Displaying publications 1 - 20 of 44 in total

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  1. Marzo, Roy Rillera
    MyJurnal
    Medical knowledge, skills, and social requirements for patient care are quickly changing, thus, doctors
    are anticipated to be life-long learners to provide effective care for the patients. This paper addresses
    instructional issues how to prepare medical students to be self-directed learners and how to improve
    medical school and postgraduate training curricula. Now the big question is self-directed learning
    (SDL) an agent in cultivating lifelong learning skills for medical students as claimed by educational
    experts? This will be the focus of my critical reflection on lifelong learning.
  2. Bhattacharya S, Pradhan KB, Bashar MA, Tripathi S, Semwal J, Marzo RR, et al.
    J Family Med Prim Care, 2019 Nov;8(11):3461-3464.
    PMID: 31803636 DOI: 10.4103/jfmpc.jfmpc_155_19
    In this paper, we have described the health care problem (maldistribution of doctors) in India. Later, we have introduced the concept of artificial intelligence and we have described this technology with various examples, how it is rapidly changing the health care scenario across the world. We have also described the various advantages of artificial intelligence technology. At the end of the paper, we have raised some serious concerns regarding complete replacement of human based health care technology with artificial intelligence technology. Lastly, we concluded that we have to use artificial intelligent technology to prevent human sufferings/health care problems with proper caution.
  3. Marzo RR, Bhattacharya S, Ravichandran S, Lakshmanan P, Jeffery VR, Moralitheran P, et al.
    PMID: 32002422 DOI: 10.4103/jehp.jehp_192_19
    INTRODUCTION: Smoking is one of the leading factors of mortality in Malaysia. Most youngsters start at adolescence, fascinated by the concept of smoking. Interventions that harness the broad availability of mobile phones, as well as adolescents' interest in their appearance, may be an innovative way to advance school-based prevention. This study aims to determine the perceptions of facial-aging apps among secondary school students.

    METHODOLOGY: For this research, descriptive cross-sectional study using simple random sampling method was used. Population sampling was targeted toward three government schools. The total number of respondents is 383, with all of them aged between 13 and- 16 years of age. Legal considerations were taken to maintain the confidentiality of respondents. The specific objectives are: 1. To determine the level of change of intention on smoking, 2. To know the perceived reactions of the peer groups on the appearances of students as nonsmokers, 3. To determine whether the students learned new benefits of nonsmokingand, 4. To measure the impact of a facial-aging app among students.

    RESULTS: The number of respondents who smoke was 40 (10.4%), while the number of respondents who do not smoke was 343 (89.6%). About 89% of the respondents agree that their three-dimensional selfie image motivates them not to smoke. In addition, 87.8% of respondents admit that the perceived reactions of their classmates make them think that they look better as nonsmokers. After learning the effects of smoking, about 86.4% of the respondents acknowledged that they would educate their peer groups. Furthermore, 85.9% of the respondents found this "Smokerface" app enjoyable.

    CONCLUSION: The facial-aging intervention was effective in motivating Malaysian pupils to stay away from tobacco use. Thus, the analysis on the study of facial app usage in smoking prevention among youngsters concludes that most of the adolescents concur that the "Smokerface" app helps in the prevention of smoking among youths.

  4. Bhattacharya S, Singh A, Semwal J, Marzo RR, Sharma N, Goyal M, et al.
    PMID: 32154300 DOI: 10.4103/jehp.jehp_423_19
    INTRODUCTION: Disaster can occur at any time any place. Disaster preparedness plays an important role to reduce the loss of a community/country. The aim of this interventional study was to ascertain the impact of a video-based educational intervention program on improvement in knowledge and attitude of paramedical students in a hospital.

