The Global Landscape of Domestic Violence against Women during the COVID-19 Pandemic: A Narrative Review.

The coronavirus disease (COVID-19) pandemic has led to an alarming increase in domestic violence against women owing to lockdown measures and limited access to support services. This article provides insights into the global prevalence of domestic violence, barriers to seeking help, its impact on women and children, and the best practices implemented worldwide. Domestic violence encompasses various forms of abuse; many young women experience partner violence. Barriers to seeking help include fear, financial constraints, lack of awareness of available services, and distrust among stakeholders. The consequences of domestic violence affect the mental health of both mothers and children. Countries have increased shelter funding and developed innovative protocols to reach survivors and address this issue. However, the healthcare sector's involvement in addressing domestic violence has been limited. This review advocates collaboration among healthcare institutions and government bodies. Key recommendations include utilizing telehealth services, implementing comprehensive training programs, establishing effective referral systems, enhancing health education, developing a domestic violence registry, improving the responses of law enforcement and justice systems through healthcare integration, promoting data sharing, and conducting further research. Healthcare systems should recognize domestic violence as a public health concern and detect, prevent, and intervene in cases to support survivors.

Systematic review with meta-analysis: Prevalence, risk factors, and challenges for urinary schistosomiasis in children (USC).

BACKGROUND: Schistosomiasis is a parasitic infection that causes significant public health problems in tropical countries. Schistosoma haematobium species are blamable for causing urinary schistosomiasis. The infected person, specifically children, may be carrying the disease. This systematic review aimed to identify the current knowledge of urinary Schistosmiasis in children or USC on its epidemiology, risk factors, and challenges to spread the understanding of controlling the disease and reducing the complications. METHOD: In November 2021, a systematic computer-aided literature review was conducted using PubMed, SCOPUS and Web of Science, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The results were updated in February 2022. We only used papers that have at least the abstract available in English. Relevant articles were screened, duplicates were deleted, eligibility criteria were applied, and studies that met the criteria were reviewed. The keywords Human Schistosoma infections, prevalence, risk factors and challenges were included. The protocol for the review was registered with PROSPERO (registration number CRD42022311609). Pooled prevalence rates were calculated using the programme R version 4.2.1. Heterogeneity was assessed using the I2 statistic and p-value. A narrative approach was used to describe risk factors and challenges. Studies were selected and finalised based on the review question to prioritise. The quality of the included studies was assessed using the Mixed-Method Appraisal Tool (MMAT). RESULTS: A total of 248 publications met the requirements for inclusion. Fifteen articles were included in this review, with the result showing high heterogeneity. The pooled prevalence of urinary schistosomiasis in children is 4% (95% confidence interval (CI)). Age, poor socioeconomic status, education, exposure to river water, and poor sanitation are the risk factors identified in this review. Challenges are faced due to limitations of clean water, lack of water resources, and poor hygiene. CONCLUSION: Modifiable risk factors such as poor knowledge and practices must be addressed immediately. Healthcare providers and schools could accomplish engaging in practical promotional activities. Communicating the intended messages to raise community awareness of urinary schistosomiasis is critical.

Improving Tuberculosis Medication Adherence: The Potential of Integrating Digital Technology and Health Belief Model.

Tuberculosis (TB) is a significant public health concern. Globally, TB is among the top 10 and the leading cause of death due to a single infectious agent. Providing standard anti-TB therapy for at least 6 months is recommended as one of the crucial strategies to control the TB epidemic. However, the long duration of TB treatment raised the issue of non-adherence. Non-adherence to TB therapy could negatively affect clinical and public health outcomes. Thus, directly observed therapy (DOT) has been introduced as a standard strategy to improve anti-TB medication adherence. Nonetheless, the DOT approach has been criticized due to inconvenience, stigma, reduced economic productivity, and reduced quality of life, which ultimately could complicate adherence issues. Apart from that, its effectiveness in improving anti-TB adherence is debatable. Therefore, digital technology could be an essential tool to enhance the implementation of DOT. Incorporating the health belief model (HBM) into digital technology can further increase its effectiveness in changing behavior and improving medication adherence. This article aimed to review the latest evidence regarding TB medication non-adherence, its associated factors, DOT's efficacy and its alternatives, and the use of digital technology and HBM in improving medication adherence. This paper used the narrative review methodology to analyze related articles to address the study objectives. Conventional DOT has several disadvantages in TB management. Integrating HBM in digital technology development is potentially effective in improving medication adherence. Digital technology provides an opportunity to improve medication adherence to overcome various issues related to DOT implementation.

