Introduction Several countries have started mass vaccination programs to halt the spread of the COVID-19 pandemic. With an R naught value of 2 to 3, about 70% of the population needs to be immunized to achieve herd immunity. This study aimed to investigate the reasons for acceptance or refusal of COVID-19 vaccines among the Malaysian population. Methodology An exploratory, descriptive qualitative design was performed. The cross-sectional survey used a non-probability convenient sampling technique to recruit the respondents, who were required to answer an open-ended question: Either "If you are willing to get the vaccine, please state your reason" or "If you are not willing to get vaccinated, please state your reason." The survey also included questions on demography such as age, gender, and place of residence. According to the Health Belief Model, the data was transcribed, translated, and analyzed: perceived susceptibility, perceived severity, perceived barrier, and cues for action. Results A total of 1091 respondents who completed the online survey comprised 685 (62.8%) females, 406 (37.2%) males, with a mean age of 38.16 (SD = 16.44). The majority (81.1%) were willing to get vaccinated. Thematic analysis showed that most respondents perceived that the vaccine is safe, effective, protective and will provide herd immunity. Barriers to vaccination include unknown long-term side effects, rapid vaccine production, inadequate information and concerns regarding halal status. Cues to vaccination included individual desire, social responsibility, economic concerns and wait-and-see behavior. Conclusions The public should be well informed about the vaccine, its efficacy, side effects, and halal status to increase vaccine acceptability and achieve herd immunity.

Background: Gargling had been reported to have significant roles in the prevention and treatment of respiratory tract infections. The purpose of this study was to assess the ability of regular gargling to eliminate SARS-CoV-2 in the oropharynx and nasopharynx. Methodology: This pilot, open labeled, randomized, parallel study compared the effect of 30 seconds, 3 times/day gargling using 1% povidone-iodine (PVP-I), essential oils and tap water on SARS-CoV-2 viral clearance among COVID-19 patients in a tertiary hospital in Kuala Lumpur. Progress was monitored by day 4,6 and 12 PCR (Ct value), gargling and symptoms diary as well as clinical observations. Results: Five confirmed Stage 1 COVID-19 patients were recruited for each arm. The age range was from 22 to 56 years old. The majority were males. Two respondents had co-morbidities, which were asthma and obesity. Viral clearance was achieved at day 6 in 100%, 80%, 20% and 0% for 1% PVP-I, essential oils, tap water and control group respectively. Analysis of 1% PVP-I group versus control group showed significant p-value for comparison of PCR results on Day 4, Day 6 and Day 12. Conclusions: This preliminary study showed that gargling with 1% PVP-I and essential oils show great potential to be part of the treatment and management of Stage 1 COVID-19. Larger studies are required to ascertain the benefit of gargling for different stages of COVID-19 patients. This study was registered in clinicaltrial.gov (NCT04410159).

Background: Absenteeism amongst pre-school children is often due to illnesses such as hand, foot, and mouth disease, acute gastroenteritis, cold and fu, which are easily spread amongst them. This is because of weak immunity and lack of knowledge on proper hand hygiene. This quasi-experimental study assessed the efcacy of an intervention consisting of a hand hygiene education programme, along with digital tools in bringing about a change in behaviour and health conditions amongst preschool children in Klang Valley, Malaysia. Methods: A total of 377 school children, male and female, aged 5–6 years old, participated and were assigned to either the intervention or a control group. During the 2 months intervention period, children in the test group were trained on proper hand hygiene practices and techniques with the aid of the interactive android-based tablets. The numbers of absent days of all the children were recorded for 2 months before the intervention and during the intervention. Results: In the test group, there was a 25% increase in the total number of absent days from the pre-intervention period to the intervention period, a much lesser increment observed as compared to that of control group in which the increase was much higher at 89%. Results: showed a signifcant diference (P<0·05) between the absenteeism rates for the test and control group during the intervention period. Conclusion: These results suggest that proper education and intervention increase hand hygiene compliance, which may help decrease school absenteeism due to illness; however, a longer study duration may be necessary to evaluate the beneft further.

