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Fulltext Determinants of Successful Human Immunodeficiency Virus Treatment Outcomes: A Linkage of National Data Sources in Malaysia

Wan Mohamad Darani WNS, Chen XW, Samsudin EZ, Mohd Nor F, Ismail I

Malays J Med Sci, 2023 Feb;30(1):172-184.
PMID: 36875201 DOI: 10.21315/mjms2023.30.1.15

BACKGROUND: Concerted efforts have been undertaken to reduce the human immunodeficiency virus (HIV) infection by the year 2030 in Malaysia. A situational analysis of the performance of successful HIV treatment and its determinants is vital; however, this information remains scarce. This study aimed to identify the determinants of undetectable viral load among people living with HIV (PLHIV).
METHODS: Newly diagnosed HIV cases (n = 493) registered under the Malaysia HIV/AIDS-related national databases from June 2018 to December 2019 were studied. The deterministic matching method was applied to link the records in two national databases (at Kuala Lumpur and Putrajaya Federal Territories Health Department, JKWPKLP HIV line-listing database and National AIDS Registry). Successful HIV treatment, an outcome variable, was measured by the undetectable viral load < 200 copies/mL after 1 year of antiretroviral therapy initiation. Logistic regression analysis was applied in the current study.
RESULTS: Results showed that 454/493 (92.2%; 95% confidence interval [CI]: 89.8%, 94.6%) PLHIV had successful HIV treatment. Study participants had a mean (SD) age of 30 (8.10) years old, predominantly male (96.1%) and sexually transmission (99.9%). The multiple logistic regression analysis revealed two significant determinants including the timing of ART initiation (AOR = 3.94; 95% CI: 1.32, 11.70; P = 0.014) and establishment of Sexually Transmitted Infection Friendly Clinic (STIFC) (AOR = 3.40; 95% CI: 1.47, 7.85; P = 0.004). Non-significant variables included gender, education level, HIV risk exposure, and co-infections of tuberculosis and Hepatitis C.
CONCLUSION: JKWPKLP is on the right track to achieving universal treatment as a prevention strategy. Reinforcement of early ART initiation and establishment of STIFC are recommended.
Development and validation of the information-motivation-behavioural skills model-based human immunodeficiency virus education kit for adolescents in Malaysia

Wan Mohamad Darani WNS, Mat Ruzlin AN, Azhar ZI, Chen XW

Sci Rep, 2024 Mar 22;14(1):6890.
PMID: 38519534 DOI: 10.1038/s41598-024-57593-y

The growing Human Immunodeficiency Virus (HIV) incidences and insufficient HIV knowledge among Malaysian late adolescents necessitate immediate attention to HIV prevention via education. This study aims to develop and validate an Information-Motivation-Behavioural skills (IMB) model-based education kit for adolescents, PREM-Kit, to educate on HIV prevention among Malaysian late adolescents. Utilizing the Analysis, Design, Development, Implementation, and Evaluation model, we conducted the study in three phases: needs assessment, development of PREM-Kit, and validation of PREM-Kit by applying the IMB model to map the PREM-Kit's contents. PREM-Kit, developed in Malay language, consisted of an infographic flip chart and videos. Five multi-disciplinary experts validated the PREM-Kit using the content validity index (CVI), and 13 end-users validated the PREM-Kit using the Malay version of the Patient Education Materials Assessment Tool for Printable and Audiovisual Materials. The infographic flip chart comprised three modules covering 15 topics, and an animated video accompanied each module. PREM-Kit achieved CVI scores of 1.0 and median scores of over 80% for understandability and actionability. Overall, the newly developed IMB model-based HIV education kit has good content validity, is simple to comprehend and apply, and is ready for testing its effectiveness in improving adolescents' knowledge, attitudes, and practices for HIV prevention.
Fulltext Effectiveness of an information-motivation-behavioural skills model-based education kit (PREM-Kit) on human immunodeficiency virus knowledge and attitude among Malaysian late adolescents

Wan Mohamad Darani WNS, Mat Ruzlin AN, Azhar ZI, Chen XW

Sci Rep, 2025 Nov 21;15(1):41327.
PMID: 41271975 DOI: 10.1038/s41598-025-25215-w

The increasing incidence of Human Immunodeficiency Virus (HIV) among Malaysian late adolescents, coupled with insufficient HIV knowledge, necessitates immediate attention to HIV prevention via education. This study aims to evaluate the effectiveness of a new Information-Motivation-Behavioural Skills (IMB) model-based education kit (PREM-Kit) in improving knowledge and attitudes related to HIV among Malaysian late adolescents. A 16-week quasi-experimental trial was conducted at two campuses of a local public university, involving 187 participants. The intervention group received PREM-Kit's intervention in addition to the curriculum-mandated basic science and biology module, whereas the control group received only the curriculum-mandated basic science and biology module. Repeated measure analysis of variance (RMANOVA) and covariance (RMANCOVA) were used to examine the effectiveness of PREM-Kit's intervention on knowledge and attitudes between groups at four time points (t0-t3). The intervention group exhibited a significant increase in the knowledge score (mean difference = 2.66; 95% CI = 2.22,3.10; p
Fulltext Association Between Cardiovascular Disease and Cataracts: Protocol for a Systematic Review and Meta-Analysis

Yap JF, Heng PP, Wan Mohamad Darani WNS, Mat Rifin H, Muhamad NA, Pong MY, et al.

JMIR Res Protoc, 2026 Nov 03;15:e96552.
PMID: 42976319 DOI: 10.2196/96552

BACKGROUND: There is emerging evidence suggesting shared pathophysiological mechanisms between cataracts and cardiovascular disease (CVD), indicating a potential link between these 2 prevalent noncommunicable diseases. Oxidative stress, resulting from an imbalance between reactive oxygen species production and the body's antioxidant defenses, contributes to lens protein aggregation in cataracts and lipid oxidation in atherosclerosis, a key feature of several CVD subtypes. This shared pathophysiology implies that systemic vascular health may influence cataractogenesis. However, the epidemiological evidence supporting this relationship remains inconclusive.
OBJECTIVE: The main objective of this systematic review is to synthesize existing evidence on the odds or risk of developing cataracts in adults with underlying CVD.
METHODS: This systematic review will adhere to the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols). Using the population, exposure, comparator, and outcome framework, this review will identify the association between established CVD and the risk of cataract development or needing cataract surgery. Systematic literature searches will be conducted in PubMed, Scopus, Web of Science, and Embase using MeSH terms from database inception to December 31, 2024. Original research articles involving adults (aged ≥18 years) that assess the statistical relationship between CVD and cataracts will be included. Two independent reviewers will screen studies, extract data, and appraise the studies' quality using the Newcastle-Ottawa Scale. If deemed feasible, meta-analyses will be conducted using random-effects models to calculate pooled effect estimates, with heterogeneity assessed using the I2 statistic.
RESULTS: This study did not receive any external funding. The literature search, study screening, and data extraction will be conducted in 2026, and data analysis will be performed accordingly. The findings are anticipated to be published in 2027.
CONCLUSIONS: This systematic review will provide a consolidated and up-to-date evaluation of the relationship between CVD and cataracts. The findings will highlight the potential importance of integrating cardiovascular risk assessment into routine ophthalmologic care. Continued refinement of study methodologies and standardization of outcome measures may be needed to address observed heterogeneity and strengthen future evidence, ultimately supporting more holistic management of patients with coexisting cardiovascular and ocular conditions.