Knowledge, attitude and practice levels regarding malaria among the Semai sub-ethnic indigenous Orang Asli communities in Pahang, Peninsular Malaysia: a stepping stone towards the prevention of human malaria re-establishment.

BACKGROUND: In Malaysia, despite a decline in cases, malaria remains a major public health concern, especially among the vulnerable indigenous people (i.e. Orang Asli) in remote areas. Effective preventive and control measures require an evidence-based understanding of their knowledge, attitudes, and practices (KAP) regarding malaria. This study aimed to evaluate the KAP regarding malaria in an indigenous settlement in Peninsular Malaysia. METHODS: A household-based cross-sectional study was conducted in March 2024 in six Semai sub-ethnic indigenous villages in Pos Lenjang, Kuala Lipis, Pahang. A structured questionnaire was administered to randomly selected individuals (≥ 12 years old) to collect data on sociodemographic characteristics and KAP. Data were analysed using descriptive statistics and predictors of KAP were determined using logistic regression. A p-value less than 0.05 was considered statistically significant. RESULTS: A total of 267 individuals from 160 households were interviewed. Nearly half had good knowledge (49.4%) and positive attitudes (54.3%) towards malaria, with high practice scores for prevention and control (83.1%). Multivariate logistic regression analysis showed higher odds of good knowledge in those aged 40-59 years (adjusted odd ratio [aOR] = 6.90, p = 0.034), with primary (aOR = 2.67, p = 0.015) or secondary education (aOR = 2.75, p = 0.019), and with previous malaria history (aOR = 5.14, p < 0.001). Higher odds of a good attitude were found in those with secondary education (aOR = 4.05, p < 0.001) and previous malaria history (aOR = 2.74, p = 0.017). Lower odds were observed for the unemployed (aOR = 0.25, p = 0.018) and those collecting forest products (aOR = 0.25, p = 0.049) for attitude and practice, respectively. DISCUSSION: The overall practice level on malaria prevention was high among the Semai Orang Asli in Pahang. However, to ensure sustainability, the low levels of knowledge and attitude regarding malaria must be strengthened through increased health education and continuous community engagement.

Factors related with lung functions among Orang Asli in Tasik Chini, Malaysia: a cross-sectional study.

BACKGROUND: Orang Asli lifestyle and household setting may influence their health status especially respiratory system and lung functions. This cross-sectional study was carried out to investigate the status of lung functions of Orang Asli community and the associated factors. METHODS: Data collection was carried out from November 2017 until May 2018 among 211 Orang Asli respondents aged 18 years old and above, who lived in five villages in Tasik Chini, Pahang. All respondents who fulfilled the inclusion criteria were recruited in this study. Interview-guided questionnaire was administered, and spirometry test that include Forced Expiratory Volume in one second (FEV1), Forced Vital Capacity (FVC), and Peak Expiratory Flow Rate (PEFR) was carried out. Data were analyzed using SPSS software version 23.0. In the first stage, descriptive analysis was done to describe the characteristics of the respondents. In the second stage, bivariable analysis was carried out to compare proportions. Finally, multiple logistic regression was performed to assess the effects of various independent predictors on spirometry parameters. RESULTS: The respondents' age ranged from 18 to 71 years old in which 50.2% of them were female. The majority ethnicity in Tasik Chini was Jakun tribe (94.3%). More than half of the respondents (52.1%) were current smoker, 5.2% were ex-smoker and 41.7% were non-smoker. More than half of them (62.1%) used woodstove for cooking, compared to only 37.9% used cleaner fuel like Liquefied Petroleum Gas (LPG) as a fuel for everyday cooking activity. The lung function parameters (FEV1 and FVC) were lower than the predictive value, whereas the ratio of Forced Expiratory Volume in one second and Forced Vital Capacity (FEV1/FVC) (%) and PEFR were within the predictive value. The FEV1 levels were significantly associated with age group (18-39 years old) (p = 0.002) and presence of woodstove in the house (p = 0.004). FVC levels were significantly associated with presence of woodstove in the house (p = 0.004), whereas there were no significant associations between all factors and FEV1/FVC levels. CONCLUSIONS: FEV1 levels were significantly associated with age group 18-39 years old, whereas FVC levels were significantly associated with the presence of woodstove in the house. Thus, environmental interventions such as replacing the use of woodstove with LPG, need to be carried out to prevent further worsening of respiratory health among Orang Asli who lived far from health facilities. Moreover, closer health monitoring is crucial especially among the younger and productive age group.

