Displaying publications 41 - 60 of 103 in total

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  1. Fulltext Efficacy and long-term safety of a dengue vaccine in regions of endemic disease
    Hadinegoro SR, Arredondo-García JL, Capeding MR, Deseda C, Chotpitayasunondh T, Dietze R, et al.
    N Engl J Med, 2015 Sep 24;373(13):1195-206.
    PMID: 26214039 DOI: 10.1056/NEJMoa1506223
    BACKGROUND: A candidate tetravalent dengue vaccine is being assessed in three clinical trials involving more than 35,000 children between the ages of 2 and 16 years in Asian-Pacific and Latin American countries. We report the results of long-term follow-up interim analyses and integrated efficacy analyses.
    METHODS: We are assessing the incidence of hospitalization for virologically confirmed dengue as a surrogate safety end point during follow-up in years 3 to 6 of two phase 3 trials, CYD14 and CYD15, and a phase 2b trial, CYD23/57. We estimated vaccine efficacy using pooled data from the first 25 months of CYD14 and CYD15.
    RESULTS: Follow-up data were available for 10,165 of 10,275 participants (99%) in CYD14 and 19,898 of 20,869 participants (95%) in CYD15. Data were available for 3203 of the 4002 participants (80%) in the CYD23 trial included in CYD57. During year 3 in the CYD14, CYD15, and CYD57 trials combined, hospitalization for virologically confirmed dengue occurred in 65 of 22,177 participants in the vaccine group and 39 of 11,089 participants in the control group. Pooled relative risks of hospitalization for dengue were 0.84 (95% confidence interval [CI], 0.56 to 1.24) among all participants, 1.58 (95% CI, 0.83 to 3.02) among those under the age of 9 years, and 0.50 (95% CI, 0.29 to 0.86) among those 9 years of age or older. During year 3, hospitalization for severe dengue, as defined by the independent data monitoring committee criteria, occurred in 18 of 22,177 participants in the vaccine group and 6 of 11,089 participants in the control group. Pooled rates of efficacy for symptomatic dengue during the first 25 months were 60.3% (95% CI, 55.7 to 64.5) for all participants, 65.6% (95% CI, 60.7 to 69.9) for those 9 years of age or older, and 44.6% (95% CI, 31.6 to 55.0) for those younger than 9 years of age.
    CONCLUSIONS: Although the unexplained higher incidence of hospitalization for dengue in year 3 among children younger than 9 years of age needs to be carefully monitored during long-term follow-up, the risk among children 2 to 16 years of age was lower in the vaccine group than in the control group. (Funded by Sanofi Pasteur; ClinicalTrials.gov numbers, NCT00842530, NCT01983553, NCT01373281, and NCT01374516.).
    Matched MeSH terms: Dengue/prevention & control*
  2. Factors influencing stakeholders attitudes toward genetically modified aedes mosquito
    Amin L, Hashim H
    Sci Eng Ethics, 2015 Jun;21(3):655-81.
    PMID: 24906652 DOI: 10.1007/s11948-014-9557-5
    Dengue fever is a debilitating and infectious disease that could be life-threatening. It is caused by the dengue virus which affects millions of people in the tropical area. Currently, there is no cure for the disease as there is no vaccine available. Thus, prevention of the vector population using conventional methods is by far the main strategy but has been found ineffective. A genetically modified (GM) mosquito is among the favoured alternatives to curb dengue fever in Malaysia. Past studies have shown that development and diffusion of gene technology products depends heavily upon public acceptance. The purpose of this study is to identify the relevant factors influencing stakeholders' attitudes toward the GM Aedes mosquito and to analyse the relationships between all the factors using the structural equation model. A survey was carried out on 509 respondents from various stakeholder groups in the Klang Valley region of Malaysia. Results of the survey have confirmed that public perception towards complex issues such as gene technology should be seen as a multi-faceted process. The perceived benefit-perceived risk balance is very important in determining the most predominant predictor of attitudes toward a GM mosquito. In this study the stakeholders perceived the benefit of the GM mosquito as outweighing its risk, translating perceived benefit as the most important direct predictor of attitudes toward the GM mosquito. Trust in key players has a direct influence on attitudes toward the GM mosquito while moral concern exhibited an indirect influence through perceived benefits. Other factors such as attitudes toward technology and nature were also indirect predictors of attitudes toward the GM mosquito while religiosity and engagement did not exhibited any significant roles. The research findings serve as a useful database to understand public acceptance and the social construct of public attitudes towards the GM mosquito to combat dengue.
