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P
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Vo
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14
,
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.
3
,
Sep
tem
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er
20
25
,
p
p
.
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(
LIS
A)
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in
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o
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.
Districts,
sp
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v
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rd
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li
m
in
a
ti
o
n
g
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a
ls
in
M
a
lay
sia
.
K
ey
w
o
r
d
s
:
Ho
ts
p
o
t
I
n
cid
en
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r
ate
Me
asles
Mo
r
an
Sp
atial
clu
s
ter
in
g
T
h
is i
s
a
n
o
p
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n
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c
c
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CC B
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C
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A
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:
No
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Dep
ar
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f
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m
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Sch
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Me
d
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Sc
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Un
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s
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s
Ma
lay
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Ker
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Kela
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t
an
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Ma
lay
s
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m
ail:
az
wan
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@
u
s
m
.
m
y
1.
I
NT
RO
D
UCT
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O
N
Me
asles
is
a
v
ac
cin
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-
p
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tab
le
d
is
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s
e
th
at
is
c
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ar
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t
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ized
b
y
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ev
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,
co
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,
r
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n
n
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s
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co
n
ju
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,
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d
m
ac
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lo
p
a
p
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lar
r
ash
es.
I
t
r
e
m
ain
s
a
s
ig
n
if
ican
t
ch
allen
g
e
to
g
lo
b
al
h
ea
lt
h
d
u
e
to
its
h
ig
h
ly
in
f
ec
tio
u
s
n
atu
r
e
an
d
th
e
p
o
ten
tial
f
o
r
s
ev
e
r
e
o
u
tb
r
ea
k
s
d
esp
ite
th
e
av
ailab
ilit
y
o
f
v
ac
cin
es.
Nu
m
er
o
u
s
co
u
n
tr
ies
h
av
e
im
p
lem
en
te
d
m
ea
s
les
elim
in
atio
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p
r
o
g
r
am
s
,
aim
in
g
to
elim
in
ate
th
e
d
is
ea
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e
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th
in
th
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.
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asles
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d
elim
in
ated
in
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it
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ain
tain
in
ter
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p
ted
tr
an
s
m
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s
io
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at
least
3
6
m
o
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t
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s
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with
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in
cid
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f
allin
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elo
w
o
n
e
ca
s
e
p
er
m
illi
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n
p
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p
u
latio
n
[
1
]
.
E
ig
h
ty
-
th
r
ee
co
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n
tr
ies,
ac
co
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tin
g
f
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3
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ld
wid
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t
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h
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m
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m
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elim
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s
tatu
s
.
Ho
wev
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r
,
at
th
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r
e
g
io
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lev
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n
o
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et
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d
ec
lar
ed
to
h
a
v
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elim
in
ated
m
ea
s
les
[
2
]
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
14
,
No
.
3
,
Sep
tem
b
er
20
25
:
1
1
1
9
-
1
1
2
8
1120
Glo
b
ally
,
th
er
e
h
as
b
ee
n
a
s
ig
n
if
ican
t
r
ed
u
ctio
n
in
m
ea
s
les
ca
s
es,
d
r
o
p
p
in
g
f
r
o
m
3
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m
illi
o
n
in
2
0
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to
u
n
d
er
4
0
0
,
0
0
0
b
y
2
0
1
8
,
as r
ep
o
r
ted
by
Patel
et
a
l.
[
3
]
.
De
s
p
ite
th
is
g
lo
b
al
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ed
u
ctio
n
o
f
c
ases
,
th
e
in
cid
en
ce
r
ate
o
f
m
ea
s
les
in
f
ec
tio
n
s
s
till
s
h
o
ws
v
ar
iatio
n
ac
r
o
s
s
d
if
f
er
en
t
co
u
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tr
ies
o
r
r
eg
io
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s
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p
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ti
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lar
ly
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th
at
h
av
e
n
o
t
ac
h
iev
ed
m
ea
s
les
elim
in
atio
n
[
4
]
–
[
6
]
.
L
o
ca
l
s
tu
d
ie
s
in
Ma
lay
s
ia
s
h
o
w
th
at
th
e
i
n
cid
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ate
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s
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if
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t
s
tates
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d
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d
o
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o
t
alig
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with
th
e
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al
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n
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ce
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ate.
T
h
e
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cid
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ce
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ate
in
2
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v
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ie
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wid
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f
r
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as
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d
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as
1
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9
p
er
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n
p
o
p
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l
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[
7
]
–
[
9
]
.
T
h
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s
,
th
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s
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d
y
aim
s
to
d
eter
m
in
e
t
h
e
in
cid
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s
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m
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les
in
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s
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d
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tr
icts
in
Ma
lay
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r
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m
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2
,
p
r
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ate
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iew
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n
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d
eter
m
in
in
g
th
e
h
o
ts
p
o
t
ar
ea
s
o
f
m
ea
s
les
in
Ma
lay
s
ia.
T
h
e
f
in
d
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s
m
ay
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tr
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te
to
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n
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s
tan
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g
m
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id
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Ma
lay
s
ia
an
d
ass
is
t
in
cr
ea
ti
n
g
tar
g
eted
a
p
p
r
o
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h
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f
o
r
d
is
ea
s
e
p
r
ev
en
tio
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an
d
c
o
n
tr
o
l,
aid
in
g
th
e
g
lo
b
al
ef
f
o
r
t to
elim
in
ate
m
ea
s
les.
2.
M
E
T
H
O
D
Ma
lay
s
ia
is
a
co
u
n
tr
y
i
n
So
u
t
h
ea
s
t
Asi
a
th
at
co
v
er
s
an
ar
ea
o
f
ap
p
r
o
x
im
ately
3
2
9
,
8
4
7
k
m
2
.
I
t
s
p
an
s
r
o
u
g
h
ly
b
etwe
en
latitu
d
es
1
°
an
d
7
°N
a
n
d
lo
n
g
itu
d
es
1
0
0
°
an
d
1
1
9
°E.
Ma
la
y
s
ia
is
d
iv
id
ed
in
to
two
d
is
tin
ct
r
eg
io
n
s
,
wh
ich
ar
e
Pen
in
s
u
lar
Ma
lay
s
ia,
a
lan
d
co
n
n
ec
ted
t
o
m
ain
lan
d
Asi
a
,
an
d
E
ast
Ma
l
ay
s
ia,
th
e
n
o
r
th
er
n
p
ar
t
o
f
th
e
is
lan
d
o
f
B
o
r
n
e
o
.
T
h
er
e
ar
e
1
3
s
tates
an
d
3
f
ed
er
al
ter
r
ito
r
ies
in
Ma
lay
s
ia,
wh
ich
a
r
e
f
u
r
th
er
d
iv
id
ed
in
t
o
1
6
0
d
is
tr
icts
,
s
p
r
ea
d
in
g
ac
r
o
s
s
its
d
iv
er
s
e
g
eo
g
r
a
p
h
ic
ar
ea
[
1
0
]
.
T
h
is
s
tu
d
y
was
co
n
d
u
cte
d
u
s
in
g
r
etr
o
s
p
ec
tiv
e
s
ec
o
n
d
ar
y
d
a
ta
o
f
m
ea
s
les
ca
s
es
f
r
o
m
2
0
1
8
to
2
0
2
2
f
r
o
m
th
e
e
-
m
ea
s
les
d
atab
ase
p
r
o
v
id
ed
b
y
th
e
d
is
ea
s
e
co
n
tr
o
l
d
iv
is
io
n
,
Min
is
tr
y
o
f
H
ea
lth
Ma
lay
s
ia
.
E
-
m
ea
s
les
is
a
s
y
s
tem
th
at
s
tan
d
ar
d
izes
r
e
p
o
r
tin
g
o
f
m
ea
s
les
ca
s
es,
in
v
esti
g
atio
n
s
,
a
n
d
f
in
d
in
g
s
at
th
e
d
is
tr
ict,
s
tate,
an
d
n
atio
n
al
lev
els
f
o
r
m
ea
s
les
co
n
tr
o
l
an
d
p
r
ev
en
tio
n
[
9
]
.