Impact of cultural, nutrition, and lifestyle transition on human milk composition between the Orang Asli communities in Peninsular Malaysia: A study protocol.

Background: Human milk provided by healthy, well-nourished mothers represents the best food available for infants. Human milk is species-specific and recommended as the sole source of nutrition for the first 6 months of life and is an important food source until the infants reach 2 years of life. Unlike infant formula, which has a standardized composition, human milk composition varies among and within women. Aim: While many studies of human milk composition have been conducted, none have been done among the Orang Asli people in Malaysia. Hence, this study protocol is designed to determine the human milk composition of the Orang Asli in Peninsular Malaysia and how the transition of culture, nutrition, and different lifestyle experiences will affect the nutrient content of their milk. Methods: Quantitative (interviewer-administered questionnaire) and qualitative (focus group discussion) approaches will be employed in this study and in addition, laboratory works will also be carried out to analyze the nutrient composition of the milk samples collected from various Orang Asli subethnic groups in Peninsular Malaysia. Conclusion: Standardized, multipopulation studies of human milk composition are sorely needed to create a rigorous, comprehensive reference inclusive of nutrients and other factors. The establishment of any dietary parameters positively affecting the nutrient content of human milk may help design healthcare strategies in Malaysia to improve the quality of human milk and therefore the infants' health status.

Psychological Resilience among Orang Asli Youths in Selangor during COVID-19 and Its Associated Factors.

Background: Coronavirus disease (COVID-19) has affected everyone and stress-related mental health issues affect young people more than other groups, including marginalised populations. As a result of this pandemic, society is being urged to examine indigenous psychological resilience, especially among Orang Asli (OA) communities in Malaysia. Hence, this study aims to identify factors associated with psychological resilience among OA youths of Kampung Orang Asli (KOA) in Gombak during the COVID-19 pandemic. Method: A cross-sectional study comprising OA communities was conducted between January 2022 and September 2022 in the Gombak District, Selangor. A self-administered online questionnaire using Google Forms and a self-administered printed questionnaire was used to collect data from youths aged 18 years old-24 years old. The Malay version of Conner-Davidson Resilience Scale-25 (CD-RISC-25) was used to assess psychological resilience. Data analysis was performed using SPSS version 28.0, and multiple linear regression analyses were conducted to evaluate the associated factors and their significance level. Result: A total of 158 participants were involved in this study. The mean score for psychological resilience was estimated at 69.28 (SD = 14.52). The social relationships domain recorded the highest mean score for quality of life (71.54, SD = 13.72). Meanwhile, the total mean score for self-esteem fell into the high-level category (35.77, SD = 4.94), and the domain of relationship and family dynamics under family environment scored the highest mean score of 18.83 (SD = 2.89). Psychological resilience was associated with youths of KOA Batu 12 (ß = -14.274, P < 0.05), KOA Ulu Batu (ß = -17.789, P < 0.05), less than four siblings (ß = -6.495, P < 0.05), owner of residential property (ß = -7.543, P < 0.05), high self-esteem (ß = 0.612, P < 0.05) and good relationship and family dynamic (ß = 1.391, P < 0.05). Conclusion: Developing interventions aimed at psychological resilience determinants may assist OA youths in coping with future threats.

Population data for 15 autosomal STR loci in Orang Asli subgroups of Peninsular Malaysia.

Short tandem repeats (STRs) data for the Orang Asli population in Peninsular Malaysia is still scanty, especially for specific Orang Asli subgroups. The Orang Asli is believed as the earliest population arrived in Peninsular Malaysia about 50,000 years ago and currently makes up only 0.6% of the total population of Malaysia. This study reports the allele frequencies and several forensic statistical parameters for 15 autosomal STR loci for six Orang Asli subgroups. A total of 164 Orang Asli individuals representing the Semai, Che Wong, Orang Kanaq, Lanoh, Bateq, and Kensui subgroups were recruited for this study. This STR data will enrich the existing Malaysian autosomal STR database and will be useful for kinship testing and forensic applications.

Diseases among Orang Asli community in Malaysia: a systematic review.

