Among several vector control methods commonly used, environmental management is one of the control measures to mitigate dengue in such vulnerable communities. Since there is no curative treatment for dengue yet, targeted environmental and ecosystem management is increasingly relevant. Hence, this review was conducted to identify the effectiveness of environmental management intervention strategy to reduce dengue cases. We searched PUBMED, CENTRAL, SCOPUS, Web of Science, CIJE, WHO ICTRP, and ClinicalTrials.gov up to January 2021. A total of 521 articles were screened. Only 16 studies were included in this review. There were 6 studies that applied all three types of environmental management interventions (manipulation, modification and behavior), 8 studies applied two types of interventions (manipulation and behavior) and 2 studies applied one type of intervention (manipulation or behavior). All included studies reported reduction of Aedes entomological indices. The studies showed reduction in dengue cases and density of Aedes population through environmental interventions. It is recommended for the health authority to incorporate environmental management intervention in dengue control activities and enhanced the community involvement to ensure sustainability with high impact on dengue reduction.
Background: Typhoid fever causes global morbidity and mortality and is a significant health burden, particularly in low- and middle-income countries. The direct fecal-oral route is the main transmission mode, but indirect environmental transmission could occur, particularly in urban settings. This study aimed to investigate the burden and trend of typhoid fever, reporting the coverage system between government and private practice and pattern of multidrug-resistant (MDR) typhoid cases in the urban Klang Valley area from 2011 to 2015. Methods: The data from a cross-sectional study retrieved from the e-Notifikasi System, a national reporting system for communicable diseases provided by the Disease Control Division, Ministry of Health Malaysia and secondary data of all the typhoid cases were obtained from the public and private hospitals and laboratories in Klang Valley. Descriptive analysis was performed to examine the sociodemographic characteristics, spatial mapping was conducted to examine trends, and the crude incidence rates of confirmed typhoid cases and percentage of reporting coverage were calculated. Significant differences between MDR and non-MDR Salmonella typhi were determined in the patient’s sociodemographic characteristics, which were analyzed using χ2 test. P values < 0.05 were considered statistically significant. Results: In total, 507 typhoid fever cases were reported in Klang Valley; however, only 265 cases were confirmed by culture tests. The crude incidence rates of confirmed cases were between 0.5 to 0.7 but peaked at 1.42 per 100,000 population in 2015. Most typhoid fever cases were observed among men (55.6%), individuals aged 21 to 30 years (27.6%), Malaysians (86.3%) and individuals of Malay ethnicity (52.1%). The reporting coverage of confirmed cases was 78.9% and non-reporting coverage of unconfirmed typhoid cases was 79.5%. The predictive value positive (PVP) was 89.3, and 7.5% were detected as MDR Salmonella typhi. Statistical significance was found in gender, citizenship and ethnicity regarding MDR Salmonella typhi (p = 0.004, p = 0.008 and p = 0.034, respectively). Conclusions: The local transmission of typhoid is still prevalent in the Klang Valley despite rapid urbanization and development in recent years. These findings are essential for policy makers to plan and implement focused and effective preventative activities to curb typhoid infection in urban areas.
25 May 2023 in The Lancet Regional Health - Western Pacific
This study assesses the neutralizing antibodies response to Omicron subvariants and examines factors associated with seropositivity in a vaccinated Malaysian cohort. It is a prospective cohort study, conducted between June 2021 and October 2022. Descriptive and binary logistic regression analyses were performed on 1,117 adults aged 18 and above. Among the subvariants, seropositivity rates were: BA.2 (81.9%), BA.1 (68.4%), and BA.4/5 (64.2%). Non-Malaysians had significantly higher odds of testing positive for BA.2 compared to Malaysians (OR: 8.009; 95% CI: 1.273–50.402). Recipients of AstraZeneca (OR: 3.955; 95% CI: 2.414–6.482) and CanSino (OR: 1.980; 95% CI: 1.047–3.743) vaccines had higher odds of BA.2 seropositivity compared to Pfizer recipients. For BA.4/5, individuals aged 60 and above had greater odds of seropositivity (OR: 1.751; 95% CI: 1.029–2.979) compared to those aged 18–39. Chinese ethnicity was associated with lower odds of seropositivity than Malay ethnicity across BA.1 (OR: 0.508; 95% CI: 0.350–0.736), BA.2 (OR: 0.570; 95% CI: 0.377–0.861), and BA.4/5 (OR: 0.671; 95% CI: 0.467–0.963). This study highlights that completing primary vaccination and booster doses remains critical to reducing severe COVID-19 outcomes, underscoring the need for ongoing surveillance and targeted strategies for vulnerable demographic and socio-environmental groups.
