Abdul Mutalip MH, Robert Lourdes TG, Abdul Aziz MI
… +1 more, Ramly N
Asia Pac J Public Health
· 2026 May · PMID 42104830
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Alcohol consumption profiles among the Orang Asli (OA) remain tribe specific. This study presents the first nationwide analysis of consumption patterns among 9225 OA adults across various tribes, based on the 2022 Orang...Alcohol consumption profiles among the Orang Asli (OA) remain tribe specific. This study presents the first nationwide analysis of consumption patterns among 9225 OA adults across various tribes, based on the 2022 Orang Asli Health Survey. Alcohol consumption was assessed using the validated Alcohol Use Disorder Identification Test (AUDIT-M) questionnaire; subsequently, multinomial logistic regression was performed using Stata 16 to identify sociodemographic factors associated with non-drinkers, low-risk drinkers, and risky drinkers. Current drinker prevalence was 9.1% (95% confidence interval [6.4, 12.8]), and 88.1% preferred beer. Among drinkers, 59.5% were risky drinkers, 36.3% were binge drinkers, and 8.0% were heavy episodic drinkers. Risky drinking was significantly associated with males ( < .001), younger adults ( = .001), smokers ( < .001), the Senoi ( < .001) and Proto-Malay tribes ( = .014), and those residing in fringe ( < .001) or urban ( = .009) areas. Integrating targeted alcohol screening into community health campaigns is essential to mitigate risky drinking behaviors within these vulnerable populations.
Asia Pac J Public Health
· 2026 Apr · PMID 42035306
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Child marriage (CM) reflects gender inequality, resulting in adverse health outcomes for adolescent girls in low- and middle-income countries (LMICs). Community participation is vital in preventing CM, but community-led...Child marriage (CM) reflects gender inequality, resulting in adverse health outcomes for adolescent girls in low- and middle-income countries (LMICs). Community participation is vital in preventing CM, but community-led interventions lack sufficient research. This study assessed the effectiveness of community-based interventions in reducing CM in LMICs. Following Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 guidelines, we searched PubMed, Scopus, ScienceDirect, and Web of Science for peer-reviewed studies published between 2015 and 2024. Eight studies of high to moderate quality were summarized through a narrative method, guided by three frameworks: the typology of community approaches, the continuum of participation, and the drivers of marriageability. Analysis shows a competing priority between scalability and sustainability. Economic interventions could delay eligibility but were fragile without normative change. Interventions that emphasized desirability, through dialogue or skills training, more effectively changed girls' perceptions. Community success relied on participation: passive consultation did not change norms, but "shared leadership" created local enforcement. Addressing CM requires targeted solutions. Effective strategies merge economic incentives for immediate poverty relief with community mobilization and vocational training to shift perceptions of girls' value. Future policies should change from "empowerment-lite" to integrated "structural-plus" approaches, transforming communities from passive recipients to active enforcers and owners of programs.
Limon MIH, Yahya A, Nik Farid ND
… +1 more, Gani MS
Asia Pac J Public Health
· 2026 May · PMID 42011553
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The double burden of malnutrition (DBM), defined as the coexistence of undernutrition and overnutrition, is a growing concern in South Asia, which is home to over half of the world's undernourished children and nearly 5...The double burden of malnutrition (DBM), defined as the coexistence of undernutrition and overnutrition, is a growing concern in South Asia, which is home to over half of the world's undernourished children and nearly 5 million overnourished children. This systematic review aimed to identify factors associated with DBM among South Asian preschool children. Following Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines, with protocol registered in the International Prospective Register of Systematic Reviews (PROSPERO), five databases (PubMed, Web of Science, ScienceDirect, EBSCOhost, and Cochrane Library) were searched for studies published from January 2014 to October 2024. Study quality was assessed using the Joanna Briggs Institute (JBI) checklist. Of 4714 retrieved articles, 45 met the inclusion criteria. Key factors for undernutrition included older age, male sex, low maternal education, maternal underweight, low birth weight, food insecurity, recent morbidity, maternal employment, more children in the household, and higher birth order. Overnutrition was commonly associated with younger age, male sex, maternal overweight, higher wealth index, and lower birth order. These findings show that malnutrition among South Asian preschoolers is shaped by demographic, maternal, and household determinants, underscoring the need for integrated, context-specific interventions to reduce the burden.
