Non-communicable diseases (NCDs) are a health challenge among Malaysia's Orang Asli population. This study examined factors associated with undiagnosed diabetes, hypertension, and hypercholesterolemia using Orang Asli Health Survey (OAHS) 2022 data where 9216 Orang Asli adults participated. OAHS was a nationally representative cross-sectional survey using two-stage stratified random sampling. Data was analysed using SPSS version 29. The prevalence of undiagnosed diabetes, hypertension, and hypercholesterolemia was 11.6%, 20.8%, and 39.9% respectively. Predictors of undiagnosed diabetes included Senoi (aOR 1.83) and Proto-Malay (aOR 2.24) tribes, fringe locality (aOR 1.70), lower education (aOR 1.37), and hypercholesterolemia (aOR 2.23). Undiagnosed hypertension was associated with males (aOR 1.98), age ≥60 years (aOR 4.20), remote locality (aOR 1.58), lower education (aOR 1.52), unmarried (aOR 1.24), obesity (aOR 1.99), and current drinkers (aOR 1.51). Undiagnosed hypercholesterolemia was linked to age 40 to 59 years (aOR 1.21), and Senoi tribe (aOR 2.02). Targeted and culturally tailored interventions are essential.

Obesity is a risk factor for hypercholesterolemia; however, evidence of obesity among Orang Asli (OA) adults remains limited. Lifestyle changes, including unhealthy diets and sedentary behavior, may increase vulnerability to noncommunicable diseases. This study examined the sex-specific associations between body mass index (BMI) and hypercholesterolemia using data from the OA Health Survey 2022. A total of 8160 adults aged ≥18 years with complete questionnaires, anthropometric data, and blood data were analyzed. The prevalence of hypercholesterolemia among OA adults was 47.6%; of these, 41.5% were previously undiagnosed. Compared with normal BMI, overweight and obesity were associated with a higher odds of hypercholesterolemia in both sexes. Older age, Senoi tribe affiliation, and diabetes were associated with hypercholesterolemia in both sexes. These findings highlight the need for culturally tailored interventions to strengthen obesity prevention and cholesterol testing in primary care and outreach services to reduce cardiovascular risk in OA communities.

BACKGROUND:Type 2 diabetes mellitus (T2DM) is a growing public health problem globally, and in Malaysia. Orang Asli, the Indigenous population in Peninsular Malaysia, often experience a disproportionate burden of diabetes, driven by social disadvantage, lifestyle transitions, and limited access to healthcare. Given that no nationwide diabetes assessment has been conducted among this under-represented group, this study therefore aimed to determine the prevalence of diabetes and its associated factors among Orang Asli adults in Peninsular Malaysia. METHODS:The Orang Asli Health Survey (OAHS) 2022 was a nationwide cross-sectional survey with a complex sampling design conducted among Orang Asli adults living in non-institutional households across nine states of Peninsular Malaysia. A two-stage stratified sampling strategy was used, with locality (urban, fringe, remote) as the primary stratum and tribe (Senoi, Proto-Malay, Negrito) as the secondary stratum. Data were collected using structured interviewer-administered questionnaires and standardised clinical measurements. Diabetes was defined as self-reported physician-diagnosed diabetes or fasting blood glucose ≥7.0 mmol/L. Descriptive statistics, chi-square tests, and multiple logistic regression were performed using SPSS Version 20, accounting for the complex survey design. The adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were reported. RESULTS:A total of 9,206 Orang Asli adults participated in the diabetes module. The overall prevalence of diabetes was 16.1% (95% CI: 14.3-17.9). Diabetes prevalence was higher among the females (16.8%), those aged ≥60 years (28.1%), urban residents (21.1%), Proto-Malay (18.8%) and Senoi (14.0%) tribes, participants with no formal or incomplete primary education (19.1%), those with monthly household income ≥RM2000 (21.2%), obese individuals (21.1%), respondents with hypertension (24.2%) and those with high total cholesterol (21.7%). In multivariable analysis, diabetes was significantly associated with age 40-59 years (AOR 1.64; 95% CI: 1.35-1.99) and ≥60 years (AOR 2.14; 95% CI: 1.40-3.28), urban (AOR 1.73; 95% CI: 1.07-2.79) and fringe (AOR 1.63; 95% CI: 1.13-2.35) localities, Senoi (AOR 1.70; 95% CI: 1.08-2.68) and Proto-Malay (AOR 2.41; 95% CI: 1.50-3.86) tribes, incomplete primary education (AOR 1.28; 95% CI: 1.02-1.60), household income ≥RM2000 (AOR 1.47; 95% CI: 1.12-1.93), hypertension (AOR 1.42; 95% CI: 1.03-1.95) and hypercholesterolemia (AOR 2.17; 95% CI: 1.70-2.76). CONCLUSIONS:Diabetes is common among Orang Asli adults in Peninsular Malaysia. Older age, urban and fringe residence, specific tribal groups, lower education, higher income, hypertension, and hypercholesterolaemia were associated with diabetes. These findings highlight the need for culturally appropriate diabetes prevention, screening, and management strategies tailored to Orang Asli communities, particularly for the elder subgroup and those living in urbanised settings.