Correction to: Malay Version of the Fear of COVID-19 Scale: Validity and Reliability.

[This corrects the article DOI: 10.1007/s11469-020-00355-4.].

Health Education Module Based on Information-Motivation-Behavioural Skills (IMB) for Reducing Depression, Anxiety, and Stress among Adolescents in Boarding Schools: A Clustered Randomised Controlled Trial.

Depression, anxiety, and stress (DAS) among adolescents have become a public health concern. The aim of this study was to develop, implement, and measure an IMB-based health education intervention module for reducing DAS among adolescents in boarding schools in the state of Negeri Sembilan, Malaysia. A single-blinded cluster randomised control trial (RCT) was conducted among students with abnormal DASS-21 scores. They were divided into an intervention group (three schools, 62 participants) and a control group (three schools, 57 participants). Participants in the intervention group received IMB-based health education, while participants in the control group underwent the standard care session. To determine the effectiveness of the intervention, the Generalised Linear Mixed Model (GLMM) analysis was conducted. A total of 119 students participated in this study, and no loss to follow-up was reported. Both intervention and control groups showed significantly reduced DAS scores (p < 0.005). However, the reduction of these scores was greater in the intervention group. The GLMM analysis revealed that the intervention was effective in reducing depression (ß = -2.400, t = -3.102, SE = 0.7735, p = 0.002, 95% CI = -3.921, -0.878), anxiety (ß = -2.129, t = -2.824, SE = 0.7541, p = 0.005, 95% CI = -3.612, -0.646), and stress (ß = -1.335, t = -2.457, SE = 0.536, p = 0.015, 95% CI = -2.045, -0.266) among adolescents. The IMB-based health education module was effective in reducing DAS among adolescents in boarding schools.

Study on the Development of a Conceptual Framework to Identify the Risk Factors of Diabetic Retinopathy among Diabetic Patients: A Concept Paper.

The most common complication of diabetes mellitus (DM) is diabetic retinopathy (DR). The control of DR risk factors is essential for the effective prevention of DR. There is currently a lack of research to guide DR-related research in Malaysia. This concept paper aimed to review published studies and propose a conceptual framework (CF) as a guide for future research to determine the prevalence of DR and its risk factors across DM patients. After a review of prior research, this study has presented a CF that takes into account these four key elements: the patient's sociodemographic characteristics, comorbidities, complications, and diabetes conditions, namely, the length of the disease and glycaemic control. In the suggested CF, ethnicity was highlighted as a crucial risk factor for DR across lower- to middle-income countries (LMIC) and multiracial countries. In order to guide future studies, scientific guidance is essential. The proposed CF would help future research to conduct scientific research related to DR. Also, the proposed CF was tailored to suit research across LMIC and multiracial countries.

Mediating Effect of Psychological Process Variables on the Relationship between Dysfunctional Coping and Psychopathologies: A Comparative Study on Psychopathologies during COVID-19.

