Exploring community needs in combating aedes mosquitoes and dengue fever: a study with urban community in the recurrent hotspot area.

BACKGROUND: Aedes mosquitoes are the main vector of dengue infection, a global health threat affecting millions of people annually. Conventional prevention and control methods against dengue outbreaks have only achieved marginal success. Recognizing the complex issue at hand, a multilevel participatory approach is crucial. Thus, alternative strategies that involve community engagement are increasingly being considered and attempted. While community-based vector control programs have been conducted, sustaining behavioral changes among the population remains a challenge. This study aimed to identify the specific community needs in combating Aedes mosquitoes and dengue fever as a basis to guide the development of community-driven initiatives and foster a deeper sense of ownership in the fight against dengue. METHODS: Between 1 August 2022 and 30 November 2022, we conducted a study in Hulu Langat district, Selangor, using a mixed-method design. All participants consented to the study, which comprised 27 participants (FGDs) and 15 participants (IDIs). The IDIs included two participants with a history of dengue fever, one community leader, one faith leader, seven local authorities, and four district health officers. Semi-structured interviews and discussions were performed among stakeholders and community members recruited via purposive and snowball sampling techniques. All interviews were audio-recorded before being analyzed using reflexive thematic analysis. RESULTS: These results derived from qualitative data explored the perspectives and needs of communities in combating Aedes mosquitoes and dengue fever. Interviews were conducted with various stakeholders, including community members, leaders, and health officers. The study identified the necessity of decisive actions by authorities to address the impact of the dengue epidemic, the importance of community engagement through partnerships and participatory approaches, the potential benefits of incentives and rewards to enhance community participation, and the need for sustained community engagement and education, especially via the involvement of young people in prevention efforts. These findings provide valuable insights into the design of effective strategies against Aedes mosquitoes and dengue fever. CONCLUSIONS: In short, there is an urgent need for a comprehensive approach involving multiple stakeholders in the fight against Aedes mosquitoes and dengue fever. The approach should incorporate efforts to raise awareness, provide practical resources, and foster community responsibility. The active involvement of teenagers as volunteers can contribute to long-term prevention efforts. Collaboration, resource allocation, and community engagement are crucial for effective dengue control and a healthier environment.

Exploring community behaviours and stakeholder challenges in engaging communities with dengue prevention behaviour in Malaysia: implementation research for a qualitative study with a community-based participatory research design.

OBJECTIVES: To use a community-based participatory research (CBPR) design to explore local community behaviours and stakeholders' challenges in engaging communities in dengue prevention behaviours in Hulu Langat, Selangor, Malaysia. DESIGN: This CBPR design in implementation comprised in-depth interviews (IDIs) and focus group discussions (FGDs). Themes were identified from the data with inductive and deductive thematic analysis. SETTING: FGDs were conducted in local community areas and IDIs were conducted in the local authority (LA) office and the Hulu Langat district health office. PARTICIPANTS: All FGD and IDI participants consented to the study, and included health authorities (n=4), LAs (n=7), community leader (n=1), faith leader (n=1), patients diagnosed with dengue (IDIs, n=2) and permanent residents of Hulu Langat who had been exposed to dengue infectious disease (FGDs, n=27). RESULTS: The main themes were categorised into community behaviour and stakeholder challenges. The community behaviour-related themes were awareness of dengue disease and Aedes mosquitoes, perception of risk and severity, and involvement of authorities. The themes related to stakeholder challenges were resource constraints and capacity issues, jurisdictional constraints and coordination, and educational dissemination and vandalism. CONCLUSIONS: The actions of the authorities shape community and stakeholder behaviours. Effective communication, including clear and aesthetically pleasing messages, motivates individuals to take appropriate actions. It is crucial for the authorities to engage in inclusive communication and consider diverse perspectives, such as those of residents and individuals exposed to dengue infection. Authorities that provide accurate and unbiased information foster transparency and enable informed decision-making by all stakeholders.

Impacts of climate change and environmental degradation on children in Malaysia.

The impacts of climate change and degradation are increasingly felt in Malaysia. While everyone is vulnerable to these impacts, the health and wellbeing of children are disproportionately affected. We carried out a study composed of two major components. The first component is an environmental epidemiology study comprised of three sub-studies: (i) a global climate model (GCM) simulating specific health-sector climate indices; (ii) a time-series study to estimate the risk of childhood respiratory disease attributable to ambient air pollution; and (iii) a case-crossover study to identify the association between haze and under-five mortality in Malaysia. The GCM found that Malaysia has been experiencing increasing rainfall intensity over the years, leading to increased incidences of other weather-related events. The time-series study revealed that air quality has worsened, while air pollution and haze have been linked to an increased risk of hospitalization for respiratory diseases among children. Although no clear association between haze and under-five mortality was found in the case-crossover study, the lag patterns suggested that health effects could be more acute if haze occurred over a longer duration and at a higher intensity. The second component consists of three community surveys on marginalized children conducted (i) among the island community of Pulau Gaya, Sabah; (ii) among the indigenous Temiar tribe in Pos Kuala Mu, Perak; and (iii) among an urban poor community (B40) in PPR Sg. Bonus, Kuala Lumpur. The community surveys are cross-sectional studies employing a socio-ecological approach using a standardized questionnaire. The community surveys revealed how children adapt to climate change and environmental degradation. An integrated model was established that consolidates our overall research processes and demonstrates the crucial interconnections between environmental challenges exacerbated by climate change. It is recommended that Malaysian schools adopt a climate-smart approach to education to instill awareness of the impending climate change and its cascading impact on children's health from early school age.