Dengue has become a global public health problem. Despite reactive efforts by the government in Malaysia, the dengue cases are on the increase. Adequate knowledge, positive attitude and correct practice for dengue control are essential to stamp out the disease. Hence, this study aims to assess the factors associated with dengue knowledge, attitude and practice (KAp), as well as the association with dengue igM and igG seropositivity. A community-based cross-sectional study was conducted in a closed, dengue endemic area with multi-storey dwellings. Five hundred individuals (aged 18 years and above) were approached for pre-tested KAp and seroprevalences assessment. the study showed only half of the total participants have good knowledge (50.7%) but they had insufficient knowledge about dengue during pregnancy. 53.2% of people had poor attitude and 50.2% reported poor practice for dengue control. Out of 85 respondents who agreed to participate in the dengue seroprevalence study, 74.1% (n = 63) were positive for dengue IgG and 7.1% (n = 6) were positive for dengue IgM. Among all sociodemographic variable, race is the only independent predicator for all KAp levels (p < 0.05). In conclusion, proactive and sustainable efforts are needed to bring a behavioural change among communities in order to fight dengue outbreaks in endemic areas. Dengue fever is a mosquito-borne viral disease caused by a flavivirus. There are four distinct serotypes of dengue virus, namely DEN-1, 2, 3 and 4. Female Aedes aegypti and Aedes albopictus mosquitoes are the primary and secondary vectors in Malaysia, respectively. Evidently, dengue is the most rapidly spreading arboviral disease in the world. The Global Burden of Disease reported that dengue incidence has multiplied to six-folds from 1990 to 2013, with Southeast Asia region contributing 52% of the disease burden 1. World Health Organisation (WHO) estimates that 50 million to 100 million cases occur annually 2 .The disease is currently endemic in more than 100 countries, with SouthEast Asia being among the worst affected region. Dengue fever was established in Malaysia ever since the first reported case of dengue in 1902. From then on, the numbers of cases continued to rise despite numerous initiatives undertaken by the Ministry of Health to curb the disease 3,4. According to WHO, the recent cumulative case count in Malaysia from 1 Jan to 2 Mac 2019 was 157% higher than that of the same period in 2018 5. In addition, a total of 79,151 dengue cases have been reported until end of July 2019 nationwide, with Selangor state contributing more than 50% of the cases (n = 40,849, 51.6%) 6. Vector control and surveillance is still the mainstay of dengue prevention strategies since there is no specific treatment for disease and vaccination remains a non-viable option 7. Local programs like Communications for Behavorial Changes (COMBI) in Malaysia have proved their potential effect in reducing dengue morbidity 8 but it requires understanding from community as well 9. Besides, vector control measures ...

Background Dengue is a global disease, transmitted by the Aedes vectors. In 2018, there were 80 615 dengue cases with 147 deaths in Malaysia. Currently, the nationwide surveillance programs are dependent on Aedes larval surveys and notifications of lab-confirmed human infections. The existing, reactive programs appear to lack sensitivity and proactivity. More efficient dengue vector surveillance/control methods are needed. Methods A parallel, cluster, randomized controlled, interventional trial is being conducted for 18 months in Damansara Damai, Selangor, Malaysia, to determine the efficacy of using gravid oviposition sticky (GOS) trap and dengue non-structural 1 (NS1) antigen test for early surveillance of dengue among Aedes mosquitoes to reduce dengue outbreaks. Eight residential apartments were randomly assigned into intervention and control arms. GOS traps are set at the apartments to collect Aedes weekly, following which dengue NS1 antigen is detected in these mosquitoes. When a dengue-positive mosquito is detected, the community will be advised to execute vector search-and-destroy and protective measures. The primary outcome concerns the the percentage change in the (i) number of dengue cases and (ii) durations of dengue outbreaks. Whereas other outcome measures include the change in density threshold of Aedes and changes in dengue-related knowledge, attitude and practice among cluster inhabitants. Discussion This is a proactive and early dengue surveillance in the mosquito vector that does not rely on notification of dengue cases. Surveillance using the GOS traps should be able to efficiently provide sufficient coverage for multistorey dwellings where population per unit area is likely to be higher. Furthermore, trapping dengue-infected mosquitoes using the GOS trap, helps to halt the dengue transmission carried by the mosquito. It is envisaged that the results of this randomized controlled trial will provide a new proactive, cheap and targeted surveillance tool for the prevention and control of dengue outbreaks. Trial registration This is a parallel-cluster, randomized controlled, interventional trial, registered at ClinicalTrials.gov (ID: NCT03799237), on 8th January 2019 (retrospectively registered). Electronic supplementary material The online version of this article (10.1186/s40249-019-0584-y) contains supplementary material, which is available to authorized users.

Dengue remains a major public threat and existing dengue control/surveillance programs lack sensitivity and proactivity. More efficient methods are needed. A cluster randomized controlled trial was conducted for 18 months to determine the efficacy of using a combination of gravid oviposition sticky (GOS) traps and dengue non-structural 1 (NS1) antigen for early surveillance of dengue among Aedes mosquito. Eight residential apartments were randomly assigned into intervention and control groups. GOS traps were placed at the intervention apartments weekly to trap Aedes mosquitoes and these tested for dengue NS1 antigen. When dengue-positive pool was detected, the community were notified and advised to execute protective measures. Fewer dengue cases were recorded in the intervention group than the control. Detection of NS1-positive mosquitoes was significantly associated with GOS Aedes index (rs = 0.68, P < 0.01) and occurrence of dengue cases (rs = 0.31, P < 0.01). Participants’ knowledge, attitude, and practice (KAP) toward dengue control indicated significant improvement for knowledge (P < 0.01), practice (P < 0.01) and total scores (P < 0.01). Most respondents thought this surveillance method is good (81.2%) and supported its use nationwide. Thus, GOS trap and dengue NS1 antigen test can supplement the current dengue surveillance/control, in alignment with the advocated integrated vector management for reducing Aedes-borne diseases.

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24.0%) cases were confirmed to be positive. Multivariable analysis revealed that LNM was associated with head/uncinate location (p=0.021), largest tomur size>2cm (p=0.004), increasing tumor grade (p=0.021), lymph vascular invasion (p<0.001) and distant metastasis (p=0.001). With a median follow up of 34.5 months, 144 (13.5%) patients recurred and 124 (11.6%) patients died of disease progression. The median OS of N1 group was 127.2 moths, which was significantly shorter than N0/Nx group (176.4 months, p<0.001). For patients underwent curative resection (R0/R1, n=1012), the median RFS in N0/Nx group was also superior to N1 group (not reached vs. 91.1 months, p<0.001). In addition, number of positive lymph node>5 was associated with worse OS (p=0.013). Lymphadenectomy was mostly performed in distal pancreatectomy (59.9%), tumor size >2cm (89.7%), and grade G3 (93.8%). The median OS in Nx group (190.9 months) was similar to N0 group (176.4 months, p=0.265). Conclusion: LNM are valuable predictor of poor outcomes for pNETs. Surgery without LA is safe in selected patients with small G1 lesions, normal sized and soft lymph nodes.