Background Point-of-care testing (POCT) is commonly used in epidemiological surveys due to its various advantages, such as portability and immediate test results. The CardioChek ® PA analyser 3-in-1 lipid panel measures total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol. This study tested the reliability and diagnostic accuracy of the CardioChek ® PA analyser using a 3-in-1 lipid panel. Methods A cross-sectional study design with quota sampling was used. A total of 203 respondents aged 18 years and above from a research centre in the Ministry of Health, Malaysia, were recruited. Venous blood was sent to the laboratory, while a POCT analyser was used for capillary blood measurements. Intraclass coefficient correlation (ICC) analysis was employed to determine the agreement between capillary and venous blood parameters. The diagnostic performance of the evaluated tests was evaluated using STATA version 12. Results The agreement between capillary and laboratory venous blood was moderate (0.64–0.67) for TC and HDL, good (0.75) for LDL and excellent (0.91) for TG). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were as follows: TC, 57.1%, 94.3%, 92.3% and 64.8%; TG, 76.0%, 100%, 100%, and 96.6%; HDL, 96.2%, 83.2%, 47.2% and 99.3%; and LDL, 81.0%, 100%, 100% and 68.3%, respectively. Conclusions The CardioChek ® PA analyser showed acceptable diagnostic accuracy for screening high-risk individuals more often in places where laboratories are inaccessible. It could also be used in clinical settings where patients would benefit from swift treatment decisions.

Abstract Treatment intensification is essential to ensure guideline targets are attained in diabetes patients. The failure to intensify treatment when the targets are not achieved is therapeutic inertia. This study aimed to determine the proportions and factors associated with treatment intensification and therapeutic inertia of antihypertensive therapy in type 2 diabetes patients with uncontrolled hypertension in Malaysia. A retrospective cohort analysis was conducted utilising registry data. Diabetes hypertensive patients with uncontrolled baseline systolic or diastolic blood pressure were included. Treatment intensification was the increase in the number of antihypertensive agents from the index treatment. Therapeutic inertia was the absence of treatment intensification when the second blood pressure reading was still uncontrolled. About 6956 patients were followed up over 2.5 ± 1.1 person-years. Treatment intensification was observed in 29.8% of patients, while 38.6% had therapeutic inertia. Chinese, Indian, and ‘others’ ethnic groups, retinopathy, more antihypertensive agents, and higher systolic blood pressure were associated with therapeutic inertia. Underweight, overweight patients and those with dyslipidaemia had lower risks for therapeutic inertia. The results indicate suboptimal quality of care in public health clinics in Malaysia. Further studies are needed to determine the underlying causes to formulate precise interventions to tackle the problem in Malaysia.

