As Chikungunya virus (CHIKV) infection continues to rise globally, including in Malaysia, it is essential for healthcare workers (HCWs) to have adequate knowledge about the disease for diagnostic accuracy and to improve public health surveillance systems. This study aimed to assess awareness and measure the level of knowledge of CHIKV infection among HCWs in the Hulu Langat district and explore associated sociodemographic and skill-related factors. This was a cross-sectional study in which the questionnaire was physically distributed to participants using the universal sampling method. All participants (100%) were aware of CHIKV infection, and most (80.1%) had knowledge of the disease. Furthermore, networks such as professional members, family, and friends (27.8%), followed by professional development programs (23.1%), were identified as the common platforms utilized by HCWs to access information regarding CHIKV infection. Ordinal logistic regression analysis further demonstrated that the level of education (odds ratio [OR] = 2.23, 95% confidence interval [CI] [1.14, 4.35]) and HCWs who attended Continuing Medical Education (CME)/courses on CHIKV infection (OR = 1.73, 95% CI [1.00, 3.01]) and had experience in handling the case (OR = 3.23, 95% CI [1.44, 7.28]) were significantly associated with awareness and knowledge of the disease. Implementing continuous education and training can enhance HCWs' understanding of CHIKV infection.
China's aging population has witnessed a surge in widowed older adults, raising concerns about their mental health. Losing a spouse is a profoundly distressing experience with enduring effects on well-being. Despite the proverbial belief in time's healing power, existing studies often neglect the potential decline in depressive symptoms during widowhood. Drawing data from the 2015 and 2018 China Health and Retirement Longitudinal Study, this study delves into the impact of widowhood duration on depression among 8370 older adults and uncovered significantly higher depression scores among widowed individuals, particularly in the initial 3 years. The research reveals that widowhood contributes to heightened depression levels even after accounting for sociodemographic factors. Although the depressive impact lessens over time, it persists beyond 3 years, underscoring the need for heightened awareness and support for this vulnerable population.
Social support (SS) has been widely recognized to have a protective effect influencing older adults' emotional and psychological well-being. This study attempted to determine the relationships of structural SS and functional SS on depression and quality of life among the community-dwelling older adults in the rural and Asian context. A cross-sectional study was conducted among 2324 community older adults aged 60 years and above in Kuala Pilah, Malaysia. Participants were recruited via multistage sampling and interviewed face-to-face. The relationships were analyzed using structural equation modeling. Structural SS was associated with functional SS (β = 0.05). Only functional SS (having a role, knowing what is going on, and having a confidant) was found to be significantly associated with depression (β = -0.07) and quality of life (physical component [β = 0.08], mental component [β = 0.31]). In summary, functional SS and familial SS should be addressed to reduce depression and improve quality of life among older adults. Community initiatives to increase awareness in optimizing social support should be conducted for quality of life among community older adults.
Food environment (FE), an interface where people interact with a broader food system, is critical to health. Understanding the Asian FE may help to tackle the "triple burden of malnutrition" through informed research and policy. This review identifies FE domains assessed in the Asian context and collates the tools/measures used in these evaluations. We further synthesized the reported associations of FE with diet and health outcomes and identified knowledge gaps. Forty-two articles were reviewed (East Asia, n = 25, 60%; South Asia, n = 8, 19%; and Southeast Asia, n = 9, 21%). The results showed that FE was frequently examined in children, adolescents, or adults, but data were scarce in older adults. Food availability (n = 30) and accessibility (n = 19) were popularly studied domains. Furthermore, FE was measured using geographic information systems (n = 18), market (n = 7), or stakeholder (n = 21) surveys. Twenty-eight (67%) articles assessed associations of FE exposures with diet (n = 12) and health (n = 21). Increased food availability and accessibility were associated with poorer dietary and health outcomes despite nonexisting validity and reliability reporting in 62% of articles. Limited high-quality studies emphasize the need for harmonized definitions, better study designs, and validated FE measures/tools in Asia. Improving the quality of FE research is critical to designing effective interventions to improve public health nutrition in Asia.