Orang Asli, the indigenous people of Peninsular Malaysia, is a minority population and placed behind in terms of socioeconomy, education and health. The Malaysian government has supported Orang Asli since the second Malaysia Plan in the 1970s, resulting in changes in their living standard, access to health, education and occupation. Hence, this review aims to assess the recent prevalence of diseases among Orang Asli in Peninsular Malaysia. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) review protocol guided this systematic review. The research question was formulated based on Population, Interest, Comparison and Outcome (PICO). The selected databases include Web of Science, Scopus, Ovid and EBSCOhost. The process of identification, screening and inclusion identified 33 articles. The mixed methods appraisal tool (MMAT) was then used to rank the quality of the articles. Selangor is the most frequent state involved in this review (12 studies), followed by Perak (10 studies), Pahang (10 studies) and Kedah (one study). We categorised into four categories of diseases, namely neglected tropical disease (n = 20), non-communicable disease (n = 6), nutritional status (n = 5), and hepatic disease (n = 2). The prevalence of diseases among Orang Asli is higher than in the general population, especially for soil-transmitted helminth (STH) and malnutrition. There is increasing research on non-communicable diseases due to an increasing trend in the socioeconomic status and lifestyle of the Orang Asli. Government agencies and private organisations must work together to empower Orang Asli with a healthy lifestyle, improve their socioeconomic status, and enhance food security, all of which will improve Orang Asli's health and reduce the prevalence of diseases.

Rural child malnutrition and unsuccessful outcome of food basket programme: does ethnicity matter?

Objectives: The objectives of this study were to determine the prevalence of malnutrition among five-year-olds and factors associated with unsuccessful outcome of a Food Basket Programme (FBP) in a rural district of Kelantan, Malaysia.Design: Administrative health records from selected health clinics were reviewed. Study sample includes indigenous population or Orang Asli of Malaysia. Unsuccessful outcome was defined according to failure to complete the programme according to growth gain and on-time. Multiple logistics regression was used to assess the associated factors of unsuccessful outcome of FBP.Results: This study showed that the prevalence rates of malnutrition among children below five years old were 34.2% underweight, 16.4% thinness, 32.5% stunting and 3.0% overweight, with Orang Asli children faring the worse. Orang Asli children were also five times more likely to be unsuccessful in the FBP (p < .001).Conclusion: Malnutrition is still prevalent among children below five years old in this rural setting and Orang Asli children are vulnerable to have an unsuccessful outcome from the Food Basket Programme. Further research is necessary to further explain this association to inform policy, specifically for Orang Asli children.

Cross-cultural adaptation and validation of Malay version of Rapid Estimate of Adult Literacy in Dentistry (MREALD-30) among Orang Asli population in Malaysia.

BACKGROUND: The aim of this study was to adapt, translate and validate the Rapid Estimate of Adult Literacy in Dentistry (MREALD-30) instrument for the Orang Asli population in Malaysia. METHODS: After translation and cross-cultural adaptation, interviews were conducted with 326 participants of the Temuan tribe from village Kampung Tering in Johol, Negeri Sembilan, Malaysia. The instrument's validity was assessed using the scores of MREALD-30, which were compared based on occupation, monthly household income, educational attainment, general literacy, use of dental services, and three dental outcomes. A questionnaire containing socio-behavioral information and validated Malay Oral Health Impact Profile (M-OHIP-14) was also administered. The reliability of the MREALD-30 was assessed by re-administering it to 30 subjects after two weeks. Its correlations evaluated convergent and discriminative validity of MREALD-30 with the level of education and dental visiting habits, monthly household income, respectively. Predictive validity was assessed with M-OHIP-14, while construct validity was evaluated by exploratory factor analysis using the Rasch model. RESULTS: The internal consistency of the MREALD-30 measured by Cronbach's alpha was 0.89. The test-retest reliability was excellent (ICC 0.95, k = 0.85). MREALD-30 exhibited good construct validity. Rasch analysis showed two factors, and infit mean-square statistics for MREALD-30 were all within the desired range of 0.50-2.0. The discriminant validity and predictive validity were statistically significant (p < 0.05). CONCLUSIONS: MREALD-30 showed very strong reliability, good construct, discriminant, and predictive validity, but poor convergent validity. Overall, it showed good psychometric properties and can be used in these community settings.

Serological evidence of DENV, JEV, and ZIKV among the indigenous people (Orang Asli) of Peninsular Malaysia.

