Sylvatic dengue virus type 4 in Aedes aegypti and Aedes albopictus mosquitoes in an urban setting in Peninsular Malaysia.

Dengue fever is endemic in Malaysia, contributing to significant economic and health burden in the country. Aedes aegypti and Ae. albopictus are the main vectors of the dengue virus (DENV), which circulates in sylvatic and human transmission cycles and has been present in Malaysia for decades. The study investigated the presence and distribution of DENV in urban localities in the Klang Valley, Peninsular Malaysia. A total of 364 Ae. aegypti and 1,025 Ae. albopictus larvae, and 10 Ae. aegypti and 42 Ae. albopictus adult mosquitoes were screened for the presence of DENV. In total, 31 (2.2%) samples were positive, of which 2 Ae. albopictus larvae were co-infected with two serotypes, one with DENV-2 and DENV-3 and the other with DENV-3 and DENV-4. Phylogenetic analysis determined that the isolates belonged to DENV-1 genotype I (1 Ae. aegypti adult), DENV-2 (1 Ae. albopictus larva), DENV-3 genotype V (3 Ae. aegypti larvae and 10 Ae. albopictus larvae) and DENV-4 genotype IV (6 Ae. aegypti larvae and 12 Ae. albopictus larvae), a sylvatic strain of DENV-4 which was most closely related with sylvatic strains isolated from arboreal mosquitoes and sentinel monkeys in Peninsular Malaysia in the 1970s. All four DENV serotypes were co-circulating throughout the study period. The detection of a sylvatic strain of DENV-4 in Ae. aegypti and Ae. albopictus mosquitoes in urban areas in Peninsular Malaysia highlights the susceptibility of these vectors to infection with sylvatic DENV. The infectivity and vector competence of these urban mosquitoes to this strain of the virus needs further investigation, as well as the possibility of the emergence of sylvatic virus into the human transmission cycle

A novel strategy for community screening of SARS-CoV-2 (COVID-19): Sample pooling method.

The rapid global spread of the coronavirus disease (COVID-19) has inflicted significant health and socioeconomic burden on affected countries. As positive cases continued to rise in Malaysia, public health laboratories experienced an overwhelming demand for COVID-19 screening. The confirmation of positive cases of COVID-19 has solely been based on the detection of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) using real-time reverse transcription polymerase chain reaction (qRT-PCR). In efforts to increase the cost-effectiveness and efficiency of COVID-19 screening, we evaluated the feasibility of pooling clinical Nasopharyngeal/Oropharyngeal (NP/OP) swab specimens during nucleic acid extraction without a reduction in sensitivity of qRT-PCR. Pools of 10 specimens were extracted and subsequently tested by qRT-PCR according to the WHO-Charité protocol. We demonstrated that the sample pooling method showed no loss of sensitivity. The effectiveness of the pooled testing strategy was evaluated on both retrospective and prospective samples, and the results showed a similar detection sensitivity compared to testing individual sample alone. This study demonstrates the feasibility of using a pooled testing strategy to increase testing capacity and conserve resources, especially when there is a high demand for disease testing

Pneumococcal carriage among children in Malaysia: a case-control study

Streptococcus pneumoniae (SPN) is the most common cause of bacterial pneumonia. In December 2020, the Malaysian government included the 10-valent pneumococcal conjugate vaccine (PCV10) in the National Immunisation Programme (NIP)

Multicentre case–control study of pneumococcal infections among children with pneumonia in Peninsular Malaysia (MY-Pneumo): a study protocol