Frailty and malnutrition commonly co-occur but remains undetected and untreated in community settings. This study aimed to determine the prevalence of co-occurring frailty and malnutrition, and its associated factors among community-dwelling older adults in a rural setting in Malaysia. A cross-sectional study was conducted among adults aged ≥ 60 residing in Kuala Pilah district, Negeri Sembilan, Malaysia. Physical frailty and nutritional status were assessed using the Fried phenotype and the Mini Nutritional Assessment (MNA), respectively. Among 1855 participants, 6.4% had co-occurring frailty and at-risk/malnutrition and 11.3% had co-occurring prefrailty and at-risk/malnutrition. Older age, fair-to-poor self-rated health, long-term disease, polypharmacy, activities of daily living (ADLs) and instrumental ADLs' disabilities, cognitive impairment, and poor social support were associated with higher odds of co-occurring frailty and malnutrition. Therefore, beside early identification, targeted intervention is crucial to prevent or delay the progression of frailty and malnutrition in this population.
Sarcopenia is associated with numerous adverse health outcomes, including frailty, disability, and mortality. Since the Asian Working Group for Sarcopenia 2019 guidelines, which were published in 2020, are relatively new, studies on the association between sarcopenia as defined by these guidelines and mortality are limited in the Asian region. Accordingly, this study aimed to examine the all-cause mortality risk associated with sarcopenia among community-dwelling older adults in rural Malaysia. This cohort study included 2404 older adults residing in Kuala Pilah District, Negeri Sembilan, Malaysia who were followed up for 83 months. The prevalence rates of sarcopenia and severe sarcopenia were 5.0% and 3.60%, respectively. Older adults with sarcopenia and severe sarcopenia had a 114% (hazard ratio [HR]: 2.14) and 146% (HR: 2.46) increased mortality risk compared with those without sarcopenia (HR: 2.14). Our findings indicate that early intervention is recommended to prevent sarcopenia in older adults.
In Malaysia, despite achieving leprosy-elimination status in 1994, leprosy remains a public health issue among the indigenous Penan community in Sarawak. This study aimed to determine the prevalence trend and clinical profile of leprosy among the Penans in rural Baram, Sarawak, Malaysia. A retrospective records review was conducted on 10-year (2008-2018) time trend of annual prevalence rate and 5-year (2013-2018) Penan leprosy patient clinical profile. Out of the 257 new cases of leprosy reported in Sarawak, 42.8% were Penans, and 72.7% were from Baram. The annual Penan ethnic-specific prevalence rate ranged from 2.08 to 35.5/10 000. Forty-six cases were analyzed for clinical profile: There were more males, active case detection, and multibacillary leprosy. The prevalence trend of leprosy among the Penans in rural Baram exceeded recommended elimination targets. Majority of the cases were detected through active case detection, but cases were detected late. Interventions are needed to improve early diagnosis and detection to achieve elimination of leprosy.
Breastfeeding rates in urban Malaysian mothers are below World Health Organization (WHO) targets. Our prospective survey identified breastfeeding prevalences at 3, 6, and 12 months of 85.5%, 77%, and 60%, respectively. Combined (direct and expressed) breastfeeding significantly sustained longer-term breastfeeding. Efforts should be focused on mothers of Indian ethnicity and on expression after one month postpartum.
Commuting accidents account for 48% of work-related accidents in Malaysia. However, commuting accidents among health care workers are understudied and formally reported commuting accident numbers among nurses are likely to be an underestimate of actual numbers. This is the first study in Malaysia to attempt to establish the true incidence and associated factors for commuting accidents among nurses in Malaysia. A cross-sectional study was conducted to determine the true incidence of commuting accidents and its associated factors among public hospital nurses in Selangor, Malaysia. A validated and pilot-tested self-reported questionnaires were distributed to all nurses via an online-based platform. This study found a significant difference between the incidence of formally reported and self-reported commuting accidents from 2018 to 2022, with incidence rates ranging between 0.3 and 8.6 per 1000 nurses. Multivariable logistic regression showed that nurses working in district hospitals had lower odds to be involved in commuting accidents, while nurses working in clinical departments and traveling longer distances between home and workplaces had increased odds of commuting accidents.
