Citation
Abdul Halim, Ahmad Farid Nazmi and Hassan, Mohd Rohaizat and Hod, Rozita and Sharif, Khaironi Yatim and Mohd Ali, Noor Khalili and Dapari, Rahmat and Syed Abdul Rahim, Syed Sharizman and Ahmad Zamzuri, Mohd ‘Ammar Ihsan and Jamhari, Mohd Nazrin and Md Hanif, Shahrul Azhar and Mohd Ghazali, Qistina
(2025)
Effectiveness of COMBI in dengue prevention and control and participation factor: a systematic review in Malaysia.
Medicine & Health, 20 (2).
pp. 432-452.
ISSN 2289-5728
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.
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