Each year an estimated 390 million dengue infections occur worldwide. In Malaysia, dengue is a growing public health concern but estimate of its disease burden remains uncertain. We compared the urban-rural difference of dengue seroprevalence and determined age-specific dengue seroprevalence in Malaysia. We undertook analysis on 11,821 subjects from six seroprevalence surveys conducted in Malaysia between 2001 and 2013, which composed of five urban and two rural series. Prevalence of dengue increased with age in both urban and rural locations in Malaysia, which exceeded 90 % among those aged 70 years or beyond. The age-specific rates of the 5 urban surveys overlapped without clear separation among them, while prevalence was lower in younger subjects in rural series than in urban series, the trend reversed in older subjects. There were no differences in the seroprevalence by gender, ethnicity or region. Poisson regression model confirmed the prevalence have not changed in urban areas since 2001 but in rural areas, there was a significant positive time trend such that by year 2008, rural prevalence was as high as in urban areas. Dengue seroprevalence has stabilized but persisted at a high level in urban areas since 2001, and is fast stabilizing in rural areas at the same high urban levels by 2008. The cumulative seroprevalence of dengue exceeds 90 % by the age of 70 years, which translates into 16.5 million people or 55 % of the total population in Malaysia, being infected by dengue by 2013.

Background/Objectives: This study aims to compare the health-related quality of life (HRQOL) between healthcare providers without chronic diseases and participants with chronic diseases presenting with one of the four different primary diagnoses on the health-related quality of life with six domains (HRQ-6D) scale. Methods: This is a cross-sectional study to compare the HRQOL between healthcare providers without chronic diseases and participants with chronic diseases. Data collection was performed from May 2022 to May 2023. Data for the comparison group were taken from healthcare providers without chronic diseases, and for the participant group with chronic diseases, the data were collected from actual patients with one of four types of primary diagnoses who were recruited from specialist cardiology, oncology, psychiatry, and nephrology clinics. All the participants of this study filled in the HRQ-6D. Results: There were 238 (58.6%) healthcare providers without chronic diseases who participated in this study, as well as 41 (10.1%) patients with end-stage renal disease (ESRD), 48 (11.8%) patients with cancer, and 40 (9.9%) patients who were depressed, and the remaining patients had heart disease. The means (SD) of HRQ-6D scores among healthcare providers without chronic diseases for pain, physical strength, emotion, mobility, self-care, perception of future health, and overall HRQ-6D score were 75.3% (19.8), 74.5% (21.1), 85.6% (18.4%), 93.0% (12.3), 91.6% (13.9), 74.2% (23.3), and 82.4% (13.6), respectively. In comparisons between healthcare providers without chronic diseases and participants with chronic diseases, all mean differences of the overall HRQ-6D score and its domains and dimensions were statistically significant (p < 0.001). Conclusions: The overall score of the HRQ-6D, as well as its domains and dimensions are sensitive in detecting the study participants with chronic diseases from among those without chronic diseases. Therefore, the HRQ-6D is a reliable and valid scale to measure HRQOL. Future studies may use this scale for interventional, observational, and cost-effectiveness studies.

