This study aimed to measure the proportion of adverse birth outcomes among all births and maternal factors associated with low birth weight among Indigenous (Orang Asli) infants in Kelantan, Malaysia. Proportionate stratified random sampling was done to select 327 samples from five antenatal centres involved with Orang Asli in Kelantan. Multiple logistic regression analysis was used to determine maternal factors associated with low birth weight among Orang Asli infants. The proportion of low birth weight was measured at 16.2% (substantially exceeding the national rate), preterm birth at 7.3%, stillbirth at 0.6%, early neonatal death at 0.6%, and macrosomia at 0.9%,. Maternal factors associated with low birth weight infants include primiparity (AdjOR: 2.88; 95% CI: 1.44,5.78), anaemia in pregnancy (AdjOR: 2.33; 95%CI: 1.18,4.61) and hypertension (AdjOR: 4.21; 95%CI: 1.23,14.44). In conclusion, far-reaching antenatal services and nutrition policy are essential to reduce the proportions of low birth weight among Orang Asli.
Malaysia has maintained zero cases of indigenous human malaria since 2018. However, zoonotic malaria is still prevalent in underdeveloped areas and hard-to-reach populations. This study aimed to determine the prevalence of malaria among remote indigenous communities in Peninsular Malaysia. A cross-sectional survey was conducted in six settlements in Kelantan state, from June to October 2019. Blood samples were tested for malaria using microscopy and nested polymerase chain reaction (nPCR) targeting the Plasmodium cytochrome c oxidase subunit III (cox3) gene. Of the 1,954 individuals who appeared healthy, no malaria parasites were found using microscopy. However, nPCR revealed seven cases of Plasmodium knowlesi mono-infection (0.4%), and six out of seven infections were in the group of 19 to 40 years old (P = 0.026). No human malaria species were detected by nPCR. Analysis of the DNA sequences also showed high similarity that reflects common ancestry to other P. knowlesi isolates. These findings indicate low submicroscopic P. knowlesi infections among indigenous communities in Malaysia, requiring PCR-based surveillance to support malaria control activities in the country.