Fogging to combat dengue: factors influencing stakeholders' attitudes in Malaysia.

BACKGROUND: Fogging is a conventional technique used to combat Aedes mosquitoes and prevent dengue disease. It is often implemented in outbreak areas or areas harbouring a high density of Aedes mosquitoes. Currently, studies on stakeholders' attitudes towards fogging are still limited in number. Therefore, this study aims to assess Malaysian attitudes, and identify the predicting factors influencing such attitudes. METHODS: A validated instrument was used to interview 399 randomly selected respondents from the public (n = 202, 50.6%) and scientists (n = 197, 49.4%) in the Klang Valley region of Malaysia. The data were analysed using PLS-SEM involving Smart-PLS software. RESULTS: The results confirmed that stakeholder attitudes toward fogging should be viewed in terms of a multi-dimensional association. The stakeholders surveyed were highly positive with regard to the application of fogging to control dengue but professed moderate concerns as to associated risks. The PLS-SEM analyses demonstrated that the perceived benefit was the most important factor influencing attitudes, followed by trust in key players. CONCLUSIONS: This result provides a good insight from the perspective of education and unravels the underlying fundamentals of stakeholders' attitudes toward the fogging technique. The findings also provide a positive indicator to the responsible parties involved to continue the usage of this technique in conjunction with improvements with regard to its safety aspects, and possibly in combination with other environmental-friendly alternatives in order to achieve a healthy environment without dengue in Malaysia.

The Lesser of Two Evils: Application of Maslahah-Mafsadah Criteria in Islamic Ethical-Legal Assessment of Genetically Modified Mosquitoes in Malaysia.

The release of over 6,000 genetically modified mosquitoes (GMM) into uninhabited Malaysian forests in 2010 was a frantic step on the part of the Malaysian government to combat the spread of dengue fever. The field trial was designed to control and reduce the dengue vector by producing offspring that die in the early developmental stage, thus decreasing the local Aedes aegypti population below the dengue transmission threshold. However, the GMM trials were discontinued in Malaysia despite being technologically feasible. The lack of systematic studies in terms of cost-benefit analysis, questionable research efficacy and safety-related concerns might have contributed to the termination of the field trial. Hence, this research aims to evaluate the feasibility of GMM release in Malaysia by using a holistic approach based on an Islamic ethical-legal assessment under the maslahah-mafsadah (benefit-risk) concept. Three main strategies based on the maslahah-mafsadah concept approach have been applied: 1) an evidence-based approach, 2) an impact-based approach and, 3) a priority approach. The analysis concluded that GMM could be categorised as zanniyyah (probable). GMM is a promising alternative for dengue control, but many issues must be addressed before its widespread adoption.