Introduction: Minimizing smoking initiation among adolescents has been identified as a strategy to reduce the preva- lence of tobacco induced diseases among Malaysian adults. The aims of this study were to investigate the prevalence and factors associated with smoking among secondary school- going adolescents in the state of Kelantan, Malaysia. Methods: A school-based survey was carried out in Kelantan to determine the prevalence and associated factors of smoking among Kelantanese adolescents. Two-stage cluster sampling was used to ensure the representativeness of the sample. A self-administered validated questionnaire was utilised to obtain data from the selected respondents. Multiple logistic regression analysis was used to determine the factors associated with smoking behaviour among school-going adolescents. Results: The study revealed that 10.1% (95 CI 8.5-11.9%) of the selected respondents were current smokers. The prevalence of male who smoked was significantly higher compared to female. MLR revealed that, males, respondents with at least one smoking parent/guardian, as well as the respondents with less supportive parents/ guardian were more likely to smoke. However, by having a few numbers of close friends and helpful peers in the school had shown no significant association for being the current smokers. Conclusion: The study showed that the prevalence of smoking was a bit lower than the national prevalence, and smoking behaviour was predominant among male adolescents in Kelantan state. Comprehensive measures with the involvement of parents/guardians were imperative to tackle smoking habits among adolescents by targeting high-risk groups identified in the study.
Introduction: Diabetic control depends partially on self-management. Diabetes self-care is reported to be a strong predictor of glycemic control in Type 2 Diabetes Mellitus (T2DM) patients. Factors contributing to better self-care include self-efficacy and social support. We aim to determine effects of these factors on glucose control in T2DM patients in a primary care clinic. Methods: This study utilised data from a bigger study looking into factors affecting social support and self-efficacy and their correlation in T2DM patients. This study was done among 329 T2DM pa- tients attending a primary care clinic in Selangor, Malaysia between November 2013- January 2014. Systematic ran- dom sampling was used. Instruments used were the MOS Social Support Survey and the Diabetic Management Self Efficacy Scale (DMSES). Patients’ socio-demographic data and glucose monitoring records were obtained. The asso- ciation between social support and self-efficacy with blood glucose control was determined using logistic regression. Results: The mean age of the respondents is 54.6 (+11.2), mostly female (55.3%) and Malay ethnicity (63.5%). Being older and retired were predictors for good glucose control (OR=1.05,p=0.01 and OR=2.2,p=0.023) respectively. There is also significant correlations between number of close friends/relatives with social support and self-efficacy (r=0.162,p=0.030 and r=0.190,p=0.01) respectively. The correlation of social support and self-efficacy with HbA1c levels are r= -0.044(p=0.426) and r= -0.08(p= 0.744) respectively. Conclusion: There were no correlations between social support and self-efficacy with the level of HbA1c among patients with T2DM in this study. We found older aged and retired patients to have better HbA1c levels.
Introduction: Tobacco smoking is a major public health concern worldwide as it is one of the major risk factors for non-communicable diseases leading to burden of adverse health effects in their later life. According to Global Adult Tobacco Survey Malaysia (2011), 43.9% of men, 1.0% of women, and 23.1% overall currently smoked tobacco. It is important to prevent smoking uptake and promote smoking cessation to reduce the impact of tobacco smoking. The constant monitoring of the magnitude of smoking and its influencing factors is crucial for effective planning of anti-smoking programs. This study aimed to determine the prevalence of smoking and its associated factors among male villagers in Kampung Barambangon, Kudat, Sabah. Methods: A cross-sectional study was conducted among male villagers aged 15 years and above in Kampung Barambangon, Kudat District, Sabah State. Non probability convenience sampling was employed. The study period was from March to April, 2019. Data collection was done by using pretested self-administered questionnaire and a total of 97 villagers were participated in the study. Chi-square test was used for statistical analysis. Results: The study revealed that the prevalence of smokers among male residents in Kampung Barambangon was 50.5% (95% CI: 48.6–52.1%). It was found that there were significant associations between smoking status and positive attitude towards smoking (p-value 0.001), having siblings who smoked (p value 0.001), having high percentage of friends who smoked (p-value 0.009) and high educational level (p-value 0.005). Conclusion: The prevalence of male smokers in Kampung Barambangon was higher than the national prevalence. The findings may help in understanding the magnitude of the smoking problem and its associated factors which can be used for effective tobacco control and intervention programs.