    MATERIALS AND METHODS: A pre-post study (interventional study design) was conducted on paramedic students. Our study period was 6 months which was divided into Phases I, II, and III. For administrative purpose, we included all paramedical students, and our sample size was 119. The baseline assessment of knowledge and attitude of paramedic students was done by a pretested questionnaire (Observation 1) with having a baseline scoring. After that, intervention Phase 1 was implemented, and later, end line observation (Observation 2) was made. Changes in knowledge and attitude were observed by the score difference (Observation 2-Observation 1). Descriptive statistics were calculated, and the mean of cumulative score was compared using the Wilcoxon signed-rank test. We applied Mann-Whitney U-test for finding associations between dependent variables with an independent variable using SPSS version 22 (IBM, Chicago, USA) software.

    RESULTS: Our baseline results showed that most of our participants had average knowledge (54.6%), followed by poor knowledge (24.4%). Approximately one-fifth (21.0%) of the participants had good knowledge regarding disaster preparedness. A significant improvement was observed in cumulative score (P < 0.005). A significant difference was observed in knowledge and attitude with respect to age and courses (P < 0.05). Forty percent of the students responded that they would like to get trained by that mock drill, and 26.1% were interested in disaster preparedness workshops in the future.

    CONCLUSION: Our present study results indicate that the overall knowledge and attitude level of the students was average and required improvement. A similar result was reported in some studies conducted globally for the same purpose. All of our students perceived that training for disaster preparedness is necessary for all health facilities, and it is important to have an emergency plan and disaster management committee. Regarding training methods, most of our students liked our interactive audiovisual method. However, their preferred methods were mock drill and workshops. It can be arranged in the future for them.

  5. Marzo RR, Bhattacharya S, Niranjan V, Shagaran K, Mohd Idris MAB, Clement BJ, et al.
    PMID: 32318611 DOI: 10.4103/jehp.jehp_505_19
    INTRODUCTION: In this era of globalization, urbanization, and rapidly expanding unhygienic food corners across the globe, the incidence of food poisoning is very common nowadays.

    AIM: The aim of our study was to investigate the perceptions and readiness of schoolteachers to accept notifications on food poisoning as a part of education to the students.

    METHODOLOGY: A descriptive cross-sectional study was carried out with the help of a validated questionnaire for data collection. Our research involved schoolteachers from both primary and secondary schools in Muar. The questionnaire was pretested among the eligible trainee teachers and yielded an internal consistency reliability coefficient (c = Cronbach's alpha) of 0.082. This study was conducted from October 29, 2017, to December 14, 2018, in Muar. Our sample size was 259. Ethical consent was obtained from the Institution Ethical Committee.

    RESULTS: A total of 259 schoolteachers from both primary and secondary schools in Muar were included in this study. In our study, 81.1% of the teachers responded that they can easily educate their students about food poisoning. Most of them (93.1%) were ready to receive notifications on food poisoning in any mode, and about 72% of the teachers preferred WhatsApp as their mode of receiving notification. The least (1.2%) preferred mode of notification was LINE (a social app). Teachers' willingness to disseminate the information regarding food poisoning was also higher (98.5%).

    CONCLUSIONS: We concluded that majority of the schoolteachers had a good perception and were ready to receive the notifications on food poisoning through WhatsApp as a part of education to the students.

  6. King I, Heidler P, Marzo RR
    Vaccines (Basel), 2021 Jul 15;9(7).
    PMID: 34358206 DOI: 10.3390/vaccines9070790
    Acceptance of the COVID-19 vaccine will play a crucial role in combating the current pandemic. Vaccine rollouts have started in most countries. To reach the desirable vaccine coverage and to enhance its uptake, it is imperative to assess vaccine hesitancy.

    METHODS: To assess the current vaccine acceptability in Austria and its influencing factors, an online survey was created and comprised fifteen questions segmented into a sociodemographic part and the acceptance and influencing factors of the approval of the COVID-19 vaccine.