    Matched MeSH terms: Dengue/prevention & control*
  3. Fulltext Coffee and its waste repel gravid Aedes albopictus females and inhibit the development of their embryos
    Satho T, Dieng H, Ahmad MH, Ellias SB, Hassan AA, Abang F, et al.
    Parasit Vectors, 2015 May 14;8:272.
    PMID: 25966847 DOI: 10.1186/s13071-015-0874-6
    BACKGROUND: Dengue is a prevalent arboviral disease and the development of insecticide resistance among its vectors impedes endeavors to control it. Coffee is drunk by millions of people daily worldwide, which is associated with the discarding of large amounts of waste. Coffee and its waste contain large amounts of chemicals many of which are highly toxic and none of which have a history of resistance in mosquitoes. Once in solution, coffee is brownish in colour, resembling leaf infusion, which is highly attractive to gravid mosquitoes. To anticipate the environmental issues related to the increasing popularity of coffee as a drink, and also to combat insecticide resistance, we explored the deterrence potentials of coffee leachates against the ovipositing and embryonic stages of the dengue vector, Aedes albopictus.

    METHODS: In a series of choice, no-choice, and embryo toxicity bioassays, we examined changes in the ovipositional behaviours and larval eclosion of Ae. albopictus in response to coffee extracts at different concentrations.

    RESULTS: Oviposition responses were extremely low when ovicups holding highly concentrated extract (HCE) of coffee were the only oviposition sites. Gravid females retained increased numbers of mature eggs until 5 days post-blood feeding. When provided an opportunity to oviposit in cups containing coffee extracts and with water, egg deposition occurred at lower rates in those containing coffee, and HCE cups were far less attractive to females than those containing water only. Females that successfully developed in a coffee environment preferentially oviposited in such cups when in competition with preferred oviposition sites (water cups), but this trait did not continue into the fourth generation. Larval eclosion occurred at lower rates among eggs that matured in a coffee environment, especially among those that were maintained on HCE-moistened substrates.

    CONCLUSIONS: The observations of the present study indicate a pronounced vulnerability of Ae. albopictus to the presence of coffee in its habitats during the early phases of its life cycle. The observations that coffee repels gravid females and inhibits larval eclosion provide novel possibilities in the search for novel oviposition deterrents and anti-larval eclosion agents against dengue vectors.

    Matched MeSH terms: Dengue/prevention & control*
  4. Dengue vaccine--time to act now
    Pang T, Thiam DGY, Tantawichien T, Ismail Z, Yoksan S
    Lancet, 2015 May 02;385(9979):1725-1726.
    PMID: 25943934 DOI: 10.1016/S0140-6736(15)60888-1
    Matched MeSH terms: Dengue/prevention & control*
  5. Fulltext Practices of Dengue Fever Prevention and the Associated Factors among the Orang Asli in Peninsular Malaysia
    Chandren JR, Wong LP, AbuBakar S
    PLoS Negl Trop Dis, 2015;9(8):e0003954.
    PMID: 26267905 DOI: 10.1371/journal.pntd.0003954
    BACKGROUND: Dengue is prevalent among Malaysia's indigenous peoples, known as the Orang Asli, and it poses a serious health threat to them. The study aims to look at the socio-demographic factors, health beliefs, and knowledge about dengue and its association to dengue prevention practices among Orang Asli communities in Peninsular Malaysia.

    METHODS: A cross-sectional survey was conducted in 16 randomly selected Orang Asli villages from eight states in Peninsular Malaysia from April 2012 until February 2013.

