METHOD: The study utilized data from the National Health and Morbidity Survey (NHMS) 2020, a nationwide cross-sectional survey employing a two-stage stratified random sampling technique to ensure national representativeness. HIV knowledge was assessed using the UNGASS indicators questionnaire, which comprises five questions on HIV prevention and transmission. The data were collected using the computer assisted telephone interviewing (CATI) method. Respondents who did not correctly answer all five questions were considered to have inadequate knowledge about HIV. Descriptive analysis and complex sample logistic regression were performed using SPSS version 28.0.
RESULTS: The survey identified 5,561 eligible respondents, leading to the participation of 3,187 individuals in the second phase of the study, which resulted in a response rate of 57.3%. Our study revealed an overall prevalence of inadequate HIV knowledge at 77.4%, with adolescents aged 13-19 exhibiting the highest prevalence at 86.1%. Multiple logistic regression analysis indicated that respondents with no formal education (aOR 4.34, 95% CI: 0.65, 29.08) were over four times more likely to lack HIV knowledge. Additionally, respondents with only secondary education had an increased risk of 1.79 times. Individuals residing in rural areas were significantly more likely to have inadequate HIV-related knowledge. Furthermore, respondents who worked as unpaid workers, homemakers, or caregivers (aOR 1.71, 95% CI: 1.05, 2.82) showed a higher likelihood of lacking HIV knowledge.
CONCLUSION: Three out of four individuals in the general Malaysian population were found to lack sufficient knowledge about HIV. This underscores the need for targeted interventions in HIV education, particularly in rural areas and among populations with lower educational attainment. Additionally, digital platforms and youth-focused campaigns could be especially effective for reaching adolescents. Policymakers must prioritize inclusive, accessible HIV prevention strategies to address these gaps and reduce transmission rates.
METHOD: A retrospective record review study using positive COVID-19 cases and contact-tracing data from an area in Malaysia was performed and analysed using the SNA method through R software and visualised by Gephi software. The justification for utilizing SNA is its capability to pinpoint the individuals with the highest impact and accountability for the transmission of COVID-19 within the area, as determined through SNA.
RESULT: Analysis revealed 76 (4.5%) people tested positive for COVID-19 from 1,683 people, with 51 (67.1%) of the positive ones being male. Outdegrees for 38 positive people were between 1 and 12, while 41 people had 1-13 indegree. Older males have a higher outdegree, while younger females have a higher outdegree than other age groups among same-sex groups. Betweenness was between 0.09 and 34.5 for 15 people. We identified 15 people as super-spreaders from the 42 communities detected.
CONCLUSION: Women play a major role in bridging COVID-19 transmission, while older men may transmit COVID-19 through direct connections. Thus, health education on face mask usage and hand hygiene is important for both groups. Working women should be given priority for the work-from-home policy compared to others. A large gathering should not be allowed to operate, or if needed, with strict adherence to specific standard operating procedures, as it contributes to the spread of COVID-19 in the district. The SNA allows the identification of key personnel within the network. Therefore, SNA can help healthcare authorities recognise evolving clusters and identify potential super-spreaders; hence, precise and timely action can be taken to prevent further spread of the disease.
METHODS: Monthly OPD attendance from 1,053 public primary care health clinics in Malaysia, from January 1, 2019, to June 30, 2021, was analysed. The study duration was divided into four distinct periods: pre-pandemic, pandemic with the first lockdown implementation, pandemic after the first lockdown was lifted, and pandemic with the second lockdown implementation. An interrupted time series analysis was conducted to assess the impact of different interventions at national, regional, urban-rural, and district levels. Data were then aggregated at the district level and the utilisation changes were visualised in a choropleth map. Additionally, simple linear regression (SLR) was performed to explore the association between utilisation changes and urbanisation rates of the district, for each period.
RESULTS: Nationally, OPD utilisation dropped by nearly 13% at the onset of the first lockdown and continued to decline by almost 24% monthly thereafter. In terms of urban-rural differences, urban areas in the Central and Eastern Regions showed greater fluctuations in OPD utilisation during different periods. Results from the SLR revealed that higher urbanisation rates were associated with more pronounced changes in utilisation, although the direction of these changes varied across time periods.
CONCLUSION: The OPD utilisation was affected during the COVID-19 and sporadic urban-rural differences were observed in some areas of the country. This study offers important insights into the geographic and urban-rural patterns of healthcare utilisation during the pandemic, which are crucial in improving healthcare equity in Malaysia.
METHODS AND STUDY DESIGN: This cross-sectional study was conducted from 1 May to 30 June, 2013, in three rural divisions of Sabah (the Interior, the West Coast, and Kudat). Data regarding domestic iodised salt use and iodine-containing supplement consumption were obtained from respondents through face-to-face interviews; goitre enlargement was examined through palpation and graded according to the World Health Organization classification. Spot urine samples were also obtained to assess urinary iodine levels by using an in-house modified micromethod.
RESULTS: In total, 534 pregnant women participated. The prevalence of goitre was 1.0% (n=5), noted only in the West Coast and Kudat divisions. Although all pregnant women consumed iodised salt, overall median urinary iodine concentration was only 106 μg/L, indicating insufficient iodine intake, with nearly two-thirds of the women (60%) having a median urinary iodine concentrations of <150 μg/L.
CONCLUSIONS: Pregnant women from the rural divisions in Sabah still exhibit iodine deficiency disorder despite the mandatory universal salt iodisation programme. Iodine supplementation programmes targeting pregnant women are warranted.