Suraya A, Yuliana E, Triwibowo AC
… +9 more, Rahmawati A, Zakiyah, Aryani D, Yunetti, Jenie RP, Trimawanti W, Soeharno R, Darundiyah K, Shetye M
Asia Pac J Public Health
· 2026 May · PMID 42003717
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This study examined the relationship between blood lead level (BLL) and clinical outcomes among children aged 1 to 5 years in a non-industrial urban setting. A hospital-based cross-sectional study was conducted in Jakart...This study examined the relationship between blood lead level (BLL) and clinical outcomes among children aged 1 to 5 years in a non-industrial urban setting. A hospital-based cross-sectional study was conducted in Jakarta, involving 105 hospitalized children. Data were obtained from caregiver interviews, medical record reviews, and venous BLL testing. The mean BLL was 2.0 ug/dl (95% confidence interval [1.48, 2.67]), with 20% of children having levels above 5.0 µg/dL, and two children exceeding 10.0 µg/dL. No acute lead poisoning cases were identified. Anemia and malnutrition were observed in 31.5% and 17.1% of participants, respectively. Female children and those with less-educated mothers had higher odds of elevated BLL, though associations were not statistically significant. Logistic regression showed no significant link between elevated BLL and lead-related diagnoses, growth delays, anemia, or malnutrition. Despite this, the findings highlight a hidden burden of lead exposure in children from urban non-industrial areas. These results support the need for routine BLL screening, caregiver education on household lead risks, and strengthened community monitoring to reduce early-life exposure in similar settings.
Asia Pac J Public Health
· 2026 May · PMID 41999122
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This study investigated examinations for diabetes complications and associated factors during the COVID-19 epidemic in Korea. We used data from the 2021 Korea Community Health Survey (n = 28 477). Overall, 42.7% underwen...This study investigated examinations for diabetes complications and associated factors during the COVID-19 epidemic in Korea. We used data from the 2021 Korea Community Health Survey (n = 28 477). Overall, 42.7% underwent fundus examination, and 51.7% underwent microalbuminuria examination. Factors associated with increased rates of fundus examination were increased physical activity due to COVID-19 (odds ratio [OR] = 1.16, 95% CI [1.02, 1.32]), decreased consumption of instant food (OR = 1.20, 95% CI [1.03, 1.41]), decreased alcohol drinking frequency (OR = 1.24, 95% CI [1.01, 1.53]), concern about COVID-19 infection (OR = 1.11, 95% CI [1.02, 1.20]), and COVID-19 vaccination experience (OR = 1.20, 95% CI [1.07, 1.34]). Factors associated with increased rates of microalbuminuria examination were decreased consumption of instant food decreased due to COVID-19 (OR = 1.16, 95% CI [1.00, 1.36]) and concern about criticism due to infection with COVID-19 (OR = 1.10, 95% CI [1.00, 1.20]). These results may be useful in planning for the management of chronic diseases during future periods of increased hospital workload.
Robert Lourdes TG, Saminathan TA, Abd Hamid HA
… +7 more, Mat Rifin H, Ratnam KKY, Baharudin A, Ismail H, Wan KS, Riyadzi MR, Mohd Yusoff MF
Asia Pac J Public Health
· 2026 Apr · PMID 41995384
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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 He...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.
Riyadzi MR, Abd Hamid HA, Razali MF
… +9 more, Saminathan TA, Robert Lourdes TG, Tuan Lah TMA, Hasim MH, Zakariah N, Abd Hamid MHN, Rubani AF, Baharom N, Mohd Yusoff MF
Asia Pac J Public Health
· 2026 Apr · PMID 41972943
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Tobacco use continues to pose a major public health challenge among the Orang Asli in Malaysia. This study analysed secondary data from the nationally representative cross-sectional Orang Asli Health Survey 2022, involvi...Tobacco use continues to pose a major public health challenge among the Orang Asli in Malaysia. This study analysed secondary data from the nationally representative cross-sectional Orang Asli Health Survey 2022, involving 10 192 Orang Asli aged 15 years and above. Tobacco use was measured using standardized modules adapted from the Global Adult Tobacco Survey and the National Health and Morbidity Survey, and associations were examined using logistic regression in IBM SPSS 28.0. Overall prevalence was 31.2%. The odds of tobacco use were significantly higher among males (adjusted odds ratio [aOR] = 12.7; 95% confidence interval [CI] 11.13, 14.49), the Proto-Malay tribe (aOR = 1.9; 95% CI [1.67, 2.13]), rural residents (aOR = 1.2; 95% CI [1.01, 1.53]), those with lower education (aOR = 1.5; 95% CI [1.33, 1.68]), employed persons (aOR = 1.8; 95% CI [1.57, 2.02]), and individuals with lower income (aOR = 1.2; 95% CI [1.07, 1.34]). These results demonstrate the disproportionate burden among specific sociodemographic groups. Targeted prevention and cessation efforts, alongside strategies addressing socioeconomic disadvantage and strengthened multisectoral collaboration, are needed to reduce tobacco use and improve health outcomes in this vulnerable population.