The COVID-19 crisis has had repercussions on global mental wellbeing. This study aimed: (1) to identify the mediating role of psychological process variables, namely psychological mindedness, psychological mindfulness, and psychological inflexibility on the relationship between dysfunctional coping and psychopathologies in Indonesian undergraduate students subjected to national quarantine orders throughout July, 2020 and (2) to compare the level of anxiety, depression, and anxiety between Indonesian and Malaysian undergraduate students. A cross-sectional study was performed with 869 Indonesian undergraduate students from Nahdlatul Ulama University of Surabaya (UNUSA) and 515 undergraduate students from Universiti Malaysia Sabah (UMS). The BIPM, MAAS, AAQ-I, DASS-21, and Brief COPE were used to assess the research variables. The proportion who scored "moderate" and above for depression, anxiety, and stress were 20.2%, 25.0%, and 14.2%, respectively, in Malaysian samples and 22.2%, 35.0%, and 23.48% in Indonesian samples. In Study 1, psychological mindedness, psychological mindfulness, and psychological inflexibility significantly mediated the relationship between dysfunctional coping and psychopathologies. In Study 2, Indonesians demonstrated significantly higher anxiety and stress compared to Malaysian samples. Despite the contrasting COVID-19 situations in Malaysia and Indonesia, psychopathologies were more affected in Indonesia. Hence, our study suggests how crucial it is for mental health providers to consider promoting psychological mindedness, psychological mindfulness, and psychological flexibility to alleviate the corresponding psychopathologies among undergraduate students.

Seroprevalence of Zika Virus among Forest Fringe Communities in Peninsular Malaysia and Sabah: General Population-Based Study.

Zika virus (ZIKV) has had a history in Malaysia since its first isolation in 1966. However, it is believed that the immunity status among forest fringe communities has been underreported. We conducted cross-sectional surveillance of forest fringe communities from 10 Orang Asli villages and their peripheral communities in Perak, Pahang, and Sabah in Malaysia. A total of 706 samples were collected from 2019 to 2020 and screened for ZIKV exposure using an anti-ZIKV IgG ELISA kit. A neutralization assay against ZIKV was used to confirm the reactive samples. The seroprevalence results reported from the study of this population in Malaysia were 21.0% (n = 148, 95% CI, 0.183-0.273) after confirmation with a foci reduction neutralization test. The presence of neutralizing antibodies provides evidence that the studied forest fringe communities in Malaysia have been exposed to ZIKV. Multivariate analysis showed that those older than 44 years and those with an education below the university level had been exposed significantly to ZIKV. In addition, higher seropositivity rates to ZIKV were also reported among secondary school students from Bentong (Pahang) and residents from Segaliud (Sabah). No associations were identified between Zika seropositivity and gender, household size, house radius to the jungle, and income level. The presence of neutralizing antibodies against ZIKV among the study population might indicate that the causative pathogen had already circulated widely in forest fringe regions. Intervention for vector control, protection from mosquito bites, and awareness improvement should be encouraged in this population.

Seroprevalence of COVID-19 and Psychological Distress among Front Liners at the Universiti Malaysia Sabah Campus during the Third Wave of COVID-19.

In 2020, the COVID-19 pandemic struck the globe and disrupted various aspects of psychological wellbeing, more so in frontline workers. Research on assessing the seroprevalence of COVID-19 has been scarce; in addition, there are limited studies assessing the association between the seroprevalence of COVID-19 and psychological distress. Therefore, this study aimed to determine the seroprevalence of COVID-19 and the prevalence of psychological distress and to determine whether sociodemographic variables, occupational information variables, coping styles, and psychological processes might contribute to the development of psychological distress. A cross-sectional study involving 168 Universiti Malaysia Sabah (UMS) front liners was carried out to assess these issues. The Depression, Anxiety and Stress Scale (DASS-21) was employed to assess psychological distress, together with the COVID-19 Rapid Test Kit Antibody (RTK Ab) and a series of questionnaires, including a sociodemographic and occupational information questionnaire, the Balanced Index of Psychological Mindedness (BIPM) questionnaire, the Mindfulness Attention and Awareness Scale (MAAS), the Acceptance and Action Questionnaire (AAQ-II), and the Brief COPE questionnaire. The results demonstrated a seroprevalence of COVID-19 at 8.3% (95% CI = 5.0-14.0). Non-healthcare workers (HCWs) had a higher COVID-19 prevalence. Meanwhile, the prevalence of depression, anxiety, and stress among front liners was low (3.0%, 3.6%, and 1.2%, respectively). Younger people (aged 30 years old or less) and HCWs had a higher prevalence of psychological distress; being a HCW was significantly associated with a higher level of anxiety. Dysfunctional coping and psychological inflexibility were consistently found to be predictors for higher levels of the three psychological distress variables. This study suggested some alternatives that could be explored by mental health providers to address mental health issues among front liners at universities.

