JMIR Publications

ABSTRACT

Background:

Leptospirosis is the most common zoonotic cause of disease and mortality, with the majority of its burden occurring in tropical regions and the poorest countries. Leptospirosis is becoming a significant public health issues, particularly in tropical developing nations. The disease is endemic in all Southeast and South Asian nations. Several outbreaks of leptospirosis occur after natural disasters. In Malaysia, the Communicable Diseases Control Information System (CDCIS e-Notification system) recorded 5,217 leptospirosis cases in 2019 with 32 fatalities (case fatality rate: 0.6%). The incidence rate was 15.61 per 100,000 people. Males comprised 67% of leptospirosis cases, while people aged 25–55 years accounted for 45% of cases. Furthermore, 50% of the 24 leptospirosis outbreaks recorded in 2019 occurred in households. Information and perception are crucial in influencing positive behavior. Nonetheless, information on urban and rural people’s knowledge, attitude, and practice regarding the incidence of leptospirosis is limited.

Objective:

This study aimed to develop a mobile application (app) with information on leptospirosis and measure its effectiveness in improving knowledge, attitude, and practice regarding leptospirosis among wet market workers in Selangor, Malaysia.

Methods:

A three-phase study will be conducted and includes the development of a mobile app containing information about leptospirosis, analysis of its acceptability, and application of the intervention. The participants will be recruited based on specific inclusion criteria using purposive sampling. Four wet markets will be selected according to a list provided by local municipal councils. The respondents from each selected wet market will be all workers aged ≥18 years old. The mobile app development will begin with an idea description, storyboard creation, and content approval through the nominal group technique (NGT). The mobile application content will be constructed using the health belief model (HBM) theory. Subsequently, the usability of the mobile app prototype will be evaluated using the validated Malay version of the System Usability Scale Questionnaire for the Evaluation of Mobile Applications. The study protocol entails a 12-week intervention stage, in which the baseline assessment is regarded as a pre-test, the follow-up assessment as a post-test, and the participant selection will be based on inclusion and exclusion criteria. This study will incorporate a set of validated questionnaires created by a group of leptospirosis experts. The validated questionnaire will comprise nine sections with open-ended questions on sociodemographic data, knowledge, attitude, practice, and mobile app requirements.

Results:

The main results will be the differences in the respondents’ knowledge, attitude, and practice regarding leptospirosis between the baseline and immediate follow-up after the 12-week intervention.

Conclusions:

This intervention study will be conducted in Hulu Langat district, Selangor, given the high number of reported leptospirosis cases there. With a mobile app, the results may contribute to improving wet market workers’ knowledge, attitude, and practice regarding leptospirosis. Clinical Trial: This study employed a quasi-experimental design without random allocation or a control group. Although it involved a digital health intervention and outcome evaluation, it does not fulfill the International Committee of Medical Journal Editors definition of a clinical trial, which requires prospective registration in a public trial registry. Accordingly, this study was not registered in a clinical trials registry. However, ethical approval and methodological transparency were ensured throughout the research process.