Dengue early warning system, based on many different factors including climatic factors, is likely to be a useful tool for predicting dengue cases. This study aims to assess the perceptions, attitudes, and responses to dengue early warning among a sample of residents in Kuala Lumpur, Malaysia as well as the factors associated with their willingness in participating dengue prevention public activity. A community-based cross-sectional study was conducted among residents of Titiwangsa District, Kuala Lumpur. A structured questionnaire was administered via face-to-face interview. About 75% of the respondents perceived dengue early warning as a useful tool for the community to take preventive measures. However, more than half did not know elevated temperature increases dengue cases. More than 80% wanted to know more how climate can be used to predict dengue outbreak. Willingness of participating in dengue control public activity was associated with age (p<0.001), educational level (p=0.005), perception (p<0.001), and attitude (p<0.001). Perception towards dengue early warning was positive among the urban residents. Majority of the participants reported good attitude with regard to dengue early warning while a minority demonstrated a poor response. Educational level, perception, and attitude are significantly associated with willingness to engage in dengue prevention public activity.

INTRODUCTIONThe elderly are often underrepresented in clinical trials for acute coronary syndrome (ACS), and cardiologists commonly face management dilemmas in the choice of treatment for this group of patients, particularly concerning the use of invasive revascularisation. This study analysed the characteristics of hospitalised elderly patients with ACS, and compared the outcomes of treatments.

METHODSFrom 29 December 2005 to 26 April 2010, 13,545 patients were admitted for ACS in 16 hospitals across Malaysia. These patients were divided into two groups - elderly (≥ 65 years) and non-elderly (< 65 years). The clinical characteristics, treatment received (invasive or non-invasive) and outcomes (in-hospital and 30-day all-cause mortality) of the two groups were compared. The elderly patients were then grouped according to the type of treatment received, and the outcomes of the two subgroups were compared.

RESULTSElderly patients had a higher cardiovascular risk burden and a higher incidence of comorbidities. They were less likely to receive urgent revascularisation for acute ST-segment elevation myocardial infarction (elderly: 73.9% vs. non-elderly: 81.4%) and had longer door-to-needle time (elderly: 60 minutes vs. non-elderly: 50 minutes, p = 0.004). The rate of cardiac catheterisation was significantly lower in the elderly group across all ACS strata. Elderly patients had poorer outcomes than non-elderly patients, but those who received invasive treatment appeared to have better outcomes than those who received non-invasive treatment.

CONCLUSIONElderly patients with ACS tend to be undertreated, both invasively and pharmacologically. Invasive treatment seems to yield better outcomes for this group of patients.

Acute Coronary Syndrome ; epidemiology ; Age Factors ; Aged ; Cardiovascular Diseases ; epidemiology ; Databases, Factual ; Female ; Humans ; Malaysia ; epidemiology ; Male ; Middle Aged ; Morbidity ; trends ; Registries ; Survival Rate ; trends