    RESULTS: In total, 70% of the 1350 respondents thought that the COVID-19 vaccine is an effective way to prevent and control the virus, while 13% disagreed and 17% were uncertain. Further, 71% approved the rapid development and rollout of the vaccine, while 55% were willing to accept the vaccine as soon as it became available, 18% did not want to get the vaccine, 17% wanted to delay, and 10% were already vaccinated.

    CONCLUSIONS: The results show a generally positive attitude towards the new COVID-19 vaccine. The doctor's recommendation greatly influences the decision-making process, and tailored vaccine information can support a higher vaccine coverage.

  7. Pervin MR, Parvin R, Babu MA, Ahmmed MM, Marzo RR
    J Public Health Res, 2021 Nov 08;10(s2).
    PMID: 34751531 DOI: 10.4081/jphr.2021.2271
    BACKGROUND: Bangladesh has been going through the austerity of the unique COVID-19 for more than a year like several other nations in the world in spite of concerted efforts taken by the government along with other concerned authorities who have advocated compulsory guidelines involving social distancing procedures accompanied by lockdown to have control over the pandemic. In this paper, the barriers faced by the government to protect people from the COVID-19 pandemic have been investigated. Also, the number of daily infected people against the number of daily tests has been underlined to comprehend the overall pandemic picture in Bangladesh.

    DESIGN AND METHODS: A descriptive study has been carried out to investigate the obstacles to tackle the COVID-19 pandemic for this country. The intensity of the outbreaks of the pandemic in this country is stated from March 8, 2020, to February 12, 2021. Secondary data have been employed from different sources to serve the goals of the study.

    RESULTS: The poor management in the health sector of Bangladesh has been an issue of major concern during the early stage of COVID-19 which incorporates deficiency of medical equipment, lack of facilities for testing COVID-19, poor patient management, and uncertainty in the medication system. Finally, some recommendations have been proposed for the concerned organizations to tackle the current pandemic and as well in the future.

    CONCLUSIONS: To control this COVID-19 pandemic, it is necessary to find the difficulties and discover the remedies which have been done in this paper for the Bangladesh perspective.

  8. Marzo RR, Aye SS, Naing TW, Mon Kyaw T, Win MT, Kyaw Soe HH, et al.
    J Public Health Res, 2021 Nov 08;10(2 Suppl).
    PMID: 34751532 DOI: 10.4081/jphr.2021.2279
    BACKGROUND: COVID-19 pandemic reached a public health emergency status of international concern. The impacts and events associated with this were associated with adverse psychological impacts among the general public globally. This study aimed to determine the prevalence of psychological distress and to identify predictors associated with psychological distress due to the COVID-19 pandemic among the population in Myanmar.

    DESIGN AND METHODS: A cross-sectional survey was conducted from March to April 2020 among adults, 18 years old and above, who reside in Myanmar through a structured questionnaire distributed in social media platforms. Univariate and Bivariate analyses were used to estimate the prevalence of COVID-19 Peritraumatic Distress Index (CPDI) symptoms and to test the associations between CPDI and the exposure variables. Logistic Regression Analysis was done to identify significant predictors of distress.

    RESULTS: There were 530 participants in this study.37.4% of them did not have psychological distress,55.6% experienced mild to moderate psychological distress, and 7% experienced severe psychological distress due to COVID-19 pandemic. Simple and Multiple Logistic Regression Analyses were performed to determine the factors associated with psychological distress due to COVID-19.

    CONCLUSIONS: It was shown that the self-employed group and age group older than 45 years old had more psychological distress than others. However, Buddhists and people from the capital city had less distress than other religions and districts. This study recommends the government to develop better strategies for self-employed groups, elders, and the poor for a support, relief, and resettlement of their ruined status.

