Estimating the infection burden of COVID-19 in Malaysia

PLoS Negl Trop Dis. 2022 Nov 8;16(11):e0010887. doi: 10.1371/journal.pntd.0010887. eCollection 2022 Nov.

Abstract

Malaysia has reported 2.75 million cases and 31,485 deaths as of 30 December 2021. Underestimation remains an issue due to the underdiagnosis of mild and asymptomatic cases. We aimed to estimate the burden of COVID-19 cases in Malaysia based on an adjusted case fatality rate (aCFR). Data on reported cases and mortalities were collated from the Ministry of Health official GitHub between 1 March 2020 and 30 December 2021. We estimated the total and age-stratified monthly incidence rates, mortality rates, and aCFR. Estimated new infections were inferred from the age-stratified aCFR. The total estimated infections between 1 March 2020 and 30 December 2021 was 9,955,000-cases (95% CI: 6,626,000-18,985,000). The proportion of COVID-19 infections in ages 0-11, 12-17, 18-50, 51-65, and above 65 years were 19.9% (n = 1,982,000), 2.4% (n = 236,000), 66.1% (n = 6,577,000), 9.1% (n = 901,000), 2.6% (n = 256,000), respectively. Approximately 32.8% of the total population in Malaysia was estimated to have been infected with COVID-19 by the end of December 2021. These estimations highlight a more accurate infection burden in Malaysia. It provides the first national-level prevalence estimates in Malaysia that adjusted for underdiagnosis. Naturally acquired community immunity has increased, but approximately 68.1% of the population remains susceptible. Population estimates of the infection burden are critical to determine the need for booster doses and calibration of public health measures.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19* / epidemiology
  • Humans
  • Incidence
  • Infant, Newborn
  • Malaysia / epidemiology
  • Prevalence
  • SARS-CoV-2

Grants and funding

This study is part of the COVID-19 Epidemiological Analysis and Strategies (CEASe) Project with funding from the Ministry of Science, Technology and Innovation (https://www.mosti.gov.my/en/). AB and NCW are recipient of the award (UM.0000245/HGA.GV). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.