In 2006, 4 years of planning was started by the Ministry of Health, Malaysia (MOH), to implement the HPV (human papillomavirus) vaccination programme. An inter-agency and multi-sectoral collaborations were developed for Malaysia’s HPV school-based immunisation programme. It was approved for nationwide school base implementation for 13-year-old girls or first year secondary students in 2010. This paper examines how the various strategies used in the implementation over the last 7 years (2010–2016) that unique to Malaysia were successful in achieving optimal coverage of the target population. Free vaccination was offered to school girls in secondary school (year seven) in Malaysia, which is usually at the age of 13 in the index year. All recipients of the HPV vaccine were identified through school enrolments obtained from education departments from each district in Malaysia. A total of 242,638 girls aged between 12 to 13 years studying in year seven were approached during the launch of the program in 2010. Approximately 230,000 girls in secondary schools were offered HPV vaccine per year by 646 school health teams throughout the country from 2010 to 2016. Parental consent for their daughters to receive HPV vaccination at school was very high at 96–98% per year of the programme. Of those who provided consent, over 99% received the first dose each year and 98–99% completed the course per year. Estimated population coverage for the full vaccine course, considering also those not in school, is estimated at 83 to 91% per year. Rates of adverse events reports following HPV vaccination were low at around 2 per 100,000 and the majority was injection site reactions. A multisectoral and integrated collaborative structure and process ensured that the Malaysia school-based HPV immunisation programme was successful and sustained through the programme design, planning, implementation and monitoring and evaluation. This is a critical factor contributing to the success and sustainability of the school-based HPV immunisation programme with very high coverage.

Introduction: The hepatitis B virus (HBV) is a blood-borne virus that can be transmitted by percutaneous and mucocutaneous contact with infected bodily fluid. Healthcare workers (HCWs) are more exposed to HBV infection. They must have a thorough understanding of HBV infection since they can contract and spread the virus. In this study, we systematically reviewed all published evidence on the seroprevalence of Hepatitis B virus (HBV) infection among HCWs. and synthesize evidence on the association between knowledge and awareness with HBV infection. Methods: We searched PubMed, EMBASE, Cochrane Library and Scopus for studies reporting on HBV seroprevalence from January 1997 to September 2021 among healthcare workers. We used random-effects meta-analyses to estimate the pool prevalence of HBV infection. Results: We identified 25 studies that met our inclusion criteria, with data on 10,043 adults from 11 countries and two regions: Africa and Asia. The overall seroprevalence of HBV was 5.0% (95% confidence interval [CI] 3.6%), with Africa reporting higher estimates (5.0%, 95% CI 3.7%) than Asia population (4.0%, 95% CI 1.9%). The highest pooled prevalence estimate in African countries came from studies published in the Cameroon region (8.0%, 95% CI 5–10%) while the lowest came from Ethiopia (4.0%, 95% CI 2.6%). The overall seroprevalence estimates in the African population were significantly higher than those in the Asian group. Studies in Africa found that the average knowledge and seroprevalence were 1.4% and 11.0%, respectively where, eight studies (53.3%) reported good knowledge and seven studies (46.7%) reported average knowledge. In Asia, two studies (40.0%) reported good knowledge, one study (20.0%) reporting average knowledge, and two studies (40.0%) reporting poor knowledge. African studies demonstrated good knowledge despite the fact that their HBV infection rate was higher than 6.7%. Conclusion: Africa and Asia have the highest seroprevalence of HBV infection. Improving the comparability of epidemiological and clinical studies constitutes an important step forward. More high-quality data is needed to improve the precision of burden estimates. Systematic Review Registration: PROSPERO CRD42021279905.

