Dengue remains a public health threat that consumes a significant number of resources for its prevention and control. This systematic review aimed to solidify recent costing evidence in dengue management among South East Asian (SEA) countries. All studies conducted between 2010 and 2020 were retrieved using four international databases i.e. PubMed, Scopus, Web of Science, and Emerald Insight. The review was reported according to PRISMA guidelines. Quality assessments were done independently by two reviewers using a checklist adapted for the cost of illness studies. We identified 13 original articles representing several SEA countries. Among the common reported costing measure include total cost/ health expenditure; direct medical cost; direct non-medical cost; and indirect cost. The estimated total cost for dengue management varied between countries largely due to the difference in the total incidence of dengue cases. The estimated cost spent on dengue per capita GDP ranges from less than 0.001% to 0.1%, depending on the recorded number of dengue cases of the year. The majority of the articles focused on the economic burden from the perspective of treatment such as hospitalization and ambulatory care. In a nutshell, the economic burden of managing dengue infection is costly and the evidence suggests a steady increase in health expenditure with the growing number of dengue cases

Socio-Ecological Framework on Risk of Prolonged Dengue Outbreak in Seremban District: A Qualitative Study IntroductionA prolonged duration of a dengue outbreak in a locality poses a detrimental risk to the susceptible population. There have been limited studies looking into the socio-ecological factors that can be modified to break the chain of transmission. Therefore, this study aimed to explore and identify the socio-ecological attributes experienced by the health authority in the Seremban district.MethodsA qualitative study was performed using an in-depth interview (IDI) technique based on semi-structured questionnaires. Results were thematically analysed when theoretical saturation was achieved.ResultsA total of 12 respondents participated in this study, representing various backgrounds and involved in dengue control activities. There were nine modifiable socio-ecological themes generated, namely (1) illegal dumpsite, (2) illegal gardens, (3) illegal man-made structures, (4) old unused items, (5) idle damaged vehicles, (6) construction site, (7) drainage system, (8) physical structure, and (9) lack of community engagement. A model framework was conceptualised from the analysis. The health authority identified that these issues require urgent attention and collaborative action by various stakeholders.ConclusionThe identified socio-ecological factors have been a challenge for the health authority. Nevertheless, identifying these attributes signifies the key to tackling the prolonged duration of the dengue outbreak. Ultimately, a multi-agency approach and community participation are vital to ensure a sustainable vector control program.

Breastfeeding Under Siege: A Scoping Review of Flood Impacts on Lactating Mothers Introduction Floods, as one of the most frequent and devastating natural disasters, create unique challenges for breastfeeding mothers. However, there is limited understanding of the multifaceted impacts of floods on breastfeeding practices. This review aims to examine the impact of floods on breastfeeding mothers and aims to guide disaster response strategies to support maternal and infant health. Methods A scoping review was conducted using the Arksey and O'Malley framework and the PRISMA-ScR methodology. A systematic search of PubMed, Web of Science, and Scopus databases identified eight studies that met predefined inclusion criteria. Eligibility criteria encompassed peer-reviewed articles with quantitative, qualitative, or mixed methods designs. Studies were included if they focused on breastfeeding mothers affected by floods. Results Eight studies from diverse geographic regions reported significant impacts on breastfeeding practices, including environmental hazard, sociocultural, malnutrition and psychosocial impacts dimensions. Displacement and lack of privacy (e.g., overcrowded shelters, absence of breastfeeding-friendly spaces) disrupted feeding routines. Additionally, maternal malnutrition, stress, and unregulated distribution of formula milk further undermined breastfeeding efforts. Conclusions Flood disasters pose significant challenges in terms of environmental hazard, sociocultural, malnutrition and psychosocial impacts on breastfeeding mothers, jeopardizing maternal and infant well-being. Addressing these issues requires integrated disaster response strategies, including breastfeeding-friendly facilities, nutritional aid, and mental health support. These findings underscore the importance of prioritizing breastfeeding in disaster preparedness and response plans to enhance resilience and reduceinfant mortality during crises.

