Gema Ekologi: Meneroka Interaksi Antara Persekitaran Hutan dan Vektor Malaria Pendahuluan Malaria kekal sebagai salah satu cabaran kesihatan awam yang penting di seluruh dunia, dengan kemajuan telah terbantut dalam kebelakangan ini. Memandangkan peningkatan kes malaria terutamanya di beberapa kawasan tropika, pemahaman yang lebih baik tentang hubungan ekologi yang mendasari penularan vektor malaria perlu diberikan fokus. Pendekatan pelbagai disiplin yang melibatkan ekologi, entomologi dan kesihatan awam adalah diperlukanuntuk memahami kaitan antara malaria dan habitat persekitaran. Ulasan ini bertujuan untuk mensintesis penyelidikan sedia ada tentang bagaimana ekosistem hutan mempengaruhi dinamik penularan malaria.MetodologiMenggunakan pangkalandata PubMed, Google Scholar dan Scopus, kajian literatur komprehensif telah dijalankan menggunakan kata kunci tertentu. Artikel yang berkaitan telah dinilai untuk aliran tematik. Secara keseluruhan, 42 artikel telah dipilih untuk naratif ini.Hasil Iklim mikro hutan mempengaruhi kecergasan, tingkah laku, corak aktiviti dan fisiologi organisma. Relung biologiberbeza yang disebabkanoleh suhu, kelembapan, pendedahan cahaya dan kerpasan boleh memberi kesan kepada populasi nyamuk. Ciri-ciri fiziko-biokimia badan air, termasuk suhu, pH, jumlah pepejal terlarut (TDS), kandungan nitrat, dan paras oksigen terlarut, mempunyai kesan yang ketara ke atas banyaknya larva nyamuk anopheline. Kelimpahan vektor mungkin dipengaruhi oleh kehadiran perumah dan pemangsa semulajadi. Interaksi rumit geografi, tumbuh-tumbuhan hutan, kepadatan vektor malaria, dan tingkah laku mempunyai pengaruh besar ke atas dinamik penularan malaria. Penebangan hutan mengubah landskap dan ekosistem serpihan, yang mempunyai kesan besar ke atas habitat larva vektor Plasmodium. Perubahan iklim menimbulkan ancaman besar kepada kelimpahan vektor malaria dan dinamik penghantaran.KesimpulanTerdapat banyak aspek kepada interaksi kompleks antara persekitaran hutan dan penyebaran malaria,memerlukan pengetahuan yang mendalam dan lebih banyak penyiasatan. Kerjasama antara ahli ekologi, entomologi dan pakar kesihatan awam adalah penting dalam menghasilkan model komprehensif yang meramalkan risiko malaria dengan tepat dalam persekitaran yang berubah-ubah

Introduction: The consumption of sugar-sweetened beverages (SSBs) among young adults in Malaysia has witnessed a notable increase in recent years, giving rise to concerns regarding the potential adverse health effects, including obesity and diabetes. Despite the urgent need for targeted interventions, there is a dearth of research examining the knowledge, attitudes, and practices (KAP) related to SSBs among Malaysian young adults. To address this research gap, the present study aims to assess the level of KAP concerning SSB intake and its associated factors in this specific population. Methods: A cross-sectional study was conducted involving 408 Malaysian young adults aged between 15 and 29 years. Respondents completed an online questionnaire survey, which encompassed the assessment of socio-demographic characteristics and KAP regarding SSB consumption. The collected data were analyzed using IBM’s Statistical Package for the Social Sciences (SPSS) version 22.0. Spearman correlation tests were performed at a significance level of 0.05. Results: The majority of respondents demonstrated moderate knowledge (60%) and practices (60%), while exhibiting a high positive attitude (100%) towards reducing SSB consumption. Significant correlations were observed between knowledge and attitude (p = 0.003, rs = 0.148) and between knowledge and practice (p = 0.005, rs = 0.138). Moreover, the attitude scores were found to be significantly associated with gender (χ2 (1, N = 408) = 10.421, p = 0.001) and locality (χ2 (1, N = 408) = 4.106, p = 0.043), while the practice scores exhibited a significant association with ethnicity (p = 0.006). Conclusion: This study provides valuable insights into the relationship between KAP related to SSB consumption and socio-demographic factors among Malaysian young adults. The findings underscore the importance of utilizing these insights to develop strategic interventions that aim to curtail SSB consumption and promote a healthy lifestyle, ultimately contributing to the reduction of non-communicable diseases. Health authorities are encouraged to capitalize on these findings to design targeted interventions tailored to the unique needs and circumstances of this population.