T
h
is
s
tu
d
y
in
clu
d
e
d
all
co
n
f
ir
m
e
d
m
ea
s
les
ca
s
es
id
en
tifie
d
d
u
r
in
g
th
e
s
p
e
cif
ied
s
tu
d
y
p
er
io
d
.
A
co
n
f
ir
m
ed
m
ea
s
les
ca
s
e
in
Ma
lay
s
ia
is
d
eter
m
in
ed
b
ased
o
n
th
e
ca
s
e
d
ef
in
itio
n
s
f
o
r
i
n
f
ec
tio
u
s
d
is
ea
s
e
s
in
Ma
lay
s
ia.
A
co
n
f
ir
m
ed
ca
s
e
in
cl
u
d
es
an
y
ca
s
e
th
at
is
lab
o
r
ato
r
y
-
co
n
f
ir
m
ed
b
y
d
ete
ctin
g
m
ea
s
les
-
s
p
ec
if
ic
I
g
M
a
n
tib
o
d
ies
o
r
is
o
latin
g
th
e
m
ea
s
les
v
ir
u
s
u
s
in
g
cu
ltu
r
e
o
r
m
o
lecu
lar
tech
n
iq
u
e
s
.
Ad
d
itio
n
ally
,
a
ca
s
e
ca
n
b
e
a
co
n
f
ir
m
ed
ca
s
e
if
th
e
ca
s
e
cl
in
ically
h
as
a
f
ev
e
r
an
d
m
ac
u
lo
p
ap
u
lar
r
ash
alo
n
g
with
eith
er
co
u
g
h
o
r
co
r
y
za
,
o
r
co
n
ju
n
ctiv
itis
,
an
d
h
as
an
ep
id
em
io
lo
g
ical
lin
k
to
a
lab
o
r
ato
r
y
-
co
n
f
ir
m
ed
ca
s
e
[
1
1
]
.
T
h
e
esti
m
ated
p
o
p
u
la
tio
n
f
o
r
ea
ch
d
is
tr
ict
in
Ma
la
y
s
ia
was
o
b
tain
ed
o
n
lin
e
f
r
o
m
th
e
De
p
ar
tm
en
t
o
f
Statis
tics
Ma
lay
s
ia.
T
h
e
i
n
cid
en
ce
r
ate
o
f
m
ea
s
les
f
o
r
ea
ch
d
is
tr
ict
was
ca
lcu
lated
b
y
d
i
v
id
in
g
th
e
n
u
m
b
er
o
f
co
n
f
ir
m
e
d
m
ea
s
l
es
ca
s
es
in
a
s
p
ec
if
ic
y
ea
r
with
th
e
esti
m
ated
p
o
p
u
latio
n
f
o
r
ea
ch
d
is
tr
ict
in
th
at
y
ea
r
.
I
t
was
ex
p
r
ess
ed
as
th
e
n
u
m
b
e
r
o
f
ca
s
es
p
er
1
,
0
0
0
,
0
0
0
p
o
p
u
latio
n
.
A
s
er
ies
o
f
in
cid
en
ce
r
ate
ch
o
r
o
p
leth
m
ap
s
w
as
cr
ea
ted
u
s
in
g
th
e
tm
ap
p
ac
k
a
g
e
o
f
R
s
o
f
twa
r
e
v
er
s
io
n
4
.
3
.
1
a
n
d
R
Stu
d
io
v
er
s
io
n
2
0
2
3
.
1
2
.
1
+
4
0
2
[
1
2
]
.
Sp
atial
an
aly
s
is
in
ep
id
em
io
lo
g
y
h
as
em
e
r
g
ed
as
a
to
o
l
f
o
r
u
n
d
e
r
s
tan
d
in
g
t
h
e
d
y
n
am
ics
o
f
d
is
ea
s
e
s
p
r
ea
d
an
d
th
e
id
en
tific
atio
n
o
f
g
eo
g
r
ap
h
ical
ar
ea
s
at
in
cr
e
ased
r
is
k
o
f
in
f
ec
tio
u
s
d
is
ea
s
es
s
u
ch
as
d
en
g
u
e,
tu
b
er
cu
lo
s
is
,
m
u
m
p
s
,
an
d
m
e
asles
[
1
3
]
–
[
1
6
]
.
Sp
atial
au
to
co
r
r
elatio
n
is
a
tech
n
iq
u
e
u
s
ed
in
s
p
atial
an
aly
s
is
th
at
en
ab
les
e
p
id
em
io
lo
g
is
ts
to
e
x
p
lo
r
e
th
e
d
is
tr
ib
u
tio
n
o
f
d
is
ea
s
e
ac
r
o
s
s
s
p
ec
if
ic
ar
ea
s
an
d
id
en
tify
co
r
r
elatio
n
s
b
etwe
en
th
e
in
ci
d
en
ce
r
ates
in
ad
jace
n
t
r
eg
i
o
n
s
[
1
7
]
.
Sp
atial
au
to
co
r
r
ela
tio
n
ca
n
d
eter
m
in
e
wh
eth
er
d
is
ea
s
es
ar
e
s
p
atially
clu
s
ter
ed
,
r
an
d
o
m
ly
d
is
tr
ib
u
te
d
,
o
r
d
is
p
er
s
ed
wh
ich
m
ay
h
el
p
in
d
etec
tin
g
a
r
ea
s
o
f
d
is
ea
s
e
h
o
ts
p
o
ts
.
T
h
is
is
ess
en
tial
in
th
e
p
u
b
lic
h
ea
lth
f
iel
d
as
it
ca
n
p
r
o
v
id
e
s
v
alu
ab
le
i
n
s
ig
h
t
in
to
d
e
v
is
in
g
ef
f
ec
tiv
e
in
ter
v
e
n
tio
n
an
d
p
r
e
v
en
tio
n
s
tr
ateg
ies,
in
clu
d
i
n
g
p
u
b
lic
h
ea
lth
r
eso
u
r
ce
allo
ca
t
io
n
b
ased
o
n
lo
ca
l
d
is
ea
s
e
p
atter
n
s
an
d
u
ltima
tely
aim
in
g
to
p
r
o
tect
th
e
h
ea
lth
o
f
th
e
co
m
m
u
n
ities
.
I
n
th
is
s
tu
d
y
,
we
u
s
ed
Glo
b
al
Mo
r
an
’
s
I
to
d
eter
m
in
e
wh
e
th
er
th
er
e
is
a
g
lo
b
al
s
p
atial
au
to
co
r
r
elatio
n
b
etwe
en
1
6
0
d
is
tr
icts
.
Sp
atial
au
to
co
r
r
elatio
n
is
ab
le
to
ass
es
s
th
e
d
eg
r
ee
o
f
s
im
ilar
ity
o
b
s
er
v
ed
am
o
n
g
a
ce
r
tai
n
lo
ca
tio
n
an
d
its
n
eig
h
b
o
r
in
g
u
n
it.
T
h
e
v
alu
e
o
f
Glo
b
al
Mo
r
an
’
s
I
r
an
g
e
b
etwe
en
-
1
an
d
1
.
A
p
o
s
itiv
e
v
alu
e
o
f
Glo
b
al
Mo
r
an
’
s
I
th
at
is
clo
s
e
to
1
in
d
icate
s
th
at
d
is
tr
icts
with
a
h
ig
h
n
u
m
b
er
o
f
ca
s
es
ar
e
clu
s
ter
ed
t
o
g
eth
er
,
wh
er
ea
s
a
n
eg
ativ
e
v
alu
e
clo
s
er
to
-
1
in
d
icate
s
d
is
tr
icts
w
ith
a
h
ig
h
n
u
m
b
er
an
d
a
lo
w
n
u
m
b
e
r
o
f
ca
s
es
ar
e
in
ter
s
p
er
s
ed
.
Glo
b
al
M
o
r
an
’
s
I
v
alu
e
o
f
0
m
ea
n
s
th
at
th
er
e
is
n
o
s
p
atial
clu
s
ter
in
g
an
d
th
e
d
ata
ar
e
r
an
d
o
m
ly
d
is
tr
ib
u
ted
[
1
8
]
.
Z
-
s
co
r
e
an
d
p
-
v
al
u
e
wer
e
ca
lcu
lated
to
e
v
alu
ate
t
h
e
s
i
g
n
if
ican
ce
o
f
Glo
b
al
Mo
r
an
’
s
I
.
