Background Rabies is a preventable yet deadly public health threat. Despite the availability of effective vaccines for both humans and animals, the persistence of rabies-related fatalities underscores the need for enhanced public education strategies. This study aimed to develop and validate a Rabies Health Education Module delivered via a Massive Open Online Course, targeting adult dog owners in Kelantan, Malaysia. Methods The development of RaHEM followed the ADDIE framework. A comprehensive analysis was conducted through literature reviews, cross-sectional surveys, and stakeholder interviews. The module’s content was designed and developed based on the Modified Health Belief Model and Mayer’s Cognitive Theory of Multimedia Learning. Validation was performed by a panel of six experts and ten dog owners through content and face validity indices, respectively. Results The module was organized into five core topics, each addressing specific aspects of rabies prevention. Content validity indices for all topics exceeded the acceptable threshold of 0.83, with an overall module CVI of 0.91 for relevance and 0.88 for clarity. Face validity indices also surpassed the 0.83 threshold, with overall module FVI scores of 1.00 for understandability and 0.99 for clarity. Conclusion The RaHEM MOOC was successfully developed and thoroughly validated, ensuring it met its intended objectives and was suitable for the target audience. This educational module offers a promising approach to enhancing rabies prevention through accessible and engaging online education, potentially contributing to reduced rabies transmission and fatalities. Further studies are recommended to evaluate the module’s effectiveness in improving rabies knowledge and attitudes.

Lower limb amputation (LLA) is a common complication of diabetic foot ulcer (DFU), which can lead to a higher 5-year mortality rate compared to all cancers combined. This study aimed to determine the prognostic factors of LLA among DFU patients in Kelantan from 2014 to 2018. A population-based study was conducted using secondary data obtained from the National Diabetic Registry (NDR). There were 362 cases that fulfilled the study criteria and were further analysed. The prognostic factors were determined by Multiple Cox Proportional Hazards Regression. There were 66 (18.2%) DFU patients who underwent LLA in this study, while 296 (81.8%) were censored. The results revealed that the factor leading to a higher risk of LLA was abnormal HDL-cholesterol levels (Adj. HR 2.18; 95% CI: 1.21, 3.92). Factors that led to a lower risk of LLA include DFU in patients aged 60 or more (Adj. HR 0.48; 95% CI: 0.27, 0.89) and obesity (Adj. HR 0.45; 95% CI: 0.22, 0.89). In conclusion, our model showed that abnormal HDL cholesterol was associated with a 2 times higher risk of LLA when adjusted for age and BMI. Any paradoxical phenomena should be addressed carefully to avoid wrong clinical decision making that can harm the patient.

Rabies poses a significant public health threat worldwide, primarily transmitted through dog bites. Understanding community knowledge, attitudes, and practices (KAP) regarding rabies is crucial for effective prevention and control strategies. This study aimed to determine KAP levels and their determinants among dog owners in Kelantan, Malaysia. A cross-sectional study was conducted in 2023 among 232 dog owners attending mass canine vaccination programs conducted by Kelantan State Department of Veterinary Services. A validated and structured questionnaire assessed knowledge, attitudes and practices of rabies. The determinants were analysed through multiple logistic regression analyses. Overall, 53.0% exhibited good knowledge, 26.7% had positive attitudes, and 40.0% demonstrated good practices concerning rabies. Higher education levels (AOR = 3.15,95%CI:1.07,9.26), attending rabies programs (AOR = 3.79,95%CI:1.37,10.43), and owning two dogs (AOR = 2.25,95%CI:1.09,4.61) were associated with good knowledge. Medium and long duration of dog ownership durations (AOR = 0.23,95%CI:0.10,0.53 and AOR = 0.40, 95%CI:0.16,0.98 respectively) has lower chances to have positive attitudes, while larger households (AOR = 1.49,95%CI:1.18,1.87) and higher knowledge scores (AOR = 2.80,95% CI:1.06,7.42) were associated to positive attitudes. Older age groups (AOR = 0.27,95%CI:0.12,0.6 and AOR = 0.22,95%CI:0.09,0.50) was associated with suboptimal practices, whereas higher knowledge scores (AOR = 1.29,95% CI:1.08,1.54) and acquiring dogs through formal channels (AOR = 4.79,95%CI:1.85,12.39) were associated with good practices. The study identified critical knowledge gaps, misconceptions, and suboptimal practices among dog owners in Kelantan, highlighting the need for targeted interventions. Tailored educational programs, community engagement strategies, and a comprehensive One Health approach towards the high-risk groups of dog owner are recommended to enhance rabies prevention and control efforts, ultimately safeguarding human, and animal health.

Background: Rabies remains a nearly invariably fatal zoonosis after clinical onset, requiring prevention-focused strategies. Adult dog owners are critical stakeholders in disrupting dog-mediated transmission. The objective was to evaluate the effectiveness of the Rabies Health Education Module (RaHEM) in improving the knowledge and attitudes toward rabies preventive measures, specified as two co-primary outcomes. Methodology: An open-label randomised controlled trial was conducted among 80 dog owners in Kelantan, Malaysia. Participants were randomised to RaHEM or unrelated educational material. RaHEM comprised 26 expert-led multimedia videos with interactive activities. The two co-primary outcomes were changes in knowledge and attitude scores from baseline to one-month follow-up, analysed using one-way MANOVA. The trial was retrospectively registered with Australian New Zealand Clinical Trial Registry (ACTRN12624000432516). Results: There were no statistically significant differences in sociodemographic, pet dog, or environmental factors between the intervention and control groups at baseline. The study demonstrated significant improvements in the intervention group compared to the control group (Wilks' λ=0.627; F(2,77)=22.921; p-value<0.001; partial η²=0.373). Specifically, participants in the intervention group exhibited greater changes in knowledge scores (F(1,78)=8.70; p-value=0.004; partial η²=0.10) and attitude scores (F(1,78)=46.44; p-value<0.001; partial η²=0.37). Conclusion: RaHEM improved knowledge and attitude scores towards rabies prevention at one-month follow-up among dog owners in Kelantan, Malaysia.