    RESULTS: A total of 560 Orang Asli were interviewed and 505 completed the survey. Slightly above half of the participants (n = 280, 55.4%) had a total dengue prevention score of 51-100 (of a possible score of 0-100). Multivariate analysis findings showed dengue knowledge, perceived barriers to perform dengue prevention, fogging frequency, and perceived susceptibility to dengue fever as significant factors associated to dengue prevention practices. Participants with a lower dengue knowledge score (score 0-18) were less likely (OR = 0.63, 95%CI = 0.44-0.92 vs. score 19-36, P = 0.015) to practice dengue prevention. Participants with low perceived barriers to prevent dengue (score of 1-5) were more likely (OR = 2.06, 95%CI = 1.21-3.53, vs. score of 6-10, P = 0.008) to practice dengue prevention. Villages that were not fogged (OR = 0.49, 95%CI = 0.24-0.99, P = 0.045) or rarely fogged (OR = 0.40, 95%CI = 0.22-0.75, P = 0.004) had lower dengue prevention practices than villages that were fogged often. Participants with low perceived susceptibility of acquiring dengue (score of 1-5) were less likely (OR = 0.54, 95%CI = 0.33-0.89 vs. score of 6-10, P = 0.018) to practice dengue prevention measures.

    CONCLUSION: Findings imply that educational and health programmes should focus on enhancing dengue knowledge and perceived susceptibility of acquiring dengue and reducing perceived barriers to performing dengue prevention practices among the Orang Asli. More outreach on mosquito control campaigns should be carried out especially in villages where mosquito fogging is frequent.

    Matched MeSH terms: Dengue/prevention & control*
  6. Fulltext Factors affecting dengue prevention practices: nationwide survey of the Malaysian public
    Wong LP, Shakir SM, Atefi N, AbuBakar S
    PLoS One, 2015;10(4):e0122890.
    PMID: 25836366 DOI: 10.1371/journal.pone.0122890
    Efforts to stamp dengue in many dengue endemic countries has met little success. There is a need to re-examine and understand how the public at large view the dengue prevention efforts. This study aimed to examine the demographic factors, theoretical constructs of the Health Belief Model and knowledge about dengue and how these influence the practice of dengue prevention.
    Matched MeSH terms: Dengue/prevention & control*
  7. Spatio-temporal patterns of dengue in Malaysia: combining address and sub-district level
    Ling CY, Gruebner O, Krämer A, Lakes T
    Geospat Health, 2014 Nov;9(1):131-40.
    PMID: 25545931
    Spatio-temporal patterns of dengue risk in Malaysia were studied both at the address and the sub-district level in the province of Selangor and the Federal Territory of Kuala Lumpur. We geocoded laboratory-confirmed dengue cases from the years 2008 to 2010 at the address level and further aggregated the cases in proportion to the population at risk at the sub-district level. Kulldorff's spatial scan statistic was applied for the investigation that identified changing spatial patterns of dengue cases at both levels. At the address level, spatio-temporal clusters of dengue cases were concentrated at the central and south-eastern part of the study area in the early part of the years studied. Analyses at the sub-district level revealed a consistent spatial clustering of a high number of cases proportional to the population at risk. Linking both levels assisted in the identification of differences and confirmed the presence of areas at high risk for dengue infection. Our results suggest that the observed dengue cases had both a spatial and a temporal epidemiological component, which needs to be acknowledged and addressed to develop efficient control measures, including spatially explicit vector control. Our findings highlight the importance of detailed geographical analysis of disease cases in heterogeneous environments with a focus on clustered populations at different spatial and temporal scales. We conclude that bringing together information on the spatio-temporal distribution of dengue cases with a deeper insight of linkages between dengue risk, climate factors and land use constitutes an important step towards the development of an effective risk management strategy.
    Matched MeSH terms: Dengue/prevention & control
  8. Fulltext Approaches to refining estimates of global burden and economics of dengue
    Shepard DS, Undurraga EA, Betancourt-Cravioto M, Guzmán MG, Halstead SB, Harris E, et al.
    PLoS Negl Trop Dis, 2014 Nov;8(11):e3306.
