{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:52:15Z","timestamp":1790729535209,"version":"4.1.0"},"reference-count":30,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2018,7,3]],"date-time":"2018-07-03T00:00:00Z","timestamp":1530576000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003093","name":"Ministry of Higher Education, Malaysia","doi-asserted-by":"publisher","award":["(203\/PPSP\/6770003)"],"award-info":[{"award-number":["(203\/PPSP\/6770003)"]}],"id":[{"id":"10.13039\/501100003093","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Leptospirosis is an infectious disease which can be prevented by increasing awareness and promoting preventive health behaviours among high risk groups including wet market workers. Thus, the aim of this study was to determine the effectiveness of Leptospirosis Health Intervention Program (LHIP) in improving knowledge, attitude, belief and practice towards leptospirosis among wet market workers in Kelantan. This intervention study was conducted in two main wet markets in Kelantan involving 116 participants in each control and intervention groups. The health education intervention was based on Leptospirosis Health Intervention Module. The knowledge, attitude, belief and practice scores were measured before and six weeks after the intervention to examine the effect of the program. The results showed that knowledge (p &lt; 0.001), attitude (p = 0.001), belief (p &lt; 0.001) and practice (p &lt; 0.001) scores changes were significantly higher in the intervention group compared to the control group. The adjusted mean differences were 12.93 (95% CI: 8.47, 17.39) for knowledge, 5.55 (95% CI: 2.28, 8.81) for attitude, 7.21 (95% CI: 3.43, 10.99) for belief and 7.35 (95% CI: 3.64, 11.05) for practice scores. Leptospirosis Health Intervention Program was an effective health educational tools to improve awareness and preventive behaviours among risk groups such as wet market workers.<\/jats:p>","DOI":"10.3390\/ijerph15071396","type":"journal-article","created":{"date-parts":[[2018,7,3]],"date-time":"2018-07-03T11:12:58Z","timestamp":1530616378000},"page":"1396","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Leptospirosis Health Intervention Module Effect on Knowledge, Attitude, Belief, and Practice among Wet Market Workers in Northeastern Malaysia: An Intervention Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Mas Harithulfadhli Agus Ab","family":"Rahman","sequence":"first","affiliation":[{"name":"Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4934-0001","authenticated-orcid":false,"given":"Suhaily Mohd","family":"Hairon","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6288-3791","authenticated-orcid":false,"given":"Rukman Awang","family":"Hamat","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Serdang 43400, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8269-5699","authenticated-orcid":false,"given":"Tengku Zetty Maztura Tengku","family":"Jamaluddin","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Serdang 43400, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7023-9717","authenticated-orcid":false,"given":"Mohd Nazri","family":"Shafei","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norazlin","family":"Idris","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5591-3315","authenticated-orcid":false,"given":"Malina","family":"Osman","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Serdang 43400, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surianti","family":"Sukeri","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zainudin A.","family":"Wahab","sequence":"additional","affiliation":[{"name":"Health Department of Federal Territory Kuala Lumpur and Putrajaya, Jalan Cenderasari, Kuala Lumpur 50590, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan Mohd Zahiruddin Wan","family":"Mohammad","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zawaha","family":"Idris","sequence":"additional","affiliation":[{"name":"Health Promotion Unit, Penang State Health Department, Floor 7, Bangunan Persekutuan, Jalan Anson 10400, Penang, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2706-1175","authenticated-orcid":false,"given":"Aziah","family":"Daud","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,7,3]]},"reference":[{"key":"ref_1","first-page":"116","article-title":"Leptospirosis","volume":"2","author":"Collins","year":"2006","journal-title":"Biomed. Sci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1590\/S1413-86702003000300003","article-title":"Leptospirosis in india and the rest of the world","volume":"7","author":"Rao","year":"2003","journal-title":"Braz. J. Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.2217\/fmb.10.102","article-title":"Leptospira as an emerging pathogen: A review of its biology, pathogenesis and host immune responses","volume":"5","author":"Evangelista","year":"2010","journal-title":"Future Microbiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"280","DOI":"10.3390\/pathogens3020280","article-title":"Leptospiral pathogenomics","volume":"3","author":"Lehmann","year":"2014","journal-title":"Pathogens"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Ellis, W.A. (2015). Animal leptospirosis. Leptospira and Leptospirosis, Springer.","DOI":"10.1007\/978-3-662-45059-8_6"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Victoriano, A.F.B., Smythe, L.D., Gloriani-Barzaga, N., Cavinta, L.L., Kasai, T., Limpakarnjanarat, K., Ong, B.L., Gongal, G., Hall, J., and Coulombe, C.A. (2009). Leptospirosis in the asia pacific region. BMC Infect. Dis., 9.","DOI":"10.1186\/1471-2334-9-147"},{"key":"ref_7","unstructured":"WHO (2017, February 02). Human Leptospirosis: Guidance for Diagnosis, Surveillance and Control. Available online: http:\/\/www.who.int\/iris\/handle\/10665\/42667."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Costa, F., Hagan, J.E., Calcagno, J., Kane, M., Torgerson, P., Martinez-Silveira, M.S., Stein, C., Abela-Ridder, B., and Ko, A.I. (2015). Global morbidity and mortality of leptospirosis: A systematic review. PLoS Negl. Trop. Dis., 9.","DOI":"10.1371\/journal.pntd.0003898"},{"key":"ref_9","unstructured":"CDC (2016, September 10). Leptospirosis, Available online: https:\/\/www.cdc.gov\/leptospirosis\/."