T
h
is
an
aly
s
is
was
d
o
n
e
u
s
in
g
s
p
d
ep
p
ac
k
ag
e
in
R
s
o
f
twar
e.
L
o
ca
l
in
d
icato
r
s
o
f
s
p
atial
ass
o
ciatio
n
(
L
I
SA)
ar
e
s
tatis
tic
al
m
ea
s
u
r
es
u
s
ed
to
id
en
tify
clu
s
ter
s
o
f
s
im
ilar
v
alu
es
o
r
s
p
atial
o
u
tli
er
s
with
in
g
eo
g
r
ap
h
ic
d
ata.
I
n
co
n
tr
ast
to
Glo
b
al
Mo
r
an
’
s
I
,
wh
ich
ev
alu
ates
s
p
atial
au
to
co
r
r
elatio
n
ac
r
o
s
s
an
en
tire
d
ataset,
L
I
SA
f
o
c
u
s
es
o
n
th
e
l
o
ca
l
lev
el
to
d
eter
m
i
n
e
if
s
im
ilar
v
alu
es
f
o
r
m
clu
s
ter
s
in
p
ar
ticu
lar
ar
e
as.
B
ased
o
n
L
I
SA
v
al
u
es,
th
er
e
ar
e
4
ty
p
es
o
f
clu
s
ter
s
,
w
h
ich
ar
e
h
i
g
h
-
h
i
g
h
,
lo
w
-
lo
w,
h
ig
h
-
lo
w,
an
d
lo
w
-
h
ig
h
.
Hig
h
-
h
i
g
h
clu
s
ter
s
r
e
f
er
to
d
is
tr
icts
with
a
h
ig
h
n
u
m
b
e
r
o
f
ca
s
es
s
u
r
r
o
u
n
d
ed
b
y
o
th
er
d
is
tr
icts
wh
ich
also
h
av
e
a
h
ig
h
n
u
m
b
er
o
f
ca
s
es.
I
t
in
d
icate
s
a
h
o
t
s
p
o
t
wh
er
e
th
e
n
u
m
b
er
o
f
ca
s
es
is
s
ig
n
if
ican
tly
h
ig
h
e
r
th
an
a
v
er
ag
e,
b
o
t
h
f
o
r
th
e
d
is
tr
ict
an
d
its
im
m
ed
iate
g
eo
g
r
ap
h
ic
v
icin
ity
.
L
o
w
-
lo
w
clu
s
ter
s
ar
e
d
is
tr
icts
with
a
lo
w
n
u
m
b
er
o
f
ca
s
es
th
at
ar
e
s
u
r
r
o
u
n
d
ed
b
y
o
th
er
d
is
tr
icts
th
at
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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2252
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8
8
0
6
I
n
cid
en
ce
r
a
te
a
n
d
s
p
a
tia
l c
lu
s
teri
n
g
o
f m
ea
s
les ca
s
es in
Ma
la
ysia
,
… (
Mo
h
d
R
u
jh
a
n
Ha
d
f
i Ma
t D
a
u
d
)
1121
also
h
av
e
a
s
im
ilar
ly
lo
w
n
u
m
b
er
o
f
ca
s
es.
L
o
w
-
lo
w
clu
s
ter
r
ep
r
esen
ts
a
co
l
d
s
p
o
t.
Hig
h
-
lo
w
an
d
lo
w
-
h
ig
h
clu
s
ter
s
ar
e
id
en
tifie
d
as
s
p
atial
o
u
tlier
s
.
H
ig
h
-
lo
w
clu
s
t
er
s
ar
e
d
is
tr
icts
with
a
h
ig
h
n
u
m
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e
r
o
f
ca
s
es
s
u
r
r
o
u
n
d
ed
b
y
o
th
er
d
is
tr
icts
with
a
lo
w
n
u
m
b
er
o
f
ca
s
es,
wh
er
ea
s
lo
w
-
h
ig
h
clu
s
ter
s
ar
e
d
escr
ib
ed
as
d
is
tr
icts
with
a
lo
w
n
u
m
b
e
r
o
f
ca
s
es
s
u
r
r
o
u
n
d
e
d
b
y
d
i
s
t
r
i
c
t
s
w
i
t
h
a
h
ig
h
n
u
m
b
e
r
o
f
c
a
s
e
s
.
T
h
e
d
i
f
f
e
r
e
n
c
e
i
n
a
t
t
r
i
b
u
t
e
s
o
f
i
n
t
e
r
e
s
t
c
o
m
p
a
r
e
d
t
o
t
h
e
s
u
r
r
o
u
n
d
i
n
g
a
r
e
a
m
a
k
e
s
i
t
a
s
p
a
t
i
a
l
o
u
t
l
i
e
r
.
T
h
i
s
a
n
a
l
y
s
is
w
as
d
o
n
e
u
s
i
n
g
s
p
d
e
p
p
a
c
k
a
g
e
i
n
R
s
o
f
t
w
a
r
e
.
3.
RE
SU
L
T
S AN
D
D
I
SCU
SS
I
O
N
3
.
1
.
Resul
t
s
T
h
er
e
wer
e
3
,
8
5
0
c
o
n
f
ir
m
ed
m
ea
s
les ca
s
e
s
in
Ma
lay
s
ia
r
ep
o
r
ted
f
r
o
m
2
0
1
8
to
2
0
2
2
.
T
h
e
d
is
tr
ib
u
tio
n
o
f
m
ea
s
les
in
cid
en
ce
at
th
e
d
is
tr
ict
lev
el
ac
r
o
s
s
Ma
lay
s
ia
,
e
x
p
r
ess
ed
p
er
1
,
0
0
0
,
0
0
0
p
o
p
u
l
atio
n
,
w
as
d
is
p
lay
ed
in
Fig
u
r
e
1
.
T
h
e
m
ap
s
s
h
o
w
th
at
in
2
0
1
8
,
t
h
e
h
ig
h
est
r
ate
o
f
m
ea
s
les
in
cid
en
ce
,
d
ep
icted
in
r
ed
,
was
o
b
s
er
v
ed
in
th
e
d
is
tr
icts
o
f
B
in
tu
lu
,
M
ir
i
,
an
d
Ma
r
u
d
i
in
Sar
awa
k
.
A
s
im
ilar
h
ig
h
in
cid
en
ce
o
f
m
o
r
e
th
an
5
0
0
p
er
m
illi
o
n
p
o
p
u
latio
n
was
o
b
s
er
v
ed
in
Gu
a
M
u
s
an
g
d
is
tr
ict,
Kela
n
tan
an
d
Hu
lu
T
er
en
g
g
a
n
u
d
is
tr
ict,
T
er
en
g
g
a
n
u
,
in
2
0
1
9
.
Fro
m
2
0
1
8
t
o
2
0
2
2
,
a
clea
r
d
o
wn
war
d
tr
en
d
in
i
n
cid
en
ce
r
ates
ca
n
b
e
s
ee
n
ac
r
o
s
s
d
is
tr
icts
in
Ma
lay
s
ia,
as
ev
id
e
n
ce
d
b
y
m
o
r
e
lig
h
t
o
r
an
g
e
an
d
y
ello
w
s
h
a
d
e
ar
ea
s
,
with
th
e
m
o
s
t
s
ig
n
if
ican
t
d
ec
lin
e
v
is
ib
le
b
y
2
0
2
1
.
Dis
tr
icts
with
in
Sab
ah
an
d
Sar
awa
k
s
h
o
wed
th
e
m
o
s
t
p
r
o
n
o
u
n
ce
d
d
ec
r
ea
s
e,
with
m
an
y
m
ai
n
tain
in
g
a
ze
r
o
-
in
cid
en
ce
r
ate
o
v
er
th
e
last
th
r
ee
y
ea
r
s
.
Mo
s
t
d
is
tr
icts
in
Selan
g
o
r
r
ep
o
r
ted
p
er
s
is
ten
t
in
f
ec
tio
n
o
f
m
ea
s
l
es,
with
in
cid
en
ce
r
ates
r
an
g
in
g
f
r
o
m
5
to
5
0
0
ca
s
es
p
er
m
illi
o
n
p
o
p
u
latio
n
th
r
o
u
g
h
o
u
t
t
h
e
f
iv
e
y
ea
r
s
.