    PMID: 25412506 DOI: 10.1371/journal.pntd.0003306
    Dengue presents a formidable and growing global economic and disease burden, with around half the world's population estimated to be at risk of infection. There is wide variation and substantial uncertainty in current estimates of dengue disease burden and, consequently, on economic burden estimates. Dengue disease varies across time, geography and persons affected. Variations in the transmission of four different viruses and interactions among vector density and host's immune status, age, pre-existing medical conditions, all contribute to the disease's complexity. This systematic review aims to identify and examine estimates of dengue disease burden and costs, discuss major sources of uncertainty, and suggest next steps to improve estimates. Economic analysis of dengue is mainly concerned with costs of illness, particularly in estimating total episodes of symptomatic dengue. However, national dengue disease reporting systems show a great diversity in design and implementation, hindering accurate global estimates of dengue episodes and country comparisons. A combination of immediate, short-, and long-term strategies could substantially improve estimates of disease and, consequently, of economic burden of dengue. Suggestions for immediate implementation include refining analysis of currently available data to adjust reported episodes and expanding data collection in empirical studies, such as documenting the number of ambulatory visits before and after hospitalization and including breakdowns by age. Short-term recommendations include merging multiple data sources, such as cohort and surveillance data to evaluate the accuracy of reporting rates (by health sector, treatment, severity, etc.), and using covariates to extrapolate dengue incidence to locations with no or limited reporting. Long-term efforts aim at strengthening capacity to document dengue transmission using serological methods to systematically analyze and relate to epidemiologic data. As promising tools for diagnosis, vaccination, vector control, and treatment are being developed, these recommended steps should improve objective, systematic measures of dengue burden to strengthen health policy decisions.
    Matched MeSH terms: Dengue/prevention & control
  9. Clinical efficacy and safety of a novel tetravalent dengue vaccine in healthy children in Asia: a phase 3, randomised, observer-masked, placebo-controlled trial
    Capeding MR, Tran NH, Hadinegoro SR, Ismail HI, Chotpitayasunondh T, Chua MN, et al.
    Lancet, 2014 Oct 11;384(9951):1358-65.
    PMID: 25018116 DOI: 10.1016/S0140-6736(14)61060-6
    An estimated 100 million people have symptomatic dengue infection every year. This is the first report of a phase 3 vaccine efficacy trial of a candidate dengue vaccine. We aimed to assess the efficacy of the CYD dengue vaccine against symptomatic, virologically confirmed dengue in children.
    Matched MeSH terms: Dengue/prevention & control*
  10. [Is the fight against dengue complicated with the emergence of a new viral serotype?]
    Valero N, Quiroz Y
    Invest Clin, 2014 Sep;55(3):203-5.
    PMID: 25272519
    Dengue is a viral acute febrile illness, currently considered one of the most important arbovirosis worldwide in terms of morbidity, mortality and economic impact. Various theories have been proposed to explain the pathogenesis of severe forms of dengue, involving among other factors, features related to the virus, such as the presence of more virulent strains and/or strains with increased replicative capacity. A crucial point at this time is the discovery of a new viral type, dengue 5, from nonhuman primates in Malaysia-Borneo, which could result in greater difficulties for control and vaccine production (currently in efficacy tests). Once the circulation of this viral type has been demonstrated in the human population, the high risk of infection will have extreme or controversial public health implications. Therefore, a worldwide program to combat dengue should include an urgent need to implement continuous vector elimination, community education and prevention and control of the disease. Only then, we will be aiming to reduce the morbidity and transmission risk of dengue, while new technological and effective alternatives come about.
    Matched MeSH terms: Dengue/prevention & control*
  11. Fulltext Assessment of land use factors associated with dengue cases in Malaysia using Boosted Regression Trees
    Cheong YL, Leitão PJ, Lakes T
    Spat Spatiotemporal Epidemiol, 2014 Jul;10:75-84.
