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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

Problem: The novel coronavirus disease 2019 (COVID-19) pandemic adversely affected the preparation of Malaysia’s National Health and Morbidity Survey for 2020 because conducting it would expose data collectors and participants to an increased risk of infection. Context: The survey is nationally representative and community based and is conducted by the Institute for Public Health, part of the National Institutes of Health, to generate health-related evidence and to support the Malaysian Ministry of Health in policymaking. Its planned scope for 2020 was the seroprevalence of communicable diseases such as hepatitis B and C. Action: Additional components were added to the survey to increase its usefulness, including COVID-19 seroprevalence and facial anthropometric studies to ensure respirator fit. The survey’s scale was reduced, and data collection was changed from including only face-to-face interviews to mainly self-administered and telephone interviews. The transmission risk to participants was reduced by screening data collectors before the survey and fortnightly thereafter, using standard droplet and contact precautions, ensuring proper training and monitoring of data collectors, and implementing other administrative infection prevention measures. Outcome: Data were collected from 7 August to 11 October 2020, with 5957 participants recruited. Only 4 out of 12 components of the survey were conducted via face-to-face interview. No COVID-19 cases were reported among data collectors and participants. All participants were given their hepatitis and COVID-19 laboratory test results; 73 participants with hepatitis B and 14 with hepatitis C who had been previously undiagnosed were referred for further case management. Discussion: Preparing and conducting the National Health and Morbidity Survey during the COVID-19 pandemic required careful consideration of the risks and benefits, multiple infection prevention measures, strong leadership and strong stakeholder support to ensure there were no adverse events.

Background Pre-existing comorbidities can predict severe disease requiring intensive care unit (ICU) admission among COVID-19 cases. We compared comorbidities, clinical features and other predictive factors between COVID-19 patients requiring ICU admission for intubation/mechanical ventilation and all other COVID-19 cases in Selangor, Malaysia. Method Field data collected during the COVID-19 outbreak in Selangor, Malaysia, up to 13 April 2020 were used, comprising socio-demographic characteristics, comorbidities and presenting symptoms of COVID-19 cases. ICU admission was determined from medical records. Multiple logistic regression analysis was performed to identify factors associated with ICU admission requiring intubation/mechanical ventilation among COVID-19 cases. Results A total of 1287 COVID-19-positive cases were included for analysis. The most common comorbidities were hypertension (15.5%) and diabetes (11.0%). More than one third of cases presented with fever (43.8%) or cough (37.1%). Of the 25 cases that required intubation/mechanical ventilation, 68.0% had hypertension, 88.0% had fever, 40.0% had dyspnoea and 44.0% were lethargic. Multivariate regression showed that cases that required intubation/mechanical ventilation had significantly higher odds of being older (aged 360 years) [adjusted odds ratio (aOR) = 3.9] and having hypertension (aOR = 5.7), fever (aOR = 9.8), dyspnoea (aOR = 9.6) or lethargy (aOR = 7.9) than cases that did not require intubation/mechanical ventilation. Conclusion The COVID-19 cases in Selangor, Malaysia requiring intubation/mechanical ventilation were significantly older, with a higher proportion of hypertension and symptoms of fever, dyspnoea and lethargy. These risk factors have been reported previously for severe COVID-19 cases, and highlight the role that ageing and underlying comorbidities play in severe outcomes to respiratory disease.

In the early stages of the COVID-19 crisis, there was no specific guideline for handling an outbreak if it occurred in a workplace. This study aimed to describe the first and one of the largest clusters linked to a business corporate in Malaysia. A descriptive analysis was conducted using surveillance data from the Petaling District Health Office notified between 28 Feb and 22 Mar 2020. All cases and contacts were identified through surveillance, epidemiological investigation, and laboratory investigation. The total number of confirmed cases and close contacts were 63 and 1,536, respectively. The respondents were mainly Malay, male, and the mean age was 46 years. Of the 63 positive cases, 48 (76%) were reported to have symptoms during the investigation, while the remaining 15 cases (24%) were asymptomatic. The main clinical manifestations were fever (52%), cough (37%), sore throat (27%) and shortness of breath (27%). The mean incubation period was 3.5 days. Due to the timely prevention and control measures carried out by the Petaling District Health Office, the chain of transmission was interrupted as the last case was reported on 19 Mar 2020.