Abd Razak MA, Khalil MKN, Sahril N
… +2 more, Mohd Yusoff MF, Ahmad NA
Asia Pac J Public Health
· 2026 Apr · PMID 41968602
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This study elaborates on the methodology and general findings of the Orang Asli Health Survey (OAHS), a nationwide cross-sectional study using stratified random sampling. Conducted in 68 villages, the survey achieved a r...This study elaborates on the methodology and general findings of the Orang Asli Health Survey (OAHS), a nationwide cross-sectional study using stratified random sampling. Conducted in 68 villages, the survey achieved a response rate of 89.8%. Comprehensive health data were collected, with rigorous data cleaning and weighting to ensure accuracy and representativeness. Most Orang Asli resided in fringe (45.5%) and remote -(45.9%) areas, with Senoi (41.3%), Proto-Malay (33.8%), and Negrito (24.9%) as the main tribal groups. Nearly half (49.0%) of respondents aged 7 and above had no formal education, and 86.6% of employed adults held low-skilled jobs. In addition, 64.6% earned below RM1000 monthly. Major health indicators were incorporated. Lower prevalence of complete vaccination (60.7%) and child malnutrition remained concern, with 43.8% stunting, 12.3% wasting, and 6.7% overweight. Among adults, hypertension and hypercholesterolemia were the most prevalent. While the cross-sectional design limits causality, the findings highlight persistent disparities and the need for longitudinal research and culturally sensitive interventions to improve Orang Asli's health.
Tao Z, Fang R, Ma T
… +4 more, Jiang W, Xia H, Culleton R, Jiao Y
Asia Pac J Public Health
· 2026 May · PMID 41949310
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Chinese public attitudes towards face mask usage during the COVID-19 pandemic were investigated through two online surveys (2020 and 2024). There was a high level of compliance with masking policies, with 66.7% of respon...Chinese public attitudes towards face mask usage during the COVID-19 pandemic were investigated through two online surveys (2020 and 2024). There was a high level of compliance with masking policies, with 66.7% of respondents believing masks were very important in helping to prevent the spread of COVID-19. The percentage of respondents who said they intended to continue regular mask usage post-pandemic decreased significantly from 49.2% in 2020 at the beginning of the epidemic to 35.1% in 2024. Discomfort and breathing restrictions were the primary barriers to mask usage. Fear levels were higher among mask owners (82.6%) than non-owners (67.1%). Non-surgical disposable masks were the most commonly used, avoiding competition with health care needs. The findings demonstrate strong public acceptance of masking as a preventive measure and provide valuable insights for future respiratory disease response strategies.
Tsuchiya-Ito R, Morishita-Suzuki K, Nakamura-Uehara M
… +2 more, Watanabe S, Ishibashi T
Asia Pac J Public Health
· 2026 May · PMID 41948916
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This prospective cohort study examined the differences in the association between working status and self-rated health (SRH) in older adults aged ≥75 years when stratified according to financial satisfaction. The study p...This prospective cohort study examined the differences in the association between working status and self-rated health (SRH) in older adults aged ≥75 years when stratified according to financial satisfaction. The study participants answered questionnaires in 2022 and 2024. The exposures were working status factors (e.g., number of working days/week), and the outcome was SRH decline over two years. Modified Poisson regression models were used to analyze these associations in all participants and according to financial satisfaction (high/low). Among all participants (n = 2230), older adults with no working days (adjusted relative risk: 0.73; 95% confidence interval = [0.53, 1.00]) or worked a high number of days (0.80; [0.65, 0.98]) had a lower risk of SRH decline than those who worked a medium number of days. These results were replicated only in the high financial satisfaction group. Policymakers should consider these differences when formulating strategies to provide job opportunities for older adults.