Background Diabetes is a major non-communicable health problem in both developed and developing countries, including Malaysia. People with diabetes are living longer and are vulnerable to microvascular and macrovascular complications, thus representing a significant public health problem with high morbidity, mortality, and substantial economic repercussions. We aim to determine the national prevalence of diabetes and identify associated factors among the adult population in Malaysia. Methods A nationwide cross-sectional study was conducted in 2019 involving 10,464 respondents in Malaysia. A two-stage stratified sampling design was used to select a representative sample of Malaysian adults. Structured validated questionnaires with face-to-face interviews were used to obtain data from selected respondents aged ≥ 18. Finger-pricked fasting blood glucose tests using the Accutrend GC machine were performed on respondents who claimed they did not have diabetes. Chi-square tests and logistic regression were used to determine associations between diabetes and associated factors at the significance level of = 0.05. Results The overall prevalence of diabetes among adult respondents was 18.3% (n = 2629). The highest prevalence of diabetes was among females (18.4%), those aged 60 & above (41.5%), Indian (31.4%), those without formal education (28.3%), widow/widower/divorce (33.2%), not working (24.9%), inactive (22.5%), obese (27.1%), hypertension (36.0%) and high cholesterol level (30.4%). Logistic regression analyses revealed that age group, ethnicity, education level, marital status, physical activity level, obesity, blood pressure status and cholesterol status were associated with diabetes among adults. Conclusion This study showed that the prevalence of diabetes among adult populations in Malaysia is high, with about one in five adults found to have diabetes. Awareness programs and interventions on diabetes need to be improved, especially related to behavioural charge as a strategy for the prevention and control of diabetes and its complications.

Purpose This study examines sociodemographic and lifestyle factors associated with knowledge of calories. Design/methodology/approach Data were analysed from the Komuniti Sihat Pembina Negara (KOSPEN) 2016. Logistic regressions were used to examine the effects of sociodemographic and lifestyle factors on knowledge of the definition of calories, recommended caloric intake and the effect of calories on body weight. Findings The results revealed that large proportions of respondents did not know the definition of calories (51.33%), recommended caloric intake (95.50%) and the effect of calories on body weight (64.89%). The proportions of respondents having knowledge of calories varied by income, gender, ethnicity, educational level, marital status, employment status, urbanization of states, smoking status and awareness of body mass index (BMI). Respondents were less likely to have knowledge of calories if they were low-income earners, non-Malays, less-educated, unemployed, smokers and unaware of their BMI. Practical implications Sociodemographic and lifestyle factors play an important role in affecting knowledge of calories. Policymakers should make a concerted effort to improve knowledge of calories among adults with different sociodemographic backgrounds and lifestyle profiles. Originality/value This study provides several contributions to the literature: (1) The country of interest is Malaysia, where the prevalence of obesity is high and studies related to knowledge of calories are lacking. (2) In addition to knowledge of recommended caloric intake, knowledge of the definition of calories and the effect of calories on body weight factors are considered. (3) Apart from sociodemographic variables, smoking behaviour and awareness of BMI variables are included in the analyses.

Objectives: Physical inactivity, hypertension and non -communicable diseases are major public concerns across the globe. To our knowledge, there is a lack of research that has investigated the moderating effect of age on the relationship between hypertension and physical activity in developing countries. This study had two objectives: (1) investigating hypertension and sociodemographic factors associated with physical activity and (2) investi-gating whether age moderates the relationship between hypertension and physical activity. Methods: Nationally representative data of Malaysia were used to generate cross-sectional evidence. The sample size was 2156 respondents. An ordered probit regression was utilized to assess factors associated with the practice of physical activity. Results: Respondents aged 40-49 years with hyperten- sion were 7.3% less likely to participate in high-level physical activity when compared to those without hy- pertension. The probability of having a low level of physical activity was 12.3% higher among hypertensive patients aged >60. Males, married individuals, less- educated adults, low-income earners, and individuals who were aware of their BMI, had a higher tendency to indulge in a highly active lifestyle than others. Conclusion: The effect of hypertension on physical ac- tivity was moderated by age. Factors influencing physical activity levels among adults were income, gender, marital status, education, employment status, and BMI awareness.