  9. Marzo RR, Bhattacharya S, Ujang NB, Naing TW, Huong Fei AT, Chun CK, et al.
    J Educ Health Promot, 2021;10:160.
    PMID: 34222535 DOI: 10.4103/jehp.jehp_979_20
    BACKGROUND: Patient satisfaction is a comprehensive measurement of patients' happiness with the level of health care delivered to them both inside and outside the physician's office. It is commonly used as an indicator to assess the health-care quality and affects a wide range of components related to the provision of health services such as ease of access, medical malpractice, and clinical outcomes. The study aimed to analyze patients' satisfaction with the quality of health care they received at the outpatient department of Klinik Kesihatan Maharani Muar Healthcare Facility (KMMHF), Johor.

    MATERIALS AND METHODS: This cross-sectional study was conducted between August and December 2019 period. Demographic information and information on patients' feelings about their physicians, treatment, and health facilities provided were collected from 407 consented patients in a simple random sampling survey using a researcher-made, an adapted Medical Interview Satisfaction, questionnaire which was pilot tested before administration to the patients. Data were analyzed with SPSS version 23. Descriptive statistics and correlational and group comparison analyses were utilized.

    RESULTS: Of the 407 patients studied for physician-patient satisfaction, the overall mean of all the respondents responding was 4.089 ± 0.5, which was ranked the highest among the three objectives. The effectiveness of treatment came as the second highest with the overall mean of 4.088 ± 0.5. Finally, the overall health-care facilities had the lowest overall mean of 4.077 ± 0.5 among the three.

    CONCLUSION: Most patients who visited KMMHF were mostly satisfied with the outcomes of physician-patient interaction in the clinic.

  10. Marzo RR, Singh A, Mukti RF
    PMID: 33462563 DOI: 10.1016/j.cegh.2020.100693
    INTRODUCTION: Previous studies conducted on the psychological impact of infectious outbreaks have found heavy psychological burdens among general population with more severe affect in the current pandemic. The main aim of this study is to examine the level of psychological distress during COVID-19 in Bangladesh and explore factors associated with higher psychological distress.

    METHODS: An internet-based, cross-sectional survey was conducted from March to April 2020 in Bangladesh among adults 18 years old and above using structured online questionnaires distributed through emails and other social media throughout Bangladesh with an overall response rate of 34%. Modified version of the Covid19 peritraumatic distress index (CPDI) was used to measure distress. Univariate and Bivariate analysis was used to estimate prevalence of CPDI symptoms and test for the associations between CPDI and the exposure variables. Logistic regression analyses were used to estimate the odds ratios of our outcome variable by exposure variables.

    RESULTS: Overall, 44.3% of respondents were suffering from mild to moderate distress and 9.5% were suffering from severe distress. Female respondents were 2.435 times more likely to suffer from CPDI mild to severe distress than males. As compared to Dhaka and Mymensing region of Bangladesh, odds of distress was 1.945 times more in Chittagong/Sylhet region (p-value = 0.035).

    CONCLUSION: Large proportion of adult population in Bangladesh are experiencing psychological distress, with level of distress varies by different symptoms and predictors. This study suggest the need to develop comprehensive crisis prevention system including epidemiological monitoring, screening, and referral with targeted intervention to reduce psychological distress.

  11. Marzo RR, Ismail Z, Nu Htay MN, Bahari R, Ismail R, Villanueva EQ, et al.
    PMID: 33619459 DOI: 10.1016/j.cegh.2021.100708
    The COVID-19 pandemics caused an unprecedented mortality, distress, and globally poses a challenge to mental resilience. To our knowledge, this is the first study that aimed to investigate the psychological distress among the adult general population across 13 countries. This cross-sectional study was conducted through online survey by recruiting 7091 respondents. Psychological distress was evaluated with COVID-19 Peritraumatic Distress Index (CPDI). The crude prevalence of psychological distress due to COVID-19 is highest in Vietnam, followed by Egypt, and Bangladesh. Through Multivariate Logistic Regression Analysis, the respondents from Vietnam holds the highest level of distress, while the respondents from Sri Lanka holds the lowest level of distress with reference to Nepal.Female respondents had higher odds of having reported psychological distress, and those with tertiary education were less likely to report psychological distress compared to those with lower level of education. The findings indicate that psychological distress is varies across different countries. Therefore, different countries should continue the surveillance on psychological consequences through the COVID-19 pandemic to monitor the burden and to prepare for the targeted mental health support interventions according to the need. The coping strategies and social support should be provided especially to the lower educational attainment group.
  12. Htay MNN, Marzo RR, Bahari R, AlRifai A, Kamberi F, El-Abasiri RA, et al.
    PMID: 33977169 DOI: 10.1016/j.cegh.2021.100759
    BACKGROUND: The coronavirus pandemic (COVID-19) has a social and psychological impact among healthcare workers worldwide and appropriate coping strategies are essential to avoid the negative mental health effects. This study aimed to investigate the coping strategies among the healthcare workers from different countries and their attitude towards teamwork during the COVID-19 pandemic.