A 1-year cross-sectional study on the predominance of influenza among hospitalized children in a tropical area, Kota Kinabalu, Sabah.

BACKGROUND: Children are at higher risk of influenza virus infection, and it is difficult to diagnose. They are also responsible for the transmission of influenza because of their longer viral shedding compared to adults. In Malaysia, studies on influenza in children are scarce, and as a result, policy decisions cannot be formulated to control the infection. Hence, the objective of this study is to determine the prevalence and epidemiological characteristics of influenza among children with upper respiratory symptoms in the Sabah state of Malaysia. METHODS: A cross-sectional study with a simple random sampling was conducted among children with upper respiratory symptoms in Sabah from 1 March 2019 to 29 February 2020. Patients admitted to a pediatric ward of Sabah Women and Children's Hospital who presented with a fever >38 °C and cough within 48 h of admission were enrolled in this study. A nasopharyngeal swab was taken, and influenza was diagnosed by lateral flow test. Clinical features of influenza-positive children were compared with children whose results were negative. RESULTS: A total of 323 nasopharyngeal samples were collected, and 66 (20.4%) of them were positive for influenza. Fifty-six (85%) were infected by influenza A whereas ten (15%) were by influenza B virus. Higher temperature (aOR 2.03, 95% CI 1.296-3.181), less activity (aOR 2.07, 95% CI 1.158-3.693), and seizure (aOR 4.2, 95% CI 1.614-10.978) on admission were significant risk factors associated with influenza in children. Meteorology parameters such as humidity and rainfall amount were statistically significant at 95% CI [1.133 (1.024-1.255)] and 95% CI [0.946 (0.907-0.986)]. CONCLUSION: The prevalence of influenza was high among children with upper respiratory symptoms, and they were infected predominantly with the influenza A virus. Children presented with seizures, less activity, and fever were the significant risk factors for influenza. Influenza vaccination should be prioritized as preventive measures for children.

Data of knowledge towards Zika Virus infection in Sabah, Malaysia.

This dataset presents a cross-sectional survey and was conducted to assess the knowledge on Zika Virus infection among adults in Sabah. The data were collected from December 2019 to February 2021, 274 adults living in forest fringe communities were interviewed by trained personnel and have completed the distributed questionnaires. SPSS version 27.0 was used to analyzed the data. These data could serve as auxiliary information and/or research data for other researchers in Sabah. It could also serve as guide or reference data to other researchers outside Sabah who may be interested in carrying out similar research in other state.

Malay Version of the Fear of COVID-19 Scale: Validity and Reliability.

The newly developed Persian Fear of COVID-19 Scale (FCV-19S) is a seven-item uni-dimensional scale that assesses the severity of fear of COVID-19. A translation and validation of the FCV-19S in the Malay language was expedited due to the severe psychological sequelae of COVID-19 in Malaysia. Formal WHO forward and backward translation sequences were employed in translating the English version into Malay. Malaysian university participants were recruited via convenience sampling online using snowball methods. The reliability and validity properties of the Malay FCV-19S were rigorously psychometrically evaluated (utilising both confirmatory factor analysis and Rasch analysis) in relation to socio-demographic variables and response to the depression, anxiety and stress subscales of the Malay validation of the DASS-21. The sample comprised 228 Malaysian participants. The Cronbach α value for the Malay FCV-19S was 0.893 indicating very good internal reliability. The results of the confirmatory factor analysis showed that the uni-dimensional factor structure of the FCV19S fitted well with the data. The FCV-19S-M was significantly correlated with anxiety (r = 0.481, p < 0.001) and stress (r = 0.389, p < 0.001) subscales of DASS-21. The FCV-19S-M's properties tested using Rasch analysis were also satisfactory. Hence, the Malay FCV-19S is valid and reliable, with robust psychometric properties from classical and modern psychometric methods. It therefore is a highly crucial and timely addition to the psychological toolkit both in operational and research settings in identifying, managing and responding to the psychological distress engendered by COVID-19.

