Effectiveness of the Integrated Dengue Education and Learning (iDEAL) module in improving the knowledge, attitude, practice, environmental cleanliness index, and dengue index among schoolchildren: A randomised controlled trial protocol.

BACKGROUND: Dengue is a mosquito-borne disease caused by four distinct, closely related dengue viruses (DENV). Global dengue incidence has markedly increased in the past decades. The World Health Organization reported that cases increased from 505,430 in 2000 to 5.2 million in 2019. Similarly, the total dengue cases in Malaysia increased from 7,103 in 2000 to a peak of 130,101 in 2019. Knowledge, attitude, and practice (KAP) remain the most effective dengue prevention and control tools. Furthermore, school-based health education is key to enhancing knowledge and raising awareness of the seriousness of dengue among schoolchildren and transferring knowledge and practice from classrooms to homes. Thus, it is necessary to plan an integrated module for the primary prevention of dengue infection, specifically among schoolchildren. AIMS: The present study intends to develop, implement, and evaluate the effectiveness of a theory-based integrated dengue education and learning (iDEAL) module in improving the KAP, environmental cleanliness index, and dengue index among schoolchildren in Selangor and Kuala Lumpur. METHODS: This study is a single-blinded, cluster randomised controlled trial to be conducted from 1 September 2023 to 31 August 2025. The study will involve 20 primary and 20 secondary schools in Selangor and Kuala Lumpur. The 1600 participants will be randomly allocated to intervention and control groups based on selected clusters to avoid contamination. A cluster is a comparable school that fulfils the inclusion and exclusion criteria. The intervention group will receive the iDEAL module, while the control group will receive standard education. The iDEAL module will be developed following a systematic procedure and delivered in-person by trained researchers to the participants. The outcome will be measured using validated, self-administered questionnaires at baseline (T0), immediately (T1), one month (T2), and three months (T3) post-intervention to measure the intervention module effectiveness. The data will be analysed using IBM Statistical Package for Social Science (SPSS) version 28 and descriptive and inferential statistics. Within-group changes over time will be compared using one-way repeated measure analysis of variance for continuous and normally distributed variables. Within-group analysis of categorical data will use Cochran's Q test. The main effect and interaction between and within the intervention and control groups at T0, T1, T2, and T3 will be tested using the generalised linear mixed model (GLMM). Hypothetically, the KAP, environmental cleanliness index, and dengue index among the intervention group will be significantly improved compared to the control group. The hypothesis will be tested using a significance level with a p-value of 0.05 and a confidence interval of 95%. CONCLUSIONS: The study protocol outlines developing and testing an iDEAL module for schoolchildren in Selangor and Kuala Lumpur, with no socio-demographic differences expected. The intervention aims to improve KAP, environmental cleanliness index, and dengue index, potentially reducing dengue risk. Results could inform public health policies, emphasizing school-based interventions' importance in combating diseases like dengue.

The impact of radiofrequency exposure on Aedes aegypti (Diptera: Culicidae) development.

INTRODUCTION: Wireless communication connects billions of people worldwide, relying on radiofrequency electromagnetic fields (RF-EMF). Generally, fifth-generation (5G) networks shift RF carriers to higher frequencies. Although radio, cell phones, and television have benefitted humans for decades, higher carrier frequencies can present potential health risks. Insects closely associated with humans (such as mosquitoes) can undergo increased RF absorption and dielectric heating. This process inadvertently impacts the insects' behaviour, morphology, and physiology, which can influence their spread. Therefore, this study examined the impact of RF exposure on Ae. aegypti mosquitoes, which are prevalent in indoor environments with higher RF exposure risk. The morphologies of Ae. aegypti eggs and their developments into Ae. aegypti mosquitoes were investigated. METHODS: A total of 30 eggs were exposed to RF radiation at three frequencies: baseline, 900 MHz, and 18 GHz. Each frequency was tested in triplicate. Several parameters were assessed through daily observations in an insectarium, including hatching responses, development times, larval numbers, and pupation periods until the emergence of adult insects. RESULTS: This study revealed that the hatching rate for the 900 MHz group was the highest (79 ± 10.54%) compared to other exposures (p = 0.87). The adult emergence rate for the 900 MHz group was also the lowest at 33 ± 2.77%. A significant difference between the groups was demonstrated in the statistical analysis (p = 0.03). CONCLUSION: This work highlighted the morphology sensitivity of Ae. aegypti eggs and their developments in the aquatic phase to RF radiation, potentially altering their life cycle.