Endemic channels are widely used in dengue surveillance to detect unusual increases in case counts. However, conventional approaches that rely on historical averages with fixed standard deviation (SD)-based multipliers may produce unstable thresholds and false alerts. This study compared a conventional SD-based endemic channel with a log-scale SD-based endemic channel incorporating an enhanced alert rule to identify the optimal approach for routine dengue surveillance in Malaysia. Weekly national dengue case data from 2014 to 2024 were analyzed. A rolling validation approach was used to evaluate outbreak detection performance from 2017 to 2023 using three-year historical baselines. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and the Youden Index were calculated and pooled across the validation years. The optimal multiplier was selected based on the highest pooled Youden Index using the rolling validation period (2017–2023). The selected approach was then applied independently to the 2024 surveillance data as an operational demonstration of its potential use in routine dengue surveillance. A total of 260 epidemiological weeks were analyzed, of which 42 (16.2%) were classified as outbreak weeks. The log-scale SD-based endemic channel incorporating an enhanced alert rule achieved the highest pooled Youden Index of 0.43 at the optimal multiplier of 0.50. At this multiplier, sensitivity was 0.60, specificity 0.82, positive predictive value 0.35, negative predictive value 0.93, and overall accuracy 0.79. Compared with the conventional SD-based endemic channel at its optimal multiplier (1.00), the proposed approach demonstrated improved sensitivity (0.60 vs. 0.56), specificity (0.82 vs. 0.70), positive predictive value (0.35 vs. 0.23), negative predictive value (0.93 vs. 0.91), accuracy (0.79 vs. 0.68), and Youden Index (0.43 vs. 0.26). The log-scale SD-based endemic channel incorporating an enhanced alert rule demonstrated superior overall outbreak detection performance and was selected as the optimal approach for routine dengue surveillance.

Background: Assessment of the QoL and well-being among healthcare workers is vital for better healthcare and is an essential indicator for competent health service delivery. Objectives: This cross-sectional study aims to determine the characteristics and associated factors towards QoL and well-being among healthcare workers in a tertiary hospital by using a Significant Quality of Life Measure (SigQOLM), a recent scale developed and published in 2023 which consists of four dimensions,18 domains and 69 items. Design: It performed a secondary analysis of primary data obtained from a total of 406 healthcare workers who are currently working in a tertiary hospital. Setting: All the 406 healthcare workers holding various job positions in a tertiary hospital were recruited for participating in this cross-sectional study. Main Outcome Measures Results: Apart from “Sleep quality”, “Eating regime” and “Body image”, all the other domains reported a score of more than 70.0% which indicates good to excellent QoL and well-being in these healthcare workers. Overall, the QoL and well-being among healthcare workers are good. Nevertheless, three of the modifiable factors provided a major contribution towards their QoL: marital status (p<0.05), job occupation (p<0.05) and health condition (p<0.05). Conclusions: It is recommended to measure people’s QoL and well-being using a broader spectrum of measurable parameters to elicit a more holistic understanding of their QoL and well-being so that all necessary actions can then be taken to improve their overall QoL.

Background/Objectives: The HRQ-6D is a newly developed instrument to measure Health-related quality of life (HRQOL) and EQ-5D is the gold standard for measuring HRQOL. This study aims to test the concurrent validity between EQ-5D and HRQ-6D measures among patients with different primary diagnoses. Methods: This cross-sectional study uses two HRQOL measurement instruments, EQ-5D-3L and HRQ-6D. Data collection was performed between January 2023 and May 2023. All the necessary data for this study were collected from actual patients who presented with any one of the four different types of primary diagnoses: heart disease, cancer, depressive disorders, and end-stage renal disease (ESRD). They were recruited from the four specialist clinics that cater to the treatment of each of the four different types of primary diagnoses in a tertiary hospital. Results: There were 149 patients who participated in the study wherein 40 (26.8%) of them were ESRD patients, 39 (26.2%) of them were cancer patients, 38 (25.5%) of them were mentally depressed, and the remaining were patients with heart diseases. The domains in HRQ-6D, except for the perception of future health, are significantly associated with domains in EQ-5D-3L after having controlled for patients’ primary diagnoses (i.e., p < 0.001). The HRQ-6D replaces the domain “Usual activities” with “Physical energy,” and the association between these two domains is significant (p < 0.001). The correlation between the overall HRQ-6D and EQ-VAS scores is also significant (coefficient = 0.445, p < 0.001). Conclusions: The HRQ-6D is demonstrated to have concurrent validity with EQ-5D. Therefore, clinicians and researchers can use HRQ-6D to measure patient outcomes for interventional and observational studies. (Total word count = 265 words).