Ov
er
all,
d
is
tr
icts
in
Pen
in
s
u
lar
Ma
lay
s
ia
h
av
e
s
ee
n
a
d
o
wn
war
d
tr
en
d
in
m
ea
s
les
in
cid
en
ce
r
ates
s
in
ce
2
0
1
8
,
alt
h
o
u
g
h
th
e
r
ate
f
l
u
ctu
ates
in
th
e
y
ea
r
s
2
0
2
1
an
d
2
0
2
2
,
r
a
n
g
in
g
f
r
o
m
0
to
5
0
p
er
m
illi
o
n
p
o
p
u
latio
n
.
T
h
e
Glo
b
al
Mo
r
an
’
s
I
s
tatis
ti
c
r
ev
ea
led
s
ig
n
if
ican
t
p
o
s
itiv
e
s
p
atial
au
to
co
r
r
elatio
n
,
in
d
i
ca
tin
g
th
at
m
ea
s
les
ca
s
e
s
wer
e
s
p
atially
c
lu
s
ter
ed
in
Ma
lay
s
ia
f
r
o
m
2
0
1
8
to
2
0
2
2
.
An
n
u
al
v
alu
es
o
f
Mo
r
an
’
s
I
s
tatis
tic
s
an
d
its
p
-
v
al
u
e
ar
e
p
r
esen
ted
in
T
ab
le
1
.
T
h
e
L
I
SA
m
ap
s
h
o
wn
in
Fig
u
r
e
2
illu
s
tr
ates
a
d
y
n
am
ic
p
atter
n
o
f
m
ea
s
les
in
f
ec
tio
n
h
o
ts
p
o
ts
in
Ma
lay
s
ia.
I
n
itially
,
in
2
0
1
8
,
B
in
tu
lu
d
is
tr
ict
in
Sar
awa
k
was
id
en
tifie
d
as
a
h
o
ts
p
o
t.
I
n
th
e
f
o
llo
win
g
y
ea
r
,
2
0
1
9
,
th
e
h
o
ts
p
o
t
r
e
g
io
n
s
s
h
if
ted
to
Gu
a
Mu
s
an
g
d
is
tr
ict
in
Kela
n
tan
,
as
well
as
Hu
lu
T
er
en
g
g
an
u
,
Ku
ala
T
er
en
g
g
a
n
u
,
an
d
Ku
ala
Ner
u
s
in
T
er
en
g
g
an
u
,
a
n
d
also
to
Ku
n
ak
,
Sem
p
o
r
n
a,
an
d
T
awa
u
d
is
tr
icts
,
with
B
in
tu
lu
r
etu
r
n
in
g
as
a
co
ld
s
p
o
t
.
T
h
e
y
ea
r
2
0
2
0
s
aw
th
e
em
er
g
e
n
ce
o
f
Ku
an
ta
n
a
n
d
Ma
r
an
in
Pah
an
g
,
alo
n
g
s
id
e
T
u
m
p
at,
Ko
ta
B
h
ar
u
,
an
d
B
ac
h
o
k
as
ar
ea
s
o
f
h
o
ts
p
o
ts
.
B
y
2
0
2
1
,
Ku
ala
Ner
u
s
in
T
er
en
g
g
a
n
u
was
h
ig
h
lig
h
ted
a
s
a
h
o
ts
p
o
t.
T
h
r
o
u
g
h
o
u
t
t
h
is
p
er
io
d
,
th
e
ce
n
tr
al
r
eg
io
n
o
f
M
alay
s
ia,
p
ar
ticu
lar
ly
d
is
tr
icts
with
in
th
e
s
tate
o
f
Se
lan
g
o
r
an
d
th
e
f
ed
er
al
ter
r
ito
r
ies
o
f
Ku
ala
L
u
m
p
u
r
,
co
n
s
is
t
en
tly
m
an
i
f
ested
as
h
o
ts
p
o
ts
,
in
d
icatin
g
a
p
er
s
is
ten
tly
h
ig
h
n
u
m
b
e
r
o
f
m
ea
s
les
ca
s
es
o
v
er
s
ev
er
al
y
ea
r
s
.
I
n
itially
,
th
e
n
u
m
b
e
r
o
f
lo
w
-
lo
w
d
is
tr
icts
,
k
n
o
wn
as
c
o
ld
s
p
o
t
ar
ea
s
,
d
ec
r
ea
s
ed
b
u
t
l
ater
ex
p
e
r
ien
ce
d
a
s
tead
y
in
c
r
ea
s
e
o
v
er
th
e
y
ea
r
s
.
T
h
e
m
ajo
r
ity
o
f
th
ese
co
ld
s
p
o
t
d
is
tr
icts
wer
e
lo
ca
ted
in
Sab
ah
a
n
d
Sar
awa
k
.
On
th
e
o
th
e
r
h
an
d
,
t
h
e
d
is
tr
icts
ex
h
ib
itin
g
a
h
ig
h
-
l
o
w
p
atter
n
,
in
d
icatin
g
th
ey
wer
e
h
ig
h
-
in
cid
en
ce
ar
ea
s
s
u
r
r
o
u
n
d
e
d
b
y
lo
w
-
in
cid
en
c
e
n
eig
h
b
o
r
s
,
d
is
p
lay
ed
v
ar
ia
b
ilit
y
in
th
eir
n
u
m
b
er
s
.
T
h
ese
f
l
u
ctu
atin
g
h
ig
h
-
l
o
w
ar
ea
s
p
r
im
ar
ily
co
n
s
is
ted
o
f
d
is
tr
icts
in
Kela
n
tan
,
T
er
en
g
g
an
u
,
Pah
an
g
,
an
d
J
o
h
o
r
.
3
.
2
.
Dis
cus
s
io
n
T
h
is
s
tu
d
y
ex
am
i
n
es
th
e
d
is
tr
i
b
u
tio
n
a
n
d
in
cid
en
ce
r
ate
o
f
m
ea
s
les
in
f
ec
tio
n
ac
r
o
s
s
v
ar
io
u
s
d
is
tr
icts
in
Ma
lay
s
ia,
aim
in
g
to
d
etec
t
s
p
atial
clu
s
ter
in
g
an
d
id
en
tif
y
h
o
ts
p
o
ts
ar
ea
s
o
f
m
ea
s
les.
Desp
ite
ef
f
o
r
ts
to
elim
in
ate
m
ea
s
les
th
r
o
u
g
h
a
n
atio
n
al
elim
in
atio
n
p
r
o
g
r
a
m
,
Ma
lay
s
ia
co
n
tin
u
es
to
f
ac
e
ch
allen
g
es
in
co
m
b
atin
g
th
e
d
is
ea
s
e.
O
v
e
r
a
l
l,
t
h
e
t
r
e
n
d
o
f
m
e
as
l
es
i
n
c
i
d
e
n
ce
r
a
t
es
ac
r
o
s
s
M
al
a
y
s
i
a
s
h
o
ws
a
d
e
c
l
i
n
e
.
H
o
we
v
e
r
,
t
h
e
r
e
a
r
e
f
l
u
c
t
u
a
ti
o
n
s
i
n
r
a
t
es
b
y
d
i
s
t
r
ic
t
u
p
t
o
2
0
2
2
,
s
u
g
g
est
i
n
g
t
h
a
t
m
e
as
l
es
t
r
a
n
s
m
is
s
i
o
n
s
ti
l
l
p
e
r
s
i
s
ts
i
n
t
h
e
c
o
u
n
t
r
y
.
T
ab
le
1
.
Glo
b
al
M
o
r
an
’
s
I
s
p
a
tial a
u
to
co
r
r
elatio
n
a
n
aly
s
is
o
f
m
ea
s
les in
f
ec
tio
n
in
Ma
lay
s
ia
f
r
o
m
2
0
1
8
to
2
0
2
2
Y
e
a
r
M
o
r
a
n
’
s I
st
a
t
i
st
i
c
s
p
-
v
a
l
u
e
*
2
0
1
8
0
.
4
8
<
0
.
0
0
1
2
0
1
9
0
.
2
2
<
0
.