Monitoring SARS-CoV-2 antibody levels can provide insights into a person's immunity to COVID-19 and inform decisions about vaccination and public health measures. Anti-S may be useful as an indicator of an effective immune response. Thus, we conducted this study that aimed to determine the immune response of anti-S antibodies against SARS-CoV-2 for all the vaccine types over time among adult recipients in Malaysia and to determine the associated factors. This study was a cohort that recruited 2513 respondents aged 18 years and above from June to December 2021. Each participant was followed-up for 1-year period from the initial vaccine dose (baseline). We found that the anti-S antibody generally increased for all vaccine types and peaked at two weeks after the second dose vaccination, with Pfizer recipients having the highest median of 100 (100.00-100.00). During the third-month follow-up, the seropositivity of anti-S antibody and the median level decreased for all vaccines. We found that type of vaccines, comorbid status, infection, and booster status were significantly associated with the anti-S antibody level after one year.
This study examined quitting behavior and use of cessation aids (CAs) among Malaysian adult smokers aged ≥18 years (n = 1,047). Data were from the 2020 International Tobacco Control (ITC) Malaysia Survey were analyzed. A total of 79.9% of Malaysian smokers attempted to quit in the past 12 months and 85.2% intended to quit in the next 6 months. The most common CAs were e-cigarettes (ECs) (61.4%), medication/nicotine replacement therapies (NRTs; 51.0%), and printed materials (36.7%); the least common CA was infoline/quitline services (8.1%). Multivariable logistic regression analysis was performed to examine the association between sociodemographic variables and CAs use. Male smokers were more likely to use infoline/quitline services (adjusted odds ratio [aOR] = 3.27; P = .034). Malay smokers were more likely to use infoline/quitline services (aOR = 3.36; P = .002), ECs (aOR = 1.90; P = .004), printed materials (aOR = 1.79; P = .009), and in-person services (aOR = 1.75; P = .043). Most Malaysian smokers wanted to quit smoking. Furthermore, ECs were the most popular CAs, highlighting the need to assess the effectiveness of ECs for quitting smoking in Malaysia.
The diversity of protein food sources, animal and plant, may be a proxy measure of protein quality and adequate protein nutrition. A population-based sample of 1604 Malaysians aged ≥18 y completed one 24-h dietary recall and a new 29-item protein diversity indicator (PDI). Socio-demographic data were obtained by self-report. Mean total protein intakes were 75.2 g/d from 24-h recalls and 74.9 g/d from PDI. Protein diversity indicator-estimated protein intakes were 36.2% from meat and poultry, 8.8% from fish, 16.0% from eggs and dairy, and 39.0% from plants. Intakes of animal proteins varied with socioeconomic status and ethnicity and were associated with higher protein quality, defined as the adequacy of essential amino acids (EAAs) relative to protein requirements. Protein intakes and protein quality in Malaysia were generally adequate. Protein diversity indicator metrics can complement current methods of dietary assessment and may be useful for monitoring protein diversity and quality in other countries currently undergoing nutrition transition.
Although post-COVID-19 condition (PCC) is a major public health concern, studies on PCC in Southeast Asia are lacking. This study aimed to describe PCC symptoms and its functional impact among COVID-19 survivors undergoing outpatient rehabilitation in Malaysia. We evaluated 3037 patients with confirmed COVID-19, referred between November 2020 and September 2022, 3 to 6 months after infection. PCC was diagnosed in 71.1%. Fatigue and dyspnea were the most common symptoms. The PCC patients had reduced respiratory, ambulatory, and musculoskeletal function, and higher fatigue and pain scores, and were less likely to return to work (odds ratio [OR] = 0.55) compared with non-PCC patients. Recognition of PCC symptoms and its functional impact can guide early, tailored, rehabilitation interventions.
We investigated the COVID-19 pandemic's impact on values and religiosity in multi-ethnic Malaysia. Values were measured as changes in values, daily activities, and life priorities using a 5-point Likert scale (-2 to +2). Centrality of Religiosity Scale measured changes in religiosity. Around 176 predominantly female (66.5%), Chinese (68.2%) respondents, aged 35.5 ± 14.1 completed the survey. Most life values changed positively: a sense of security at home (2, interquartile range [IQR]: 1-2), connection with family (1, 1-2), and contribution to society (1, 1-2). Certain life priorities' importance increased: health (2, IQR 2-2), family (2, 2-2), and happiness (2, 1-2); except power and money. These significant positive changes in values and religiosity varied between genders and ethnicities.