
  8. Fulltext A decade of Japanese encephalitis surveillance in Sarawak, Malaysia: 1997-2006
    Wong SC, Ooi MH, Abdullah AR, Wong SY, Krishnan S, Tio PH, et al.
    Trop Med Int Health, 2008 Jan;13(1):52-5.
    PMID: 18291002 DOI: 10.1111/j.1365-3156.2007.01967.x
    Japanese encephalitis virus (JEV) is an important encephalitis virus in Asia, but there are few data on Malaysia. A hospital-based surveillance system for Japanese encephalitis (JE) has been in operation in Sarawak, Malaysia, for the last 10 years. JEV is endemic in Sarawak, with cases occurring throughout the year and a seasonal peak in the last quarter (one-way anova, P < 0.0001). Ninety-two per cent of 133 cases were children aged 12 years or younger; the introduction of JE vaccination in July 2001 reduced the number of JE cases (84 in the four seasons prior to vs. 49 in the six seasons after, McNemar's test, P = 0.0001). After implementation of the programme, the mean age of infected children increased from 6.3 to 8.0 years (Student's t-test, P = 0.0037), suggesting the need for a catch-up programme.
    Matched MeSH terms: Vaccination
  9. Epidemiology and prevention of cervical cancer in Indonesia, Malaysia, the Philippines, Thailand and Vietnam
    Domingo EJ, Noviani R, Noor MR, Ngelangel CA, Limpaphayom KK, Thuan TV, et al.
    Vaccine, 2008 Aug 19;26 Suppl 12:M71-9.
    PMID: 18945416 DOI: 10.1016/j.vaccine.2008.05.039
    Cervical cancer remains one of the leading causes of cancers in women from Indonesia, Malaysia, the Philippines, Thailand and Vietnam. High-risk human papillomavirus (HPV) types, particularly HPV-16 and 18, are consistently identified in cervical cancer cases regardless of geographical region. Factors that have been identified to increase the likelihood of HPV exposure or subsequent development of cervical cancer include young age at first intercourse, high parity and multiple sexual partners. Cervical cancer screening programs in these countries include Pap smears, single visit approach utilizing visual inspection with acetic acid followed by cryotherapy, as well as screening with colposcopy. Uptake of screening remains low in all regions and is further compounded by the lack of basic knowledge women have regarding screening as an opportunity for the prevention of cervical cancer. Prophylactic HPV vaccination with the quadrivalent vaccine has already been approved for use in Malaysia, the Philippines and Thailand, while the bivalent vaccine has also been approved in the Philippines. However, there has been no national or government vaccination policy implemented in any of these countries.
    Matched MeSH terms: Vaccination
  10. Perceived vaccination status in ecotourists and risks of anthropozoonoses
    Muehlenbein MP, Martinez LA, Lemke AA, Ambu L, Nathan S, Alsisto S, et al.
    Ecohealth, 2008 Sep;5(3):371-8.
    PMID: 18810550 DOI: 10.1007/s10393-008-0192-y
    Anthropozoonotic (human to nonhuman animal) transmission of infectious disease poses a significant threat to wildlife. A large proportion of travelers to tropical regions are not protected against vaccine-preventable illnesses, and a majority of these travelers demonstrate poor recall of actual vaccination status. Here we characterize self-perceived vaccination status among a large sample of ecotourists at the Sepilok Orangutan Rehabilitation Centre, Sabah, Malaysia. Despite their recognized travel itinerary to view endangered animals, tourists at wildlife sanctuaries are not adequately protected against vaccine-preventable illnesses. Of 633 surveys, over half reported being currently vaccinated against tuberculosis, hepatitis A, hepatitis B, polio, and measles. Fewer participants reported current vaccination status for influenza, rabies, and chickenpox. Despite the fact that the majority of visitors to Sepilok are from temperate regions where influenza is relatively more prevalent, 67.1% of those surveyed with medical-related occupations reported not being currently vaccinated for influenza. Ecotourists concerned about environmental protection are themselves largely unaware of their potential contribution to the spread of diseases to animals. The risks of negatively affecting animal populations must be communicated to all concerned parties, and this may begin by urging travelers to examine their actual vaccination status, particularly as the ecotourism industry continues its rapid expansion, and is seen increasingly as a possible tool to save great ape populations from extinction.
    Matched MeSH terms: Vaccination*
  11. Physicians' experiences with HPV vaccine delivery: evidence from developing country with multiethnic populations
    Wong LP
    Vaccine, 2009 Mar 4;27(10):1622-7.