Dengue virus (DENV), Japanese encephalitis virus (JEV), and Zika virus (ZIKV) are mosquito-borne flavivirus of medical importance in tropical countries such as Malaysia. However, much remains unknown regarding their prevalence among the underserved indigenous people (Orang Asli) living in communities in the forest fringe areas of Peninsular Malaysia. Information on the prevalence of diseases is necessary to elevate the effectiveness of disease control and preventive measures. This study aimed to determine the seroprevalence of the three major flaviviruses among the Orang Asli and investigate the association between demographic factors and seropositivities. Sampling activities were conducted in the Orang Asli villages to obtain serum samples and demographic data from consenting volunteers. The presence of DENV, JEV, and ZIKV immunoglobulin G (IgG) antibodies in the sera were examined using commercial enzyme-linked immunosorbent assay kits. A focus reduction neutralization assay was performed to measure virus-specific neutralizing antibodies. A total of 872 serum samples were obtained from the Orang Asli volunteers. Serological assay results revealed that DENV IgG, JEV IgG, and ZIKV IgG seropositivities among the Orang Asli were at 4.9%, 48.4%, and 13.2%, respectively. Neutralizing antibodies (FRNT50 ≥ 1:40) against JEV and ZIKV were found in 86.7% and 100.0%, respectively, out of the samples tested. Positive serology to all three viruses corresponded significantly to the age of the volunteers with increasing seropositivity in older volunteers. Findings from the study suggest that Orang Asli are at significant risk of contracting JEV and ZIKV infections despite the lack of active transmission of the viruses in the country.

Prevalence and risk factors of Strongyloides stercoralis infection among Orang Asli schoolchildren: new insights into the epidemiology, transmission and diagnosis of strongyloidiasis in Malaysia.

This cross-sectional study aimed to determine the prevalence and risk factors of S. stercoralis infection among 1142 Orang Asli primary schoolchildren in six different states of Peninsular Malaysia. Fecal samples were examined using direct smear, formalin-ether sedimentation (FES), agar plate culture (APC) and PCR techniques. Overall, 15.8% of the children were found to be infected with S. stercoralis. The prevalence was 0.2, 1.3, 15.2 and 13.7% by direct smear, FES, APC and PCR, respectively. Multivariate analysis showed that an age of >10 years, being male, belonging to a Proto-Malay tribe, belonging to the Senoi tribe, indiscriminate defecation, using an unimproved water source for drinking water and not wearing shoes when outside were the significant risk factors of infection among these children. In conclusion, we provide new evidence on the occurrence of S. stercoralis in Malaysia to show that there is a relatively high prevalence of infection among Orang Asli schoolchildren. Therefore, the use of specific methods for detecting S. stercoralis should be considered when screening these children for intestinal parasites. Moreover, prevention and control measures specific to S. stercoralis should be integrated into the intestinal parasitic infections control programme in Malaysia.

Status of visual impairment among indigenous (Orang Asli) school children in Malaysia.

BACKGROUND: School children are considered a high-risk group for visual impairment because uncorrected refractive errors and problems such as amblyopia can seriously affect their learning abilities and their physical and mental development. There are many studies reporting the prevalence of refractive errors among school children of different ethnic groups in Malaysia, however, studies concerning the prevalence of refractive errors among indigenous or Orang Asli children are very limited. Therefore, the objective of this study was to determine the prevalence and causes of visual impairment among Orang Asli children. METHODS: One hundred ten Orang Asli children aged 7 to 12 years old in Negeri Sembilan, Malaysia were selected. 51% of these children were boys while the remainders were girls. They underwent visual acuity test, cover test, Hirschberg's test, ocular external assessment and ophthalmoscopy. Children who failed the vision screening were then referred for further eye examination. RESULTS: Of these 110 Orang Asli children, 46 failed the vision screening and subsequently 45 of them were confirmed to have visual problems (40.9% of the total subjects). The main cause of visual impairment in this study was refractive error (34.5% of the total subjects) where the main refractive error found was hyperopia (28.2%) followed by amblyopia (2.7%), strabismus (1.8%) and ocular abnormalities (1.8%). CONCLUSION: Hence, vision screening and a comprehensive eye examination is very important and needs to be done on all Orang Asli children so that any visual problems can be detect at an early stage to avoid the development of learning difficulties among these already disadvantaged children.

