Effectiveness of COMBI in Dengue Prevention and Control and Participation Factor: A Systematic Review in Malaysia
The Effectiveness of COMBI
Abstract
Most of the disease prevention, control and mitigation strategies rely heavily on community engagement, participation and ownership. Thus, behavioural and social interventions have become essential to outbreak mitigation efforts. The Communication for Behavioural Impact (COMBI) approach has been implemented in Malaysia to mobilise the community as the primary agent to prevent dengue transmission. This systematic review aimed to assess the effectiveness of COMBI in dengue prevention and control within Malaysia and identify factors influencing participation therein. This systematic review was registered with the PROSPERO database (CRD42022341967) and reported based on the PRISMA guideline. Original articles published in English from 2001 to 2023, reporting the level of knowledge, attitude and practice (KAP) and/or entomological indices, as well as factors influencing COMBI participation in Malaysia, were collected electronically from four databases. The mixed methods appraisal tool (MMAT) was used to evaluate the quality of the included articles. Four articles were included in this review, encompassing quantitative and qualitative study designs. They showed that COMBI had improved the level of KAP and reduced the presence of vectors during the active implementation period. Factors hindering participation in COMBI and its sustainability included poor leadership and commitment at the community level, as well as a lack of publicity and monitoring by health authorities due to limited resources. More well-conducted cluster randomised controlled trials are needed to provide evidence of real-life impact. Such trials should also measure COMBI’s impact on dengue infection. Additionally, new implementation strategies must be explored to maintain active participation in COMBI and achieve sustainability.
Keywords :
COMBI; dengue; effectiveness; participation; sustainability,
Abstrak
Kebanyakan strategi pencegahan, kawalan dan mitigasi penyakit bergantung kepada penglibatan, penyertaan dan pemilikan komuniti. Oleh demikian, intervensi tingkah laku dan sosial merupakan aspek penting dalam usaha mitigasi wabak. Strategi mobilisasi sosial dan komuniti (COMBI) telah dilaksanakan di Malaysia untuk menggerakkan komuniti sebagai agen utama dalam mencegah penularan denggi. Ulasan sistematik ini bertujuan untuk menilai keberkesanan COMBI dalam pencegahan dan kawalan denggi di Malaysia serta mengenal pasti faktor-faktor yang mempengaruhi penyertaan dalam COMBI. Ulasan sistematik ini didaftarkan dengan pangkalan data PROSPERO (CRD42022341967) dan dilaporkan berdasarkan garis panduan PRISMA. Artikel asal yang diterbitkan dalam Bahasa Inggeris dari tahun 2001 hingga 2023, yang melaporkan tahap pengetahuan, sikap, dan amalan (KAP) dan/atau indeks entomologi, serta faktor-faktor yang mempengaruhi penyertaan dalam COMBI di Malaysia, telah dikumpulkan secara elektronik daripada empat pangkalan data. Kualiti artikel yang diperolehi dinilai menggunakan Alat Penilaian Kaedah Campuran (MMAT). Empat artikel telah dipilih dalam ulasan ini, yang merangkumi reka bentuk kajian kuantitatif dan kualitatif. Hasil dapatan menunjukkan bahawa COMBI berupaya meningkatkan tahap KAP dan mengurangkan kepadatan vektor semasa tempoh pelaksanaan aktif. Faktor-faktor yang menghalang penyertaan dalam COMBI dan kemampanannya termasuk kepimpinan yang lemah dan kurang komitmen di peringkat komuniti, serta kekurangan publisiti dan pemantauan oleh pihak berkuasa kesihatan akibat sumber yang terhad. Lebih banyak kajian diperlukan untuk memberikan bukti impak dalam situasi sebenar. Kajian tersebut juga perlu mengukur kesan COMBI terhadap bebanan jangkitan denggi. Selain itu, strategi pelaksanaan baru perlu diterokai bagi memastikan penyertaan aktif dalam COMBI dan seterusnya mencapai kemampanan.
Kata Kunci :
COMBI; denggi; keberkesanan; kemampanan; penyertaan,
Correspondance Address
Mohd Rohaizat Hassan. Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. Tel: +6012-6343303 E-mail: rohaizat@hctm.ukm.edu.my
