A prospective study of dengue infection in Malaysia: A structural equation modeling approach

Background: Dengue fever has been a major health threat to Malaysia over one century since 1902. This situation is getting worse every year so that the government has taken an affirmative action to tackle this particular issue. The purpose of this study was to investigate the effect of government support, climate changes, public attitude, population growth, and environment on dengue infection. Also, this study considered the environment as a mediator construct as the past literature revealed its role in dengue infection model. Methods: In order to identify the relationship between exogenous and endogenous constructs, structural equation modeling (SEM) was used. Also, in order to identify the factors affecting dengue infection, measurement and structural model evaluation were applied. Using stratified sampling method, 670 questionnaires were distributed among prospective respondents from eastern region, but in turn, only 505 cases could be used after data cleaning process. Results: Considering environment factor as a mediator, the results show that public attitude and population growth have a significant impact on the environment, while government support, public attitude, and environment factors have a significant impact on dengue infection. Population growth was the most important factor affecting dengue fever. Conclusion: According to the results, dengue fever that emanating from four exogenous and one mediator constructs are adequate to discuss on respondent perception of dengue fever in Malaysia.