Background: S. pneumoniae (SPN) is the most common cause of pneumonia. The disease can be effectively prevented through immunisation. Since December 2020, the Malaysian Government has included the 10-valent pneumococcal conjugate vaccine (PCV10) for all infants born on or after 1 January 2020 as part of the National Immunisation Programme (NIP). However, the epidemiology of pneumonia remains poorly understood. To fill the knowledge gap, we established a multicentre surveillance study to understand the burden of pneumococcal pneumonia among young children in Peninsular Malaysia.Methods: MY Pneumo is a multicentre prospective case-control study conducted in threesentinel sites located in three different states of Peninsular Malaysia – Kuala Lumpur, Pahang, and Kelantan. A cohort of at least 500 incident cases and 500 controls is enrolled beginning in October 2021 and matched for age. Cases are hospitalised children <5 years with radiologically confirmed pneumonia, and the controls are children without any features suggestive of pneumonia. Clinical samples, including nasopharyngeal swabs (NPS) and urine, are collected according to the study protocol. Biological fluids such as blood, cerebrospinal fluid (CSF) and pleural fluid are obtained from invasive pneumonia disease (IPD) patients, if available. All children are tested for SPN using polymerase chain reaction (PCR) and pneumococcal urine antigen test (PUAT) using BinaxNow.Discussion: surveillance data, including carriage rate, serotype variations and the phylogeny data structure of SPN among young children in Malaysia during PCV implementation, will be generated from this study. Trends and patterns of pneumococcal serotypes by different regions are important for targeted public health strategies. Our data will provide baseline information for estimating the impact of PCV10 implementation and will influence policymakers' decisions regarding the upgrade from PCV10 to a higher-valency conjugate vaccine in Malaysia.Trial registration: this project was registered at ClinicalTrials.gov (NCT04923035) on June 11th, 2021. The study protocol was approved by the International Medical University Joint Committee on Research & Ethics (4.15/JCM-216/2021) and the Institutional Review Board at sentinel sites (USM/JEPeM/21020190, IREC 2021-114, MREC ID No: 2021128-9769) and University of Southampton's Ethics and Research Governance (ERGo II 64844)

Prevalence of depression and anxiety among IIUM pre-clinical medical students during COVID 19 pandemic

Given the tough nature of studying medicine, medical students are at higher risk of developing mental health-related issues such as depression and anxiety than the general public. The worries about what the future holds, lack of social interactions due to shifting towards online learning, and being confined inside the house for a long period of time due to government-imposed lockdown, might negatively affect medical students’ state of mind. This study was done to determine the prevalence of depression and anxiety among International Islamic University Malaysia (IIUM) preclinical medical students during COVID-19. A cross sectional study involving Year 1 (n=77) and Year 2 (n=81) medical students of IIUM was conducted from July till August 2020, and they were recruited to answer a self-administered online survey. This study was done in accordance with terms stipulated by the institutional ethical committee (Research ID: 735). The Generalized Anxiety Disorders Scale (GAD-7) and Well Being Index (WHO-5) scores were used to assess the level of anxiety and depression among the students respectively. The data were analysed using IBM SPSS Statistics 26 (IBM, New York). From 158 respondents, 27.8% of the students experienced depression, while 86.7% of the students flagged symptoms of anxiety. In accordance with this outcome, the concern about their physical well-being, social relationship and ffectiveness of online learning during this pandemic crisis are among the factors that might contribute to the increase of depression and anxiety among the students. This study has concluded that IIUM medical students showed an increased risk of suffering from depression and anxiety during COVID-19 era. It is highly suggested that proper interventions such as university support group online gathering, interactive online learning and gamification, and promotion of online counselling be administered in order to preserve good mental health of medical students during this pandemi

Physical health of preclinical medical students during covid-19

Due to the COVID-19 pandemic, several preventive measures have been put in place including movement restriction and closure of non-essential services in Malaysia including educational premises and shifting towards online learning. Physical inactivity may impact medical students’ quality of life, particularly their physical and mental health, as both are especially influenced by doing physical activity. This study aimed to assess the physical health of medical students during the pandemic. This study has been approved by the institutional research committee (Research ID: 735). All Year 1 and Year 2 International Islamic University Malaysia (IIUM) medical students were invited to participate in this cross-sectional study. Participants were asked to complete an online, self-administered abbreviated World Health Organisation Quality of Life (WHOQOL-BREF) questionnaire from July until August 2021. Data were analysed using IBM SPSS Statistics 26 (IBM, New York). We received 158 responses, consisting of 77 Year 1 and 81 Year 2 students. All participants were undertaking online remote learning at the time of study. The mean score for overall quality of life was 14.58 (3.23) whereas the physical health domain mean score was 14.18 (2.48). We found that the requirement for medical treatment scored the highest 17.70 (3.42) whereas work capacity scored the lowest 12.25 (3.95). There was no significant difference in the scores between 14.50 (2.56) and 13.87 (2.37) for Year 1 and Year 2 students in the individual items (p=0.107- 0.862). We concluded that despite the nationwide lockdown, the medical students in IIUM reported acceptable-good quality of life and physical health. This could be due to their adaptation to the new norms by applying the right coping strategy. Future study to re-assess their quality of life is due should the lockdown are further extended or tightened