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: Self-efficacy is defined as his or her belief of their capacity to produce specific performance attainments where represent the ability of positive and negative control over their own motivation, behavior, and social environment. Interventions to increase self-efficacy are a potentially effective way of changing health behavior towards attractive results, however the subject has not been systematically reviewed. This review aims to assess the relationship between self-efficacy and change in good health behaviour.METHODS: A comprehensive and extensive search of four bibliographic data bases was conducted for papers reporting health promotion and educational interventions that explicitly targeted self-efficacy in order to change health behaviour in achieving better disease control.RESULTS: Out of 314 studies, 13 were included in the review. Of these, 8 were found to have significant association between self-efficacy and specific health behaviours. However, 5 studies failed to show any significant prediction towards health behavior. Another 6 studies showed either significant mediation effect or indirect relationship of self-efficacy and health behaviours.CONCLUSIONS: Self-efficacy appears to be an important psychosocial construct that may directly or indirectly affect health behaviour to control diseases. Self-efficacy may also function as a link between effective health promotion and educational interventions and health behaviour change in disease control.

Background: Colorectal cancer (CRC) is a major cause of cancer-related mortality worldwide. It is the second leading cause of cancer death in men and women in Malaysia and poses a major burden on society.Aims: To determine the overall survival rate of patients diagnosed with CRC and factors contributing to survival.Methods: Data were obtained from the Malaysia National Cancer Registry. All patients with CRC were identified, and a total of 15,515 patients were screened. A total of 5,675 CRC patients were included from January 1, 2012, to December 31, 2016. Sex, age groups, ethnic groups, stage at diagnosis, cancer sites, and status of treatment received were analysed. The Kaplan–Meier analysis was performed to estimate the 1-, 3-, and 5-year survival of CRC. The log-rank test was conducted to compare the survival between sex, age groups, ethnic groups, stage at diagnosis, cancer sites, and status of treatment received. Multiple Cox regression was conducted to determine the risk of CRC death.Results: Of 5,675, a total of 2,055 had died, 3,534 were censored, and another 86 were still alive within 5 years of CRC diagnosis. The 1-, 3-, and 5-year survival rates were 68.5%, 34.7%, and 18.4%, respectively with a median survival time of 24 months. Significant differences in survival rates of CRC were observed between age groups (p < 0.001), ethnic groups (p < 0.001), stages at diagnosis (p < 0.001), treatment status (p = 0.003), and treatment modalities (p < 0.001). No significant difference was observed in survival rates of CRC between sex (p = 0.235) and cancer sites (p = 0.410). Those who were 80 years old and above were found to be at higher risk of CRC death compared to those below 80 years old (adjusted hazard ratio (HR): 1.24, 95% CI 1.14–1.36). The risk of CRC death was also found four times higher among those with stage IV compared to those with stage 0 (adjusted HR: 4.28, 95% CI 3.26–5.62).Conclusion: In general, Malaysian patients with CRC had low survival rates. National health policies should focus on enhancing awareness of CRC, encouraging early screening, and developing strategies for early detection and management to reduce CRC-associated mortality.

Background: Technostress is defined as a psychological state associated with the increased usage of advanced computer technologies on a daily basis. It is also defined as an anxiety feeling or mental strain due to excessive exposure or involvement with technologies. Aim: This study aimed to determine the level of technostress associated with burnout and fatigue among healthcare workers (HCWs) in the state hospitals of Malaysia. Methods: A cross-sectional study was conducted from September 2022 to November 2023 among HCWs working in the 15-state hospitals in Malaysia. A standardized questionnaire was distributed among the HCWs in the state hospitals in Malaysia. The questionnaire contains information on socio-demography and topic-specific scales on technostress, burnout and fatigue. Results: A total of 1620 HCWs were included in the analysis, of which 244 (15%) have high level of technostress, 1089 (67%) have moderate technostress, and 287 (18%) have low technostress. Burnout, and fatigue were significantly associated with technostress. HCWs with moderate burnout were less likely to have high technostress compared to those with high burnout (B = -0.993, 95% CI; 0.231 - 0.594; p < 0.001). Those with moderate fatigue were less likely to have high technostress (B = -3.844, 95% CI; 0.003 - 0.162; p < 0.001) compared to those with high fatigue. Conclusions: This study found that majority of the HCWs have moderate level of technostress. Technostress has become more common after the COVID-19 pandemic in 2020 drastically altered working conditions and made remote work using information and communication technologies (ICT) a necessity rather than a luxury. Mitigation measures and programs that include psychological support for individuals who are struggling with the technostress and burnout are needed to overcome this issue.