Theory-Based Intervention Module on Occupational Safety and Health (TRIMOSH) in improving knowledge, attitude, and practice among food industry workers: Study protocol for a randomised controlled trial.

INTRODUCTION: The significant contribution of the food and beverage industry to Malaysia's Gross Domestic Product is projected to increase in the upcoming years. With the industry's expansion, the demand for workers on food premises would also continuously increase. The food industry workers are exposed to risks arising from physical, chemical, biological, ergonomic, and psychosocial hazards while performing their duties. Thus, it is essential for these workers to be equipped with proper knowledge, attitude, and practices (KAP) in safety and health. AIMS: This study aims to develop and evaluate the effectiveness of the safety and health programme TRIMOSH (Theory-Based Intervention Module on Occupational Safety and Health) in improving the knowledge, attitude, and practice among food industry workers. METHODS: TRIMOSH intervention study is a two-arm randomised, single-blinded, controlled, parallel trial that will be conducted among food industry workers in Selangor, Malaysia. In a partnership with Food Handler Training Schools in Selangor, 10 pairs of Food Handler Training Schools with 12 participants per group (n = 240) will be recruited for balanced randomisation intervention and control conditions. Furthermore, data collection of all participants was conducted at four time points: baseline (T0), immediately (T1), one month (T2), and three months (T3) post-intervention. Generalised Linear Mixed Model (GLMM) will be conducted to determine the effects of intervention within and between study groups. Subsequently, the primary outcomes increase the knowledge, attitude, and practice (KAP) of safety and health at food premises. Clinical Trial Registry registration was approved by the ClinicalTrials.gov committee on October 2022 with the ClinicalTrials.gov Identifier: NCT05571995. This study has also been approved by the Ethics Committee for Research Involving Human Subjects of Universiti Putra Malaysia (JKEUPM-2022-346). All participants are required to provide consent prior to participation. CONCLUSIONS: The characteristics of the respondents are expected to show no difference between the groups. It is hypothesised that TRIMOSH is effective in improving the knowledge, attitude, and practices of food industry workers in Selangor. The results will be reported and presented in international peer-reviewed journals, conferences, and other platforms. In addition, the TRIMOSH programme will be offered at the national level by the relevant authorities for the benefit of food industry workers.

Prevalence of recent occupational injury and its associated factors among food industry workers in Selangor.

INTRODUCTION: Malaysia's gross domestic product is heavily influenced by the food and beverage sector and the contribution of the industry to the national economy is expected to increase in the coming years. Thus, the need for employees in the food industry will continue to rise as this sector grows. Nevertheless, employees in the food industry are exposed to various occupational hazards that can lead to occupational injuries, mainly related to kitchen work. Given the increasing number of employees in the food industry and the rising trend of occupational injuries, this study was conducted to determine the prevalence of recent occupational injuries and their associated factors and predictors among food industry workers. METHODS: This cross-sectional study was conducted in 2023 among food industry workers in Selangor, Malaysia. The respondents were sampled using a multistage random sampling method. Data were collected via online self-administered questionnaires and analysed using descriptive statistics and logistic regression models in the SPSS software, version 25. RESULTS: A total of 250 responses were received from 342 samples, with an overall response rate of 73.0%. The prevalence of recent occupational injuries among food industry workers was 44.8%. Statistically, significant associations were present between occupational injuries and alcohol consumption (p = 0.001), poor knowledge (p = 0.031), poor compliance (p = 0.021), poor safety management (p = 0.021), poor safety training (p = 0.002), poor safety culture (p = 0.003), physical exposure (p < 0.001), and ergonomic exposure (p = 0.009). The predictors for recent occupational injuries among food industry workers were Malay (adjusted Odds Ratio; aOR = 2.60, p = 0.027, 95% Confidence Interval; CI = 1.116, 6.035), alcohol consumption (aOR = 5.31, p = 0.001, 95% CI = 2.042, 13.779), poor knowledge (aOR = 1.98, p = 0.032, 95% CI = 1.059, 3.691), poor safety culture (aOR = 2.44, p = 0.002, 95% CI = 1.372, 4.342), and exposure to physical hazards (aOR = 8.88, p < 0.001, 95% CI = 3.031, 26.014). CONCLUSION: This study has found a high prevalence of occupational injuries among food industry workers, thereby highlighting the importance of addressing alcohol consumption, improving worker knowledge, enhancing work safety culture, and better control measures on exposure to physical hazards, especially among Malay workers. By prioritising these factors, employers can create safer work environments and minimise the risk of occupational injuries.

