Applications of data science and artificial intelligence (AI) in global health are expanding, yet research remains fragmented and often misaligned with the needs of low-income and middle-income countries (LMICs). To address this misalignment, we conducted a global research priority-setting exercise using the Child Health and Nutrition Research Initiative (CHNRI) method. 155 research ideas were scored by 51 experts based on feasibility, potential impact on disease burden, paradigm shift potential, implementation potential, and equity. Top-ranked priorities focused on epidemic preparedness, including AI-based outbreak prediction, improved diagnostics for infectious diseases, and early-warning systems. Other highly ranked topics included AI-assisted resource allocation, telemedicine, culturally adapted mobile health services, and chronic disease management tools. Experts from LMICs prioritised infectious disease control and diagnostic equity, whereas experts from high-income countries emphasised infrastructure and climate-related analytics. The resulting agenda provides a roadmap for aligning AI and data science research with global health priorities, particularly in LMICs.
BACKGROUND:Accurate classification of seizure types guides diagnostic investigations and antiseizure medication (ASM) selection, and is particularly critical in resource-limited settings. We validated a pragmatic three-item focal seizure screening tool (aura, unilateral motor phenomena, oral automatisms) intended for rapid use by non-specialist clinicians. METHODS:Through a multicentre cross-sectional study spanning from 1 August 2024-31 August 2025, we recruited consecutive adults (≥18 years) with neurologist-confirmed seizure types at seven public hospitals in Malaysia. Clinicians applied the tool and finalized the scores (0-3). Diagnostic accuracy was evaluated using receiver operating characteristic analysis and area under the curve (AUC). Sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-), positive predictive value (PPV), and negative predictive value (NPV) were calculated at every cut-off score, respectively. RESULTS:Among the 428 participants (mean age 36.4 ± 14.6 years), 83.41% had focal seizures. The tool achieved an AUC of 0.751 (95% CI 0.688-0.815; p < 0.001). A cut-off score of ≥ 1 yielded high sensitivity (84.0%) and fair specificity (59.2%), with LR + of 2.06 and PPV of 91.19%, supporting its role for screening. A cut-off score of ≥ 2 improved specificity to 88.73% and PPV to 94.74%, making it suitable for diagnosis. CONCLUSIONS:The three-item focal seizure screening tool is feasible, rapid to administer, and may assist general clinicians in classifying focal-onset seizures. Cut-off scores can be selected according to clinical priorities, namely, sensitive case-finding versus high-specificity confirmation.
Abstract Objective Menopause, a universal yet diverse life stage, profoundly influences women's physical, emotional, and social well‐being. In Malaysia's multi‐ethnic context, experiences are shaped by cultural meanings, religious beliefs, healthcare structures, and socioeconomic factors. Despite this, policies and services remain limited, with low uptake of hormone replacement therapy (HRT), poor workplace recognition, and uneven access to care. This study is designed to identify the different experiences of menopause in Malaysian population. Design Qualitative study using semi‐structured interviews. Setting and Population Women in perimenopause, menopause, and post‐menopause stages from the general population. Methods Part of the Malaysian chapter of the MARIE WP2a project, this study explored lived experiences among women aged over 18, purposively recruited across ethnic, religious, and socioeconomic groups. Interviews conducted in English, Malay, or Mandarin were analysed thematically using the Delanerolle and Phiri equity‐oriented framework to identify determinants at individual, community, health system, and policy levels. Results Eleven women described a range of symptoms, from mild discomfort to severe vasomotor, psychological, and musculoskeletal issues. Surgical menopause caused abrupt, compounded symptoms. Coping strategies included exercise, herbal remedies, religious practices, and selective biomedical use. HRT uptake remained low due to cancer fears, cultural perceptions, and limited clinician engagement. Workplace support was minimal, with most relying on informal networks. Healthcare engagement was reactive, and anticipatory guidance was scarce. Equity gaps emerged around affordability, rural–urban divides, religious norms, workplace stigma, and lack of culturally appropriate information. Conclusion Menopause in Malaysia is shaped by biological, sociocultural, and systemic factors. Culturally sensitive clinical pathways, workplace reforms, and equity‐focused primary care policies are urgently needed.
Assessment of knowledge, attitude and practice (KAP) related to breast cancer (BC) is essential to ensure that screening promotion strategies are effective and culturally appropriate. Using questionnaires in the local language enhances cultural sensitivity and improves understanding of the subject. However, validated Malay-language KAP questionnaires are limited, as most studies rely on English versions. This study aimed to validate a Malay-translated version of a KAP questionnaire on BC screening for use among first-degree relatives of BC patients. The original KAP questionnaire developed by Madubogwu was translated into Malay using a forward-backward translation method. Content validation was conducted by ten radiology medical officer and five mammographer. Pilot study was carried out with 32 participants, followed by a full survey involving 112 respondents using the validated Malay version. Experts scored the questionnaire between 124 and 140 out of 144 for consistency, clarity, accuracy and grammar, with an average content validity index of 0.920. The internal consistency (Cronbach's alpha) was 0.704, and the pilot test generated 0.870, indicating good reliability. Of the 112 respondents, 95.5% were aware of BC. The main sources of information were hospitals (57.1%) and media (23.2%). A total of 81.3% agreed that breast self-examination is useful for early detection, and 63.4% practiced it regularly. Knowledge of clinical breast examination and mammograms was moderate, with 65.2% and 82.1%, respectively recognising their usefulness. The validated Malay version of the KAP questionnaire demonstrates strong psychometric properties and is a valid instrument for assessing breast cancer screening knowledge, attitudes and practices.
Background: Older adults in rural areas often face barriers to rehabilitation that affect continuity of care. This study explored barriers to and facilitators of geriatric rehabilitation in rural Malaysia. Methods: A qualitative phenomenological study involved 30 older adults aged ≥ 60 years who received rehabilitation services between 2018 and 2024, with caregiver proxies participating when necessary. Semi-structured telephone interviews were conducted in Malay, Chinese, or English and were audio-recorded. The recordings were transcribed and translated into English using an automated speech recognition model (OpenAI Whisper). Transcripts were analysed using an AI-assisted thematic analysis framework and classified into eight predefined domains based on sentence-embedding similarity with human review. Segments were manually coded as barriers or facilitators, and scored for sentiment using a rule-based tool (NLTK VADER). Inter-coder reliability was assessed using Cohen’s kappa. Results: Distance to rehabilitation services and limited transportation were the main barriers to the continuity of care. Financial costs related to travel, treatment, and assistive devices further limited attendance, and some participants reported service constraints. Strong family and community support facilitated rehabilitation engagement. Telehealth was frequently suggested as a means of providing rehabilitation guidance and maintaining continuity of care. Conclusion: Continuity of geriatric rehabilitation in rural Malaysia is constrained by long travel distances and transportation barriers. Strengthening family support and incorporating simple telehealth approaches may improve continuity of care for older adults in rural communities.
