The changing incidence of dengue fever in Hulu Langat, Selangor: a 5-year registry-based analysis

INTRODUCTION: Dengue fever, a mosquito-borne disease that occurs in tropical and subtropical areas of the world, is a significant threat for the mankind in both developing and developed countries. Dengue virus infection is a systemic disease and has dynamic change in clinical phase. This research aimed to study the epidemiology of dengue with reference to demographic profile, circulating serotypes and complications. METHOD: A literature survey was conducted and demographic data between 2014 and 2018 in e-Dengue registry were analysed to describe the epidemiology of dengue cases in Hulu Langat. RESULTS: The highest incidence rate, 254.3 per 100,000 population was recorded in 2015 (n=14,939). Urban subdistricts (88.3%), male (57%), Malay (61.5%), age group 18-40 years old (51%) and landed house (61%) contributed most of the cases. Case-fatality rate increased from 2014 to 2017 (0.0018 to 0.0022) but decreased in 2018 (0.0014). Out of 114 mortality, majority were male (53%), age 18-40 years old (46%) and Malay (63%). Complications recorded were liver failure (60%), renal failure (51%), encephalitis (18%) and myocarditis (18%). In year 2014-2015, DEN-1 serotype was dominantly reported (52.2% and 56.5%), shifted to DEN-3 in year 2016-2017 (34.8% and 43.4%) and DEN-2 in year 2018 (49.5%). DISCUSSION: Hulu Langat, being hyperendemic, the occurrence of multiple organ involvement following dengue infections has become a frequent finding. The study emphasizes the need of epidemiological and entomological surveillance to monitor trends in dengue distribution, seasonal patterns and circulating serotypes to guide dengue control activities, especially in rapidly growing urban and suburban areas

The changing incidence of dengue fever in Hulu Langat, Selangor: a 5-year registry-based analysis

INTRODUCTION: Dengue fever, a mosquito-borne disease that occurs in tropical and subtropical areas of the world, is a significant threat for the mankind in both developing and developed countries. Dengue virus infection is a systemic disease and has dynamic change in clinical phase. This research aimed to study the epidemiology of dengue with reference to demographic profile, circulating serotypes and complications. METHODS: A literature survey was conducted and demographic data between 2014 and 2018 in e-Dengue registry were analysed to describe the epidemiology of dengue cases in Hulu Langat. RESULTS: The highest incidence rate, 254.3 per 100,000 populations was recorded in 2015 (n=14,939). Urban sub-districts (88.3%), male (57%), Malay (61.5%), age group 18-40 years old (51%) and landed house (61%) contributed most of the cases. Case-fatality rate increased from 2014 to 2017 (0.0018 to 0.0022) but decreased in 2018 (0.0014). Out of 114 mortalities, majority were male (53%), age 18-40 years old (46%) and Malay (63%). Complications recorded were liver failure (60%), renal failure (51%), encephalitis (18%) and myocarditis (18%). In year 2014- 2015, DEN-1 serotype was dominantly reported (52.2% and 56.5%), shifted to DEN-3 in year 2016-2017 (34.8% and 43.4%) and DEN-2 in year 2018 (49.5%). DISCUSSION: Hulu Langat, being hyperendemic, the occurrence of multiple organ involvement following dengue infections has become a frequent finding. The study emphasizes the need of epidemiological and entomological surveillance to monitor trends in dengue distribution, seasonal patterns and circulating serotypes to guide dengue control activities, especially in rapidly growing urban and suburban areas

Effectiveness of community health workers involvement in smoking cessation programme: a systematic review