Factors associated with occupational asthma among food industry workers: A systematic review.

INTRODUCTION: Occupational asthma (OA) is a type of Work-Related Asthma characterised by variable airflow limitation and/or inflammation due to causes and conditions attributable to a particular occupational environment, and not to stimuli encountered outside the workplace. There is an increasing need to extend the depth of knowledge of OA to better manage this condition, especially among food industry workers who are affected by it. OBJECTIVE: This systematic review aimed to determine the factors associated with occupational asthma among food industry workers by electronically collecting articles from two databases (Medline and Scopus). METHODS: This systematic review was prepared in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta Analyses) updated guideline. Two independent reviewers screened the titles and abstracts of the collected data, which were then stored in Endnote20 based on the inclusion and exclusion criteria. The included articles have been critically appraised to assess the quality of the studies using the Mixed Methods Appraisal Tool (MMAT). RESULT: The search yielded 82 articles from Medline and 85 from SCOPUS, resulting in 167 unique hits. Only 22 articles have been included in the full-text assessment following a rigorous selection screening. Of the 22 articles identified, five were included in the final review. Several factors were found to have contributed to occupational asthma among food industry workers. They were classified into two categories: (1) work environment-related factors; and (2) individual factors. CONCLUSION: Several work environment and individual-related factors were found to be associated with OA among food industry workers. A better understanding of the development of the disease and its potential risk factors is needed because it can affect worker's quality of life. Pre-employment and periodic medical surveillance should be conducted to assess and detect any possible risk of developing occupational asthma among workers.

Efficiency of Malaysian states in managing the COVID-19 outbreak in 2020 and 2021.

INTRODUCTION: Many developing countries have drastically imbalanced health systems in different regions. The COVID-19 outbreak posed a further challenge as hospital structures, equipped with doctors, critical care units and respirators, were not available to a sufficient extent in all regions. OBJECTIVE: This study is a descriptive study on the efficiency of Malaysian states in facing the COVID-19 outbreak. METHODOLOGY: The efficiency of all Malaysian states was measured using Data Envelopment Analysis in which each state's Score of COVID Index (SCI) was quantified. The SCI of these states were then further compared between the year 2020 and 2021. A greater disparity would indicate a decline in the performance of a state over time, where nearly all the states in Malaysia experienced an increase in the score of COVID Index (SCI). RESULT: This study found that the central region was the most affected, since all the three states in the region (Selangor, Federal Territory of Kuala Lumpur, and Federal Territory of Putrajaya) showed a situation of inadequacy (SCI: >0.75) due to the COVID-19 outbreak. CONCLUSION: The ranking of Malaysia's states according to their vulnerability to an outbreak of COVID-19 is vitally significant for the purposes of assisting the government and policymakers in planning their responses to the outbreak and ensuring that resources are distributed appropriately.

Acceptance towards decriminalization of medical marijuana among adults in Selangor, Malaysia.

INTRODUCTION: The issue of decriminalization of medical marijuana has gained public attention globally due to the decisions of various governments in developed and developing countries who have decriminalized marijuana for medical purposes. The action was the result of the change in perception towards medical marijuana use, which is now believed to be safe, acceptable, and should be decriminalized. Due to the progress of modernization and the wide access to information, the change in perception towards medical marijuana seems to be inevitable and might have already permeated among the public in Malaysia. However, at the moment there is no baseline data to determine any of this claim. OBJECTIVE: To determine the prevalence and factors associated with acceptance towards decriminalization of medical marijuana among adults in Selangor, Malaysia. METHODOLOGY: The study was a cross-sectional study conducted in year 2021 among 462 adults aged 18 years old and above in Selangor, Malaysia. The respondents were sampled using a multistage random sampling. The data was collected via self-administered questionnaires and has been analyzed using SPSS version 25. RESULT: More than half of the respondents in this study (64.7%) show acceptance towards the decriminalization of medical marijuana in Malaysia. The results of statistical tests indicate that there are significant associations between age (p < 0.001), gender (p = 0.005), ethnicity (p < 0.012), level of education (p < 0.011), employment status (p = 0.001), ever smoked (p < 0.001), given up smoking (p = 0.002), ever used substance (p < 0.001), current substance use (p < 0.001), given up substance (p < 0.001), exposure to medical marijuana-related content (p < 0.001), perceived risk associated with medical marijuana use (p < 0.001), perceived risk of harm of medical marijuana use (p < 0.001), and perceived approval of medical marijuana use (p < 0.001) with acceptance towards decriminalization of medical marijuana. The predictors for acceptance towards decriminalization of medical marijuana are perceived high approval of medical marijuana use (aOR = 7.023, p < 0.001, 95%CI = 3.534,13.955), perceived low risk of medical marijuana (aOR = 5.716, p < 0.001, 95%CI = 2.828,11.554), perceived low risk of harm from medical marijuana use (aOR = 3.480, p = 0.001, 95%CI = 1.702,7.114), current substance use (aOR = 2.264, p = 0.050, 95%CI = 1.001,5.118), and ever used substance (aOR = 2.005, p = 0.004, 95% CI = 0.054,0.576). CONCLUSION: The results of the survey show that the current acceptance level towards decriminalization of medical marijuana is considerably high. However, the acceptance is mainly among those who are exposed to the substance and those who perceive low risk of medical marijuana. Thus, a further exploration of this phenomenon is needed, especially by increasing the sample size and expanding the study location to other states.