Relationship Between Fear of COVID-19, Psychopathology and Sociodemographic Variables in Malaysian Population.

COVID-19 has affected Malaysia in multitude aspects. Although Malaysia is on the right track to flatten the curve attributed to swift and decisive actions by the government, it is important to assess the psychological after effect that caused by the pandemic and the movement control order. This study performed in Borneo, Malaysia, was conducted using principles of snowballing, and by invitation through university students and staffs mailing list to participate. The survey collected data on sociodemographic, along with measuring psychological impact by using the newly validated Malay version Fear of COVID-19 Scale and DASS-21 scale. There were a total of 255 respondents. The majority of the respondents' age was 25 years and below, with a female male ratio of 2:1 and around 70% respondents were students. Below 25-year-old age group, and females are having significantly higher levels of fear of COVID-19, depression, anxiety, and stress. Single people have higher depression level. There was a significant difference between students and non-students for depression, anxiety, and stress, but not for fear of COVID-19. It is imperative to allay the fears and psychological sequalae of COVID-19, especially those individuals at higher risks. Psychological interventions as well as telepsychiatry mobilisation could prove useful in dealing with the distress.

Determinants of glycaemic control among type 2 diabetes mellitus patients in Northern State of Kedah, Malaysia: a cross-sectional analysis of 5 years national diabetes registry 2014-2018.

INTRODUCTION: type 2 diabetes mellitus has become a global public health crisis. The increment in the cases has contributed significantly to the parallel increase in the prevalence of overweight and obesity. This paper aimed to analyse the relationship between lipid profile, waist circumference and body mass index (BMI) with the glycaemic control of the diabetes patients in Kedah. METHODS: a cross-sectional study was conducted, using the Kedah audit samples data extracted from the National Diabetes Registry (NDR) from the year 2014 to 2018. A total of 25,062 registered type 2 diabetes mellitus patients were selected using the inclusion and exclusion criteria from the registry. Only patients with complete data on their HbA1C, lipid profile, waist circumference and BMI were analysed using SPSS version 21. RESULTS: the means for the age, BMI and waist circumference of the samples were 61.5 (±10.85) years, 27.3 (±5.05) kg/m2 and 89.46 (±13.58) cm, respectively. Poor glycaemic control (HbA1c>6.5%) was observed in 72.7% of the patients, with females having poorer glycaemic control. The BMI and waist circumference were found to be significantly associated with glycaemic control (P<0.001). The total cholesterol, triglycerides and low-density lipoproteins values showed positive correlation with glycaemic control (r = 0.178, 0.157, 0.145, p<0.001), while high-density lipoproteins values are negatively correlated (r = -0.019, p<0.001). CONCLUSION: implementing lifestyle changes such as physical activity and dietary modifications are important in the management of BMI, waist circumference and body lipids, which in turn results in improved glycaemic control.

Relationships between Psychopathology, Psychological Process Variables, and Sociodemographic Variables and Comparison of Quarantined and Non-Quarantined Groups of Malaysian University Students in the COVID-19 Pandemic.

The COVID-19 pandemic has had considerable psychological health impacts across the globe. This study aimed to establish the psychological process variables underlying psychopathology in Malaysian public university students during the national Movement Control Order (MCO). The aim was to craft structured and sustainable psychological support programs with these students. We conducted a cross-sectional study involving Malaysian university students subjected to the Malaysian MCO. Structured questionnaires measuring sociodemographic factors, measures of depression, anxiety, stress, psychological mindedness, psychological flexibility and state mindfulness were employed. A total of 515 students participated in this study with 12 students (2.3%) being quarantined at the time. Many of them scored 'moderate' or above on the Depression, Anxiety and Stress Scale (DASS) with 20.2%, 25.0% and 14.2%, respectively. Quarantined students had higher depressive symptoms, with female students scoring significantly higher for depression, anxiety, and stress. Multiple regressions suggested gender and quarantine status predicted depression scores. However, only gender significantly predicted anxiety and stress. Psychological flexibility and psychological mindedness (Insight subscale) are significantly correlated with depression, anxiety, and stress, with psychological mindedness predicting all three psychopathologies. This study demonstrates that gender, psychological flexibility, and psychological mindedness are key demographic and psychological factors impacting students. Targeting psychological flexibility and psychological mindedness may enable timely prevention and intervention programs for our students to support their mental and physical health as we move through, and out of, the pandemic.