0
0
1
2
0
2
0
0
.
2
7
<
0
.
0
0
1
2
0
2
1
0
.
1
6
<
0
.
0
0
1
2
0
2
2
0
.
5
1
<
0
.
0
0
1
*
p
-
v
a
l
u
e
f
o
r
G
l
o
b
a
l
M
o
r
a
n
I
st
a
t
i
s
t
i
c
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
14
,
No
.
3
,
Sep
tem
b
er
20
25
:
1
1
1
9
-
1
1
2
8
1122
Fig
u
r
e
1
.
T
h
e
in
cid
e
n
ce
r
ate
o
f
m
ea
s
les in
f
ec
tio
n
in
Ma
lay
s
i
a
f
r
o
m
2
0
1
8
to
2
0
2
2
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
I
n
cid
en
ce
r
a
te
a
n
d
s
p
a
tia
l c
lu
s
teri
n
g
o
f m
ea
s
les ca
s
es in
Ma
la
ysia
,
… (
Mo
h
d
R
u
jh
a
n
Ha
d
f
i Ma
t D
a
u
d
)
1123
Fig
u
r
e
2
.
Ma
p
o
f
l
o
ca
l in
d
icat
o
r
o
f
s
p
atial
au
t
o
co
r
r
elatio
n
(
L
I
SA)
an
aly
s
is
o
f
m
ea
s
les ca
s
es
at
d
is
tr
ict
lev
el
in
Ma
lay
s
ia
f
r
o
m
2
0
1
8
t
o
2
0
2
2
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
14
,
No
.
3
,
Sep
tem
b
er
20
25
:
1
1
1
9
-
1
1
2
8
1124
I
n
2
0
1
8
,
B
in
tu
lu
d
is
tr
ict
ex
p
er
ien
ce
d
a
n
o
tab
le
r
is
e
in
ca
s
es
o
f
m
ea
s
les
with
5
8
.
6
ca
s
es
p
e
r
1
0
0
,
0
0
0
p
o
p
u
latio
n
p
r
im
a
r
ily
co
n
tr
ib
u
ted
b
y
8
1
.
6
%
o
f
ca
s
es
o
cc
u
r
r
in
g
in
r
esid
en
tial
ar
ea
s
in
clu
d
in
g
h
o
u
s
in
g
ar
ea
s
,
v
illag
es,
lo
n
g
h
o
u
s
es,
an
d
g
o
v
er
n
m
en
t
q
u
a
r
ter
s
co
m
p
ar
e
d
to
1
1
.
2
%
o
cc
u
r
r
in
g
at
wo
r
k
p
lace
[
1
9
]
.
Am
o
n
g
th
e
ca
s
es
d
etec
ted
in
B
in
tu
lu
,
m
o
r
e
th
an
h
alf
o
f
th
em
h
a
d
u
n
k
n
o
wn
im
m
u
n
izatio
n
s
t
atu
s
.
Su
p
p
lem
en
tar
y
im
m
u
n
izatio
n
ac
tiv
ities
(
SIA
s
)
in
v
o
lv
in
g
c
h
ild
r
en
ag
e
d
6
m
o
n
th
s
to
1
5
y
ea
r
s
o
ld
we
r
e
im
p
lem
en
ted
in
B
in
tu
lu
to
cu
r
b
th
e
s
p
r
ea
d
o
f
d
is
ea
s
e.
SIA
s
d
eliv
er
v
ac
cin
atio
n
to
all
tar
g
eted
in
d
iv
id
u
als
r
eg
ar
d
less
o
f
th
eir
v
ac
cin
atio
n
s
tatu
s
an
d
p
r
io
r
h
is
to
r
y
with
th
e
aim
to
r
ap
id
ly
r
aise
p
o
p
u
latio
n
lev
el
im
m
u
n
ity
an
d
r
e
d
u
ce
th
e
n
u
m
b
er
o
f
s
u
s
ce
p
tib
le
in
d
iv
i
d
u
als.
T
h
is
ca
m
p
aig
n
r
esu
lts
in
a
r
ed
u
ctio
n
o
f
m
ea
s
les
ca
s
es
in
B
in
tu
lu
in
th
e
s
u
b
s
eq
u
en
t
y
ea
r
s
[
2
0
]
.
An
o
u
tb
r
ea
k
was
also
r
ep
o
r
ted
in
2
0
1
8
in
v
o
lv
in
g
Ma
r
u
d
i
d
is
tr
ict
with
v
is
ito
r
s
f
r
o
m
Mir
i
d
is
tr
ict
id
en
tifie
d
as
th
e
p
r
im
ar
y
s
o
u
r
ce
o
f
in
f
ec
tio
n
.
T
h
is
o
u
tb
r
ea
k
s
p
r
ea
d
d
u
r
i
n
g
a
f
u
n
er
al
in
a
r
u
r
al
v
illag
e
in
Ma
r
u
d
i
d
is
tr
ict.
Ho
wev
er
,
th
e
tr
an
s
m
is
s
io
n
was
lim
ited
o
n
ly
to
th
e
atten
d
ee
s
an
d
d
id
n
o
t
af
f
ec
t
th
e
wid
er
v
illag
e
p
o
p
u
latio
n
.
T
h
is
co
n
tain
m
en
t w
as a
ttrib
u
ted
to
th
e
h
er
d
im
m
u
n
ity
p
r
esen
t a
m
o
n
g
ch
ild
r
en
in
th
e
r
u
r
al
v
illag
e
a
n
d
t
h
u
s
h
ig
h
lig
h
tin
g
th
e
im
p
o
r
tan
ce
o
f
r
ea
c
h
in
g
h
er
d
im
m
u
n
ity
in
a
co
m
m
u
n
ity
[
2
1
]
.
I
n
2
0
1
9
,
a
lar
g
e
-
s
ca
le
o
u
tb
r
ea
k
in
v
o
l
v
in
g
p
r
ed
o
m
in
an
tly
u
n
v
ac
cin
ated
in
d
iv
id
u
als
o
cc
u
r
r
ed
in
Gu
a
Mu
s
an
g
d
is
tr
ict
a
n
d
H
u
lu
T
er
en
g
g
an
u
d
is
tr
ict
ca
u
s
in
g
a
s
p
i
k
e
o
f
in
cid
e
n
ce
r
ate
in
b
o
th
a
r
ea
s
.
T
h
e
o
u
tb
r
ea
k
was
r
esp
o
n
s
ib
le
f
o
r
1
1
0
co
n
f
ir
m
ed
m
ea
s
les
ca
s
es
in
clu
d
in
g
1
1
d
ea
th
s
.
T
h
e
o
u
tb
r
ea
k
o
c
cu
r
s
am
o
n
g
B
ateq
tr
ib
e
in
d
iv
i
d
u
als
in
G
u
a
Mu
s
an
g
,
a
tr
i
b
e
with
n
o
m
a
d
ic
h
ab
its
wh
o
s
e
m
o
v
em
en
ts
to
n
eig
h
b
o
r
in
g
d
is
tr
ict
f
ac
ilit
ate
d
th
e
s
p
r
ea
d
o
f
th
e
d
is
ea
s
e
to
Hu
lu
T
er
en
g
g
an
u
[
8
]
.
T
h
e
o
u
tb
r
ea
k
h
ig
h
lig
h
ts
th
e
cr
itical
r
o
le
o
f
p
o
p
u
latio
n
m
o
b
ilit
y
in
tr
an
s
m
itti
n
g
m
ea
s
les
an
d
h
eig
h
ten
ed
th
e
d
is
ea
s
e
r
is
k
as
s
o
ciate
d
with
b
ein
g
u
n
v
ac
cin
ated
.
T
h
er
ef
o
r
e,
p
u
b
lic
h
ea
lth
ap
p
r
o
ac
h
es
s
h
o
u
ld
a
cc
o
u
n
t
f
o
r
th
e
liv
in
g
co
n
d
itio
n
s
an
d
b
e
h
av
io
r
s
o
f
p
o
p
u
latio
n
s
to
en
s
u
r
e
in
clu
s
iv
ity
an
d
n
o
o
n
e
is
lef
t
b
e
h
in
d
p
ar
ticu
lar
ly
in
v
ac
ci
n
atio
n
p
r
o
g
r
am
.