    METHODS: A cross-sectional study was conducted by using an online, web-based questionnaire, which was distributed to healthcare workers from 32 countries during April and May 2020. The respondents were recruited by the non-random convenience sampling method.

    RESULTS: A total of 2166 respondents responded to the survey and the majority were working in low- and middle-income countries. Among them, 36% were doctors, 24% were nurses and 40% worked in other healthcare sectors. More than 70% of the respondents answered that "getting family support" and "positive thinking" were coping methods for them during the COVID-19 pandemic. Approximately half of the respondents worshiped according to their belief and conducted prayers (58.4%) and had adequate sleep and food intake (48.2%). The significant associations were observed between attitude score towards interprofessional teamwork and gender (p = 0.009), age (31-45 years) (p 

  13. Kamberi F, Sinaj E, Jaho J, Subashi B, Sinanaj G, Jaupaj K, et al.
    PMID: 34751254 DOI: 10.1016/j.cegh.2021.100824
    BACKGROUND: The COVID-19 pandemic impacted health care workers in many ways including mental health. This impact is usually underestimated in particular in developing countries.

    OBJECTIVES: The study aims to assess the level of anxiety, depression, risk perception, and coping strategies of Albanian healthcare workers during the COVID-19 pandemic and to identify associated factors.

    METHODS: A cross-sectional online study was conducted from April to May 2020 by recruiting health care personnel through the snowballing method. Data collection was carried out through social media using the Generalized Anxiety Disorder (GAD-7) scale and Patient Health Questionnaire (PHQ-9) by Google forms. Participants were recruited from all health care sectors including doctors, nurses, etc. working in both the public and private sectors.

    RESULTS: 410 questionnaires were included in the analysis. Most participants were nurses (59.3%), female (78.5%), and belonged to the age group 26-40 years (46.3%). Mild levels of anxiety were expressed in 26.9% of participants while 7.2% of them expressed moderate levels. 23.1% and 12.1% of participants expressed respectively mild and moderate depression levels. High levels of risk perception were found. A statistical association was found between occupation (p = 0.011), gender (p = 0.031), providing care for COVID-19 patients (p = 0.011), and the availably of mental health support in the workplace. Poor coping strategies were reported among participants.

    CONCLUSIONS: Mental health support should be a priority of the healthcare system in particular for young health care workers caring for COVID-19 patients. It can improve the mental health status of health care workers and their family members, impacting the quality of care provided.

  14. Marzo RR, Vinay V, Bahari R, Chauhan S, Ming DAF, Nelson Fernandez SFA, et al.
    PMID: 34549098 DOI: 10.1016/j.cegh.2021.100868
    INTRODUCTION: The outbreak of coronavirus posits deleterious consequences on global healthcare system while affecting human life in every aspect. Despite several measures undertaken to limit the socio-economic effect of coronavirus, various challenges remain pervasive, and one such challenge is mental health, particularly depression and anxiety. Therefore, this study examines the prevalence and determinants of depression and anxiety in Malaysian population during third wave of COVID-19.

