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Background: We reviewed studies on the prevalence of Chlamydia infection as a risk factor for developing cervical cancer in a meta-analysis studies published in that subject area. Methods: Cochrane Library and PubMed databases were systematically searched for articles (observational and randomized controlled trials) published from 2008-2018. A meta-analysis of studies was performed to analyse the association between chlamydia infection and cervical cancer. Results: Five articles were included in the final analysis (N=5271). All five articles were case-control studies, of which three studies sampled from population-based registries. All studies involved with sexually active women with minimum 15 years old. Three studies reported the association of C. trachomatis infection cervical cancers, two other studies reported C. trachomatis-HPV co-infection in association with cervical cancer. Result showed C. trachomatis has an overall prevalence of 31.9%, pooled OR 1.96, 95% CI 1.05 to 3.67, OR 2.13, 95% CI 1.78 to 2.54 among cervical cancer. There was a mild publication bias detected at 3.0 effect estimation. Heterogeneity detected from clinical and methodological diversities particularly from C. trachomatis-HPV co-infection subgroup analysis, including sampling bias, geographical strain diversity, and different outcome endpoint measured. Conclusion: C. trachomatis infection was significantly associated with the development of cervical cancer. Co-infection of C. trachomatis-HPV with cervical cancer is plausibly sound but temporality of C. trachomatis-HPV with the development of cervical cancer need to be proven in future prospective cohort studies.

Background: The insecticides used widely has led to resistance in the vector and impose a challenge to vector control op- eration. Objectives: This review aims to analyse the distribution of insecticide resistance of dengue vectors in South East Asia and to describe the mechanism of insecticide resistance. Methods: Literature search for articles published on 2015 to 2019 from PubMed, Scopus and ProQuest was performed. Total of 37 studies included in the final review from the initial 420 studies. Results: Pyrethroid resistance was concentrated on the west coast of Peninsular Malaysia and Northern Thailand and scat- tered at Java Island, Indonesia while organophosphate resistance was seen across the Java Island (Indonesia), West Sumatera and North Peninsular Malaysia. Organochlorine resistance was seen in Sabah, Malaysia and scattered distribution in Nusa Tenggara, Indonesia. V1016G, S989P, F1269C gene mutation in Aedes Aegypti were associated with Pyrethroid resistance in Singapore and Indonesia. In Malaysia, over-expressed with monooxygenase P450 genes (CYP9J27, CYP6CB1, CYP9J26 and CYP9M4) Glutathione S-transferases, carboxylesterases commonly associated with pyrethroids resistance in Aedes Aegypti and CYP612 overexpressed in Aedes Albopictus. The genetic mutation in A302S in Aedes Albopictus was associated with organochlorine resistance in Malaysia. Conclusions: Rotation of insecticide, integration with synergist and routine assessment of resistance profile are recom- mended strategies in insecticide resistance management. Keywords: Insecticide resistance; vector management; Aedes; pyrethroid; mortality.

This study primarily intends to determine visitors’ perception of leptospirosis health hazard warning signage and its effectiveness within natural recreational parks in the district of Hulu Langat. This cross-sectional study was conducted in four out of seven natural recreational parks, installed with leptospirosis health hazard warning signage. A total of 209 respondents were recruited purposively in this study and completed the questionnaires. Majority of the respondents were male (57.4%), 40 years old and below (89.5%), received tertiary education (68.5%), staying outside Hulu Langat district (83.2%), visited for the first time (63.6%), and noticed the presence of leptospirosis health hazard warning signage at the park entrance (69.4%) and within the recreational park (64.2%). A significant relationship was discovered between respondents’ education level and perception of the health hazard warning signage (p-value 0.034). The rate of visits and noticeability of the health hazard warning signage were significantly associated with the effectiveness of the content on the health hazard warning signage (p-value 0.002 and 0.004, respectively). The construction of health hazard warning signage at the recreational areas should suit the social and educational background of the population. Visitors’ discernment of the effectiveness of erecting leptospirosis health hazard warning signage within natural recreational parks in the district of Hulu Langat is good if the signage is perceptible even with subsequent repeated visits to the parks.