Public health communication on emerging vector-borne disease risk in remote regions of South and Southeast Asia

Vector-borne diseases (VBDs) continue to pose a persistent global health burden, disproportionately impacting low- and middle-income countries where surveillance and healthcare infrastructure are constrained. Within these countries, residents of remote island communities are particularly vulnerable to emerging VBD threats, yet they remain critically understudied. We conducted a community-based cross-sectional survey of 300 residents from Shahpori Island, Bangladesh, and Gaya Island, Malaysia, to assess knowledge, attitudes, and practices (KAP) related to VBDs. Using a structured questionnaire and mixed-effects Poisson regression modeling, we evaluated socio-demographic predictors of VBD-related knowledge, alongside statistical comparisons to examine differences between the two settings. Significant disparities were observed between the two islands: Gaya islanders demonstrated a higher level of awareness regarding VBDs and preventive practices compared to Shahpori residents. Education was a strong predictor of VBD knowledge, with individuals possessing secondary education or above exhibiting significantly better knowledge (β = 0.2024, p = 0.0003). Marital status was also a significant factor, with unmarried respondents showing lower levels of knowledge (β = –0.1657, p = 0.0372). Age was positively associated with VBD knowledge, suggesting incremental increases with age (β = 0.0051, p = 0.0119), whereas income, gender, occupation, and household size were not significantly associated with knowledge. Despite basic awareness of VBD symptoms and transmission, detailed understanding of mosquito ecology and breeding prevention strategies was notably poor, especially among Shahpori residents. Our findings highlight critical gaps in VBD knowledge and prevention behaviors shaped by socio-economic and educational inequalities. Community-focused public health strategies, including educational campaigns, establishment of health infrastructure, improved access to trained health-care providers, and integrated vector control interventions are urgently needed to build resilience against future VBD outbreaks and emerging threats such as drug-resistant malaria in remote island populations.