    PMID: 19100803 DOI: 10.1016/j.vaccine.2008.11.107
    Physicians' experiences in providing human papillomavirus (HPV) immunization were assessed by mailed questionnaire. Response rate of 41.4% was achieved. Malay Muslim physicians were more likely to agree that cultural sensitivity is an issue when recommending HPV vaccines. Pediatricians and family physicians were more likely to agree that acceptance is better if vaccines were recommended to prevent cervical cancer than to prevent a sexually transmitted disease. Near 70% rated success of HPV vaccines recommendation in their practice as very poor with the majority patients preferred to postpone immunization. Physicians reported cultural disparities in vaccine uptake and perceived high vaccination cost limits its use.
    Matched MeSH terms: Vaccination/economics; Vaccination/utilization
  12. Immunogenicity and safety of low dose virosomal adjuvanted influenza vaccine administered intradermally compared to intramuscular full dose administration
    Künzi V, Klap JM, Seiberling MK, Herzog C, Hartmann K, Kürsteiner O, et al.
    Vaccine, 2009 Jun 2;27(27):3561-7.
    PMID: 19464535 DOI: 10.1016/j.vaccine.2009.03.062
    Despite the established benefit of intramuscular (i.m.) influenza vaccination, new adjuvants and delivery methods for comparable or improved immunogenicity are being explored. Intradermal (i.d.) antigen administration is hypothesized to initiate an efficient immune response at reduced antigen doses similar to that observed after i.m. full dose vaccination.
    Matched MeSH terms: Vaccination
  13. Fulltext Knowledge, attitude and vaccination status of varicella among students of Universiti Kebangsaan Malaysia (UKM)
    Hesham R, Cheong JY, Mohd Hasni J
    Med J Malaysia, 2009 Sep;64(3):257-62.
    PMID: 20527284 MyJurnal
    Varicella is a highly infectious disease that can lead to severe complications such as pneumonia, encephalitis and death. Vaccination is the best method to prevent the disease. The objective of this study was to assess the level of knowledge, attitude and vaccination status of varicella among UKM students. A cross sectional study involving pre-tested questionnaires was undertaken between February and April, 2005. Questionnaires were distributed and filled by the first and second year students from four faculties in UKM (n=879). The faculties included were divided into two categories: medical fields and non-medical fields. The results showed that the overall level of knowledge on varicella among respondents was intermediate. The score of knowledge was significantly higher among medical students (t = 10.9, p < 0.05) compared to non-medical students. The varicella vaccination coverage was low among UKM students (19.3%). The vaccination status was significantly higher among medical students compared to non-medical students (chi2 = 8.6, p < 0.05). Vaccination status of varicella among respondents had no association with the level of knowledge (chi2 = 2.42, p > 0.05).
    Matched MeSH terms: Vaccination/statistics & numerical data*
  14. Fulltext Food safety issues in recent Flood 2006-2007 in Johore
    Daud, A.R., Thayalan, R., Farhatun Najmi, M.G.
    Malaysian Journal of Community Health, 2009;15(3):55-59.
    MyJurnal
    Background and Objective : Johor was affected by the worst flood in 100 years in December 2006 and again in January 2007. The concern that improper sanitary facilities and contaminated water supply at relief centres would result in contaminated food made monitoring of food hygiene vital. The objective of this paper is to describe food hygiene surveillance activities carried out in flood relief centres and flood affected areas and the challenges faced in carrying out these activities.
    Methodology : The food hygiene surveillance activities were carried out by the Assistant Environmental Health Officers (AEHO) in the districts. Among the surveillance activities carried out are inspection of food preparation areas in relief centres, inspection of food premises in flood affected areas and food sampling. Premise inspections were carried out using a specific inspection format. Food samples taken were sent to Public Health Laboratory, Johor Bahru for microbiological analysis. Anti typhoid vaccination for food handlers were also carried out. Apart from that, observations made by the health teams were alsotaken into account.
    Results : A total of 3,159 food preparation areas in relief centres were inspected. During the same period, a total of 2,317 food premises in flood affected areas were inspected as soon these premises started operating after the floods. Inspections showed that 69 food preparation areas in relief centres and 181 food premises in flood affected areas had unsatisfactory hygiene. A total of 1,566 holding samples were taken and 425 samples were sent to the laboratory for analysis. Forty-six of the samples analysed were found to be positive for pathogenic bacteria such as e. coli, staphylococcus aureus and salmonella.
    Conclusion : The health personnel from the Johor Health Department in various districts carried out an excellent job in ensuring food safety during the floods. There were no outbreaks of food poisoning. However analysis of food samples taken during the floods did show the presence of pathogenic organisms but probably their numbers were not high enough to cause any food poisoning. The promotion and enforcement of food hygiene requirements should be carried out continuously to ensure that every individual understands the need for hygiene and food safety during disaster situation such as flood.