Introduction: The number of children diagnosed with Autism Spectrum Disorder (ASD) keeps increasing every year. ASD is a neurodevelopmental disability that affects social communication and social interaction. They also demon-strate restricted, repetitive pattern of behaviour, interest or activities (RRB) that shows at an early developmental age. Due to this characteristic, ASD children are facing difficulties in social skills aspect such as eye contact, expression, and making friends. Studying and reciting the Quran are often used in Malaysia to ameliorate the symptoms, but there is no specific study in Malaysia that demonstrates the impact of these renditions on ASD’s children’s social skills. The objective of this study was to investigate the effect selected Qur’anic verses recitation on the social skills of the children with Autism Spectrum Disorder (ASD). Methods: This study will use the quasi-experimental research design. This study will be held at IDEAS Autism Centre, Rawang. The purposive sampling technique will be used and 14 ASD Muslim children aged 4-6 years old will be chosen. The ASD children will be divided into an experimental and control group. The experimental group will be listening to selected Qur’anic verses before the intervention. The Social Responsiveness Scale- Second Edition (SRS-2) will be used to assess the response. The scale consists of a 65-item questionnaire, with a 4-point Likert-scale. Results: The expected result for this study is the ASD children in the experimental group will have lower Total-scores of SRS-2 compared to control group. Conclusion: Listening to Qur’anic recitation provides a cost-effective complementary therapy to improve social skills among Muslim ASD children. Information from this study also can be used as a stepping stone in developing the teaching module to ASD children.
Introduction: Violence Against Women has increasingly been recognized in the international areas as an obstacle to women’s development and it may have a myriad of devastating consequences on women’s long or short- term health and wellbeing. The study explored the highlight the prevalence and health effects of Violence Against Women which might reflect the probable causes, the types of injuries, leading factors and consequences of the violence. Methods:Hospital based case study, which was referred to forensic department, Mandalay General Hospital from 1st Jan 2000 to 30th Sept 2000. Personal interview and medical examination of 50-100 victims, girls & women, who were phys-ically and sexually violated was done. Results: Total 92 patients were interviewed and examined, prevalence of dif-ferent age ranging from 5 to 56, were physically and sexually violated during the study period, 62 patients were phys-ically assaulted, and 30 victims were sexually violated. 20-40 age group is more commonly conflicted by physical violence 69.3%) while 10-20 age group were commonly conflicted by sexual violence (56.6%). Pattern of different types of injury and locations are also recorded as a consequence of physical assault and commonest injury is bruise (47%). Commonest location is injury over head & neck (61.8%). Relationship to perpetrator were recorded, physical assaults were commonly by spouse (39%) while sexual assaults were acquaintance (58%). Events leading to violence at home are recorded as nuclear family and alcohol consumption is more common, fights were most common events in community setting. Conclusion: Violence Against Women is neither prevalent nor uncommon in Myanmar. In this study, all forms of injuries were recorded and among them the commonest injuries were bruises, the event leading to violence recorded as fights, alcohol consumption, nuclear family was most common. Violence has a psychological impact on other members of the family, particularly children. However, a multi-sectoral approach has become a necessity to create a happy family, society and nation. It could be achieved by uplifting the socio-economic status of the family, practising the religious teachings and abiding within the framework of the laws. The Trans-National Committed should be formed to effectively minimize trafficking in women and children in the Region.
Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) is a bacteria or germ which many people carry in their nose or on their skin and it is resistant to a range of antibiotics including methicillin. The primary mode of transmission of S. aureus is by direct contact usually, skin-to-skin contact, although contact with contaminated objects and surfaces or might also play a role. The risk of infection by antibiotic-resistant organisms is a common problem in a hospital setting. When it comes to caring for the patient with an infectious disease such as MRSA, most nursing students tried to avoid caring for the patient because they fear of getting infected. So, in this regards that it is important to find out the perception of nursing students towards MRSA patients. Methods: This study is a descriptive cross-sectional study design and a structured questionnaire used to evaluate the perception among student nurses regarding care for a patient with MRSA. The population of this study consists only of the nursing student of year 2 and year 3, which is 118 students. A minimum of 60 respondents selected by convenient sampling from this population. Results: Findings showed the respondent’s perception towards MRSA patients that 83.55% (n=55) of the respondent has the feeling of avoiding getting close to MRSA patients. While 16.7% (n=11) did not have the feeling to avoid them. 47% (n=31%) respondents felt refused to do any procedure on MRSA patients. While 53% (n=35) did not feel refuse to do any procedure on MRSA patient. 92.4% (n=61) respondents wear full PPE before caring for patients with MRSA. The other 7.6% (n=5) did not wear full PPE before caring for patients with MRSA. 98.5% (n=65) respondents always follow 5 moments of hand hygiene. While the other 1.5% (n=1) did not always follow 5 moments of hand hygiene. Conclusion: To conclude, even though most of the respondents know about MRSA but some of them did not know that MRSA is curable or not, some confusion about the mode of transmission of MRSA and did not know that they should wear full PPE in caring for the patient with MRSA. Lack of knowledge about MRSA might influence them to ask their friends to do procedures for the patient instead of doing it by themselves. Without good knowledge and skills about how to handle infectious patients, it is difficult for the nursing students to approach the patient with an infectious disease such as MRSA.
Introduction: Autism spectrum disorder (ASD) is a developmental disability that can cause significant social, com- munication and behavioral challenges. According to the 2017 survey by the Ministry of Health Malaysia, children between the ages of 18 to 26 months showed ASD occurs approximately 1.6 in1000 children. In Sabah, 400 autistic children had been registered under Sabah Autism Society (SAS). The increasing prevalence of ASD had become a major concern not only to the parents but to the community. A correct understanding and perception about ASD are crucial especially to the nursing profession as they must be able to educate caregiver on how to manage patients with ASD. Methods: This is a quantitative study using a cross-sectional approach. The respondents are all nursing students in Sabah. The type of sampling is purposive, which is using snowball sampling methods. Research instruments were developed and distributed to all nursing colleges in Sabah. Results: A total of 115 students responded. The majority of age is within range of 18–20 years old and female students. Fifty percents (50%) respondents perceived that of autism is a socio-emotional and neuro-developmental disorder with a non-verbal behaviors’ impairment, curable disorder with proper treatment. More than fifty percent (50%) disagree that autistic child does not want friends and equivalent stand on the statement about autistic child can live independently. Ninety five percent (90%) agree that social media plays an important platform to deliver facts about autism, and health care provider remains as a key role to increase the level of awareness to the community. Conclusion: Results of this study revealed that nursing students in Sabah have a good awareness and perception towards autistic disorder. Nursing students in Sabah agree that social media plays a vital part to increase the level of awareness and perception.
Introduction: HIV/AIDS is one of the leading health problems worldwide. There is an increasing rate among the ages between 13 to 49 years old. School based intervention is an important component of community-based interventions for HIV/AIDS and is the best stage to promote abstinence which is best maintained among those not sexually experienced. Objectives: This study was carried out to determine attitude towards sex among secondary school children in Selangor state. Methods: A cross-sectional study design was used. Four out of nine districts in Selangor state were selected at random. Students were divided according to gender, academic performance (good or poor) with no behavioural problems
and students with evidence of behaviour problems (at risk). Results: Out of 149 students, the majority (56.4%) were females. The majority of students did not think sex should be discussed in depth and do not speak to parents, teachers, religious teachers, counselors, relatives, doctors or nurses but speak to friends regarding sex. More than half watch pornography. A significantly higher percentage of male students in the weak and at-risk group admit to thinking of intimacy (hugging and kissing) with the opposite gender. A higher number of these students would try sex out of curiosity, for fun, because it was difficult to say ‘no’ to and that they would like it. A significantly higher percentage will try sex because they did not want to hurt their girlfriends’ feeling by saying ‘no’. While the majority of students think intimacy will end in sex, a significantly higher percentage of male at-risk students think just talking with the opposite gender will end in sex. The majority of male students responded feeling attracted to the picture of a girl in sexy clothing but a significantly higher percentage of at-risk students also felt attracted to the picture of a girl properly attired. A significantly higher percentage of male at-risk students say parents do not say sex before marriage is wrong and a significantly higher percentage of
male students of weak and at-risk groups say girlfriends say sex before marriage is okay. A significantly higher percentage of weak and at-risk students speak to doctors regarding sex and think sex should be discussed in depth. Conclusion: Weak and at-risk male students appeared to have a more vulnerable attitude towards sex. This may predispose them to risky sexual behaviours leading to HIV/AIDS. Poor academic performance and behaviour problems may not be different as potential sexual risk predictors. The information obtained will be useful in designing intervention programmes in the prevention of HIV/AIDS.