BACKGROUND Tuberculosis (TB) profile in Malaysia showed an average annual growth rate of 2.23%, with an estimated 92 cases per 100,000 people reported in 2018. CXR remains the best conventional method for the early detection of pulmonary TB infection. The intervention of AI in TB diagnosis could efficiently aid human interpreters and reduce health professionals' work burden. To date, no evaluation of AI studies has been carried out in Malaysia. OBJECTIVE This study aims to determine the diagnostic accuracy and evaluate the performance of Qure.ai and Putra Analytica AI software. METHODS We will conduct a retrospective case-control study in Respiratory Medicine Institute (IPR), Kuala Lumpur Health Clinic and Bandar Botanik Klang Health Clinic. Patients' medical reports on TB investigation will be retrieved by accessing electronic and hardcopy medical records and collecting demographic data. Prior to conducting the study, patients' PTB status will be obtained by identifying MTB culture (reference standard) results in order to create a case and a control group. A total of 2000 CXR images will be retrieved, of which 1000 images will be the case (abnormality). Normal and abnormal CXR will be categorized into film and digital CXR, which will be screened onto the said AI software (index tests). RESULTS Results obtained from the AI software will be compared with the reference standard, and significant statistical analysis will be computed CONCLUSIONS We hope that the findings of this evaluation study will provide sufficient information for stakeholders and to implement AI technology in the medical imaging field for better management of TB in hospital and clinic settings.

BACKGROUND Soil-transmitted helminth (STH) infection is one of the 13 notable Neglected Tropical Diseases (NTDs) according to the CDC and WHO. In 2010, it is estimated that 1.73 billion people are infected with STH globally of which 70% of cases occur in Asia. To date, there is a dearth of published literature on the prevalence of STH infection throughout Malaysia. OBJECTIVE The objectives of this study are to review research activity on STH infection in Malaysia, to estimate the prevalence of STH infection among Malaysian, and to identify significant risk factors associated with the infection. METHODS We will conduct a scoping review based on the 6-stages structured framework of Arksey and O’Malley’s (2005) methodology. A comprehensive search strategy focusing on STH infection will be executed using electronic databases (Scopus, PubMed, Web of Science and EMBASE). A systematic approach to searching, screening, reviewing and data extraction will be applied based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Review (PRISMA-ScR). Mendeley software and Microsoft Excel programmes will be used to manage the references and to remove duplicates. Relevant data from selected articles will be extracted using a standardized data extraction form using the Google Form application. Results will be summarized descriptively in tabular form including types of interventions, study design, settings, tools used, and the outcomes of each study. RESULTS We would like to provide further evidence on the prevalence of STH in terms of parasite species that predominately cause the infection and the intensity of the infection. Finally, we will present the significant risk factors that contribute to STH infection and discuss prevention taken by considering the government or private sectors involvement towards curbing this issue. CONCLUSIONS We hope that the findings of this scoping review will provide information for policymakers and strengthen policy guidelines to eradicate STH infection, and for researchers to further study and investigate any STH-related issue in Malaysia.

Background 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. Methods 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. Results 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. Conclusion 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.

IntroductionThe first Malaysian case of covid-19 was the ninth case reported at the beginning of February 2020 . This 42-year-old businessman had a travel history to Singapore from 16th to 23rd January 2020 for an International Conference. He was also the index case of the first local transmission cluster in Malaysia . Malaysia was free of COVID-19 cases for 11 days before the second wave of the disease arrived late February 2020 . Most of the early cases in the second wave were initially imported and sporadic . However, a case notified on 28th February 2020 to Petaling District Health Office (DHO) in the Selangor State, Malaysia, was later found to link to a cluster from a business corporate in Malaysia . During this time, there was no specific guidelines from the Ministry of Health Malaysia for the corporate companies on handling the outbreak. Here, we reported the detection and management of this COVID-19 first business cluster in Malaysia by Petaling DHO. ObjectiveThis study aimed to report the detection and management of COVID-19 from the first and one of the largest clusters linked to a business corporate in Malaysia from Petaling District, Selangor Material and MethodsThis is a descriptive study analysis that was conducted from the surveillance data of Petaling district health office (DHO) notified on 28th February 2020 until 22nd of March 2020. All cases and contacts were identified through surveillance, epidemiological investigation, and laboratory investigation. The network graph was done using the software R and the epidemiology curve was done using Microsoft Excel. Results and DiscussionFrom 28th February to 22nd March 2020, a total of 1536 people were traced by Petaling DHO linked to the cluster. The total number of positive COVID-19 cases from this cluster was 126 out of 1536 which come to an attack rate of 8.2% 63 of them, which was 50% of the total number in the cluster, lived in Petaling District. Other positive cases were transferred to the respective districts according to their house addresses. ConclusionCluster of COVID-19 in this workplace setting was curbed quickly, within three weeks, due to the efficient control efforts by the Petaling DHO with mutual co-operation with the employer and other related DHO. They did all the necessary measures to prevent the outbreak from getting worse and bigger.

