Suhaily Mohd Hairon

Background: Rabies remains a nearly invariably fatal zoonosis after clinical onset, requiring prevention-focused strategies. Adult dog owners are critical stakeholders in disrupting dog-mediated transmission. The objective was to evaluate the effectiveness of the Rabies Health Education Module (RaHEM) in improving the knowledge and attitudes toward rabies preventive measures, specified as two co-primary outcomes. Methodology: An open-label randomised controlled trial was conducted among 80 dog owners in Kelantan, Malaysia. Participants were randomised to RaHEM or unrelated educational material. RaHEM comprised 26 expert-led multimedia videos with interactive activities. The two co-primary outcomes were changes in knowledge and attitude scores from baseline to one-month follow-up, analysed using one-way MANOVA. The trial was retrospectively registered with Australian New Zealand Clinical Trial Registry (ACTRN12624000432516). Results: There were no statistically significant differences in sociodemographic, pet dog, or environmental factors between the intervention and control groups at baseline. The study demonstrated significant improvements in the intervention group compared to the control group (Wilks' λ=0.627; F(2,77)=22.921; p-value<0.001; partial η²=0.373). Specifically, participants in the intervention group exhibited greater changes in knowledge scores (F(1,78)=8.70; p-value=0.004; partial η²=0.10) and attitude scores (F(1,78)=46.44; p-value<0.001; partial η²=0.37). Conclusion: RaHEM improved knowledge and attitude scores towards rabies prevention at one-month follow-up among dog owners in Kelantan, Malaysia.

Non-typhoidal Salmonella remains a major, yet fragmented foodborne threat in Asia, driven by evolving food systems, demographic transitions, cross-border mobility, and antimicrobial resistance. This study combined bibliometric and narrative approaches to map research trends (2015-2024) and synthesise public health–relevant evidence to identify gaps and priorities. Peer-reviewed articles were retrieved from PubMed/PMC, Scopus, and Web of Science. Publication trends, keyword networks, and thematic evolution were assessed using bibliometrix R package. Evidence on burden, serovar distribution, antimicrobial resistance, and molecular epidemiology was extracted and synthesised thematically. A total of 186 studies were included, with an average annual growth rate of 21.45%. Research was concentrated in East and Southeast Asia, limiting geographical representativeness. Dominant themes were disease occurrence and surveillance, serovars, and AMR, with marked geographical heterogeneity. Studies primarily focused on paediatric, hospitalised, and invasive infections, while asymptomatic carriage and community-level burden were underrepresented. Salmonella Typhimurium and Enteritidis predominated; however, monophasic variants and shifting sequence types, notably an increase in ST34, were reported. Widespread multidrug resistance and mobile resistance genes highlight growing treatment challenges and the risk of regional dissemination. Genomic surveillance is expanding but geographically uneven. Strengthening surveillance, expanding genomic capacity, and regional coordination are crucial to address this escalating public health threat.

Osong Public Health and Research Perspectives

Breast cancer screening hesitancy remains a major public health concern in China, where institutional screening resources are unevenly distributed. Breast

Background Breast cancer screening is essential for early detection and reducing mortality; however, hesitancy towards screening persists globally, particularly in low- and middle-income countries (LMICs). To further understand the psychological, cultural, and structural barriers we need to utilize the validated tools to measure screening hesitancy as the first step in improving participation rates in the future. Method This systematic scoping review uses the Arksey and O’Malley framework together with the PRISMA extension, to filter studies based on relevancy regarding breast cancer screening and analytical quality. Studies are pulled from academic databases such as PubMed, Scopus, Web of Science, and Google Scholar that include frameworks such as the Health Belief Model (HBM) and Knowledge Attitude Practice (KAP) that focus on psychological and behavioral factors. The studies are pulled from the past decade. Results This review identified numerous frameworks used around the globe for determining screening hesitancy. However, among the most developed countries, HBM and KAP were the most widely used frameworks. These tools have good measurements of psychometric factors, but their lack of cultural adaptation limits their application in more diverse environments, especially in LMICs. Conclusion The findings highlight there need to have a more culturally adaptive, and a high psychometric standard tool for measuring breast cancer screening hesitancy. In the future, research should focus on developing more adaptive tools and using digital platforms to increase accessibility. By addressing these gaps, public health strategies can better reduce screening hesitancy, enhance early detection, and improve health conditions worldwide. BJMS, Vol. 24 No. 04 October’25 Page : 1304-1328

ObjectivesThis study aimed to validate the psychometric properties of the recently developed knowledge, attitudes, and perceptions questionnaire for community-based surveillance of infectious diseases (KAP-CBS-ID questionnaire), using confirmatory factor analysis (CFA) and item response theory (IRT).MethodsA cross-sectional study using multistage sampling recruited 470 schoolteachers from Kelantan, Malaysia. The self-administered KAP-CBS-ID questionnaire consists of 3 domains: knowledge (31 items), attitudes (23 items), and perceptions (21-items). Two-parameter logistic (2-PL) IRT analysis and CFA were performed to validate the knowledge section. For attitudes and perceptions sections, CFA proceeded using a 4-factor model to evaluate both model fit and construct validity.ResultsTwo-PL IRT analysis of the knowledge section resulted in elimination of 14 items due to inadequate discrimination or difficulty parameters. The 3-factor CFA model demonstrated good fit indices for knowledge (root mean square error of approximation [RMSEA], 0.028; comparative fit index [CFI], 0.945; Tucker-Lewis index [TLI], 0.941) without any modifications. The attitudes section required re-specification, ultimately yielding 21 items across 4 factors with acceptable fit indices (standardized root mean square residual [SRMR], 0.067; RMSEA, 0.055; CFI, 0.937; TLI, 0.927). Similarly, the perceptions section was refined to 17 items across 4 factors, showing good model fit (SRMR, 0.055; RMSEA, 0.059; CFI, 0.962; TLI, 0.954). Factor loadings ranged from 0.33 to 0.98, while Raykov’s rho reliability estimates ranged from 0.71 to 0.93. Factor determinacy exceeded 80% for all factors.ConclusionThe KAP-CBS-ID is a valid and reliable instrument for assessing community representatives’ knowledge, attitudes, and perceptions regarding community-based surveillance of infectious diseases.