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"7229","DOI":"10.3390\/ijerph10127229","article-title":"Leptospirosis: A silent epidemic disease","volume":"10","author":"Schneider","year":"2013","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1264\/jsme2.ME12154","article-title":"Pathogenic and saprophytic leptospira species in water and soils from selected urban sites in peninsular malaysia","volume":"28","author":"Benacer","year":"2013","journal-title":"Microbes Environ."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"704","DOI":"10.4269\/ajtmh.12-0662","article-title":"Isolation and molecular characterization of leptospira interrogans and leptospira borgpetersenii isolates from the urban rat populations of kuala lumpur, malaysia","volume":"88","author":"Benacer","year":"2013","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1111\/tmi.13033","article-title":"Seroprevalence of leptospira antibodies among market workers and food handlers in the central state of malaysia","volume":"23","author":"Suhailah","year":"2018","journal-title":"Trop. Med. Int. Health"},{"key":"ref_14","first-page":"52","article-title":"The rise of leptospirosis in kelantan 2014: Characteristics, geographical pattern and associated factors","volume":"3","author":"Azimullah","year":"2016","journal-title":"Int. J. Public Health Clin. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Zahiruddin, W.M., Arifin, W.N., Mohd-Nazri, S., Sukeri, S., Zawaha, I., Bakar, R.A., Hamat, R.A., Malina, O., Jamaludin, T.Z.M.T., and Pathman, A. (2018). Development and validation of a new knowledge, attitude, belief and practice questionnaire on leptospirosis in malaysia. BMC Public Health, 18.","DOI":"10.1186\/s12889-018-5234-y"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1111\/j.1365-2648.2004.03095.x","article-title":"Health promotion and health education: Advancing the concepts","volume":"47","author":"Whitehead","year":"2004","journal-title":"J. Adv. Nurs."},{"key":"ref_17","first-page":"5","article-title":"Health promotion: An effective tool for global health","volume":"37","author":"Kumar","year":"2012","journal-title":"Indian J. Community Med. Off. Publ. Indian Assoc. Prev. Soc. Med."},{"key":"ref_18","unstructured":"Glanz, K., Rimer, B.K., and Viswanath, K. (2008). Health Behavior and Healtheeducation: Theory, Research, and Practice, John Wiley & Sons. [4th ed.]."},{"key":"ref_19","unstructured":"Allender, J., Rector, C., and Warner, K. (2013). Community & Public Health Nursing: Promoting the Public\u2019s Health, Lippincott Williams & Wilkins. [8th ed.]."},{"key":"ref_20","first-page":"161","article-title":"Effectiveness of leptospirosis intervention module in improving knowledge, attitude and practice among town service workers in northeastern Malaysia","volume":"8","author":"Azfar","year":"2018","journal-title":"Int. J. Sci. Res. Methodol."},{"key":"ref_21","first-page":"30","article-title":"Educational interventions to increase knowledge of leptospirosis in navsari district","volume":"1","author":"Bipin","year":"2010","journal-title":"Natl. J. Community Med."},{"key":"ref_22","unstructured":"(2018, April 02). Online Cambrige Dictionary. Available online: https:\/\/dictionary.cambridge.org\/dictionary\/."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Arbiol, J., Orencio, P.M., Nomura, H., Takahashi, Y., and Yabe, M. (2016). Knowledge, attitude and practices towards leptospirosis among lakeshore communities of calamba and los banos, laguna, philippines. Agriculture, 6.","DOI":"10.3390\/agriculture6020018"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"149","DOI":"10.4278\/0890-1171-15.3.149","article-title":"Promoting health: Intervention strategies from social and behavioral research","volume":"15","author":"Smedley","year":"2001","journal-title":"Am. J. Health promot. AJHP"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1037\/0022-3514.90.4.556","article-title":"Understanding knowledge effects on attitude-behavior consistency: The role of relevance, complexity, and amount of knowledge","volume":"90","author":"Fabrigar","year":"2006","journal-title":"J. Personal. Soc. Psychol."},{"key":"ref_26","unstructured":"Marsh, K., and Wallace, H. (2005). The Influence of Attitudes on Beliefs: Formation and Change, Psychology Press."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"960","DOI":"10.26719\/2011.17.12.960","article-title":"Impact of an educational programme on knowledge, beliefs, practices and expectations about care among adolescent glaucoma patients in cairo","volume":"17","author":"Mohamed","year":"2011","journal-title":"East. Mediterr. Health J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"19","DOI":"10.4314\/evj.v17i2.2","article-title":"A study on knowledge, attitude and practice of rabies among residents in addis ababa, ethiopia","volume":"17","author":"Ali","year":"2013","journal-title":"Ethiop. Vet. J."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Dhimal, M., Aryal, K.K., Dhimal, M.L., Gautam, I., Singh, S.P., Bhusal, C.L., and Kuch, U. (2014). Knowledge, attitude and practice regarding dengue fever among the healthy population of highland and lowland communities in central nepal. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0102028"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Sambo, M., Lembo, T., Cleaveland, S., Ferguson, H.M., Sikana, L., Simon, C., Urassa, H., and Hampson, K. (2014). Knowledge, attitudes and practices (kap) about rabies prevention and control: A community survey in tanzania. PLoS Negl. Trop. Dis., 8.","DOI":"10.1371\/journal.pntd.0003310"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/15\/7\/1396\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T15:11:05Z","timestamp":1760195465000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/15\/7\/1396"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7,3]]},"references-count":30,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2018,7]]}},"alternative-id":["ijerph15071396"],"URL":"https:\/\/doi.org\/10.3390\/ijerph15071396","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,7,3]]}}}