This study explores the correlates of sociodemographic factors, smoking, and caloric knowledge to body mass index awareness with a focus on Malaysia. Logistic regressions were estimated to examine sociodemographic factors associated with body mass index awareness. More than half of respondents were unaware of their body mass index (54.8%). Age was negatively associated with body mass index awareness. Adults without formal education were less likely to know their body mass index than those with tertiary-level education. Adults were less likely to be aware of their body mass index if they engaged in smoking. Adults with knowledge of the definition of calories were more aware of their body mass index than others. The findings emphasize the urgent need for a forthcoming sociodemographic factors-specific policy directed toward improving body mass index awareness to lower the prevalence of obesity in Malaysia.

Alcohol consumption is a risk factor for various diseases, especially non-communicable diseases (NCDs) and injuries. The reduction of the harmful use of alcohol is mentioned in Target 3.5 of the Sustainable Developmental Goals (SDG). This study aimed to determine factors associated with current alcohol drinking among Malaysians aged 15 years and above. Data from the National Health and Morbidity Survey (NHMS) 2019, a cross-sectional nationwide survey using a two-stage stratified random sampling design, was used. Current alcohol drinking was defined as having consumed any alcoholic beverage in the past 12 months. Descriptive statistics and multiple logistic regression analysis were employed. The prevalence of current drinkers was 11.5%; 95% CI: 9.8, 13.5. The majority (65%) consumed alcoholic beverages in Category 2, which is mainly beer. Current drinkers consumed alcohol mostly once a month (59.0%), one or two drinks (71.1%), on a typical day. Most respondents had six or more drinks less than once a month (27.6%). Sex, age, ethnicity, education, employment, and smoking were found to be significantly associated with current alcohol drinking. Marital status, locality of residence, and household income were not significantly associated. Alcohol drinking is a problem among certain vulnerable groups and should be tackled appropriately.

INTRODUCTION: The prevalence of hypertension and diabetes continues to rise globally. This study examined the national prevalence of hypertension among the diabetes population in Malaysia and its associated risk factors. MATERIALS AND METHODS: A sub-analysis of data from the National Health and Morbidity Survey (NHMS) 2015 was conducted among 4229 respondents with diabetes. The data was obtained from respondents aged 18 years and above. Diabetes was defined as those who self-reported to have diabetes or had fasting capillary blood glucose of >= 6.1 mmol/L or non-fasting blood glucose of >11.1 mmol/L. Hypertension was defined as one who has systolic and diastolic blood pressure of >= 140 mmHg and >= 90 mmHg, respectively. RESULTS: The prevalence of hypertension among respondents with diabetes was 57.9% (95% CI : 55.8,60.0). The prevalence of hypertension among diabetes was higher among females (58.7%), >= 60 years old (80.1%), Chinese (61.1%), those with primary education (69.6%), widow/widower/divorce (75.4%), not working (67.7%), rural residents (60.6%), non-smokers (60.1%), non-drinkers (58.1%), those who were obese (66.0%) and with abnormal cholesterol level (63.5%). Multiple logistic regression analyses revealed that age group, working status, obesity and cholesterol were associated with hypertension among respondents with diabetes. CONCLUSION: Prevalence of hypertension among diabetes population in Malaysia is high. Early detection of hypertension should be an integral part of diabetes management.

In the article “Hypercholesterolemia Prevalence, Awareness, Treatment and Control Among Adults in Malaysia: The 2015 National Health and Morbidity Survey, Malaysia” which appeared in Volume 10, No. 7(2018), a sentence in the abstract under results section, “Only a mere 12.7% (95% CI:12.4 -13.1) among those who were aware were on treatment and out of which only 53.7% (95% CI: 50.1-57.2) had their cholesterol levels controlled” appeared incorrect and should have appeared as “Only a mere 12.7% (95% CI:12.4 -13.1) were on treatment and out of which only 53.7% (95% CI: 50.1-57.2) had their cholesterol levels controlled”. We apologise to the readers of Global Journal of Health Science for this error.