    METHODS: A cross-sectional online survey was carried out via social media platforms and 1544 Malaysians were selected. The level of depression was assessed by Patient Health Questionnaires (PHQ-9) and scored accordingly for categorization. Zung's Self-Rating Anxiety Scale (SAS) was used as a self-assessment survey to quantify the level of anxiety of persons experiencing anxiety-related symptoms. Percentage distribution and logistic regression analysis were used in the data analysis.

    RESULTS: Results showed that one-fourth (25.1%) of the participants had severe depressive symptoms. Almost one-sixth (18.7%) had mild depressive symptoms and one-third (34.1%) had mild to moderate anxiety symptoms. Age, gender, and friends infected with virus were the three important predictors of depression and anxiety. The odds of having depression (OR = 1.44; C·I. = 1.32-1.62) and anxiety (OR = 1.36; C·I. = 1.27-1.47) were significantly higher among females than in males.

    CONCLUSION: A significant proportion of the study participants were facing mild to severe depression and anxiety symptoms which is very alarming as the pandemic is still now increasing across the country. Immediate interventions including community counselling programmes, TV and social media campaigns are urgently needed to reduce the psychological stress among the Malaysian population.

  15. Bhattacharya S, Saleem SM, Singh DK, Marzo RR, Singh A
    PMID: 33688550 DOI: 10.4103/jehp.jehp_280_20
    INTRODUCTION: We know that risk communication is equally important as risk identification, which is usually not communicated properly to the patients and resulting in poor outcomes, especially in hypertensive patients.

    OBJECTIVE: Our study objective was to evolve and test a colour coded client segmentation based public health approach to educate the community to deal with problem of hypertension.

    METHODOLOGY: This cross-sectional pilot study was done in March 2020 among purposively approached in a primary health centre to 100 people aged above 18 years, among them 41 gave written consent for the study and their demographic information was noted. They were given colour coded cards as per the current blood pressure level and previous history of hypertension. On each colour coded card, specific advice was written for that category. For all the participants, blood pressure and treatment seeking behaviour was noted. For hypertensive patients, adherence to medication and non-pharmacological measures was noted.

    RESULTS: Mean age of the participants was 46.5 ± 13.06 years. Mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the participants were 135 ± 16.85 mm Hg and 86 ± 11.42 mm Hg, respectively. Among the participants, 10 (24.39%) had a known history of hypertension. Among them, as per the blood pressure levels measured on the day of the study 50% (5) had their blood pressure levels under control. Interestingly 16 (39%) participants were found hypertensive incidentally.

    DISCUSSION: It is evident from the studies that colour coded approach is used in multiple ways, in multiple settings, for multiple diseases. To our knowledge, little focus has been given for hypertensive disorders in the community level. We merely bother about making their risk profiling, even in the digital age. Sometimes physicians in emergency become puzzled whenever patients collapsed in front of them and we missed the "Golden Hour" for the treatment by searching patients' medical details.

    CONCLUSION AND RECOMMENDATIONS: The above problem can be solved by risk profiling of chronic patients by colour coded OPD/Health cards.

  16. Marzo RR, Ahmad A, Islam MS, Essar MY, Heidler P, King I, et al.
    PLoS Negl Trop Dis, 2022 01;16(1):e0010103.
    PMID: 35089917 DOI: 10.1371/journal.pntd.0010103
    BACKGROUND: Mass vaccination campaigns have significantly reduced the COVID-19 burden. However, vaccine hesitancy has posed significant global concerns. The purpose of this study was to determine the characteristics that influence perceptions of COVID-19 vaccine efficacy, acceptability, hesitancy and decision making to take vaccine among general adult populations in a variety of socioeconomic and cultural contexts.

    METHODS: Using a snowball sampling approach, we conducted an online cross-sectional study in 20 countries across four continents from February to May 2021.