T
h
is
is
cr
itical
to
p
r
ev
e
n
t p
o
c
k
ets o
f
v
u
ln
er
ab
le
p
o
p
u
latio
n
s
to
ex
is
t.
B
etwe
en
2
0
1
8
an
d
2
0
2
2
,
Ma
l
ay
s
ia
ex
p
er
ien
ce
d
a
n
o
tab
le
d
ec
lin
e
in
th
e
in
cid
en
ce
r
ate
o
f
m
ea
s
les,
a
tr
en
d
lar
g
ely
attr
ib
u
tab
le
to
th
e
ef
f
ec
tiv
en
ess
o
f
p
u
b
lic
h
ea
lth
p
o
licies
an
d
in
itiativ
es.
T
h
i
s
p
er
io
d
witn
ess
ed
th
e
ef
f
ec
t
o
f
m
o
d
if
icatio
n
in
h
ea
lth
p
o
licy
r
e
g
ar
d
i
n
g
v
ac
cin
a
tio
n
s
ch
ed
u
les
in
2
0
1
6
an
d
th
e
in
ten
s
if
icatio
n
o
f
n
atio
n
wid
e
v
ac
cin
atio
n
s
tr
ateg
ies.
Pre
v
io
u
s
ly
,
v
ac
cin
atio
n
s
wer
e
ad
m
in
is
ter
ed
at
1
2
m
o
n
th
s
an
d
7
y
ea
r
s
o
f
ag
e.
Star
tin
g
in
2
0
1
6
,
th
e
p
o
li
cy
was
am
e
n
d
ed
to
p
r
o
v
id
e
v
ac
cin
atio
n
s
at
a
n
ea
r
lier
ag
e
,
s
p
ec
if
ically
at
9
a
n
d
1
2
m
o
n
t
h
s
[
2
2
]
,
[
2
3
]
.
T
h
is
ch
a
n
g
e
led
to
ea
r
lier
p
r
o
tectio
n
o
f
ch
ild
r
en
ag
ain
s
t
m
ea
s
les
an
d
th
u
s
f
ac
ilit
ate
d
th
e
ea
r
lier
estab
lis
h
m
en
t
o
f
h
er
d
i
m
m
u
n
ity
,
r
esu
ltin
g
in
a
r
e
d
u
c
ed
r
is
k
o
f
d
is
ea
s
e
tr
an
s
m
is
s
io
n
an
d
,
s
u
b
s
eq
u
e
n
tly
d
ec
r
ea
s
e
in
t
h
e
in
cid
e
n
ce
r
ate
o
f
m
ea
s
les
in
Ma
lay
s
ia.
W
id
esp
r
ea
d
p
r
o
m
o
tio
n
o
f
im
m
u
n
izatio
n
ac
tiv
ities
ac
r
o
s
s
Ma
lay
s
ia
th
r
o
u
g
h
m
ass
m
ed
ia,
ca
m
p
ai
g
n
s
an
d
h
ea
lth
ed
u
ca
tio
n
i
n
h
ea
lth
f
a
cilities
an
d
p
r
o
m
o
tio
n
v
ia
s
o
cial
m
ed
ia
h
a
d
c
o
n
tr
ib
u
ted
to
th
e
in
cr
ea
s
e
in
v
ac
cin
atio
n
co
v
er
ag
e.
Acc
o
r
d
in
g
to
a
r
ep
o
r
t
b
y
th
e
W
o
r
ld
Hea
lth
Or
g
an
izatio
n
,
th
e
c
o
v
e
r
ag
e
f
o
r
th
e
f
ir
s
t d
o
s
e
o
f
m
ea
s
les
-
co
n
tain
in
g
v
ac
ci
n
e
h
as in
cr
ea
s
ed
b
y
y
ea
r
f
r
o
m
9
2
% in
2
0
1
4
a
n
d
co
n
s
is
ten
tly
m
ain
tain
ed
ab
o
v
e
9
5
% si
n
ce
2
0
1
8
[
2
4
]
.
T
h
e
f
lu
ct
u
atio
n
i
n
m
ea
s
les
in
cid
en
ce
r
ates
ac
r
o
s
s
d
is
tr
icts
,
p
ar
ticu
lar
ly
in
2
0
2
1
a
n
d
2
0
2
2
,
ca
n
b
e
d
ir
ec
tly
lin
k
ed
to
th
e
g
lo
b
al
d
is
r
u
p
tio
n
s
ca
u
s
ed
b
y
t
h
e
C
OVI
D
-
1
9
p
a
n
d
em
ic,
w
h
ich
h
ad
a
d
u
al
im
p
ac
t
o
n
m
ea
s
les
b
y
b
o
th
r
e
d
u
cin
g
an
d
in
cr
ea
s
in
g
th
em
u
n
d
er
d
if
f
er
en
t
cir
cu
m
s
tan
ce
s
.
I
n
Ma
lay
s
ia,
m
ea
s
u
r
es
to
co
u
n
ter
ac
t
C
OVI
D
-
1
9
,
s
u
ch
as
lo
ck
d
o
wn
s
,
h
y
g
ien
e
p
r
ac
tices
,
an
d
p
h
y
s
ical
d
is
tan
cin
g
,
in
ad
v
er
te
n
tly
co
n
tr
ib
u
ted
to
a
d
ec
r
ea
s
e
in
m
ea
s
les
ca
s
es.
T
h
e
en
f
o
r
c
em
en
t
lo
ck
d
o
wn
o
r
d
e
r
s
,
th
e
clo
s
u
r
e
o
f
ed
u
ca
tio
n
al
in
s
titu
tio
n
s
,
in
clu
d
in
g
s
ch
o
o
l
s
an
d
k
i
n
d
er
g
a
r
ten
s
an
d
th
e
im
p
lem
en
tatio
n
o
f
wo
r
k
-
f
r
o
m
-
home
p
o
licy
m
ay
lo
wer
th
e
r
is
k
o
f
m
ea
s
les
tr
an
s
m
is
s
io
n
b
y
lim
itin
g
in
ter
p
er
s
o
n
al
in
ter
ac
tio
n
s
[
2
5
]
.
C
o
n
v
e
r
s
ely
,
th
e
p
an
d
em
ic
p
r
ec
ip
itated
wid
esp
r
ea
d
in
te
r
r
u
p
tio
n
s
in
r
o
u
tin
e
im
m
u
n
izatio
n
s
er
v
ices,
as
h
ea
lth
c
ar
e
s
y
s
tem
s
wer
e
o
v
er
b
u
r
d
en
ed
with
m
an
ag
in
g
C
OVI
D
-
1
9
ca
s
es.
T
h
is
s
itu
atio
n
was
co
m
p
o
u
n
d
ed
b
y
th
e
d
iv
er
s
io
n
o
f
h
ea
lth
ca
r
e
r
eso
u
r
ce
s
to
ad
d
r
ess
th
e
p
an
d
e
m
ic,
s
id
elin
in
g
p
r
ev
e
n
tiv
e
s
er
v
ices
lik
e
m
ea
s
les
v
ac
cin
atio
n
ca
m
p
aig
n
s
an
d
d
elay
i
n
g
im
m
u
n
izatio
n
s
,
wh
ich
co
u
l
d
p
o
ten
tially
elev
ate
th
e
r
is
k
o
f
m
ea
s
les
s
p
r
ea
d
.
Ad
d
itio
n
ally
,
th
e
f
ea
r
o
f
co
n
t
r
ac
tin
g
C
OVI
D
-
1
9
d
is
co
u
r
ag
e
d
in
d
iv
id
u
als
f
r
o
m
s
ee
k
in
g
h
ea
lth
ca
r
e
f
o
r
n
o
n
-
C
OVI
D
-
r
elate
d
h
ea
lth
is
s
u
es,
in
clu
d
in
g
m
ea
s
les,
th
er
eb
y
h
i
n
d
er
in
g
ef
f
o
r
ts
to
c
o
n
tr
o
l
an
d
m
itig
ate
th
e
s
p
r
ea
d
o
f
th
is
h
ig
h
ly
in
f
ec
tio
u
s
d
is
ea
s
e
[
2
5
]
,
[
2
6
]
.