    Matched MeSH terms: Vaccination
  15. Fulltext Needlestick injury: a review of twelve theses among healthcare personnel in Malaysia
    Noor Hassim Ismail, Rosnah Ismail, Rampal, K.G.
    Malaysian Journal of Community Health, 2009;15(1):47-50.
    MyJurnal
    Aims : The review was to determine the prevalence of needlestick injury especially among health care personnel and to determine the score of knowledge and compliance to the Standard Universal Precaution.
    Method : Twelve theses were reviewed from year 1996 to 2007 of Master in Community Health Science, Master in Community Health and Postgraduate Diploma in Occupational Health of Community Health Department Universiti Kebangsaan Malaysia Medical Center involving of 1645 respondents of health care personnel, support staff and student of nursing and medical. Eleven studies were cross sectional design and only one study was retrospective.
    Results : Respondents were dominated by female (74.6%) and Malay ethnicity (65%), as young as 19 years old to 56 years old of age. Majority had received Hepatitis B vaccination (79.4%) but only 37.1% had completed the 3 doses regime. The incidence of episodes of needle stick injury among health care personnel was double (53.7%) compared to final year medical students (20.9%). Needle stick injuries did not occur at random as there were a few health care personnel injured repeatedly. Those who had higher mean or median score for compliance to Standard Universal Precaution were non case of needlestick injury. Work practices had been highlighted in few studies of being risk factors for needlestick injury such as blood withdrawing related activities. Other risk factors were job category, predictive factor for compliance to Standard Universal Precaution, risk perception and training.
    Conclusion : Even though the review could not extrapolated to general population of healthcare personnel but it gave some illustrated pictures to what had happened in small clustered locations. Episodes of needle stick injury was 53.7% for past 12 years, it was double in comparison to final year medical students in year 2001. 13.2% were injured repeatedly. The score of knowledge was more the 50% of range but compliance to Standard Precaution made differences in being cases or non cases among respondents. The seroconversion status till date was unknown.
    Matched MeSH terms: Vaccination
  16. Fulltext Should doctors apologize and disclose medical errors?
    Aimi Nadia Mohd Yusof
    Medical Health Reviews, 2009;2009(2):5-16.
    MyJurnal
    No vaccination is available to provide doctors with the immunity from errors and mistakes. Humans make mistakes everyday and eventually doctors will make mistakes or errors during their practice. Therefore, knowing how to handle the mistakes is crucial in improving patient safety and management. Disclosure of errors can be argued to play a significant role in respecting the patients’ rights and interest. We need to know that in a doctor-patient relationship, trust and vulnerability exist. If errors occur and doctors try to keep patients away from the truth, patients may no longer maintain their trust and this could lead to a negative turn in the relationship. Moreover, if errors are disclosed, doctors then may face a legal and ethical dilemma on whether to apologize for the errors made. This issue of apology has created debates among health professionals and lawyers in searching for the best answer. Apology can be a powerful tool to reconcile relationships but at the same time can also be a tool of deception.
    Matched MeSH terms: Vaccination
  17. Influenza vaccine concurrently administered with a combination measles, mumps, and rubella vaccine to young children
    Lum LC, Borja-Tabora CF, Breiman RF, Vesikari T, Sablan BP, Chay OM, et al.
    Vaccine, 2010 Feb 10;28(6):1566-74.
    PMID: 20003918 DOI: 10.1016/j.vaccine.2009.11.054
    Children aged 11 to <24 months received 2 intranasal doses of live attenuated influenza vaccine (LAIV) or placebo, 35+/-7 days apart. Dose 1 was administered concomitantly with a combined measles, mumps, and rubella vaccine (Priorix). Seroresponses to measles and mumps were similar between groups. Compared with placebo, response rates to rubella in LAIV+Priorix recipients were statistically lower at a 15 IU/mL threshold (83.9% vs 78.0%) and the prespecified noninferiority criteria were not met. In a post hoc analysis using an alternate widely accepted threshold of 10 IU/mL, the noninferiority criteria were met (93.4% vs 89.8%). Concomitant administration with Priorix did not affect the overall influenza protection rate of LAIV (78.4% and 63.8% against antigenically similar influenza strains and any strain, respectively).
    Matched MeSH terms: Vaccination/methods*
  18. Fulltext Analysis of factors in response to rotavirus vaccination counselling in a private paediatric clinic
    Kannan Kutty P, Pathmanathan G, Salleh NM
    Med J Malaysia, 2010 Jun;65(2):127-32.