Introduction : Shift work is practised in manufacturing industry to increase production capacity up to three times compared to the normal daily eight hours working system and able to optimize the utilization of machine and equipment. However, shift work has negatif effects on human social interaction, health and safety.
Methodology : The study was conducted to evaluate production workers’ perception on the effects of working at night shift. The respondents of the study were production workers in Company X in Kuala Lumpur. The Data was collected using self administered questionnaires. The study objectives was to study the work schedule design, to find out their perceptions on the effects of night shift and to study on personal factors, employees’ level of acceptance on the work schedule design and personal factors that cause safety and health disruption.
Result : A total of 200 production workers participated in the study. The result of the study shows 61% of production workers took sick leave and 43.5% were absent between 1 and 2 times a month. In terms of health and safety disruption, 77% of respondents agreed that they faced lack of focus with family and friends, 75.5% of them did not have enough sleep and 76.5% felt sleepy during working time. Regarding the work schedule and workstation design, 81.5% said they felt uncomfortable because they were required to stand during working and 77% felt that the resting period provided by the factory was too short and inadequate. More than 70% of the respondents proposed the rest period should be extended from the current 40 minutes to one hour. More than 80% of respondents agreed they would feel comfortable if standing at work is changed to sitting work system.
Conclusion : To minimize the unwanted effect of night shift among the production.
Introduction : The purpose of this study is to explore the differences of quality of life (QOL) of Malay and non-Malay breast cancer survivors using qualitative method.
Methods : Data was collected using in-depth face to face interview. List of the patients were obtained from Oncology & Surgery Departments and contact numbers were obtained from the medical record. The interviews were conducted either in their home or in the hospital after the appointment has been made.
Results : The majority of the Malays were unable to fulfill the needs of their families. However, the non-Malays were able to fulfill the needs of their families. The majority were satisfied with social interaction and the relationships with their families and friends. In terms of feelings, most survivors felt sad, angry and sometimes they feel like they were going to die early. However the majority coped well with their illness. Regarding sleep, all Malays did not have any sleeping problems, but most of the non-Malays reported serious problems. All survivors were worried about the other female members of the family of getting the same illness. Most survivors did not have any problems with altered body image.
Conclusion : Malays did not have any sleeping problems, but most of the non-Malays reported serious problems. However, the majority of survivors coped well with their illnesses.
The objectives were to assess the prevalence, severity, the psychological and social impacts of fluorosis among school children and their parents in the Kuala Pilah area, Negeri Sembilan, Malaysia. Methods: A convenience sample of 431 students aged 16-17 years old from 3 secondary schools in Kuala Pilah, Negeri Sembilan were selected. The students were assessed for presence of dental fluorosis using Dean’s Index and to assess impacts. Questionnaires were administered to all the dental fluorosis students and selected matched students with no fluorosis. They constituted a control group for the case control study. Questionnaires were sent to the parents of dental fluorosis and control non fluorosis cases. Results: The prevalence of dental fluorosis was 27.8%; 82% of the fluorosis cases were questionable to mild and 18% moderate to severe fluorosis. 16.1% of students with dental fluorosis and 8.5% of non-fluorosis students had psychological impacts. 12.8% of the parents of children with fluorosis reported that their child had an impact. More girls with fluorosis (35.7%) had psychological impacts compared than boys (25.0%). In the 16.1% of fluorosis cases who had psychological impacts, difficulty smiling and showing teeth, affected 35.7% of girls and 25 % of boys. The percentage of students with dental fluorosis who had psychological impacts on carrying out school work was 2.7%, and 3.6% had impacts related to going out with friends. Conclusions: There were considerable psychological impacts on smiling and showing teeth among Malaysian teenagers with dental fluorosis and some of their parents were concerned about the fluorosis. But the impacts were mild and do not have a major impact on students’ lives. Dental fluorosis is not aesthetically displeasing to most subjects but does have psychological and social impacts on a small percentage with fluorosis.