A systematic review and meta-analysis of the effects of temperature on the development and survival of the Aedes mosquito.

Introduction: The Aedes mosquito species, which are the vectors for the transmission of the dengue virus (DENV) to humans, are becoming increasingly susceptible to the formidable effects of influential factors, especially temperature. However, there are still very few studies that have systematically reviewed the existing literature. Hence, in the present study, a systematic literature review and meta-analysis was conducted into the effects of temperature on dengue vectors. Method: Several research methodologies were incorporated into the current study, and a review was carried out using PRISMA as a guide. The publications for this study were chosen from two prominent databases, Scopus and Web of Science. All of the studies were assessed, reviewed, and evaluated independently by two reviewers. The meta-analysis tool, Review Manager (RevMan Copenhagen Version 5.4.1), was used to record the extracted data for the meta-analysis. Moran's I 2 and a funnel plot were utilized to measure heterogeneity, and publication bias was investigated. A 95% confidence interval (CI) and overall risk difference (RD) were estimated using a random-effects model. Result and discussion: As a consequence of the search efforts, a total of 46 articles were selected for inclusion in the systematic review and meta-analysis. This review was divided into five major themes, based on a thematic analysis: (i) hatching rate, (ii) development time, (iii) longevity, (iv) survival rate, and (v) wing morphology. In addition, the development time, survival rate, and wing morphology revealed significantly higher risk differences between the maximum and minimum temperatures (RD: 0.26, 95% CI: 0.16, 0.36; p = < 0.00001; RD: 0.10, 95% CI: 0.05, 0.14; p < 0.0001; and RD: 0.07, 95% CI: 0.02, 0.12; p = 0.006, respectively). This study makes several substantial contributions to the body of knowledge and to practical applications. Finally, a number of recommendations are made at the conclusion of this research for the future reference of researchers.

Efficacy of Bacillus thuringiensis Treatment on Aedes Population Using Different Applications at High-Rise Buildings.

Bacillus thuringiensis israelensis (Bti) is an effective biological insecticide for killing mosquito larvae. However, choosing the suitable application method for larviciding is critical in increasing its effectiveness. Therefore, this study aimed to determine the effectiveness of Bti (VectoBac®) WG using various applications at high-rise buildings. Three different applications of Bti treatment were applied at three high-rise buildings in Bandar Saujana Putra. The ULV machine is used for Pangsapuri Impian, a mist blower for Pangsapuri Seri Saujana and a pressured sprayer for BSP 21. BSP Skypark does not undergo treatment and acts as a control. The efficacy of Bti treatment was measured by analyzing the ovitrap surveillance data collected (POI and MLT) for pre and post-treatment. Post-treatment ovitrap surveillance indicates that the Aedes sp. mosquito density was lower than the density at the time of pre-treatment surveillance. Overall, the Aedes albopictus species in both an indoor and outdoor environment setting had shown a reduction. The highest Aedes sp. density reduction is seen through the use of mist blowers in outdoor settings for Aedes albopictus, (%POI reduction = 87.4%; %MLT reduction = 93.8%). The mist blower yielded results that is significantly higher compared to other larviciding applications; the order from greatest to the least was mist blower > pressured sprayer > ULV. It can be concluded that each application produces different degrees of effectiveness in reducing the Aedes sp. density in different environmental settings.