Lodz NA, Abdul Mutalip MH, Mahmud MAF
… +4 more, Yoep N, Asari FN, Lin CZ, Razali A
Asia Pac J Public Health
· 2026 Apr · PMID 41937263
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Tuberculosis (TB) remains a significant global health challenge, particularly among marginalized populations such as the Orang Asli in Malaysia. This study aimed to determine the prevalence of TB and identify associated...Tuberculosis (TB) remains a significant global health challenge, particularly among marginalized populations such as the Orang Asli in Malaysia. This study aimed to determine the prevalence of TB and identify associated risk factors within this community. A cross-sectional study was conducted across nine states in Peninsular Malaysia from July to September 2022, involving 10 192 respondents from 68 selected villages. Data were collected through face-to-face interviews and analysed using descriptive statistics and multiple logistic regression. The self-reported TB prevalence from prior diagnosis among Orang Asli was 3.2% [95% CI: 2.29, 4.49], with higher rates among males, rural residents, the Negrito tribe, individuals with low education levels, and those aged 70 and above. Using multiple logistic regression, age group was the only statistically significant risk factor (aOR = 9.73, 95% CI [4.41, 21.49]). These findings highlight the need for targeted interventions focusing on early detection and treatment compliance to reduce TB prevalence among the Orang Asli population.
Lai WK, Chong CT, Ibrahim NH
… +4 more, Lim KK, Sahril N, Khalil MKN, Wahab NA
Asia Pac J Public Health
· 2026 Apr · PMID 41937262
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Indigenous populations face persistent health disparities, and the of Peninsular Malaysia are no exception, yet limited research examined malnutrition and stunting among this population. This study aimed to assess the p...Indigenous populations face persistent health disparities, and the of Peninsular Malaysia are no exception, yet limited research examined malnutrition and stunting among this population. This study aimed to assess the prevalence and factors associated with stunting among children under 5. This study performed secondary data analysis on 1955 children from the Health Survey (OAHS) conducted in 2022. Multivariable analysis was employed to identify associations between stunting and sociodemographic factors, household characteristics, child morbidities, vaccination status, and other nutritional indicators. The prevalence of stunting was 43.8%. Multivariable analysis revealed that Negrito tribe (adjusted odds ratios [AOR] = 2.62, 95% CI [1.25, 5.47]), low birth weight (LBW) (AOR = 2.09, 95% CI [1.46,2.99]), and being underweight (AOR = 8.47, 95% CI [5.90,12.17]) were significantly associated with stunting. The study underscores the need for targeted nutritional interventions, including improved maternal and early childhood nutrition. Active community involvement is essential to bridge the gap between these biological drivers and local sociocultural realities, ensuring interventions are culturally acceptable, sustainable, and address unique environmental barriers. Strengthening existing programs through community-led, culturally sensitive approaches is vital to effectively reduce the burden of chronic undernutrition in this vulnerable population.
Shim H, Kim BS, Han K
… +6 more, Koo HY, Kim S, Lee D, Cho IY, Jung W, Shin DW
Asia Pac J Public Health
· 2026 May · PMID 41937258
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This study investigated temporal patterns and risk factors for diabetes mellitus (DM) in breast cancer survivors, stratified by age. Using a Korean database, this nationwide cohort study analyzed 65 982 breast cancer sur...This study investigated temporal patterns and risk factors for diabetes mellitus (DM) in breast cancer survivors, stratified by age. Using a Korean database, this nationwide cohort study analyzed 65 982 breast cancer survivors and 168 214 matched controls. We assessed DM risk using multivariable Fine-Gray models with landmark analyses, stratifying by age (≤50 and >50 years). Diabetes mellitus risk peaked in the first year post-diagnosis for women ≤50 (sub-distribution hazard ratio [sHR] = 3.74; 95% confidence interval CI [3.08, 4.55] and >50 (sHR = 1.71; 95% CI [1.52, 1.93], with risk diminishing thereafter. Significant risk factors included high body mass index, smoking, hypertension, dyslipidemia, and taxane use. Tamoxifen was a specific risk factor for younger women (sHR = 1.22; 95% CI [1.06, 1.40]). Breast cancer survivors, especially younger women, have the highest DM risk within the first year post-diagnosis. Proactive monitoring is crucial for those with established clinical and treatment-related risk factors.
