The COVID-19 pandemic is associated with increases in child mental health problems, but the persistence of these changes in the post-pandemic era remains uncertain. Additionally, it is unclear whether changes in mental health problems during the pandemic exceed the anticipated increases as children age. This study controls for the linear effect of age in 1399 children, investigating the course of child-reported anxiety, depression, hyperactivity, and inattention symptoms during and after the pandemic, and identifies risk and protective factors that predict these mental health trajectories.

Children (51% male; ages 9–11 at the first timepoint) provided mental health ratings at three pandemic timepoints (July–August 2020; March–April 2021; November 2021–January 2022) and one post-pandemic timepoint (January–July 2023). Mothers reported pre-pandemic mental health (2017–2019) and socio-demographic factors. Children reported socio-demographic factors, risk (e.g. screen time, sleep), and resilience (e.g. optimism) factors during the first timepoint.

Average mental health symptoms increased over time, with more children exceeding clinical cut-offs for poor mental health at each subsequent pandemic timepoint. Growth curve modeling, adjusting for age-related effects, revealed a curvilinear course of mental health symptoms across all domains. Examination of risk and protective factors revealed that pre-existing mental health symptoms and optimism were associated with the course of symptoms.

After considering age effects, children's mental health follows a curvilinear pattern over time, suggesting an initial decline followed by a rising trend in symptoms post-COVID. These findings underscore the continued need for additional resources and timely, evidence-based mental health prevention and intervention for children.

The aim of this study is to assess knowledge and attitudes toward Zika virus disease (ZVD) as well as mosquito prevention practices in Malaysia at a nationwide level.

Computer-assisted telephone interviews (CATI) were conducted between June 2019 and February 2020.

There are gaps in knowledge about the symptoms, mode of transmission, and risk of microcephaly. The mean for the Zika-related knowledge score was 5.9 (SD ± 4.4) out of a possible score of 14. The majority perceived little or no risk of getting ZVD (75.0%) and 75.5% were a little or not at all worried about ZVD. A high proportion reported the use of insect sprays or mosquito coils to prevent mosquito bites; however, a relatively lower proportion of people reported fixing mosquito netting on doors and windows, and using mosquito bed nets. The mean for the mosquito prevention practices score was 11.9 (SD ± 4.7) out of a possible score of 27. Important factors influencing mosquito prevention practices include household income, environment factors, risk perception, and Zika-related knowledge.

Zika prevention measures should be targeted in priority toward residents in lower socioeconomic neighborhoods. Campaigns should focus on messages highlighting the high risk of getting dengue.