T
h
ese
c
o
n
d
itio
n
s
h
ig
h
lig
h
t
th
e
n
ee
d
f
o
r
s
u
s
tain
ed
v
ig
ilan
ce
an
d
th
e
m
ain
ten
an
ce
o
f
ad
e
q
u
ate
m
ea
s
les
v
ac
cin
atio
n
co
v
er
ag
e
d
esp
ite
th
e
c
h
allen
g
es
p
o
s
ed
b
y
t
h
e
p
a
n
d
em
ic.
T
h
e
p
a
n
d
em
ic
illu
s
tr
ates
th
e
cr
itical
b
alan
ce
b
etwe
en
m
an
ag
in
g
im
m
e
d
iate
p
u
b
lic
h
ea
lth
cr
is
es
an
d
m
ain
tain
in
g
r
o
u
tin
e
h
ea
lth
s
e
r
v
ices
to
p
r
ev
en
t
o
u
tb
r
ea
k
s
o
f
v
ac
cin
e
-
p
r
ev
en
tab
le
d
is
ea
s
es
s
u
ch
as
m
ea
s
le
s
.
T
h
is
d
elica
te
eq
u
ilib
r
iu
m
n
ec
e
s
s
itate
s
s
tr
ateg
ic
p
lan
n
in
g
an
d
r
eso
u
r
ce
allo
ca
tio
n
to
en
s
u
r
e
th
e
co
n
tin
u
atio
n
o
f
ess
en
tial h
ea
lth
s
er
v
ices,
in
clu
d
in
g
im
m
u
n
izatio
n
p
r
o
g
r
am
s
,
ev
en
d
u
r
in
g
g
lo
b
al
h
ea
lth
em
e
r
g
en
cies.
Glo
b
al
Mo
r
an
I
s
tatis
tic
was
u
tili
ze
d
in
th
e
s
tu
d
y
to
d
etec
t
th
e
p
r
esen
ce
o
f
s
p
atial
au
to
co
r
r
elatio
n
o
f
m
ea
s
les
in
f
ec
tio
n
s
in
Ma
lay
s
ia.
T
h
er
e
was
a
s
ig
n
if
ican
t
cl
u
s
ter
in
g
o
f
s
im
ilar
v
alu
es
,
o
f
ei
th
er
h
ig
h
v
alu
es
o
r
lo
w
v
alu
es
b
etwe
en
n
eig
h
b
o
r
in
g
d
is
tr
icts
in
Ma
lay
s
ia,
as
in
d
icate
d
b
y
th
e
p
o
s
itiv
e
Glo
b
al
Mo
r
an
’
s
I
s
tatis
tic
with
a
p
-
v
alu
e
o
f
less
th
an
0
.
0
0
1
.
T
h
is
f
in
d
in
g
alig
n
s
with
p
r
ev
io
u
s
r
esear
ch
f
r
o
m
o
th
er
c
o
u
n
tr
ies,
in
d
icatin
g
th
at
m
ea
s
les
tr
an
s
m
is
s
io
n
o
cc
u
r
s
in
s
p
atial
clu
s
ter
s
[
2
7
]
,
[
2
8
]
.
An
o
t
h
er
s
tu
d
y
in
C
h
in
a
also
r
ep
o
r
te
d
s
p
atial
clu
s
ter
in
g
o
f
m
ea
s
les,
alth
o
u
g
h
t
h
e
s
tu
d
y
in
v
o
lv
es
a
lar
g
er
p
o
ly
g
o
n
s
ize
o
f
p
r
o
v
in
ce
-
le
v
el
[
2
9
]
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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lth
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N:
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-
8
8
0
6
I
n
cid
en
ce
r
a
te
a
n
d
s
p
a
tia
l c
lu
s
teri
n
g
o
f m
ea
s
les ca
s
es in
Ma
la
ysia
,
… (
Mo
h
d
R
u
jh
a
n
Ha
d
f
i Ma
t D
a
u
d
)
1125
T
h
e
s
elec
tio
n
o
f
th
e
d
is
tr
ict
a
s
th
e
u
n
it
f
o
r
o
b
s
er
v
atio
n
i
n
t
h
is
s
tu
d
y
was
ap
p
r
o
p
r
iate
g
i
v
en
th
e
r
o
le
o
f
th
e
d
is
tr
ict
h
ea
lth
o
f
f
ice
i
n
co
o
r
d
in
atin
g
m
ea
s
u
r
es
to
p
r
ev
e
n
t
an
d
co
n
tr
o
l
m
ea
s
les,
ad
d
r
ess
in
g
b
o
th
in
d
iv
id
u
al
ca
s
es a
n
d
o
u
tb
r
ea
k
s
.
Fu
r
th
er
a
n
aly
s
is
was
d
o
n
e
u
s
in
g
a
L
I
SA
m
ap
to
id
en
tif
y
th
e
lo
ca
tio
n
o
f
s
p
atial
clu
s
ter
in
g
i
n
Ma
lay
s
ia.
T
h
er
e
was
a
tem
p
o
r
ar
y
s
h
if
t
to
h
ig
h
-
h
ig
h
(
H
-
H)
clu
s
ter
ar
ea
s
f
o
r
a
y
ea
r
o
b
s
er
v
ed
in
B
in
tu
lu
a
n
d
Mir
i
in
Sar
awa
k
in
2
0
1
8
a
n
d
Gu
a
Mu
s
an
g
in
Kela
n
tan
an
d
Hu
lu
T
er
en
g
g
an
u
d
is
tr
ict
in
T
er
en
g
g
a
n
u
in
2
0
1
9
.
Th
ese
o
cc
u
r
r
en
ce
s
m
ay
b
e
t
h
e
r
esu
lt
o
f
lar
g
e
-
s
ca
le
o
u
tb
r
e
ak
s
in
th
ese
d
is
tr
icts
,
as
d
is
cu
s
s
ed
ea
r
lier
.
Ku
ala
L
u
m
p
u
r
an
d
m
ajo
r
d
is
tr
icts
in
Selan
g
o
r
h
av
e
co
n
s
is
ten
tl
y
b
ee
n
id
en
tifie
d
as
H
-
H
ar
ea
s
o
r
h
o
ts
p
o
ts
f
o
r
m
ea
s
les
o
v
er
f
iv
e
co
n
s
ec
u
tiv
e
y
ea
r
s
,
in
d
icatin
g
th
e
p
r
ese
n
ce
o
f
u
n
d
er
ly
in
g
f
ac
to
r
s
th
a
t
co
n
tr
ib
u
te
to
th
is
tr
en
d
.
T
h
ese
d
is
tr
icts
ar
e
ch
ar
a
cter
ized
b
y
th
eir
i
n
d
u
s
tr
ialized
u
r
b
an
a
r
ea
an
d
a
s
ig
n
if
ican
t p
r
esen
ce
o
f
m
ig
r
an
t
wo
r
k
er
s
,
lead
in
g
to
ar
ea
s
o
f
h
ig
h
p
o
p
u
latio
n
d
en
s
ity
[
3
0
]
.
S
u
ch
co
n
d
itio
n
s
f
ac
ilit
ate
wid
esp
r
ea
d
tr
an
s
m
is
s
io
n
o
f
th
e
v
ir
u
s
,
esp
ec
ially
in
s
ettin
g
s
wh
er
e
clo
s
e
co
n
tact
is
co
m
m
o
n
,
in
clu
d
in
g
p
u
b
lic
tr
an
s
p
o
r
tatio
n
,
ed
u
ca
tio
n
al
in
s
titu
tio
n
s
lik
e
s
ch
o
o
ls
an
d
k
in
d
er
g
ar
te
n
s
,
an
d
d
en
s
ely
p
o
p
u
lated
r
esid
en
ti
al
s
ettin
g
s
s
u
ch
as
h
ig
h
-
r
is
e
ap
ar
tm
e
n
ts
.
T
h
er
ef
o
r
e,
ad
d
itio
n
al
p
u
b
lic
h
ea
lth
m
ea
s
u
r
es
s
h
o
u
ld
b
e
im
p
le
m
en
ted
in
h
o
ts
p
o
t
d
is
tr
icts
.