    PMID: 23756797 MyJurnal
    Rotavirus vaccine is available as an optional vaccine in Malaysia. The counselling of optional vaccines is considered an integral part of the health services offered in a private paediatric clinic. While ensuring that all babies are up-todate with their compulsory immunization, counselling of optional vaccines like the rotavirus vaccine could give parents the choice to make an informed decision on the acceptance of this vaccine. Over a period of two years, we counselled the parents regarding diarrhoea caused by rotavirus disease and the rotavirus vaccine. In this study, the factors that were significantly associated with the acceptance of the rotavirus vaccine were the gender of the baby, the mother's age, the mother's occupation, the mode of payment for the vaccine, the number of previous visits to the clinic by the parents, the number of counselling sessions given to the parents and the pre-counselling awareness or knowledge of rotavirus disease and rotavirus vaccine. It is hoped that these findings may assist busy clinicians in their continuous efforts to provide health education and vaccination counselling to the parents of their patients.
    Matched MeSH terms: Vaccination
  19. Factors influencing the uptake of 2009 H1N1 influenza vaccine in a multiethnic Asian population
    Wong LP, Sam IC
    Vaccine, 2010 Jun 17;28(28):4499-505.
    PMID: 20451639 DOI: 10.1016/j.vaccine.2010.04.043
    The study aimed to determine factors influencing the uptake of 2009 H1N1 influenza vaccine in a multiethnic Asian population. Population-based, cross-sectional survey was conducted between October and December 2009. Approximately 70% of overall participants indicated willingness to be vaccinated against the 2009 H1N1 influenza. Participants who indicated positive intention to vaccinate against 2009 H1N1 influenza were more likely to have favorable attitudes toward the 2009 H1N1 vaccine. A halal (acceptable to Muslims) vaccine was the main factor that determined Malay participants' decision to accept vaccination, whereas safety of the vaccine was the main factor that influenced vaccination decision for Chinese and Indian participants. The study highlights the challenges in promoting the 2009 H1N1 vaccine. Ethnic-sensitive efforts are needed to maximize acceptance of H1N1 vaccines in countries with diverse ethnic communities and religious practices.
    Matched MeSH terms: Vaccination/psychology*; Vaccination/statistics & numerical data
  20. Burden of disease associated with cervical cancer in malaysia and potential costs and consequences of HPV vaccination
    Aljunid S, Zafar A, Saperi S, Amrizal M
    Asian Pac J Cancer Prev, 2010;11(6):1551-9.
    PMID: 21338196
    BACKGROUND: An estimated 70% of cervical cancers worldwide are attributable to persistent infection with human papillomaviruses (HPV) 16 and 18. Vaccination against HPV 16/18 has been shown to dramatically reduce the incidence of associated precancerous and cancerous lesions. The aims of the present analyses were, firstly, to estimate the clinical and economic burden of disease attributable to HPV in Malaysia and secondly, to estimate long-term outcomes associated with HPV vaccination using a prevalence-based modeling approach.

    METHODS: In the first part of the analysis costs attributable to cervical cancer and precancerous lesions were estimated; epidemiologic data were sourced from the WHO GLOBOCAN database and Malaysian national data sources. In the second part, a prevalence-based model was used to estimate the potential annual number of cases of cervical cancer and precancerous lesions that could be prevented and subsequent HPV-related treatment costs averted with the bivalent (HPV 16/18) and the quadrivalent (HPV 16/18/6/11) vaccines, at the population level, at steady state. A vaccine efficacy of 98% was assumed against HPV types included in both vaccines. Effectiveness against other oncogenic HPV types was based on the latest results from each vaccine's respective clinical trials.

    RESULTS: In Malaysia there are an estimated 4,696 prevalent cases of cervical cancer annually and 1,372 prevalent cases of precancerous lesions, which are associated with a total direct cost of RM 39.2 million with a further RM 12.4 million in indirect costs owing to lost productivity. At steady state, vaccination with the bivalent vaccine was estimated to prevent 4,199 cervical cancer cases per year versus 3,804 cases for the quadrivalent vaccine. Vaccination with the quadrivalent vaccine was projected to prevent 1,721 cases of genital warts annually, whereas the annual number of cases remained unchanged with the bivalent vaccine. Furthermore, vaccination with the bivalent vaccine was estimated to avert RM 45.4 million in annual HPV-related treatment costs (direct+indirect) compared with RM 42.9 million for the quadrivalent vaccine.

    CONCLUSION: This analysis showed that vaccination against HPV 16/18 can reduce the clinical and economic burden of cervical cancer and precancerous lesions in Malaysia. The greatest potential economic benefit was observed using the bivalent vaccine in preference to the quadrivalent vaccine.

    Matched MeSH terms: Vaccination
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