Introduction: There are increasing trend in using information and communication technology to enhance the deliverance of reminiscence work for people with dementia. Thus this study aimed to explore the feasibility of Digital Memory Album (DMA) to support reminiscence work and subsequently evaluate the psychosocial benefits of the DMA system for older adults with dementia living in community. Method: This was an exploratory case study involved five participants with mild to moderate dementia and their primary caregivers. Each participant had an opportunity to review their own life history using Life Review Experience Form (LREF) with the researcher for 8 consecutive weeks in which subsequently facilitated in development of a personalised digital life story. Caregivers provided additional information to support the development of DMA. The whole process was audio recorded. The digital life story was presented in multimedia format and displayed using the DMA. The DMA was given to the participants for review. Qualitative data was collected using semi structure questions with the participants and caregivers immediately after the completion of DMA and 6 weeks after having the DMA as a gift. Results: Analysis of the audio-records and interview data indicated that DMA promoted psychosocial wellbeing which included enjoyment, comfort, stimulate long term memory and enhanced communication and social interactions with family members and friends. Caregivers expressed the DMA helped them in recollecting the past and better understanding of their loved ones. It also reoriented their focus on their loved ones from their disability to the remaining strength. Conclusion: For the first time, this study demonstrates the feasibility of using DMA in improving the psychosocial wellbeing for people with dementia in Malaysia.
This study aims to identify the expression of emotions and how emotions are controlled by adolescents. The sample comprised three male and two female students who were from a secondary school located in Penang. Semi-structured interviews were conducted in this study. Transcribed contents of the interviews were analyzed. The main findings showed generally, adolescents like to have fun, seek to try something new, like to relax with friends, and they also follow their feelings. Female adolescents were found to be sensitive. Generally, adolescents indicated that they were more comforlable sharing problems with friends than with parents. Implications of findings area also discussed.
Commonly, teenage marriage affects schooling and being gainfully employed to support the family in later life. Most studies focused on the effects of marriage at the young age. However, less research is focusing on the experience of marriage from the perspective of the teenagers who get married at the teen age. This article aims to answer the following questions: (1) what are the experiences of teenage marriages, and (2) what are their views on teenage marriage. The article is based on semi-structured interviews with seven girls recruited by snowball technique, aged 15 to 23 years, married and living in Kuching, Sarawak. Data were analyzed by thematic analysis. Seven themes emerged on marriage experiences: being independent, nourishing patience, maintaining social boundaries, developing responsible behaviour, being inspired, staying positive and doubting their ability as a husband or wife. Moreover, four main themes described informants' views on teenage marriage: to avoid immorality, immaturity, making decisions wisely and accountability. It can be concluded that a person who gets married at the teen age is in need of help from various parties, especially parents and friends as well as community not to be stigmatized for being married at the teen age.
Equity theory suggests that perceiving equity leads to better relationship outcomes than perceiving inequity. However, cultural and relationship differences in tolerance for inequity have been found, suggesting that those from more individualistic cultures may have less tolerance for inequity with friends than those from more collectivistic cultures, with the latter group discriminating more clearly in their reactions to friends and strangers. In our first study, Kadazandusun (N=282) and Australian (N=255) participants evaluated their actual reciprocity in social support with a close friend. In our second study, 103 South East Asians and 128 Australians were randomly assigned to respond to a scenario presenting equity or inequity (underbenefit or overbenefit) with either a close friend or stranger. Study 1 found that participants from both cultures reported reduced desires for future interaction, positive feelings and closeness when they experienced under-benefit as compared to over-benefit or equity. In Study 2, participants from both cultures also reported reduced desires for future interaction, positive feelings and trust when there was inequity and reported a more negative reaction to a stranger than a close friend. These findings are consistent with equity theory and support its cross-cultural applicability.
The number of adolescents involved in drug addiction increases every year. Statistic shows that in 2015 there were 6,406 addicts from age 13 to 24 years old compared to 4,954 detected in 2014. The majority of those addicts had major depression. It is predicted that by 2020, depression will be the second leading causes of global burden of diseases after heart disease. This study aims to identify the relationship between social support and depression among adolescent drug addicts. The study used quantitative method by distributing the questionnaires to respondents. A total of 367 adolescent drug adddicts were involved in this study. The results showed a significant negative relationship between social support and depression. The results of the study also showed that there were relationships between social support from guardian, friends and closed friends and depression. The implication of the study suggested that the role of social support such as family members and close friends are crucial to help adolecents cope with depression and addiction.