Background: Body Mass Index (BMI) can be used to determine bodyweight categories. This study aimed to re-examine the previous optimal BMI cut-offs in identifying the Non-Communicable Diseases (NCDs) among the Malaysian adults’ population. Data were obtained from the National Health and Morbidity Survey (NHMS) 2019. Methods: It was a cross-sectional, population-based survey that employed a two-stage stratified random sampling design. A total of 10,472 adults aged 18 years and above participated in this survey throughout Malaysia, with the majority aged between 31 to 59 years. Results: The optimal BMI cut-off values for identifying diabetes, hypertension, hypercholesterolemia, and at least one NCD ranged from 22.92 to 24.81 kg/m2 for males. The highest optimal BMI cut-off value for at least one NCD in females was 26.29 kg/m2, while the lowest optimal BMI cut-off value was for hypercholesterolemia in females, which was 22.63 kg/m2. Our study has produced a more reliable and revised BMI cut-off point that can detect NCD at a lower BMI compared to available BMI classification. Conclusion: The findings highlight the importance of recognizing the issue of BMI and obesity to tackle NCD. A new set of modified BMI which is very useful for tertiary care, demonstrates the potential benefit of early detection and intervention in preventing morbidity and mortality. Hence, it would lessen the length and impact of the disease on a person’s quality of life and also reduce complications and lower the mortality rates of certain diseases because early treatment is often the most effective.

In 2016, the Ministry of Health (MOH) Malaysia has introduced a new programme to prevent and reduce the occurrence of non-communicable diseases (NCDs) as well as related risk factors in the work place environment known as KOSPEN Plus. This study aims to evaluate the awareness and perception of KOSPEN Plus programme after 3 years of implementation in MOH health facilities, government and private agencies in Malaysia. A cross sectional study design was employed in the study. All health facilities, government and private agencies which had implemented KOSPEN Plus programme between 2016 and 31 December 2018 in all states in Malaysia were invited to participate in the study. The computer assisted self-interview (CASI) using the pre-tested self-administered questionnaire in the electronic form was used. A total of 362 health facilities, government and private agencies which had implemented KOSPEN Plus programme was involved in this study. Overall, more than 80% of facilities/agencies in this study implemented six out of the eight scopes of KOSPEN Plus. The survey was planned with the goal of obtaining data to support the Ministry of Health in reviewing the present health activities related to workers health in Malaysia and make necessary improvement to the programme.

Abstract Introduction: Community health workers (CHW) or volunteers are health workers who are trained but do not possess a professional certificate. They are community members who live and work in that particular community. The Ministry of Health Malaysia had initiated a community-based intervention programme, Healthy Community Empowers the Nation or ‘Komuniti Sihat Pembina Negara’ (KOSPEN) in October 2013. In this programme, CHWs main task is to conduct non-communicable diseases (NCD) risk factor screening. Methods: Data from the “Evaluation of the implementation of KOSPEN programme in Malaysia 2016” was used. It is a cross-sectional study which was carried out in randomly selected KOSPEN localities throughout Malaysia. Logistic regression analysis was applied to determine factors associated with not performing KOSPEN screening activities by the volunteers. Data analysis was performed using Statistical Package for Social Sciences (SPSS) version 20. Results: A total of 700 volunteers were included in this study. Most of the volunteers were female (65.7%) and were aged 50-59 years (30.9%), followed by those aged 40-49 (27.1%). Majority had secondary education (65.3%), employed (55.7%.) and were married (80.4%). Multivariate logistic regression showed that volunteers who never attended training (aOR 2.79; 95% CI:1.66, 4.67) and who felt the content of the training module was inadequate (aOR 2.693; 95% CI: 1.46, 4.98) were more likely to not perform screening activities in the community. Conclusion: Attendance of the training should be a pre-requisite to qualify as a volunteer. Improvement to the training module should done to increase comprehensibility of the modules among the volunteers. Keywords: KOSPEN-community health workers-NCD screening-community-based intervention