IntroductionImmigrants from tuberculosis (TB) endemic countries hold significant incident for TB cases in Malaysia. Duration of residence in the host country is one of the factors influencing the risk of TB infection or TB reactivation among immigrants. MethodData were retrieved from Tuberculosis Information System (TBIS) from 2013-2018. Only new positive TB cases were selected in this study. The duration of residence was categorized into three; less than a year, 1-10 years and more than 10 years. A chi-square test was performed to search for an association between duration of residence and TB diagnosis using SPSS Version 21. ResultsThere was a total of 3838 new positive cases of TB among immigrants, of whom the majority were males (64%, n=2475), with mean age of 32.94 ± 11.66 and mainly from Indonesia (45.1%, n=1731) followed by Myanmar (19.6%, n=751) and Nepal (8.9%, n=340). Most cases were detected during immigrants’ duration of residence of 1- 10 years (64.3%, n= 2466) followed by less than a year (24.8%, n= 953) and more than 10 years (10.9%, n=419). A chi-square test of independence showed that there was a significant association between duration of residence and TB diagnosis among immigrants in Malaysia, (X2 = 18.4, p < 0.01). ConclusionImmigrants may be exposed to a wide range of risk to get TB infection or reactivation of TB during the period of residence. TST and IGRA are always recommended to increase the chances for TB detection, especially in latent TB infection among immigrants. &nbsp

IntroductionAcute myeloid leukaemia (AML) is a type of cancer in which the bone marrow makes abnormal myeloblasts (a type of white blood cell), red blood cells or platelets. Gemtuzumab ozogamicin (GO) holds promise as a new agent that also could be efficacious in newly diagnosed AML with acceptable toxicity. This paper describes the design of a protocol to conduct a systematic review of published studies assessing GO for the treatment of AML.Method and analysisWe will conduct a systematic review of randomised controlled trials that investigate the effect and safety of GO for the treatment of patients with AML. We will search for any eligible articles from selected electronic databases. We will follow the Preferred Reporting Items for Systematic reviews and Meta-Analysis for study selection and reporting. We will use The Cochrane Handbook for Systematic Reviews of Interventions and Meta-Analysis as guidance to select eligible studies. All data will be extracted using a standardised data extraction form.Ethics and disseminationThere was no patient involved in this study, therefore no ethical consideration is needed. The findings of this study will be disseminated in a peer-reviewed journal and any relevant conference presentation.PROSPERO registration numberCRD42019123286.

Aims As the Malaysian population is aging rapidly, there is an urgent need for an effective management plan for healthy aging, to extend life expectancy and to improve quality of life (QoL). Urinary incontinence (UI), which is common in older persons, is often linked to reduced QoL. This study aimed to determine the effects of UI on QoL among older persons in Malaysia. Methods This study was based on data obtained from 3716 Malaysians aged ≥60 years as part of the National Health and Morbidity Survey (NHMS) 2018. QoL was measured using the Control, Autonomy, Self-realization and Pleasure 19-item (CASP-19) questionnaire. UI was measured using the Questionnaire Urinary Incontinence Diagnosis (QUID) score. Association between UI and QoL were examined using linear regression analysis, after controlling socio-demographic variables and comorbidities. Results Overall, the prevalence of UI was 5.2%. By subtypes, the prevalence of stress UI and urge UI were both 2.0%, while that of mixed UI was 1.3%. The UI group rated their lives more negatively in all four domains of QoL compared with non-UI group. Those who were incontinent had lower standardized scores on control and autonomy domains of CASP-19 as well as total score. Results from linear regression analysis indicated that UI had a significantly negative impact on control and autonomy domains of QoL after controlling for socio-demographic factors and comorbidities. Conclusion UI contributes to a significant reduction on QoL of older persons. Healthcare providers need to be sensitive in evaluating and discussing UI, particularly with their older patients. Geriatr Gerontol Int 2020; 20: 38-42.

