​In Malaysia although mortality rate among women of reproductive ages has reduced over the years, the reduction has been stagnant for the past ten years. In order to achieve the 5th Millennium Development Goal, several measures need to be taken including a proper implementation of pre-pregnancy services in this country. This study explores the awareness, intention and usage of pre-pregnancy care (PPC) services and its determinant among women of reproductive ages in Kedah, Malaysia. This is a qualitative study, which consisted of a focus group discussion (FGD) among women in the ages of 18 to 45 years old from all ethnic groups who attended four government clinics in the state of Kedah. The mothers were chosen through purposive sampling from twelve districts that were selected through a multistage random sampling. A semi-structured questionnaire was utilized during the FGD. The results from the FGD were recorded verbatim and thematic analysis was finalized once saturation of information from respondents was achieved. These are two themes was identified, namely personal reasons and reasons of service and there are several subthemes under two main themes. Under the Personal reason themes, the subthemes including awareness and intention to used the services, knowledge, perception, social support and history of medical illness. While under pre-pregnancy care services themes, the subthemes including the promotion of the services, the communication relationship with the health staff, the waiting time and also the accessibility of the service. As a conclusion, there is still part of society who was unaware of pre-pregnancy services and its importance in reducing maternal mortality rate as well as producing good pregnancy outcome. Information and knowledge on pre-pregnancy care services should be disseminated among community members through various means including roadshows and pre wedding workshops.​

Field trials of Wolbachia-transinfected mosquitoes, as a biological approach to curb dengue transmission, have been initiated. This study aimed to determine the knowledge regarding dengue fever (DF), practice of vector control, and acceptance of Wolbachia as a dengue control method among Universiti Kebangsaan Malaysia Medical Centre (UKMMC) healthcare staff. A questionnaire assessing knowledge regarding DF, vector control practices, and acceptance of Wolbachia was conducted among 330 UKMMC healthcare staff via convenience sampling. More than 70% of the respondents had good knowledge regarding DF, good vector control practice, and good acceptance of Wolbachia. Being female and having household income >MYR3000 had higher odds of having good knowledge regarding DF [(aOR 2.40; 95%CI 1.13, 5.12) and (aOR 3.86; 95%CI 1.91, 7.80)]. Having household income >MYR3000 had higher odds of having good vector control practice (aOR 2.33; 95%CI 1.20, 4.54) while academicians were three times (1-0.24) less likely to have good vector control practice than non-academicians (aOR 0.24; 95%CI 0.13, 0.48). Good acceptance of Wolbachia was associated with being academicians (aOR 8.83; 95%CI 2.60, 29.96) and having good knowledge regarding DF (aOR 6.07; 95% CI 2.89, 12.74). Gender, different income level and type of occupation have significant association with either good knowledge regarding DF or practice on vector control. Different type of occupation and level of knowledge also were notably significantly associated with good acceptance on Wolbachia as dengue biological control. These factors may be the focus for future plan to enhance the knowledge, acceptance and practice regarding DF and its control.
Wolbachia ; Dengue, Aedes ; Knowledge ; Practice ; Acceptance ; Questionnaire ; Healthcare staff

Thalassaemia and abnormal haemoglobins are the most common genetic disorder worldwide. School-based screening thalassaemia program for form four students was introduced with the objective to screen for the thalassaemia status. There is paucity in the data in Kedah on distribution of thalassaemia carrier and the associated factors. Hence this study aims to identify the factors associated with being a thalassaemia carrier and to describe the laboratory cost for the thalassaemia screening. This study used secondary data from the school-based thalassaemia screening in 2018 obtained from Kedah State Health Department. Results showed the prevalence of thalassaemia carrier among form four students in Kedah was 10.91%. Multivariate logistic regression showed that students from Baling, Padang Terap and Yan were 1.40, 1.34 and 1.23 times more likely to be a thalassaemia carrier respectively compared to Kota Setar (aOR Baling 1.40;95% CI 1.21,1.64; aOR Padang Terap 1.34;95% CI 1.11,1.61 and aOR Yan 1.23;95% CI 1.03,1.47). Malay and Siamese students were five times more likely be thalassaemia carriers compared to Indian (aOR Malay 5.16;95%CI 3.42,7.79, aOR Siamese 5.63;95%CI 3.19,9.97). Meanwhile, Chinese students had 2.61 higher odds to be a thalassaemia carrier compared to Indian (aOR Chinese 2.61;95%CI 1.65,4.12). The laboratory cost for the thalassaemia screening ranged from RM2.14 to RM142.14 per participant. As for conclusion, this study reported high prevalence (10.91%) of thalassaemia carriers in Kedah. Our study also confirmed that the district and the ethnicity significantly influenced the thalassaemia carrier status. The identified factors should inform future thalassaemia campaign to prevent higher prevalence of thalassaemia patients.