Background: Sustainable Development Goals (SDG) has set the target to reduce premature mortalities from non-communicable diseases (NCDs) by one-third. One of the ways to achieve this is through strengthening the countries’ implementation of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). Community health workers (CHWs) involvement has shown promising results in the prevention of NCDs. This systematic review is aimed at critically evaluating the available evidence on the effectiveness of involving CHWs in smoking cessation. Materials and methods: We systemically searched PubMed and CENTRAL up to September 2019. We searched for published interventional studies on smoking cessation interventions using the usual care that complemented with CHWs as compared to the usual or standard care alone. Our primary outcome was abstinence of smoking. Two reviewers independently extracted data and assessed study risks of bias. Result: We identified 2794 articles, of which only five studies were included. A total of 3513 smokers with 41 CHWs were included in the studies. The intervention duration range from 6 weeks to 30 months. The studies used behavioral intervention or a combination of behavioral intervention and pharmacological treatment. Overall, the smoking cessation intervention that incorporated involvement of CHWs had higher smoking cessation rates [OR 1.95, 95% CI (1.35, 2.83)]. Significant smoking cessation rates were seen in two studies. Conclusion: Higher smoking cessation rates were seen in the interventions that combined the usual care with interventions by CHWs as compared to the usual care alone. However, there were insufficient studies to prove the effectiveness. In addition, there was high heterogeneity in terms of interventions and participants in the current studies

Urbanisation effect on dengue cases in Hulu Langat, Selangor (2014-2018)

INTRODUCTION: The frequency and magnitude of epidemic disease continued to increase in tandem with rapid urbanization. Mosquitoes carrying the dengue virus can increase following unplanned and unhealthy urbanization. In the large urban regions, crowded human populations live in intimate association with equally large mosquito populations provides the ideal home for maintenance of the viruses and the periodic generation of epidemic strains. METHOD: Data from e-Dengue registry including the urban sub-districts, between 2014 to 2018 were reviewed. Descriptive analysis was conducted to examine the epidemiology of Dengue fever in the urban regions of Hulu Langat district, Selangor which consist of Kajang, Cheras and Ampang sub-districts. RESULTS: Total incidence rate of Dengue in urban sub-districts in year 2014 was 1,060 per 100,000 populations (n=10,254) while in year 2018 the incidence decreased to 691 per 100,000 populations (n=6,762). Most of the cases were contributed by sub-district Kajang (43%) and Ampang (23%). Meanwhile the cases were most recorded from premises of landed houses (61%) and strata (21.1%). Case-fatality rate was increasing in trend from year 2014 to 2017 (0.18% to 0.22%) however noted to decrease in 2018 with 0.15%. Most of the death were from Kajang sub-district (37%),followed by Ampang (36%). DISCUSSION: Dense population in urban regions contributed to Dengue hyperendemicity in Hulu Langat. Orchestrated holistic approach in controlling Dengue outbreak in urban regions must be conducted wisely

Urbanisation effect on dengue cases in Hulu Langat, Selangor (2014-2018)

INTRODUCTION: The frequency and magnitude of epidemic disease continued to increase in tandem with rapid urbanisation. Mosquitoes carrying the dengue virus can increase following unplanned and unhealthy urbanisation. In the large urban regions, crowded human populations live in intimate association with equally large mosquito populations provides the ideal home for maintenance of the viruses and the periodic generation of epidemic strains. METHODS: Data from e-Dengue registry including the urban sub-districts, between 2014 to 2018 were reviewed. Descriptive analysis was conducted to examine the epidemiology of Dengue fever in the urban regions of Hulu Langat district, Selangor which consist of Kajang, Cheras and Ampang sub-districts. RESULTS: Total incidence rate of Dengue in urban sub-districts in year 2014 was 1,060 per 100,000 populations (n=10,254) while in year 2018 the incidence decreased to 691 per 100,000 populations (n=6,762). Most of the cases were contributed by sub-district Kajang (43%) and Ampang (23%). Meanwhile the cases were mostly recorded from premises of landed houses (61%) and strata (21.1%). Case-fatality rate was increasing in trend from year 2014 to 2017 (0.18% to 0.22%) however noted to decrease in 2018 with 0.15%. Most of the death were from Kajang sub-district (37%), followed by Ampang (36%). DISCUSSION: Dense population in urban regions contributed to Dengue hyperendemicity in Hulu Langat. Orchestrated holistic approach in controlling Dengue outbreak in urban regions must be conducted wisely