Aim Quality of life (QoL) among the older persons provides valuable insights into the potential modifiable risk factors that affect well-being in later life. This study aimed to describe the QoL and psychosocial factors of QoL of older persons in Malaysia. Methods We used the 19-item Control, Autonomy, Self-realization and Pleasure scale, a validated instrument that measures psychological well-being related to QoL in older persons. Scores range from 0 to 57, and higher scores indicate better QoL. We included several factors as covariates. Analysis of complex samples was carried out using Stata 15. Descriptive analysis was carried out to determine QoL by sociodemographic characteristics and other factors. Linear regression analysis was used to identify psychosocial factors that influence QoL. Results A total of 3444 individuals aged ≥60 years completed all 19-item Control, Autonomy, Self-realization and Pleasure items. The estimated mean QoL score was 47.01 (95% CI 46.30-47.72). Adjusted for confounders, QoL was lower among individuals with no formal education (-2.554, 95% CI -3.684, -1.424), probable depression (-1.042, 95% CI -1.212, -0.871) and food insecurity (-0.815, 95% CI -1.083, -0.548). QoL continued to improve with improved ADL score (0.302, 95% CI 0.052, 0.552), IADL score (0.646, 95% CI 0.382, 0.909) and better social support (0.308, 95% CI 0.187, 0.429). Conclusions Lower education, depression, food insecurity, presence of limited functional status and poor social support negatively influenced QoL in older Malaysians. This study identified potentially modifiable factors that could be targeted for interventions to enhance QoL of older persons in Malaysia. Geriatr Gerontol Int 2020; 20: 92-97.

Background Tuberculosis (TB) among children remains a significant public health problem in many parts of the world. The objective of this study was to describe the characteristics of TB patients and to determine the predictors of treatment success among children in Malaysia. Methods Secondary data from MyTB version 2.1, a national database, were analysed using R version 3.6.1. Descriptive analysis and multivariable logistic regression were conducted to identify treatment success and its determinants. Results In total, 3630 cases of TB cases were registered among children in Malaysia between 2013 and 2017. The overall treatment success rate was 87.1% in 2013 and plateaued between 90.1 and 91.4% from 2014 to 2017. TB treatment success was positively associated with being a Malaysian citizen (aOR = 3.43; 95% CI = 2.47, 4.75), being a child with BCG scars (aOR = 1.93; 95% CI = 1.39, 2.68), and being in the older age group (aOR = 1.06; 95% CI = 1.03, 1.09). Having HIV co-infection (aOR = 0.31; 95% CI = 0.16, 0.63), undergoing treatment in public hospitals (aOR = 0.38; 95% CI =0.25, 0.58), having chest X-ray findings of advanced lesion (aOR = 0.48; 95% CI = 0.33, 0.69), having EPTB (aOR = 0.58; 95% CI = 0.41, 0.82) and having sputum-positive PTB (aOR = 0.58; 95% CI = 0.43, 0.79) were negatively associated with TB treatment success among children. Conclusions The overall success rate of treatment among children with TB in Malaysia has achieved the target of 90% since 2014 and remained plateaued until 2017. The socio-demographic characteristics of children, place of treatment, and TB disease profile were associated with the likelihood of TB treatment success among children. The treatment success rate can be increased by strengthening contact tracing activities and promoting early identification targeting the youngest children and non-Malaysian children.