    PMID: 25113593 DOI: 10.1016/j.sste.2014.05.002
    The transmission of dengue disease is influenced by complex interactions among vector, host and virus. Land use such as water bodies or certain agricultural practices have been identified as likely risk factors for dengue because of the provision of suitable habitats for the vector. Many studies have focused on the land use factors of dengue vector abundance in small areas but have not yet studied the relationship between land use factors and dengue cases for large regions. This study aims to clarify if land use factors other than human settlements, e.g. different types of agricultural land use, water bodies and forest are associated with reported dengue cases from 2008 to 2010 in the state of Selangor, Malaysia. From the correlative relationship, we aim to generate a prediction risk map. We used Boosted Regression Trees (BRT) to account for nonlinearities and interactions between the factors with high predictive accuracies. Our model with a cross-validated performance score (Area Under the Receiver Operator Characteristic Curve, ROC AUC) of 0.81 showed that the most important land use factors are human settlements (model importance of 39.2%), followed by water bodies (16.1%), mixed horticulture (8.7%), open land (7.5%) and neglected grassland (6.7%). A risk map after 100 model runs with a cross-validated ROC AUC mean of 0.81 (±0.001 s.d.) is presented. Our findings may be an important asset for improving surveillance and control interventions for dengue.
    Matched MeSH terms: Dengue/prevention & control
  12. Fulltext Influence of container design on predation rate of potential biocontrol agent, Toxorhynchites splendens (Diptera: Culicidae) against dengue vector
    Mohamad N, Zuharah WF
    Trop Biomed, 2014 Mar;31(1):166-73.
    PMID: 24862057 MyJurnal
    Toxorhynchites splendens larvae are a natural predator of dengue vector mosquito larvae, Aedes albopictus. This study was carried out to evaluate the predation rate of Tx. splendens third instar larvae on Ae. albopictus larvae in 24 h. Each predator was offered prey at a density between 10 to 50 individuals. Predation rate of Tx. splendens were also tested with two manipulated factors; various types of container and different water volumes. The experiment was evaluated in man-made containers (tin cans, plastic drinking glasses and rubber tires) and natural container (bamboo stumps) which were filled with different water volumes (full, half full, 1/4 full, and 1/8 full). The prey density and the characteristics of the container were found as significant factors which influence the predation rate of Tx. splendens. The predator consumed significantly more prey at higher prey densities (40 and 50 preys) compared to the lowest density (10 preys) (F=3.935, df=4, p=0.008). The results showed significantly higher consumption in horizontal shaped container of rubber tire than in vertical shape of bamboo stumps (F=3.100, df=3, p=0.029). However, the water volume had no significant effect on predation rate of Tx. splendens (F=1.736, df=3, p=0.162). We generally suggest that Tx. splendens is best to be released in discarded tires or any other containers with horizontal shape design with wide opening since Tx. splendens can become more effective in searching prey in this type of container design. This predator is also a suitable biocontrol candidates to be introduced either in wet and dry seasons in Malaysia.
    Matched MeSH terms: Dengue/prevention & control*
  13. Fulltext Bacteria as a source of oviposition attractant for Aedes aegypti mosquitoes
    Arbaoui AA, Chua TH
    Trop Biomed, 2014 Mar;31(1):134-42.
    PMID: 24862053 MyJurnal
    Since a safe and effective mass vaccination program against dengue fever is not presently available, a good way to prevent and control dengue outbreaks depends mainly on controlling the mosquito vectors. Aedes aegypti mosquito populations can be monitored and reduced by using ovitraps baited with organic infusions. A series of laboratory experiments were conducted which demonstrated that the bacteria in bamboo leaf infusion produce volatile attractants and contact chemical stimulants attractive to the female mosquitoes. The results showed that the female mosquitoes laid most of their eggs (59.9 ± 8.1 vs 2.9 ± 2.8 eggs, P<0.001) in bamboo leaf infusions when compared to distilled water. When the fresh infusion was filtered with a 0.45 μm filter membrane, the female mosquitoes laid significantly more eggs (64.1 ± 6.6 vs 4.9 ± 2.6 eggs, P<0.001) in unfiltered infusion. However when a 0.8 μm filter membrane was used, the female laid significantly more eggs (62.0 ± 4.3 vs 10.1 ± 7.8 eggs, P<0.001) in filtrate compared to a solution containing the residue. We also found that a mixture of bacteria isolated from bamboo leaf infusion serve as potent oviposition stimulants for gravid Aedes mosquitoes. Aedes aegypti laid significantly more eggs (63.3 ± 6.5 vs 3.1 ± 2.4 eggs, P<0.001) in bacteria suspension compared to sterile R2A medium. Our results suggest microbial activity has a role in the production of odorants that mediate the oviposition response of gravid mosquitoes.