METABOLIC ASSOCIATED FATTY LIVER DISEASE (MAFLD): ASSESSING THE KNOWLEDGE AND PRACTICE OF PRIMARY CARE DOCTORS IN SEREMBAN DISTRICT, NEGERI SEMBILAN Introduction: Metabolic-associated fatty liver disease (MAFLD) is the liver manifestation of metabolic syndrome, which is commonly seen in primary care settings. This study aimed to determine the knowledge and practice of primary care physicians regarding MAFLD in Seremban District, Negeri Sembilan. Methods: This cross-sectional study was conducted among medical officers in 14 health clinics in Seremban District, using a validated, self-administered online questionnaire. Results: A total of 240 medical officers from 14 health clinics in Seremban District, participated in this study. Most participants (85.4%) passed the knowledge test. Their practice was acceptable, but only a minority were familiar with non-invasive testing of liver fibrosis (e.g. APRI or FIB-4), medication and specific diet for the treatment of MAFLD. Conclusion: Most primary care physicians in Seremban District are knowledgeable in identifying risk factors and managing patients with MAFLD. However, there are still areas to improve in terms of management, particularly regarding the use of silymarin, vitamin E and pioglitazone.

REPLY TO: OFF-LABEL USE OF REPURPOSED IVERMECTIN FOR SARS-COV-2 INFECTION SHOULD BE BANNED BY AUTHORITIES UNLESS EFFICACY IS PROVEN ank you for the opportunity to address the concerns raised regarding our recent publication titled ‘Knowledge, attitude and prevalence of ivermectin use as coronavirus disease treatment: A cross-sectional study among a Malaysian population’.1,2 We appreciate the critical evaluation of our study design. Indeed, while electronic questionnaires oer convenience, we acknowledge their limitations, including the potential for inaccurate reporting and diculty in conrming the identity of respondents. However, they also oer advantages such as ease of data collection and the potential for anonymity, which can encourage more candid responses. While electronic surveys have inherent limitations, they are costeective and facilitate easy data collection, particularly during the COVID-19 pandemic, when the data were collected and when in-person interactions were limited. Rigorous validation processes can help ensure the reliability of collected data. We agree that future research could benet from a more robust methodology, such as employing a multicentre design to enhance the representativeness of the sample.

KNOWLEDGE, ATTITUDE AND PREVALENCE OF IVERMECTIN USE AS CORONAVIRUS DISEASE TREATMENT: A CROSS-SECTIONAL STUDY AMONG A MALAYSIAN POPULATION Introduction: During the coronavirus disease (COVID-19) pandemic, there was a widespread public misconception regarding ivermectin use in managing the disease. There is no approval of ivermectin as COVID-19 treatment by the Food and Drug Administration, and the adverse effects of the drug are alarming. This study aimed to evaluate the knowledge and attitude towards and prevalence of ivermectin use as COVID-19 treatment among the Malaysian population. Methods: This cross-sectional study was conducted among 391 Malaysians aged ≥18 years. A validated online self-administered questionnaire disseminated via Google Forms was used to evaluate the knowledge and attitude towards and prevalence of ivermectin use as COVID-19 treatment. The socio-demographic characteristics and knowledge and attitude towards and prevalence of ivermectin use among the respondents were evaluated through descriptive analysis. The chi-square test was used to identify the association between the variables. Results: The respondents had moderate levels of knowledge and attitude towards ivermectin use, while the prevalence of ivermectin use was 3.58%. The respondents’ sex (P=0.014), age (P=0.012) and monthly income (P=0.049) were significantly associated with their level of knowledge. The respondents’ sex (P=0.04) was significantly associated with their level of attitude. Conversely, no socio-demographic characteristics were significantly associated with the prevalence of ivermectin useas COVID-19 treatment. Conclusion: The majority of Malaysians have moderate levels of knowledge and attitude towards ivermectin use as COVID-19 treatment, with a low prevalence of actual use.

The important role of non-dental healthcare professionals (HCPs) in promoting oral health is well-accepted and has received increased attention in recent years. However, greater efforts are needed to train them in ensuring better competency in delivering this role. The aim of the present study is to assess oral health and care knowledge among HCPs by further exploring possible challenges faced by them in managing oral health problems, particularly in regard to patients in a public primary healthcare clinic. In the case of the current research, a focus group discussion was carried out with ten HCPs who are directly involved with patients from different units within the health clinics. In particular, the questions developed for the focus group discussion were divided into two parts: (1) knowledge on oral health and its link to general health, and (2) issues and challenges faced by HCPs in handling patients with oral health problems in their daily routine. The session was recorded on a digital audio tape, the responses were then transcribed, followed by the grouping of the scripts which were then qualitatively analysed. The results revealed that majority of the participants appeared to have good knowledge of general and basic oral health; however, only very few of them were aware of the relationship between oral health problems with systemic conditions. Meanwhile, one of the main challenges faced by HCPs in handling patients with oral health problems is their limited knowledge of oral health problems. Specifically, the main challenges refer to the management of medically compromised patient requiring dental treatment as well as the difficulty in changing the mindset of patients regarding oral health issues, especially in terms of seeking dental treatment. In conclusion, it has been clearly observed that HCPs involved in the present study have good knowledge of general health and oral health but limited knowledge related to oral health to systemic health. Furthermore, they tend to face numerous challenges when dealing with patients, especially due to their limited knowledge of oral health facts and drug prescription for oral problems. Therefore, there is an urgent need of additional training for both HCPs and dental teams for the purpose of enabling both parties to provide coordinated and comprehensive service to patients with oral health problems at the primary healthcare clinics.