Strengthening public understanding and prevention of dengue in Malaysia: insights and recommendations based on knowledge, attitudes, and practices toward vector control and vaccination.

Objectives: Malaysia continues to experience a high dengue burden, despite long-standing national education and control efforts. This study aimed to examine public Knowledge, Attitudes, and Practices related to dengue prevention, with a focus on informing more targeted education, vector control, and vaccination strategies. Methods: This study analysed Malaysia-specific data from the publication Knowledge, Attitudes and Practices toward Dengue Fever, Vector Control, and Vaccine Acceptance Among the General Population in Countries from Latin America and Asia-Pacific: A Cross-Sectional Study (Growth and Emerging Markets Knowledge, Attitude and Practice [GEMKAP]) conducted between September and October 2022. A total of 400 adults aged 18-60 from Malaysia completed the online questionnaire, which assessed dengue-related knowledge, attitudes, practices, and vaccine willingness. Results: Awareness of dengue transmission was high, however, misconceptions about reinfection risks, availability of a cure, and vaccine safety remain. Knowledge score (46%) aligned with global and Asia-Pacific averages, while Attitude (61%) and Practice (46%) scores were slightly lower than global benchmarks (66 and 48%, respectively). Although most respondents perceived dengue as a serious threat and reported removing stagnant water as a preventive measure, more intensive actions were less commonly practised. A total of 41% expressed high willingness to receive a dengue vaccine, as measured before a dengue vaccine TAK-003 (Qdenga) became available in Malaysia. Key barriers included concerns about side effects and insufficient information. Subgroup analysis showed higher willingness to vaccinate among respondents with prior dengue exposure, strong perceptions of disease severity, a generally pro-vaccine stance, and prior COVID-19 vaccination. While healthcare professionals were widely trusted sources of dengue information, this did not translate into higher vaccine acceptance. In addition, 40% of Malaysian respondents supported a multi-pronged dengue prevention strategy incorporating vaccination, education, and vector control. Conclusion: Future prevention efforts should prioritise coordinated messaging led by the Ministry of Health, through a multi-stakeholder task force involving healthcare professionals and community leaders. Efforts should focus on addressing misconceptions on dengue and vaccination, strengthening communication through trusted channels, and promoting more consistent adoption of vector control practices. Improving access to clear and reliable information on dengue vaccines will be critical to reducing hesitancy and supporting uptake.