Background: According to the World Bank, Malaysia reported an estimated 97 tuberculosis cases per 100,000 people in 2021. Chest x-ray (CXR) remains the best conventional method for the early detection of pulmonary tuberculosis (PTB) infection. The intervention of artificial intelligence (AI) in PTB diagnosis could efficiently aid human interpreters and reduce health professionals’ work burden. To date, no AI studies have been evaluated in Malaysia. Objective: This study aims to evaluate the performance of Putralytica and Qure.ai software for CXR screening and PTB diagnosis among the Malaysian population. Methods: We will conduct a retrospective case-control study at the Respiratory Medicine Institute, National Cancer Institute, and Sungai Buloh Health Clinic. A total of 1500 CXR images of patients who completed treatments or check-ups will be selected and categorized into three groups: (1) abnormal PTB cases, (2) abnormal non-PTB cases, and (3) normal cases. These CXR images, along with their clinical findings, will be the reference standard in this study. All patient data, including sociodemographic characteristics and clinical history, will be collected prior to screening via Putralytica and Qure.ai software and readers’ interpretation, which are the index tests for this study. Interpretation from all 3 index tests will be compared with the reference standard, and significant statistical analysis will be computed. Results: Data collection is expected to commence in August 2023. It is anticipated that 1 year will be needed to conduct the study. Conclusions: This study will measure the accuracy of Putralytica and Qure.ai software and whether their findings will concur with readers’ interpretation and the reference standard, thus providing evidence toward the effectiveness of implementing AI in the medical setting. International Registered Report Identifier (IRRID): PRR1-10.2196/36121
Background: Soil-transmitted helminth (STH) infection is 1 of the 20 notable neglected tropical diseases according to the Centers for Disease Control and Prevention and World Health Organization. In 2010, it is estimated that 1.73 billion people are infected with STH globally, of which 70% of cases occur in Asia. To date, there is a dearth of published literature on the prevalence of STH infection throughout Malaysia. Objective: The objectives of this study are to review research activity on STH infection in Malaysia, to estimate the prevalence of STH infection among Malaysians, and to identify significant risk factors associated with the infection. This review aims to provide the current state of evidence pertaining to STH infections, focusing on the main areas, limitations, and biases of research and mapping out the morbidity distribution of the diseases and their causative agents, and to identify significant risk factors for preventive measures. Methods: We will conduct a scoping review based on the 6-stage structured framework developed by Arksey and O’Malley. A comprehensive search strategy focusing on STH infection will be executed using electronic databases (Scopus, PubMed, Web of Science, and Embase). A systematic approach for searching, screening, reviewing, and data extraction will be applied based on the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Mendeley software and Microsoft Excel will be used to manage the references and to remove duplicates. Relevant data from selected articles will be extracted using a standardized data extraction form. Results: A total of 164 potential manuscripts were retrieved. Data extraction is currently in progress and completion is expected by the end of 2022. Conclusions: Our scoping review will summarize the current state of research in this field and provide comprehensive information regarding STH infections in Malaysia for future reference. Trial Registration: National Medical Research Register NMRR-20-2889-54348; https://nmrr.gov.my/research-directory/e52ea778-d31c-4eb4-9163-a45bb3680bbf International Registered Report Identifier (IRRID): DERR1-10.2196/36077