Background Cataract is the leading cause of blindness in developing countries including Malaysia. Federal Territory Islamic Religious Council (MAIWP) and Ministry of Health, Malaysia (MOH) have established a cataract day care centre called Pusat Pembedahan Katarak, MAIWP- Hospital Selayang (MAIWP- Selayang Hospital Cataract Surgery Centre) to offer a day care cataract surgery with the aim reduce the waiting list among patients plan for cataract operation at the MOH referral hospital in Klang Valley. This smart partnership enables more patients to undergo cataract surgery with a lesser waiting period irrespective of their religious belief. Objective This paper aims to estimate the cataract surgery rate (CSR) of Pusat Pembedahan Katarak, MAIWP- Hospital Selayang (Cataract Operation Centre) from 2013 to 2016 and descriptive assessments of the patients who received eye treatments in the centre. Methods All cataract patients who underwent for operations in Selayang Hospital were requested to complete the “Registration Form,” that consist of the these information namely name, sex, age, home address, cataract classification, detailed ophthalmological exam information (such as naked eyesight, optometry, tonometry, etc.), cataract surgeon, surgical management, intraocular lens (IOL) implantation or not, operation cost origin, operation outcome (mainly 1st–3rd postoperative day corrected visual acuity (VA), etc. Cataract surgery data are entered into the local Eye Clinic Management System (ECMS) which synchronises with National Eye Database (NED) at regular intervals. Results Cataract surgery rate for 2013 was about 27 and increased to 37.3 in 2014. However, it was declined to 25 in 2015 before bouncing back to 36 in year of 2016. Female patients who received eye treatment at Pusat Pembedahan Katarak, MAIWP- Hospital Selayang was higher (53.7%) as compared to male patients (46.3%). Mean duration of cataract surgery from 2013 to 2016 was 21.25 ± 11.071 minutes. Conclusions Increased in cataract surgery rate for MAIWP-HS through smart partnership for day care cataract surgery proved that easy accessibility is possible to achieve the short and long-term strategies for the reduction and prevention of blindness in Malaysia.

Background: Coronavirus Disease (COVID-19) has spread rapidly across the globe, since it was first discovered in late December 2019 We are still learning about

Introduction: The possible impact of ambient air pollution exposure on the development of active tuberculosis (TB) remains obscure. This study investigated the potential role of ambient air pollution in activating pulmonary TB (PTB) compared to extrapulmonary TB (EPTB). Materials and Methods: Data on TB cases were obtained from national surveillance data in Malaysia during 2013 and air pollution data were obtained from 52 air-monitoring stations around the country for the 3-year period of 2011-2013. Analyses were performed to estimate the odds of PTB vs. EPTB with changes in the 3-year (2011-2013) average Air Pollutant Index (API) and specific ambient air pollutants. Results: Results showed that the 95th-percentile of API levels during 2011-2013 was moderate and it was not associated with PTB. However, the odds of active PTB compared to EPTB was significantly elevated with the 95th-percentile levels for particulate matter with an aerodynamic diameter of 10 μm or less (aOR = 1.006, 95% CI: 1.002, 1.011), p-value < 0.01, and sulfur dioxide (aOR = 1.012, 95% CI: 1.006, 1.019), p-value < 0.01. Conclusions: These results provide suggestive evidence of the effects of ambient air pollution on development of active pulmonary TB compared to extrapulmonary TB. Additional research on the impacts of ambient air pollution on TB is warranted.

Introduction: A psychoactive substance has become an overwhelming public health burden globally. It causes social problems for the user and surrounding people which may affect work or study and cause negative economic impact. Objective: This study aims to translate and culturally adapt the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) into Malay and to assess its reliability and validity. Methods: The Malay version of the ASSIST v 3.1 was developed after the translation and back-translation, which included the stages recommended by Beaton. The ASSIST v 3.1 was administered to 125 respondents. The Malay ASSIST v 3.1 was completed twice by each respondent 7 to 14-day intervals to assess test-retest reliability based on the intra-rater and interrater correlation coefficient. Results: Majority of the respondents were male, Malay and currently employed. The intra-rater reliability is 0.84 and the test-retest reliability (ICC = 0.97) were excellent. Conclusion: Malay ASSIST v3.1 was a valid and reliable tool to screen substances abuse at varying degree. Nonetheless, further studies are needed to assess its responsiveness.

Parental protective factors do play an important role in preventing Internet addiction. A self-administered questionnaire was used to measure health risk behaviors among Malaysian adolescents. The prevalence of Internet addiction was significantly higher among adolescents with perceived lack of parental supervision (30.1% [95% confidence interval (CI) = 28.7-31.4]) and lack of parental connectedness (30.1% [95% CI = 28.5-31.7]), compared with their counterparts. Adolescents who perceived a lack of parental supervision, respect for privacy, connectedness, and bonding were more likely to have Internet addiction: (adjusted odds ratio [aOR] = 1.39; 95% CI = 1.27-1.52), (aOR = 1.23; 95% CI = 1.16-1.31), (aOR = 1.09; 95% CI = 1.02-1.16), (aOR = 1.06; 95% CI = 1.00-1.12), respectively. Among girls, Internet addiction was associated with those who perceived lack in all 4 parental factors, while among boys, those who perceived lack of parental supervision and respect for privacy were more prone to Internet addiction.