Awaluddin SM, Abd Wahab N, Shamsuddin N
… +5 more, Rosslan NH, Adnan MAA, Tat CC, Husni Zain S, Ahmad NA
Asia Pac J Public Health
· 2026 Apr · PMID 41928390
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Childhood vaccination is a vital public health measure to prevent infectious diseases and reduce mortality among children under five. This study aimed to determine the prevalence of primary vaccination and identify facto...Childhood vaccination is a vital public health measure to prevent infectious diseases and reduce mortality among children under five. This study aimed to determine the prevalence of primary vaccination and identify factors associated with incomplete vaccination among Orang Asli children aged 12 to 59 months in Peninsular Malaysia. Data were derived from the 2022 Orang Asli Health Survey, a cross-sectional study using a complex multistage sampling design with structured questionnaires and verified immunization records. The overall prevalence of complete vaccination was 87.7%, with incomplete vaccination more common among younger children, those from the Negrito tribe, and those residing in urban and remote areas. Multivariable logistic regression showed that Negrito tribal affiliation (aOR = 3.31; 95% CI: [1.80, 6.09]) was associated with higher odds of incomplete vaccination, while older age was protective, reducing the odds with each additional month (aOR = 0.87; 95% CI: [0.84, 0.90]). The presence of respiratory symptoms was also protective, likely reflecting increased health care contact facilitating vaccination review (aOR = 0.02; 95% CI: [0.00, 0.28]). Targeted, culturally appropriate strategies, including engagement with tribal leaders and outreach, are essential to improve vaccination equity in these populations.
Asia Pac J Public Health
· 2026 May · PMID 41885358
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Improper disposal of household pharmaceutical waste (HPW) contributes to environmental contamination and public health risks, yet safe disposal practices remain inconsistent in many communities. This study examined the b...Improper disposal of household pharmaceutical waste (HPW) contributes to environmental contamination and public health risks, yet safe disposal practices remain inconsistent in many communities. This study examined the behavioral intentions of urban Malaysian residents toward safe HPW disposal using the Health Belief Model (HBM). A cross-sectional survey was conducted with 450 stratified pharmacy customers across the Klang Valley. Respondents completed a self-administered digital questionnaire assessing HBM constructs on a 6-point Likert scale. Data was analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). The final model explained 63.7% of the variance in behavioral intention (R = 0.637; adjusted R = 0.635). Cues to action and self-efficacy were identified as the strongest predictors, while perceived susceptibility and perceived benefits influenced perceived severity. Findings highlight three public health strategies: integrating disposal guidance into routine care, embedding visible cues to action in health care and community settings, and strengthening regulatory frameworks to expand accessible take-back infrastructure.
Abdul Raob NA, Mohd Radzi NA, Nik Mohamed MH
… +2 more, Luai AF, Md Sabri BA
Asia Pac J Public Health
· 2026 May · PMID 41865254
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The Generation End Game (GEG) policy in Malaysia aims to establish a smoke-free generation and has prompted substantial media attention. This qualitative cross-sectional study employed a netnographic approach to analyse...The Generation End Game (GEG) policy in Malaysia aims to establish a smoke-free generation and has prompted substantial media attention. This qualitative cross-sectional study employed a netnographic approach to analyse Malaysian online news articles published between January 2022 and January 2024 in response to the policy. Data from news portals were collected via NCapture and analysed in NVivo using thematic content analysis. A total of 441 news articles were analysed and categorised into three timeframes: the initial announcement, the official announcement and the removal of the GEG provision from the bill. A positive slant prevailed across all timeframes with 52.2%, 42.1% and 37.8%, respectively, while negative slants were observed with 32.6%, 30.3% and 21.6%, respectively. Supportive arguments emphasised anticipated public health benefits, whereas opposition centred on concerns of the enforcement challenges. Most online news articles reported the GEG policy positively, suggesting that online media predominantly played a role in garnering support for the policy.