Objective: Various public health and social measures have been used during the COVID-19 outbreak, including lockdowns, contact-tracing, isolation and quarantine. The objective of this manuscript is to describe outbreaks of COVID-19 in Selangor, Malaysia, the public health strategies used and the observed impact of the measures on the epidemic curve. Methods: Information on all confirmed COVID-19 cases in Selangor between 25 January and 28 April 2020 was obtained. Clusters were identified, and cases were disaggregated into linked, unlinked and imported cases. Epidemic curves were constructed, and the timing of movement control orders was compared with the numbers of cases reported. Results: During the study period, 1395 confirmed COVID-19 cases were reported to the Selangor Health Department, of which 15.8% were imported, 79.5% were linked and 4.7% were unlinked cases. For two main clusters, the number of cases decreased after control measures were instituted, by contact-tracing followed by isolation and home quarantine for the first cluster (n = 126), and with the addition of the movement control order for the second, much larger cluster (n = 559). Discussion: The findings suggest that appropriate, timely public health interventions and movement control measures have a synergistic effect on controlling COVID-19 outbreaks.

Introduction: The rising prevalence of human immunodeficiency virus (HIV) among people who inject drugs is a major public health issue. This study intends to explore education and demographic correlates of use of condoms among male drug users in Malaysia. Methods: Data were extracted from the Integrated Biological and Behavioral Surveillance Survey 2017. Pearson’s chi-square tests and a logistic regression were used to examine the associations between condom use and education, and demographic factors. Results: Only a small proportion of drug users used condoms (25.7%). Educational backgrounds, age, ethnicity and marital status were associated with condom use. The likelihood of using condoms was lower among less educated drug users (aOR: 0.308–0.339). There was an interaction effect of education and age on condom use (aOR: 0.116–0.308). Chinese (aOR: 3.117) and those of other ethnicities (aOR: 2.934) were more likely to use condoms when compared with Malays. Being married (aOR: 0.291) or divorced/widowed (aOR: 0.346) was associated with reduced odds of using condoms. Conclusion: Education and demographic factors play an important role in influencing the decisions of Malaysian drug users to use condoms. Therefore, HIV-preventive measures targeting drug users could benefit by paying special attention to these factors.

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. Methods: 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.