Recovering drug addict is affected by two main factors, namely internal factors (such as resilience and self-confidence) and external (support from families, employers, friends, and community). One of the internal factors that appear to influence the level of recovery of former drug addict is selfconfidence. Therefore this study aims to measure the level of self-confidence among former drug addicts, also known as Orang Kena Pengawasan (OKP) who underwent rehabilitation in 6-11 months and 12-24 months. The study was conducted using cross-sectional surveys. A total of 386 former drug addicts in Peninsular Malaysia were involved in this study with 198 respondents undergoing 6-11 months rehabilitation programme and 197 were respondents who were released within 12-24 months. The data obtained were analyzed using descriptive statistics. This analysis was used to measure the level of self-confidence between respondents who underwent the 6-11 months rehabilitation programme (Group 1) and 12-24 months (Group 2). The study found that the majority of both groups showed no signiticant difference in the level of recovery from the aspect of self-confidence. The study also found the majority of respondents of both groups showed a moderate level of confidence of 58.5 percent. However, Group 1 showed a higher percentage of self-confidence (63.5%) compared to Group 2 of (53.8%). The findings have implications for the development of strategies towards a strong self-confidence among the inmates to reduce recidivism rates in Malaysia.
Cigarette smoke produces more than 4,000 toxic chemicals and 53 of these chemicals can cause cancer. Smoking increases your health risks such as lung cancer, heart attack and stroke. In Malaysia, between 10% and 12% of causes of death are caused by smoking and this results in over 10,000 deaths a year. According to the National Health Morbidity Survey (NHMS) in 2015, the number of smokers aged 15 and above in Malaysia is estimated to be more than 5 million (22.8%). This alarming amount will lead to increased health costs. Smoking can also lead to a reduction in worker productivity and air pollution and the pollution due to cigarette smoke. Therefore, smokers need to be aware of the effects of smoking habits and the importance of maintaining a tobacco-free environment for the health and well-being of their families, friends and the community around them. To address this, Smoke Busters have created an innovation called Blue Ribbon Star Certification with an additional component of humanization into the TFI Buddies existing Blue Ribbon Certification. The main goal of this innovation is to make University of Technology MARA (UiTM) campuses 100% tobacco free. The first project at the Sungai Buloh Campus resulted in a decrease in the percentage of ‘hotspots’, whereby the number of cigarette butts was found to be greatly reduced. In addition, the percentage of staff with good knowledge and attitude on the effects of cigarettes increased. Feedback from users comprising staff and students also showed a very positive response. The direct impact on faculty and campuses include cost savings in terms of medical expenses and increase in staff productivity. The long-term effects include enhancing UiTM’s image nationally and internationally. From a social point of view, this in addition creates a more caring and responsible generation of colleagues and the environment.
The objective of this study was to evaluate consumers' perceptions regarding "modern medicines" in Penang, Malaysia. To conduct this exploratory study, qualitative techniques were used. Consumers more than 19 years of age and could speak English, who had visited a pharmacy in the last 30 days, were included from the four major areas of Penang. Eighteen interviews were conducted until the point of saturation. The interviews were audio-taped and then transcribed verbatim for thematic content analysis. Many consumers correctly identified the major characteristics and properties of modern medicines; however, others raised doubts regarding the safety, quality and efficacy of "modern medicines". There were many misconceptions such as "all modern medicines can cause dependence", traditional medicines are completely "free of side-effects" and "Western medicines cure while Chinese medicines don't". Color was also considered a strong determinant of the safety and characteristics of a medicine. Regarding consumers' "medicine information seeking behavior", many consumers would seek information from doctors and pharmacists; however, there were others, who would look for books, or get it from the internet and friends. Of concern many consumers emphasized that while "self-searching for drug information" they would only look for side-effects. Misconceptions regarding medicine-taking behavior, medicine use and compliance were also identified. Though several consumers complied with the medicine-taking instructions, many reported that they would stop taking medicines, once they feel better. Though many consumers correctly identified the characteristics of "modern medicines", misconceptions regarding "medicine information sources and "medicine-taking behavior" were rampant. The situation demands corrective actions including community-oriented educational campaigns to improve "medicine use" in the society.
Chikungunya infections were detected in Singapore among returning travelers who had visited friends and relatives (VFR) in India and Malaysia. These sporadic imported cases occurred over a year before the 2008 chikungunya outbreaks in Singapore, demonstrating the potential for introducing this emerging viral infection into new areas via VFR travel.