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: Newly diagnosed CRC cases between 2010 and 2016 in Malaysia were identified from the National Cancer Registry. Residential addresses were geocoded. Clustering analysis was subsequently performed to examine the spatial dependence between CRC cases. Differences in socio-demographic characteristics of individuals between the clusters were also compared. Identified clusters were categorized into urban and semi-rural areas based on the population background.
RESULT: Most of the 18 405 individuals included in the study were male (56%), aged between 60 and 69 years (30.3%) and only presented for care at stages 3 or 4 of the disease (71.3%). The states shown to have CRC clusters were Kedah, Penang, Perak, Selangor, Kuala Lumpur, Melaka, Johor, Kelantan, and Sarawak. The spatial autocorrelation detected a significant clustering pattern (Moran's Index 0.244, p< 0.01, Z score >2.58). CRC clusters in Penang, Selangor, Kuala Lumpur, Melaka, Johor, and Sarawak were in urbanized areas, while those in Kedah, Perak and Kelantan were in semi-rural areas.
CONCLUSION: The presence of several clusters in urbanized and semi-rural areas implied the role of ecological determinants at the neighbourhood level in Malaysia. Such findings could be used to guide the policymakers in resource allocation and cancer control.