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.