International Journal of Science and Healthcare Research Vol.3; Issue: 4; Oct.-Dec. 2018 Website: www.ijshr.com Original Research Article ISSN: 2455-7587 The Comparison of Environmental Conditions between Hotspot and Non Hotspot Areas of Dengue Outbreak in Selangor, Malaysia Nurul Akmar Ghani1, Shamarina Shohaimi1, Alvin Kah Wei Hee1, Chee Hui Yee2, Oguntade Emmanuel3, Lamidi Sarumoh Alaba Ajibola4 1Department of Biology, Faculty of Science, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia 2Department of Microbiology and Parasitology, Faculty of Medicine, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia 3Institute for Mathematical Research, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia 4Department of Mathematics, Faculty of Science, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia Corresponding Author: Nurul Akmar Ghani ABSTRACT INTRODUCTION Dengue affects 40% of worldwide Dengue fever is one of the most killer vector- population and becomes the most killer borne disease in the world and Malaysia has vector-borne disease in the world. [1] In recorded increases in number of dengue cases Asia, high dengue incidences were reported, and deaths since 2012. For several years, and in Southeast Asia, the tropical and Selangor state recorded the highest number of cases and deaths in Malaysia due to dengue warmer part of Asia, mortality and morbidity rate of dengue were continuously fever. Most of the dengue infections occur [2] among people who live in hotspot areas of reported at higher incidence annually. dengue, and less likely to occur among people Two most well-known mosquitoes that who live in non-hotspot areas. This study aims spread dengue virus are Aedes aegypti and to compare the difference of environmental Aedes albopictus. [3] conditions between hotspot and non-hotspot Malaysia, a country located in areas of dengue. 20 hotspot and 20 non-hotspot Southeast Asia also experiences high areas in Selangor were chosen in this study and number of dengue incidence which reaches 10 variables were checked and given scale high peaks once every few years. In 2013 according to their conditions. Total marks of the number of dengue incidence was 43,436 each area were then calculated and difference in means between hotspot and non-hotspot areas cases and in 2014 and 2015, the number was compared using Independent T-test. Result increased to 108,698 and 120,836, shows that there was significant mean difference respectively. In 2016, the number of dengue of marks of environmental conditions between incidence in Malaysia slightly decreased both areas (p value: <0.001; 28.30 vs 22.90). with 101,357 cases. Nevertheless, the The result of this study shows that non-hotspot number was still high compared to a few areas were cleaner and more hygienic than years before that. [4] Selangor recorded the hotspot areas, which suggests public health highest dengue incidence among all states in education and routine hygiene inspection to be Malaysia, with total number of 62,867 and done more frequently in hotspot areas to ensure 51,652 cases in 2015 and 2016 respectively. their cleanliness in order to fight dengue [5] outbreak, which consequently helps reduce the number dengue cases and deaths. Selangor is a state with high population density in Malaysia compared to Keywords: Dengue, Dengue environment, other states and the behaviour of its citizens Dengue Incidence, Dengue Hotspot, Dengue has high influence on dengue spread and Outbreak transmission. [6] Most dengue cases usually occur in urban area, favourable for its high density population and rapid development International Journal of Science and Healthcare Research (www.ijshr.com) 197 Vol.3; Issue: 4; October-December 2018 Nurul Akmar Ghani et.al. The Comparison of Environmental Conditions between Hotspot and Non Hotspot Areas of Dengue Outbreak in Selangor, Malaysia that help the process of dengue transmission based on their current status in iDengue to be faster. [4] The condition of surrounding portal website supervised by Malaysia areas affects dengue spread too, where Ministry of Health and Ministry of Science, institutional, workshops and agriculture Technology and Innovation which is areas presented more dengue vector habitat updated on a weekly basis. especially after rainy seasons, while areas The assessment comprised of 9 with systematic and cleaner surroundings categories; building colour, building showed to have less habitats suitable for condition, cleanliness, parking area, Aedes. [5] playground, presence of possible Aedes In Malaysia, hotspot dengue is breeding sites, disposal system, sanitary and characterized by an area which has dengue drainage system, and presence of tires or outbreak for more than 30 days, while non- cans or bottles. Each categories were hotspot is an area free from dengue outbreak evaluated using Likert scale of 1 to 5, where