Association of barriers of learning during COVID-19 pandemic with mental health

On March 11, 2020, World Health Organization (WHO) declared that COVID-19 has become a pandemic. Therefore, online learning (OL) has replaced face-to-face teaching and learning sessions in many schools and colleges. This has forced the students to adapt to a new environment and overcome some barriers during the OL. However, the increase in suicidal rate among students is a disturbing phenomenon due to mental vulnerability experienced during the current worldwide situation. This study was done to investigate the association between barriers of learning during Covid-19 with mental well-being among International Islamic University Malaysia (IIUM) pre-clinical medical students. A cross-sectional study was conducted among the Year 1 (n=77) and Year 2 (n=81) medical students of IIUM, from July until August 2021. They were recruited to answer self-administered online questionnaires based on 5 remote learning barriers (inadequate interaction with classmates and teachers, lack of peer support and confidence to handle online tasks, and difficulty in applying taught concepts). The survey includes Generalised Anxiety Disorder (GAD-5) and Well Being Index (WHO5) to assess mental well-being and was approved by the institutional ethical committee (Research ID: 735). The results were analysed using IBM SPSS Statistics 26 (IBM, New York). The prevalence of depression and anxiety among medical students were 27.8% and 86.7% respectively. More than half of the respondents agreed with all learning barriers listed. However, the difficulty in applying taught concepts is the only significant barrier associated with depression (p<0.05). In conclusion, although only one item was identified as significant, it was an undeniable factor. Corrective measures must be taken to minimize it as continuous exposure may deteriorate mental health among medical students. Careful evaluation is required in order to ensure the quality of education remains upheld to its highest standards without jeopardizing the students’ psychological well-being

Perceptions of the online learning experience among medical students during COVID-19

Social gatherings have been limited during the COVID 19 pandemic to reduce the transmission of viruses. Many academic institutions have shifted their classes from traditional methods into online remote teaching and learning sessions. Since neither the students nor lecturers were familiar with this setting, the delivery of medical education has undoubtedly impacted as the lectures, clinical placements and key examinations were discontinued. Many adjustments need to be made in order to make sure that the online teaching is held properly. This study was conducted to investigate the perceptions of online learning experience among medical students during the pandemic. An online survey was distributed to 158 medical students from Year 1 and Year 2 of International Islamic University Malaysia (IIUM) from July 2021 till August 2021. The Learning Community Scale and Student Support Scale based on Course Experience Questionnaire (CEQ) were applied to measure the participants' perceptions. The data were analysed using Statistical Package for the Social Sciences (SPSS) version 26. Based on the Learning Community scale, higher response values signified better feelings towards the learning community. The average scores of all five questions were high level (3.68-4.36 on 5-Likert scale), suggesting that the participants were feeling well towards their learning community. Likewise, higher response values in the Student Support scale indicated that better student support is perceived. The average scores of all five questions were also high (3.11-4.31 on 5-Likert scale), indicating that the respondents perceived an adequate amount of student support. In conclusion, the study conjectured positive perceptions towards their learning experience during COVID-19 pandemic among the students despite the sudden shift from physical to online teaching and learning sessions. However, broader ethnic groups and larger sample sizes might be useful for more precise and reliable future results

Perceptions of the online learning experience among medical students during covid-19

Social gatherings have been limited during the COVID 19 pandemic to reduce the transmission of viruses. Many academic institutions have shifted their classes from traditional methods into online remote teaching and learning sessions. Since neither the students nor lecturers were familiar with this setting, the delivery of medical education has undoubtedly impacted as the lectures, clinical placements and key examinations were discontinued. Many adjustments need to be made in order to make sure that the online teaching is held properly. This study was conducted to investigate the perceptions of online learning experience among medical students during the pandemic. An online survey was distributed to 158 medical students from Year 1 and Year 2 of International Islamic University Malaysia (IIUM) from July 2021 till August 2021. The Learning Community Scale and Student Support Scale based on Course Experience Questionnaire (CEQ) were applied to measure the participants' perceptions. The data were analysed using Statistical Package for the Social Sciences (SPSS) version 26. Based on the Learning Community scale, higher response values signified better feelings towards the learning community. The average scores of all five questions were high level (3.68-4.36 on 5-Likert scale), suggesting that the participants were feeling well towards their learning community. Likewise, higher response values in the Student Support scale indicated that better student support is perceived. The average scores of all five questions were also high (3.11-4.31 on 5-Likert scale), indicating that the respondents perceived an adequate amount of student support. In conclusion, the study conjectured positive perceptions towards their learning experience during COVID-19 pandemic among the students despite the sudden shift from physical to online teaching and learning sessions. However, broader ethnic groups and larger sample sizes might be useful for more precise and reliable future results