    Matched MeSH terms: Dengue/prevention & control
  14. Fulltext Factors associated with larval control practices in a dengue outbreak prone area
    Mohamad M, Selamat MI, Ismail Z
    J Environ Public Health, 2014;2014:459173.
    PMID: 25309602 DOI: 10.1155/2014/459173
    In order to reduce the risk of dengue outbreak recurrence in a dengue outbreak prone area, the members of the community need to sustain certain behavior to prevent mosquito from breeding. Our study aims to identify the factors associated with larval control practices in this particular community. A cross-sectional study involves 322 respondents living in a dengue outbreak prone area who were interviewed using a pretested questionnaire. The level of knowledge about Aedes mosquitoes, dengue transmission, its symptoms, and personal preventive measures ranges from fair to good. The level of attitude towards preventive measures was high. However, reported level of personal larval control practices was low (33.2%). Our multiple logistic regression analysis showed that only those with a good level of attitude towards personal preventive measure and frequent attendance to health campaigns were significantly associated with the good larval control practices. We conclude that, in a dengue outbreak prone area, having a good attitude towards preventive measures and frequent participation in health campaigns are important factors to sustain practices on larval control.
    Matched MeSH terms: Dengue/prevention & control*
  15. [A possible fifth dengue virus serotype]
    da Silva Voorham JM
    Ned Tijdschr Geneeskd, 2014;158:A7946.
    PMID: 25227888
    Sylvatic dengue viruses are both evolutionarily and ecologically distinguishable from the human dengue virus (DENV). Sporadic episodes of sylvatic human infections in West Africa and Southeast Asia suggest that sylvatic DENV regularly come into contact with human beings. Following a study on the sylvatic transmission cycle in Malaysia in 2007, researchers announced that a new DENV serotype, DENV-5, had been discovered. Scientists are still sceptical about these new findings, and indicate that more data is necessary to determine whether this 'new' virus really is a different serotype or whether it is a variant of one of the four DENV serotypes already known. The good news is that this new variant has not yet established itself in the human transmission cycle. However, if it really is a new serotype this will have implications for the long-term control of dengue using vaccines currently under development.
    Matched MeSH terms: Dengue/prevention & control
  16. Fulltext Dynamic spatiotemporal trends of dengue transmission in the Asia-Pacific region, 1955-2004
    Banu S, Hu W, Guo Y, Naish S, Tong S
    PLoS One, 2014;9(2):e89440.
    PMID: 24586780 DOI: 10.1371/journal.pone.0089440
    BACKGROUND: Dengue fever (DF) is one of the most important emerging arboviral human diseases. Globally, DF incidence has increased by 30-fold over the last fifty years, and the geographic range of the virus and its vectors has expanded. The disease is now endemic in more than 120 countries in tropical and subtropical parts of the world. This study examines the spatiotemporal trends of DF transmission in the Asia-Pacific region over a 50-year period, and identified the disease's cluster areas.

    METHODOLOGY AND FINDINGS: The World Health Organization's DengueNet provided the annual number of DF cases in 16 countries in the Asia-Pacific region for the period 1955 to 2004. This fifty-year dataset was divided into five ten-year periods as the basis for the investigation of DF transmission trends. Space-time cluster analyses were conducted using scan statistics to detect the disease clusters. This study shows an increasing trend in the spatiotemporal distribution of DF in the Asia-Pacific region over the study period. Thailand, Vietnam, Laos, Singapore and Malaysia are identified as the most likely clusters (relative risk = 13.02) of DF transmission in this region in the period studied (1995 to 2004). The study also indicates that, for the most part, DF transmission has expanded southwards in the region.