Introduction: The term "urban heat island" refers to a phenomenon that occurs when temperatures in urban areas are higher than those in the areas that surround them (suburban area). Methods: The urban heat island phenomenon can result in increase of energy consumption, increase of air pollution, decrease of water quality, and increase of greenhouse gas emissions, all of which have the potential to negatively impact people in a variety of ways. Results: In this review we identified certain groups such as elderly, children, woman, pregnant woman, single person, and minority communities, who are living in dense area or in high rise building, low education level, low income, work in outdoor environment and had pre-existing illnesses may face health issues or insufficient resources to cope with the heat in urban area. There were more susceptible to heat-related illnesses and mortality, particularly during extreme heat events. Conclusions Recognising these vulnerable populations is crucial to develop effective strategies to mitigate the effects of urban heat islands and protect them. This can aid policy makers and urban planners to implement targeted interventions to address these issues. Keywords Urban heat island – UHI – Vulnerable population – Heat exposure

Pengenalan : Pencemaran sungai di Malaysia pada masa ini berada di tahap yang kritikal dan amat membimbangkan dengan pelbagai masalah pencemaran sungai berlaku hampir setiap hari. Tahap pengetahuan, sikap dan tingkah laku individu memberikan impak yang besar terhadap isu pencemaran sungai. Oleh itu, kajian ini bertujuan untuk menilai tahap pengetahuan, sikap dan tingkah laku komuniti yang tinggal berhampiran Sungai Klang. Metodologi : Kajian keratan rentas yang menggunakan persampelan rawak mudah telah dilakukan untuk mengkaji tahap pengetahuan, sikap dan tingkah laku komuniti Sungai Klang terhadap pencemaran sungai. Responden kajian terdiri daripada penduduk kawasan setinggan dan penduduk kawasan perumahan biasa yang menetap berhampiran Sungai Klang. Kajian ini telah menggunakan borang soal selidik. Analisis deskriptif dan ujian t telah digunakan untuk menganalisis data. Hasil Kajian : Hasil deskriptif mendapati bahawa tahap pengetahuan (min=3.13, s.p.=0.40), sikap (min=3.28, s.p.=0.65) dan tingkah laku (min=2.96, s.p.=0.72) pencemaran sungai bagi penduduk setinggan adalah lebih rendah daripada penduduk perumahan biasa. Ujian t juga menunjukkan perbezaan yang signifikan (p<0.05) untuk tahap pengetahuan, sikap dan tingkah laku antara penduduk setinggan dan penduduk perumahan biasa. Rumusan Kesimpulannya, tahap pengetahuan, sikap dan tingkah laku pencemaran sungai komuniti Sungai Klang berada di tahap yang tidak memuaskan. Oleh yang demikian, tindakan perlulah diambil oleh pihak yang berkaitan untuk memantapkan lagi tahap pengetahuan, sikap dan tingkah laku penduduk berkaitan pencemaran sungai agar isu pencemaran sungai ini dapat diatasi.

Introduction: The construction workers are performing manual tasks in harsh conditions. Various environmental risk factors could have significant influence on work fatigue. Methods: This review article discussed the environmental causal factors which involved in work fatigue development in the occupational health perspective, with the aim in enhancing the body of knowledge specifically in the construction industry so that mitigation measures and interventions can be formulated and implemented for fatigue prevention and productivity enhancement. Results: Data derived from a total of 11 relevant articles identified climatic heat, vibration and elevation change as the major risk factors that associated with work fatigue. The mechanism of the environmental factors’ influences on muscle, mental and visual fatigue were understood, pointedly the underlying physiological alteration. Additionally, appropriate preventive measures in accordance to the OSHA guides including work-break cycles, work management, cool-down arrangements with drinking water were discussed. The limitation of existing OSH requirements on work limits at heat exposure was recognized, including the lack of consideration on personal characteristics therefore might inaccurately estimate the personal heat tolerance time. Conclusions The proper understanding of the environmental stressors and its impact on workers production and safety performance may help construction organisations and regulatory body to develop strategies for workers protection and fatigue-related accidents prevention.