Dep
lo
y
m
en
t
o
f
m
o
b
ile
team
s
f
r
o
m
n
o
n
-
h
o
ts
p
o
t
d
is
tr
icts
an
d
c
o
n
d
u
ctin
g
s
u
p
p
lem
en
tar
y
im
m
u
n
izatio
n
ac
tiv
ities
in
h
o
t
s
p
o
t
zo
n
es
ca
n
s
er
v
e
as
co
m
p
l
em
en
tar
y
s
tr
ateg
ies
to
au
g
m
e
n
t
ex
is
tin
g
m
ea
s
les
p
r
ev
en
tio
n
an
d
co
n
tr
o
l
ef
f
o
r
ts
in
Ma
lay
s
ia.
T
h
e
r
e
was
a
n
o
ticea
b
le
in
cr
ea
s
e
in
th
e
n
u
m
b
e
r
o
f
l
o
w
-
lo
w
(
L
-
L
)
ar
ea
s
o
r
c
o
ld
s
p
o
ts
,
s
u
g
g
esti
n
g
th
at
m
ea
s
les
v
ac
cin
atio
n
ef
f
o
r
ts
h
a
v
e
b
ee
n
s
u
cc
ess
f
u
l
in
th
e
m
ajo
r
ity
o
f
d
is
tr
icts
ac
r
o
s
s
th
e
co
u
n
tr
y
.
T
h
e
escalatin
g
o
cc
u
r
r
en
ce
o
f
h
i
g
h
-
lo
w
(
H
-
L
)
d
is
tr
icts
is
a
co
n
ce
r
n
in
Ma
lay
s
ia.
T
h
ese
H
-
L
d
is
tr
icts
p
o
s
s
es
s
t
h
e
p
o
ten
tial
to
tr
an
s
f
o
r
m
in
to
h
o
ts
p
o
ts
in
th
e
f
u
tu
r
e
if
th
er
e
ar
e
n
o
ef
f
ec
ti
v
e
p
r
ev
en
tio
n
an
d
co
n
tr
o
l m
ea
s
u
r
es in
th
ese
d
is
tr
icts
.
A
n
o
tab
le
s
tr
en
g
th
o
f
th
is
r
esear
ch
is
it
s
u
tili
za
t
io
n
o
f
ex
ten
s
iv
e,
n
atio
n
wid
e
d
ata
f
r
o
m
ac
r
o
s
s
Ma
lay
s
ia,
en
ab
lin
g
a
th
o
r
o
u
g
h
ex
p
lo
r
atio
n
o
f
th
e
d
is
ea
s
e'
s
d
is
tr
ib
u
tio
n
th
r
o
u
g
h
o
u
t
th
e
n
ati
o
n
.
B
y
d
r
awin
g
o
n
d
ata
th
at
s
p
a
n
s
th
e
e
n
tire
co
u
n
tr
y
,
t
h
e
s
tu
d
y
b
e
n
ef
its
f
r
o
m
a
co
m
p
r
eh
en
s
iv
e
p
er
s
p
ec
tiv
e,
en
co
m
p
ass
in
g
all
r
eg
io
n
s
an
d
t
h
er
eb
y
p
r
o
v
id
in
g
a
d
etailed
o
v
er
v
iew
o
f
m
ea
s
les
d
is
tr
ib
u
tio
n
p
atter
n
s
.
T
h
e
s
t
u
d
y
'
s
m
eth
o
d
o
lo
g
y
is
n
o
tab
ly
s
tr
en
g
t
h
en
ed
b
y
th
e
u
s
e
o
f
c
o
n
f
ir
m
ed
m
ea
s
les
c
ase
r
ep
o
r
ts
s
o
u
r
ce
d
f
r
o
m
th
e
e
-
m
ea
s
les
d
atab
ase
wh
ich
is
m
an
ag
e
d
b
y
th
e
Dis
ea
s
e
C
o
n
tr
o
l
Div
is
io
n
o
f
th
e
Min
is
tr
y
o
f
Hea
lth
Ma
lay
s
ia.
T
h
e
Min
is
tr
y
o
f
Hea
lth
Ma
lay
s
ia,
b
ein
g
th
e
p
r
im
ar
y
b
o
d
y
r
esp
o
n
s
ib
le
f
o
r
th
e
co
llectio
n
an
d
o
v
er
s
ig
h
t
o
f
m
ea
s
les
d
ata
in
th
is
co
u
n
tr
y
,
p
r
o
v
id
es
a
h
ig
h
ly
c
r
ed
ib
le
f
o
u
n
d
atio
n
f
o
r
th
is
s
t
u
d
y
.
T
h
e
r
elian
ce
o
n
th
is
o
f
f
icial,
au
th
o
r
itativ
e
s
o
u
r
ce
en
s
u
r
es th
at
th
e
an
aly
s
is
is
b
a
s
ed
o
n
d
ep
en
d
a
b
le
d
ata,
ess
en
tial f
o
r
d
r
awin
g
ac
cu
r
ate
co
n
clu
s
io
n
s
ab
o
u
t
th
e
s
p
atial
d
is
tr
ib
u
tio
n
o
f
m
e
asles
.
Ho
wev
er
,
th
e
s
tu
d
y
f
ac
es
lim
itatio
n
s
r
elate
d
to
th
e
n
atu
r
e
o
f
s
ec
o
n
d
a
r
y
d
ata
an
d
th
e
p
o
ten
tial
o
f
in
co
m
p
leten
ess
o
f
th
e
d
ata
an
d
u
n
d
er
r
e
p
o
r
tin
g
,
p
ar
ticu
lar
ly
in
r
em
o
te
ar
ea
s
wh
er
e
ac
ce
s
s
to
h
ea
lth
ca
r
e
an
d
r
ep
o
r
tin
g
m
ec
h
a
n
is
m
s
m
ay
b
e
lim
ited
.
T
h
is
co
u
ld
af
f
ec
t
t
h
e
ac
c
u
r
ac
y
o
f
in
cid
e
n
ce
r
ate
ca
lcu
latio
n
s
an
d
h
o
ts
p
o
t i
d
en
tific
atio
n
.
4.
CO
NCLU
SI
O
N
I
n
co
n
clu
s
io
n
,
th
e
f
l
u
ctu
atin
g
in
cid
en
ce
o
f
m
ea
s
les
in
Ma
la
y
s
ia
f
r
o
m
2
0
1
8
t
o
2
0
2
2
,
d
esp
i
te
n
atio
n
al
im
m
u
n
izatio
n
e
f
f
o
r
ts
,
u
n
d
er
s
co
r
es
th
e
p
er
s
is
ten
t
th
r
ea
t
o
f
tr
an
s
m
is
s
io
n
,
p
ar
ticu
lar
ly
i
n
id
en
tifie
d
h
o
ts
p
o
t
ar
ea
s
.
T
h
e
s
tu
d
y
'
s
s
p
atial
an
aly
s
is
r
ev
ea
led
s
ig
n
if
ican
t
clu
s
ter
in
g
o
f
ca
s
es,
h
ig
h
lig
h
tin
g
th
e
n
e
ed
f
o
r
tar
g
eted
p
u
b
lic
h
ea
lth
in
te
r
v
en
tio
n
s
.
C
o
n
tin
u
o
u
s
s
u
r
v
eillan
ce
a
n
d
tailo
r
ed
v
ac
cin
atio
n
ca
m
p
ai
g
n
s
ar
e
cr
itical
to
ac
h
iev
in
g
m
ea
s
les
elim
in
atio
n
.
Fu
tu
r
e
r
esear
c
h
s
h
o
u
ld
ex
p
lo
r
e
th
e
s
o
cio
-
e
co
n
o
m
ic,
cu
ltu
r
al,
an
d
en
v
ir
o
n
m
en
tal
f
ac
to
r
s
th
at
co
n
tr
ib
u
te
to
s
u
s
tain
ed
tr
an
s
m
is
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ip
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is
p
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an
d
f
ac
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co
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r
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.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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Sep
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20
25
:
1
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RE
F
E
R
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NC
E
S
[
1
]
W
o
r
l
d
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t
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2
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.
A
.
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.
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.
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M
.
K
.
P
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,
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6
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E.
H
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l
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[
7
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N
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u
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8
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[
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