for a month or more. [4] This study aims to low value meant dirtier and high value were compare environmental conditions between given to cleaner environment. Total marks hotspot and non-hotspot areas of dengue of all categories were calculated and outbreak. compared between hotspot and non-hotspot areas. METHODS Student’s t-test was used to compare A self-completed assessment was significant difference of marks of both areas conducted from November 2015 to October and statistical significance was set at 2016 in selected 20 hotspot and 20 non- p<0.05. This study obtained ethical approval hotspot areas in Selangor. Status of hotspot from Ministry of Health, Malaysia via and non-hotspot dengue areas were chosen National Medical Research Registry. RESULTS Table 1: Total score of each areas according to their level of cleanliness District Area Total score Mean (SD) for district Mean (SD) for hotspot/non-hotspot Petaling Taman Sri Serdang 17.00 22.63 (6.09) 22.90 (4.77) Taman Universiti Indah 24.00 Taman Sg Besi Indah 18.00 Pangsapuri Enggang 14.00 Pangsapuri Putra Permai 23.00 Pangsapuri Damai Utama 33.00 Taman Lestari Putra 26.00 Taman Pinggiran Putra 26.00 Hulu Langat Pangsapuri Suakasih 24.00 26.01 (1.90) Taman Kajang Mulia 27.00 Seksyen 3 Bandar Baru Bangi 28.03 Pangsapuri Cempaka 25.00 Seksyen 16 Bandar Baru Bangi 28.00 Taman Taming Jaya 24.00 Gombak Taman Sunway Bt Caves 7 23.00 20.17 (3.19) Taman Sunway Bt Caves 9 23.00 Taman Sri Gombak 23.00 Flat Pinggiran Bt Caves 16.00 Flat Selasih 18.00 Flat Samudera 18.00 Gombak Taman Wahyu 28.00 28 28.30 (2.7) Taman Tasik Indah 28.00 Petaling Taman Lestari Permai 27.00 31.4 (4.16) Kota Perdana 27.00 Pangsapuri Mayang 36.00 Kondo Desaminium 33.00 Taman Puncak Jalil 6 34.00 Hulu Langat Taman Saujana Impian 29.00 27.40 (0.89) Seksyen 4 Bandar Baru Bangi 27.00 Seksyen 7 Bandar Baru Bangi 27.00 Taman Kantai Permai 27.00 Taman Damai Mewah 27.00 Kuala Taman Iram Perdana 27.00 27 International Journal of Science and Healthcare Research (www.ijshr.com) 198 Vol.3; Issue: 4; October-December 2018 Nurul Akmar Ghani et.al. The Comparison of Environmental Conditions between Hotspot and Non Hotspot Areas of Dengue Outbreak in Selangor, Malaysia Table 1 to be continued... Langat Taman Panglima 27.00 Hulu Taman Anggerik 27.00 27 Selangor Taman Kemboja 27.00 Taman Seroja 27.00 Kuala Taman Serindit 27.00 27 Selangor Taman Melawati Jaya 27.00 Taman Rhu Permai 27.00 Table 1 shows total score of each area of than 27 marks with lowest value at 14, hotspot and non-hotspot with respect to their while for non-hotspot areas most of them level of cleanliness, presence of Aedes scored more than 27 marks with 36 as the breeding sites, pond, forest and other highest value. Hotspots areas in Gombak hotspots nearby. The higher the marks, the showed the lowest average, 20.17 while better the overall environment condition of non-hotspot areas in Petaling showed the areas. Most hotspot areas scored less highest average value, 28. Table 2: Comparison of mean marks of environmental condition between Hotspot and Non-hotspot Areas Variables Hotspot Non Mean difference T-statistic P value (n=20) Hotspot (n=20) (95% CI) (df) Mean (SD) Mean (SD) Environment 22.90 (4.77) 28.30 (2.70) 5.40 (2.90, 7.90) 38 <0.001 Table 2 illustrates results of T-test Aedes albopictus were found significantly comparing mean difference of higher in hotspot areas. [7] Previous studies environmental conditions total marks in Ecuador demonstrated that the abundance between hotspot and non-hotspot areas. presence of Aedes mosquitoes were highly Result shows that there was significant correlated with poor housing conditions, difference of total marks of environmental poor sanitary system, low income, housing condition between hotspot and non-hotspot type and cost to buy vector control. [8] areas, where mean of overall environmental According to the survey, people condition for non-hotspot areas was higher living in non-hotspot areas had better than hotspot areas (22.90 vs 28.30). The careers, higher average household income, mean difference was reported to be 5.40 higher education level and smaller (95% CI 2.90, 7.90), with p value of less household numbers than people living in than 0.001. hotspot areas. Education level does affect The results indicate that non-hotspot people’s knowledge, attitude and practices areas had better, cleaner and more on control on vector, where people with comfortable environmental conditions to better literacy level show more live in with less risk exposure to dengue responsibility on taking care of their homes outbreak. and surrounding. [9] People with smaller households, and with children show more DISCUSSION concern to maintain cleanliness and safety The result of this study shows that of their environment than people with more the dirtier the environment of an area is, the household and with no children.