Various factors contribute to suicidal attempt. This study aims to determine the relationship between suicidal attempt and its associated factors among school-going adolescents in Malaysia. Data from the National Health and Morbidity 2017 survey were analyzed. This survey was implemented as a nationwide school-based survey targeting adolescents 13 to 17 years old. Descriptive and multiple logistic regression analysis was done using SPSS version 20. A total of 27 399 adolescents participated in this survey. The prevalence of suicidal attempt was 6.9% (95% confidence interval = 6.2-7.7). Multivariate analysis found that the odds of suicidal attempt among adolescent with depression is 4.3 (adjusted odds ratio = 4.3; 95% confidence interval = 3.9-4.8). Other significant factors are young adolescent, non-Malay ethnicities especially Indian, adolescent with parents living apart, and those without peer support and parental connectedness. A holistic approach for the planning of preventative strategies and public health policies should be made according to these risk factors.

Sexual activities among adolescents poses to sexually transmitted infection (STI) and also unintended pregnancies. This study aims to determine the prevalence of risky sexual activities among school going adolescent in Malaysia. A cross-sectional study with a total of 27,497 secondary school students was done in March-April 2017. A self-administered structured and validated questionnaire was given to answer. The prevalence of ever had sex among adolescents in Malaysia was 7.3% and mostly among males and Indians. The associated factors to sexual activity among adolescents include ever used drugs with aOR=10.201 and ever smoked aOR=1.628. Among those who ever had sex, 87.3% did not use condom, 16.6% had multiple sexual partners and 31.7% had sex before the age of 14 years. The risky sexual behaviours are relatively high among these adolescents. Sexual health educations and programmes in school is vital to prevent any sexual-health related issues among adolescents.

IntroductionDengue is among the most important mosquito-borne diseases, with more than half of the world’s population at risk of infection in dengue endemic countries. Environmental management, which includes any activities that involve environmental modification, environmental manipulation and changes to human behaviour have been used to mitigate the risk of dengue transmission. In this protocol, we will integrate the data from various sources to assess the overall effect of environmental management on the incidence of dengue and other entomological indices.Methods and analysesWe will conduct a systematic review of intervention that assess the effect of environmental management on the incidence of dengue and/or entomological indices. We will include any studies that include intervention through environmental management for dengue control, involving environmental modification, environmental manipulation and changes to human behaviour. A comprehensive search will be performed in electronic databases PUBMED, CENTRAL, SCOPUS, Web of Science and relevant research websites such as PROPSERO, WHO ICTRP and ClinicalTrials.gov to identify studies that meet our inclusion criteria. A systematic approach to searching, screening, reviewing and data extraction will be applied based on Preferred Reporting Items for Systematic reviews and Meta-Analysis. Titles, abstract, keywords for eligibility will be examined independently by researchers. The quality of the included studies will be assessed using quality assessment tool for studies with diverse design and Cochrane risk of bias tool. The characteristics of the selected articles will be described based on the study design, types of intervention and outcomes of the study in various countries. These include the types of environmental management intervention methods and the effectiveness of the intervention in reducing dengue cases or incidence and impact on entomological indices.Ethics and disseminationWe will register this systematic review with the National Medical Research Register, Ministry of Health Malaysia. This protocol also had been registered with the PROSPERO. No ethical approval is necessary, as there will be no collection of primary data. The results will be disseminated though a peer-reviewed publication and conference presentation.Trial registration numberCRD42018092189.

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.

INTRODUCTION: “Doktor Muda” (DM) programme was developed by the Ministry of Health (MOH), Malaysia to train a group of pupils as peer educator for change in motivating and assisting their peers to adopt healthy practices especially in hand washing through good knowledge, positive attitude, high self-efficacy and skill to deliver health messagesAIM: This study aims to identify the association of socio demographic, knowledge, attitude, and practices with self-efficacy in proper hand washing.METHODS: A cross-sectional study using a self-administered questionnaire and observation checklists for hand washing demonstration skills.RESULT: This study showed that the subjects` knowledge (16.7%), practice (23.8%) and self-efficacy (41.7) in proper hand washing were low. Significant association were found between gender (p=0.004), academic achievements (p=0.038) and practices (p=0.003) with self-efficacy in proper hand washing.CONCLUSION: Various strategies are needed to strengthen DM role as peer educators and health change agents in school as levels of their knowledge, practice and self-efficacy were low.