Colorectal cancer and potential predictors of never screened for faecal occult blood test: a narrative review.

Colorectal cancer (CRC) is a major public health threat. Therefore, CRC screening uptake has been a focus with the established precancerous lesion and the strong association of early detection with staging and survival of the disease. However, CRC screening is relatively low in many countries. This article briefly discussed the current situation of CRC, recommendations, and current uptake of CRC screening in various countries. Besides that, this article also highlights the potential factors that help to predict the CRC screening uptake worldwide. Identification of those factors could guide policymakers to develop an effective strategy to improve the CRC screening uptake and ultimately improve the health outcome of the population.

Retrospective Analysis of Psychological Factors in COVID-19 Outbreak Among Isolated and Quarantined Agricultural Students in a Borneo University.

Introduction: Much has been known about the psychological issues that can emerge in people who are quarantined and unable to move freely. The COVID-19 pandemic has no contrast from previous outbreaks like SARS and MERS regarding their ensuing worries and boosted anxiety levels. This article seeks to examine the unique psychological changes that occur in students who have been quarantined inside a university campus and assess sociodemographic factors associated with certain psychological factors. Methodology: The data was collected from students in an Agricultural Campus. In the first phase, the factor structure of the modified National Index Psychological Wellness (NIPW) was acceptable, and to establish statistical parameters for validation an exploratory factor analysis was done. In the second phase, Independent T-tests, ANOVA, and Hierarchical Multiple regression were performed. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 26.0. Result/Discussion: A total of 46 male and 76 female students enrolled in this study. The Bartlett's test of sphericity was significant (p < 0.001) and the Kaiser-Mayer-Olkin measure of sampling adequacy for the AUDIT-M was 0.901. The Cronbach's alpha of the entire modified NIPW was 0.657 which suggests reasonable internal consistency and subscales between 0.913 and 0.924. Raw scores of 12 positive items were higher for the quarantined group except for "I can do daily routines," "I understand what happens," and "I understand the action that is performed is fair." Raw mean scores of eight negative scoring items were higher in the quarantined group, except for "I feel angry" (2.88 vs. 2.89 for non-quarantined group). There were statistically significant differences between year groups for the questions "I understand what happens," "I understand the action that is performed is fair," and "I think everyone is good." Conclusion: Movement control orders or compulsory quarantine orders can be distressing and may cause understandable psychological sequelae. Holistic management of a quarantine center that addresses the needs and health of an individual student will give a positive impact on psychological wellness. Quarantining facilities can be a place of positivity, allowing people to live a shared experience together, provide peer support for each other, and give each other hope.

Knowledge, attitude and practice on COVID-19 among students during the early phase of pandemic in a university in Borneo, Malaysia.

BACKGROUND: COVID-19 related knowledge, attitude and practice plays a major role in determining the readiness of the community to adopt the behavioural change towards recommended preventive measures outlined by public health officials. This study aims to assess the knowledge, attitude, and practice regarding COVID-19 among university students as well as its associated factors. METHOD: This is a cross sectional study that was conducted among students in a public university during the early phase of COVID-19 pandemic in Malaysia. An online validated self-administered questionnaire was used to collect the data. Mann-Whitney U and Kruskal Wallis test was used to determine the association between independent variables with knowledge, attitude, and practice score. RESULTS: Overall response rate of this study was 92.9 (n=524). Median score of knowledge domain was 78.0 (IQR= ±12.0), median attitude score of 49.0 (IQR= ±5.0), and median practice score of 80.0 (IQR= ±11.0). The mean knowledge, attitude and practice score were significantly higher among diploma holder (vs degree holder, p<0.05), residing in main Kota Kinabalu campus (vs non-KK campus, p<0.001), studying in medical faculty (vs non-medical faculty, p<0.001), and attended COVID-19 education (vs non-attendance; p<0.05). CONCLUSION: COVID-19 related knowledge and attitude were below satisfactory level during earlier phase of the pandemic. However, majority of respondents have positive behaviour towards COVID-19 prevention. This highlights the importance of accurate and tailored health education to improve the level of knowledge, attitude and practice of recommended measures to prevent COVID-19 spread.