Teachers in kindergarten play important role in educating correct hygiene practices to children. This study was conducted to assess the knowledge, practice and perceived barrier of hand hygiene among kindergarten’s teachers. Teachers from two kindergartens were recruited non randomly for a semi-structured face-to-face interview. The open-ended question comprised of questions on what, how and why to do hand hygiene, including what were perceived to impede and facilitate hand hygiene and monitoring process. Eight teachers agreed to participate. Four had attended courses related to hand hygiene and infections. None of them were able to demonstrate proper steps of hand hygiene. Most teachers suggested health promotion and campaigns to promote hand hygiene practices. Respondents believed that too much work hindered them from practicing hand hygiene. Hand hygiene knowledge was inadequate. Measures should be taken to ensure kindergarten teachers and caretakers are adequately trained and competent in providing safe environment to children under their care. Keywords: hand hygiene, teachers, kindergarten, childcare provider

Background- Infections spread easily among children in nurseries due to overcrowding and their natural intimacy. Disease transmission via skin (particularly hand) contact is preventable through proper hand hygiene and good sanitation. Parental support and involvement in developing child’s hygienic behavior are essential in promoting child’s well being. This study aimed to determine knowledge, attitudes and practices of parents on hand hygiene, related to the care of their children. Methods- This cross-sectional study involved 240 parents of preschoolers in the Klang Valley, Malaysia. Participants were given self-administered questionnaires consisting statements related to personal hand hygiene, hand hygiene practices during childcare and infections related to poor hand hygiene. Results- The mean score for knowledge of hand hygiene was 2.72(SD 0.26) out of 3.00.Meanwhile, the mean score for attitude and practice of hand hygiene were 4.56(SD 0.58) out of 5.00 and 4.36 (SD 0.65) out of 5.00 respectively. Overall results showed that majority of parents had a good understanding of hand hygiene. However, about two thirds parents did not agree on washing hands before interacting with their children. Of concern, about 76% parents are unaware of correct hand washing techniques. Conclusions- This study highlighted the need for more comprehensive educational programs to create awareness regarding the importance of hand hygiene particularly among parents and children. This is very important for prevention of communicable diseases in the community.

Hajj is one of the largest religious mass gatherings in the world that occurs once a year. Whereas umrah is a smaller scale gathering that occurs all-year round. Mass gatherings in Hajj and Umrah present unique challenges to both the host and travellers’ countries. Transmission of communicable diseases, primarily, airborne agents are facilitated by the nature of the hajj which includes long stay at holy sites, fatigue, high temperature and cramped accommodation. While mandatory meningococcal vaccination has proven highly effective in curtailing such diseases among pilgrims, a spectrum of other infectious threats persists. This article endeavours to shed light on existing infection control protocols while offering forward-looking recommendations to further fortify infectious diseases management. By diligently addressing these concerns, we can ensure the health and well-being of pilgrims, safeguarding these sacred journeys for generations to come.

Staphylococcus aureus is part of the normal human flora that can commonly be found on the skin and mucous membranes of the nasal area. However, in immunosuppressed patients such as those with kidney failures, colonization can potentially lead to infection. There is a concern of increasing antibiotic resistance in S. aureus. This study aimed to determine the prevalence of S. aureus nasal colonization and its antimicrobial susceptibility among haemodialysis-dependent populations. Methods: A cross-sectional study at the Nephrology Unit, Hospital Canselori Tuanku Mukhriz (HCTM) was conducted among haemodialysis-dependent patients between February 2017 to February 2018. Nasal swabs were obtained and cultured on mannitol salt agar. S. aureus isolates were identified by gram staining, tube coagulase and Deoxyribonuclease (DNase). Cefoxitin disc (30 µg) were used to identified the presence of MRSA (methicillin-resistance S. aureus). The S. aureus colonies were further tested against six antibiotics using Kirby Bauer disc diffusion. Result: A total of 134 patients were recruited. S. aureus isolates were detected from 27 patients (20.1%). All S. aureus were phenotypically identified as methicillin-sensitive S. aureus (MSSA) based on the cefoxitin disc. Teicoplanin and linezolid were the most effective with 100% susceptibility. S. aureus exhibited a high resistance rate towards erythromycin (29.6%). No MRSA was isolated in this study. Conclusion: This study highlighted the high prevalence of S. aureus nasal colonization in haemodialysis patients. Teicoplanin and linezolid were found to be the most effective antibiotics against isolated S. aureus.