    RESULTS: A total of 10,477 participants were included in the analyses with a mean age of 36±14.3 years. The findings revealed the prevalence of perceptions towards COVID-19 vaccine's effectiveness (78.8%), acceptance (81.8%), hesitancy (47.2%), and drivers of vaccination decision-making (convenience [73.3%], health providers' advice [81.8%], and costs [57.0%]). The county-wise distribution included effectiveness (67.8-95.9%; 67.8% in Egypt to 95.9% in Malaysia), acceptance (64.7-96.0%; 64.7% in Australia to 96.0% in Malaysia), hesitancy (31.5-86.0%; 31.5% in Egypt to 86.0% in Vietnam), convenience (49.7-95.7%; 49.7% in Austria to 95.7% in Malaysia), advice (66.1-97.3%; 66.1% in Austria to 97.3% in Malaysia), and costs (16.0-91.3%; 16.0% in Vietnam to 91.3% in Malaysia). In multivariable regression analysis, several socio-demographic characteristics were identified as associated factors of outcome variables including, i) vaccine effectiveness: younger age, male, urban residence, higher education, and higher income; ii) acceptance: younger age, male, urban residence, higher education, married, and higher income; and iii) hesitancy: male, higher education, employed, unmarried, and lower income. Likewise, the factors associated with vaccination decision-making including i) convenience: younger age, urban residence, higher education, married, and lower income; ii) advice: younger age, urban residence, higher education, unemployed/student, married, and medium income; and iii) costs: younger age, higher education, unemployed/student, and lower income.

    CONCLUSIONS: Most participants believed that vaccination would effectively control and prevent COVID-19, and they would take vaccinations upon availability. Determinant factors found in this study are critical and should be considered as essential elements in developing COVID-19 vaccination campaigns to boost vaccination uptake in the populations.

  17. Marzo RR, Sami W, Alam MZ, Acharya S, Jermsittiparsert K, Songwathana K, et al.
    Trop Med Health, 2022 Jan 05;50(1):4.
    PMID: 34983692 DOI: 10.1186/s41182-021-00393-1
    BACKGROUND: Vaccines are effective and reliable public health interventions against viral outbreaks and pandemics. However, hesitancy regarding the Coronavirus disease (COVID-19) vaccine is evident worldwide. Therefore, understanding vaccination-related behavior is critical in expanding the vaccine coverage to flatten the infection curve. This study explores the public perception regarding COVID-19 vaccination and identifies factors associated with vaccine hesitancy among the general adult populations in six Southeast Asian countries.

    METHODS: Using a snowball sampling approach, we conducted a descriptive cross-sectional study among 5260 participants in Indonesia, Malaysia, Myanmar, Philippines, Thailand, and Vietnam between February and May 2021. Binary logistic regression analysis with a backward conditional approach was applied to identify factors associated with COVID-19 vaccine hesitancy.

    RESULTS: Of the total, 50.6% were female, and the median age was 30 years (range: 15-83 years). The majority of the participants believed that vaccination effectively prevents and controls COVID-19 (81.2%), and 84.0% would accept COVID-19 vaccines when they become available. They agreed that health providers' advice (83.0%), vaccination convenience (75.6%), and vaccine costs (62.8%) are essential for people to decide whether to accept COVID-19 vaccines. About half (49.3%) expressed their hesitancy to receive the COVID-19 vaccines. After adjustment for other covariates, COVID-19 vaccine hesitancy was significantly associated with age, residential area, education levels, employment status, and family economic status. Participants from Indonesia, Myanmar, Thailand, and Vietnam were significantly more likely to express hesitancy in receiving COVID-19 vaccines than those from Philippines.

    CONCLUSIONS: In general, participants in this multi-country study showed their optimistic perception of COVID-19 vaccines' effectiveness and willingness to receive them. However, about half of them still expressed their hesitancy in getting vaccinated. The hesitation was associated with several socioeconomic factors and varied by country. Therefore, COVID-19 vaccination programs should consider these factors essential for increasing vaccine uptake in the populations.

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