INTRODUCTION:Many studies have revealed that exposure to secondhand smoke (SHS) substantially increases the risk of smoking related diseases especially among the vulnerable groups, yet data on the location of SHS exposure among youth in Malaysia are still lacking. The study aims to describe the prevalence and factors associated with SHS exposure at home, outside the home, and inside the school among school-going adolescents in Malaysia. METHODS:We derived the data from the TECMA study, which used a cross-sectional study design and multi-stage sampling method to obtain a representative sample of school-going adolescents aged 11-19 years in Malaysia in 2016. Data were collected through a self-administered approach using a pre-validated standard questionnaire. Descriptive and multivariate analyses were used to analyze the data, and results are presented as adjusted odds ratio (AOR) with 95% confidence interval (95% CI). RESULTS:SHS exposure for the past seven days was higher outside the home (51.2%; 95% CI: 49.2-53.2) compared to at home (37.8%; 95% CI: 35.8-39.9) while 27.3% (95% CI: 25.1-29.5) of school-going adolescents reported exposure to SHS inside the school in the past one month. In the regression analyses, older adolescents, those of Malay and Bumiputra Sarawak ethnicities, adolescents from rural areas and current smokers had higher likelihood of exposure to SHS at home, outside home and inside the school. Our study also found that adolescents who were current smokers had higher odds of being exposed to SHS at home (AOR=2.87; 95% CI: 2.57-3.21), outside the home (AOR=3.46; 95% CI: 3.05-3.92) and in the school (AOR=2.25; 95% CI: 2.01-2.51). CONCLUSIONS:Health promotion measures should target parents/guardians and household members to reduce SHS exposure among adolescents. In addition, smoke-free regulation should be fully enforced in school. Furthermore, more public places should be designated non-smoking areas to reduce SHS exposure and denormalize smoking behavior.

AimThe objective of this study is to determine the prevalence of self‐reported diabetes, hypertension and hypercholesterolemia among older persons in Malaysia and their associated factors.MethodsThe study used data from the National Health and Morbidity Survey in 2018. It was a cross‐sectional study with two‐staged stratified cluster sampling design. In total, 3977 adults aged ≥60 years were selected for this study. Respondents were interviewed face to face using a structured questionnaire. Self‐reported diabetes, hypertension or hypercholesterolemia was defined as having ever been told they have these diseases by a medical doctor or paramedic. Data were analyzed using SPSS version 25. The multiple logistic regression model was used to examine the factors associated with the prevalence of self‐reporting.ResultsThe prevalence of self‐reported diabetes, hypertension and hypercholesterolemia among older persons in Malaysia were 27.7%, 51.1% and 41.8% respectively. Presence of other comorbidities and being obese showed higher odds for all three diseases. Indians, unemployed, inactive had higher odds for diabetes. Other Bumiputras, unemployed, non‐smoker, obese and inactive had higher odds for hypertension. Non‐smoker had higher odds for hypercholesterolemia.ConclusionsHealth promotion, vigilance, attention and services targeting on the associated factors should be strengthened for older persons in Malaysia to ensure healthy aging. Geriatr Gerontol Int 2020; 20: 79–84.

Background The prevalence of chronic kidney disease (CKD) in Malaysia was 9.07% in 2011. We aim to determine the current CKD prevalence in Malaysia and its associated risk factors. Methods A population-based study was conducted on a total of 890 respondents who were representative of the adult population in Malaysia, i.e., aged ≥18 years old. Respondents were randomly selected using a stratified cluster method. The estimated glomerular filtration rate (eGFR) was estimated from calibrated serum creatinine using the CKD-EPI equation. CKD was defined as eGFR < 60 ml/min/1.73m 2 or the presence of persistent albuminuria if eGFR ≥60 ml/min/1.73m 2 . Results Our study shows that the prevalence of CKD in Malaysia was 15.48% (95% CI: 12.30, 19.31) in 2018, an increase compared to the year 2011 when the prevalence of CKD was 9.07%. An estimated 3.85% had stage 1 CKD, 4.82% had stage 2 CKD, and 6.48% had stage 3 CKD, while 0.33% had stage 4–5 CKD. Hypertension (aOR 3.72), diabetes mellitus (aOR 3.32), increasing BMI (aOR 1.06), and increasing age (aOR 1.06) were significantly associated with CKD. Conclusion Our study has shown that CKD has become one of the leading public health issues in Malaysia. Thus, there is an urgent need to screen for CKD and prevent its progression, associated morbidity, and mortality at the national level.