Knowledge, Attitude and Practice on Diabetic Wound Care Management among Healthcare Professionals and Impact from A Short Course Training in Sabah, Borneo.

OBJECTIVE: Healthcare professionals with an advanced level of knowledge and skills on diabetic wound care management are needed to effectively manage complex wounds. This study aimed to determine the effects of an educational intervention to enhance the management of wound care among healthcare professionals. METHOD: This study was part of a quasi-experimental pre-post research design where 82 healthcare professionals were recruited and assigned to intervention and control groups. The participants in the intervention group attended two days of educational intervention training on diabetic wound care management, while there was no intervention in the control group. A questionnaire on knowledge, attitude, and practice was applied before and one-month post-intervention to both groups. RESULTS: Pre-test resulted in a low level of knowledge 72.1% and 74.4%, negative level of attitude 67.4% and 66.7%, and a moderate level of practice 79.1% and 76.9% in both intervention and control groups respectively. Post-test resulted in increasing levels of knowledge (76.7%), positive attitude (100%), and practice (76.7%) in the intervention group. At the same time, there was no significant change in the control group. Repeated Measure ANOVA for within-subject and between-subject effects resulted in a statistically significant p-value of 0.001 for knowledge, attitude, and practice after the educational intervention. CONCLUSION: Health professionals have only a moderate level of knowledge on diabetic wound care management. It is important to improve this level by specific trainings and by using a good training module.

The east coast districts are the possible epicenter of severe dengue in Sabah.

BACKGROUND: Malaysia recorded the highest number of dengue cases between 2014 and 2017. There are 13 states and three federal territories in Malaysia, and each area varies in their prevalence of dengue. Sabah is one of the states situated in Borneo, Malaysia. Although dengue has been increasing for the last several years, no study was being done to understand the burden and serotype distribution of the dengue virus (DENV) in Sabah. Therefore, the present study was carried out to understand the epidemiology of the dengue infection and the factors responsible for severe dengue in Sabah. METHODS: Data on dengue infection were extracted from the dengue database of the state of Sabah from 2013 through 2018. DENV NS-1-positive serum samples from multiple sites throughout Sabah were sent to the state public health laboratory, Kota Kinabalu Public Health Laboratory, for serotype determination. The analysis of factors associated with severe dengue was determined from the data of 2018 only. RESULTS: In 2013, there were 724 dengue cases; however, from 2014, dengue cases increased exponentially and resulted in 3423 cases in 2018. Increasing dengue cases also led to increased dengue mortality. The number of dengue deaths in 2013 was only five which then gradually increased, and in 2018, 29 patients died. This is an increase of 580% from 2013 to 2018. Deaths were considerably more in the districts of the east coast of Sabah compared with districts in the west coast. During the study period, all DENV serotypes could be identified as serotypes circulating in Sabah. In 2018, the predominant serotype was DENV-3. The monthly peak of dengue infection varied in different years. In the logistic regression analysis, it was identified that children were 6.5 times, patients infected with mixed serotype of DENV were 13 times, and cases from the districts of the east coast were 5.2 times more likely to develop severe dengue. CONCLUSIONS: An increasing trend of dengue infection has been observed in Sabah. The burden of dengue, severe dengue, and mortality was noted especially in the districts of the east coast of Sabah. Severe dengue was most likely developed in children, cases from the east coast, and patients infected with mixed serotype of DENV.