ArticleScientific reports2026
Uneven mosquito control knowledge, attitudes, and practices in Malaysia shape sustainable dengue prevention across urban and rural settings.
Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Dengue remains a persistent public health challenge in Malaysia, where rapid urbanization, ecological transformation, and behavioral gaps sustain Aedes mosquito proliferation despite decades of control programs. Understanding geographic and urban-rural disparities in community knowledge and preventive practices is essential for developing sustainable, evidence-based strategies. This cross-sectional study, conducted from February to May 2024, involved 866 respondents from 12 states in Peninsular Malaysia representing diverse urban and rural populations. Using a validated Knowledge, Attitudes and Practices (KAP) questionnaire, composite Knowledge, Practice, and Overall KAP indices were computed on a 0-100% scale. State-level differences were examined using one-way ANOVA with post-hoc tests, and urban-rural disparities were evaluated using Welch's t-tests and Mann-Whitney U tests. Significant heterogeneity was found across states for all indices. Knowledge scores varied widely (F(11,854) = 8.42, p < 0.001, η²=0.10), with Selangor and Perak scoring highest (≥ 80%) and Kedah and Pulau Pinang lowest (< 60%). Practices lagged behind knowledge (F(11,854) = 6.17, p < 0.001, η²=0.07), with Johor showing the strongest knowledge-behavior alignment. Urban respondents exhibited higher knowledge in Johor (+ 0.34, 95% CI: 0.21-0.47) and Pahang (+ 0.29, 95% CI: 0.14-0.44), whereas rural communities in Selangor scored slightly higher (-0.13, 95% CI: - 0.24 to - 0.01). The findings reveal persistent state-level and urban-rural inequalities in mosquito control literacy and behavior. These results highlight the broader relevance of localized, participatory strategies for strengthening dengue prevention across diverse socio-ecological settings, with potential applicability to other endemic regions globally.
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