    CONCLUSIONS: This information will lead to the improvement of DF prevention and control strategies in the Asia-Pacific region by prioritizing control efforts and directing them where they are most needed.

    Matched MeSH terms: Dengue/prevention & control
  17. Fulltext Safety and immunogenicity of a tetravalent dengue vaccine in healthy children aged 2-11 years in Malaysia: a randomized, placebo-controlled, Phase III study
    Hss AS, Koh MT, Tan KK, Chan LG, Zhou L, Bouckenooghe A, et al.
    Vaccine, 2013 Dec 2;31(49):5814-21.
    PMID: 24135573 DOI: 10.1016/j.vaccine.2013.10.013
    Dengue disease is a major public health problem across the Asia-Pacific region for which there is no licensed vaccine or treatment. We evaluated the safety and immunogenicity of Phase III lots of a candidate vaccine (CYD-TDV) in children in Malaysia.
    Matched MeSH terms: Dengue/prevention & control*
  18. Tropical medicine. Surprising new dengue virus throws a spanner in disease control efforts
    Normile D
    Science, 2013 Oct 25;342(6157):415.
    PMID: 24159024 DOI: 10.1126/science.342.6157.415
    Matched MeSH terms: Dengue/prevention & control*
  19. Challenges in reducing dengue burden; diagnostics, control measures and vaccines
    Lam SK
    Expert Rev Vaccines, 2013 Sep;12(9):995-1010.
    PMID: 24053394 DOI: 10.1586/14760584.2013.824712
    Dengue is a major public health concern worldwide, with the number of infections increasing globally. The illness imposes the greatest economic and human burden on developing countries that have limited resources to deal with the scale of the problem. No cure for dengue exists; treatment is limited to rehydration therapy, and with vector control strategies proving to be relatively ineffective, a vaccine is an urgent priority. Despite the numerous challenges encountered in the development of a dengue vaccine, several vaccine candidates have shown promise in clinical development and it is believed that a vaccination program would be at least as cost-effective as current vector control programs. The lead candidate vaccine is a tetravalent, live attenuated, recombinant vaccine, which is currently in Phase III clinical trials. Vaccine introduction is a complex process that requires consideration and is discussed here. This review discusses the epidemiology, burden and pathogenesis of dengue, as well as the vaccine candidates currently in clinical development.
    Matched MeSH terms: Dengue/prevention & control*
  20. Factors affecting dengue fever knowledge, attitudes and practices among selected urban, semi-urban and rural communities in Malaysia
    Al-Dubai SA, Ganasegeran K, Mohanad Rahman A, Alshagga MA, Saif-Ali R
    Southeast Asian J. Trop. Med. Public Health, 2013 Jan;44(1):37-49.
    PMID: 23682436
    Dengue fever is a major public health problem in Malaysia. This study aimed to assess factors affecting knowledge, attitudes, and practices regarding dengue fever among a selected population in Malaysia. A descriptive, community-based, cross sectional study was conducted with 300 participants from three different geographical settings in urban, semi-urban, and rural areas within the states of Selangor and Kuala Lumpur. The questionnaire included questions on demographic data, knowledge, attitudes, and practices regarding dengue fever. Mean age of respondents was 34.4 (+/- 5.7) years, and the age ranged from 18 to 65 years. The majority of respondents were married (54.7%), Malays (72.7%) and heard about dengue fever (89.7%). Television was the common source of information about dengue fever (97.0%). Participants answered 4 out of 15 items of knowledge incorrectly. There was no significant association between knowledge score and socio-demographic factors. About one-fifth of the respondents (24%) believed that immediate treatment is not necessary for dengue fever, and the majority of them were not afraid of the disease (96.0%). Attitudes toward dengue fever were significantly associated with the level of education and employment status (p < 0.05). Practice was associated significantly with age, marital status, and geographic area (p < 0.05) and knowledge on dengue fever (p = 0.030). There is a need to increase health promotion activities through campaigns and social mobilization to increase knowledge regarding dengue fever. This would help to mold positive attitudes and cultivate better preventive practices among the public to eliminate dengue in the country.
    Matched MeSH terms: Dengue/prevention & control
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