Background and aims: Forest bathing or Shinrin-Yoku is a practice of being mindful of nature and it offers multiple health benefits in both physiological and psychological factors. This study aimed to determine the knowledge and attitude of Universiti Kebangsaan Malaysia (UKM) medical students towards forest bathing and its relationship with the sociodemographic factors. Materials and methods: A total of 165 UKM medical students were recruited using proportionate random sampling. The subjects were then categorized based on the academic year (Year 1 - Year 5). Exclusion criteria includes those who deferred their academic year and/or who were hospitalized. A questionnaire was given via a google form consisting of sociodemographic data details and 15 questions for each knowledge and attitude on forest bathing. Results: The prevalence of good knowledge and good attitude of UKM medical students towards forest bathing were 64.2% (n=106) and 50.9% (n=84) respectively. Female medical students had a good knowledge (n=63, 73.3%) and good attitude (n=52, 60.5%) compared to male medical students' knowledge (n=43, 54.4%) and attitude (n=32, 10.5%) leading to a p-value of 0.012 and p-value of 0.010. Otherwise, other sociodemographic factors including race, level of medical year and level of lifestyle did not affect participants' knowledge and attitude on forest bathing. Conclusion Majority of UKM medical students have a higher prevalence of good knowledge compared to good attitude on forest bathing. Therefore, intervention is recommended especially towards male medical students as forest bathing has enough evidence as preventive medicine.

Introduction: The transboundary smoke haze has become a major concern as it had a wide ranging impact in Southeast Asia from the aspect of public health to national economics. This review aims to synthesize available literature in epidemiology, economics and haze related studies to provide essential information for the valuation of health costs associated with haze in Malaysia. Methods: Evidence on health economic impact of haze was gathered by conducting a literature review and collecting information on the health effects of haze and the cost of it as well as the hospitalization cost from medical illnesses and hospital admissions due to haze. Articles were taken from those that were published from 1999 to 2016.Results: The 1997 Asian Haze episode has caused increasing trend of prematurity of mortality and respiratory problems and several series of haze later had caused increased number of hospitalization. The cost impact on hospital admission ranges from MYR1.8 million in 2005 to MYR118.9 million in 2013. During the 1997 haze, the incremental cost of illness (COI) was noted to be MYR 21million and it shot up to MYR 410 million during the 2013 haze. Conclusion: The haze gives a serious health effect to our country and our neighbours. These health effect has caused a significant health economy impact which include rise in hospital admission cost and medication, incremental cost of illness and extend to cost of medical-related leaves taken and lead to loss of income opportunities.

Congenital malformations (CM) comprise a wide range of abnormalities of body structure or function that are present at birth and are of prenatal origin. It has contributed to a significant proportion of infant morbidity and mortality. The aims of this study were to determine the extent and investigate the relationship between CM and its associated demographic variables. Data was extracted from Ministry of Health (MOH) database compiled from the reports on Stillbirth & Under 5 Mortality from year 2013 to 2014. Out of 9,827 child death, 2,840 (28.9%) were classified under CM as defined under ICD-10 classification. Majority of those with CMs died at neonatal stage (62.7%) and among mothers aged between 20 to 35 years old (67.3%). The mean age of mothers among CM children was 30.8±6.5 years old. Approximately 5.8%, 6.7% and 3.3 % of total CM were neural tube defects, heart defects and hydrops fetalis respectively. The prevalence of CM in males was 15% higher than females. The difference were evident between CM and age of death of children under 5 years old (p<0.001) as well as between CM and maternal age groups (p<0.001). CM is responsible for 28.9% of total causes of child death with higher occurrence of malformation in males. A significantly higher risk of CMs among mother aged between 20 to 35 years old was observed. This emphasises the importance of raising awareness and the need to strengthen appropriate response for surveillance and prevention program of common CM in Malaysia.

Air pollution has been widely known to have an influence on health of the general population. Air pollution can result from natural causes, human activities and transboundary air pollution. Weather and climate play crucial role in determining the pattern of air quality. In recent years, air pollution and recurrent episodes of haze has become a major concern in Malaysia. Surveillance data on concentrations of main air pollutants such as carbon dioxide, (CO2), Nitrogen Dioxide (NO2), Ozone (O3), sulphur dioxide (SO2) and particulate matter (PM10) were found to be higher during the haze days and this may have an impact on health of the community as reflected by an increase in hospital admissions particularly the respiratory and cardiovascular diseases.