Do not neglect the indigenous peoples when reporting health and nutrition issues of the socio-economically disadvantaged populations in Malaysia.

The purpose of this correspondence is to express our disappointment with the coverage of the BMC Public Health supplement: Vol 19 (4) titled "Health and Nutritional Issues Among Low Income Population in Malaysia", which neglected to include the fundamental health and nutrition issues that are adversely affecting the lives and livelihood of the indigenous peoples. The Supplement comprised 21 papers. Two of these papers included indigenous peoples as study subjects. These two papers addressed peripheral, albeit important health issues, namely visual impairment and quality of life, and not the persistent and rising health concerns impacting this population. We will provide evidence from research and reports to justify our critique that the Supplement missed the opportunity to spotlight on the serious extent of the health and nutritional deprivations of the indigenous peoples of Malaysia. As researchers of the indigenous peoples, we ought to lend our voice to the "silenced minority" by highlighting their plight in the media including scientific journals.

Oral health-related quality of life among 11-12 year old indigenous children in Malaysia.

BACKGROUND: Poor oral health among Malaysian indigenous Orang Asli (OA) children may impact on their daily performances. AIM: To assess the oral health status, related behaviours, and oral health-related quality of life (OHRQoL) among OA children in Cameron Highlands (CH), Malaysia, and to identify the predictor(s) for poor OHRQoL. DESIGN: This was a cross-sectional study involving 249, 11-12 year old OA children from 4 OA primary schools in CH. The children completed a self-administered questionnaire comprising information on socio-demographics, oral health-related behaviours, and the Malay Child Oral Impacts on Daily Performances (Malay Child-OIDP) index followed by an oral examination. Data were entered into the SPSS version 23.0 software. Non-parametric tests and multiple logistic regression were used for data analysis. RESULTS: The response rate was 91.2% (n = 227/249). The prevalence of caries was 61.6% (mean DMFT = 1.36, mean dft = 1.01) and for gingivitis was 96.0%. Despite the majority reported brushing their teeth ≥ 2x/day (83.7%) with fluoride toothpaste (80.2%), more than two-thirds chewed betel nut ≥ 1/day (67.4%). Majority of the children (97.8%) had a dental check-up once a year. Nearly three-fifths (58.6%) reported experiencing oral impacts on their daily performances in the past 3 months (mean score = 5.45, SD = 8.5). Most of the impacts were of "very little" to "moderate" levels of impact intensity with 90.2% had up to 4 daily performances affected. Most of the impacts were on eating (35.2%), cleaning teeth (22.0%) and relaxing activities (15.9%). Caries in primary teeth is associated with oral impacts among the OA children. CONCLUSIONS: The 11-12 year old OA children in Cameron Highland had high prevalence of caries and gingivitis with the majority chewed betel nut regularly. Caries in primary teeth is associated with poor OHRQoL. Future programmes should target younger age group children to promote positive oral hygiene practices, reduce caries, and improve quality of life.

Paternal lineage affinity of the Malay subethnic and Orang Asli populations in Peninsular Malaysia.

Peninsular Malaysia is populated by the Malays, Chinese, Indians, and Orang Asli. We have analyzed 17 Y-STRs loci for 243 randomly unrelated individuals, which include 153 Malays (7 Acheh, 13 Champa, 11 Rawa, 9 Kedah, 23 Minang, 15 Bugis, 43 Kelantan, 14 Jawa, and 18 Bugis) and 90 Orang Asli [54 Semang (16 Kensiu, 13 Lanoh, 25 Bateq); 30 Senoi (21 Semai, 9 Che Wong); and 6 Proto-Malay (6 Orang Kanaq)] from selected settlements in Peninsular Malaysia using the AmpFlSTR Yfiler™ kit (Applied Biosystems™). The overall haplotype diversity is 0.9966, i.e., 0.9984 for the Malays and 0.9793 for the Orang Asli. A total of 158 haplotypes (65.02%) were individually unique. The p value and pairwise Rst analysis was calculated to show the genetic structure of the samples with other world populations (from YHRD website). Based on the Y-STR data, Champa, Acheh, Kedah, Minang, and Kelantan are clustered together. Lanoh and Kensiu (Semang) are very closely related, suggesting similar paternal ancestry. Jawa Malays and Indonesian Java, plus the Bugis Malays and Australian Aborigines shared high degree of paternal lineage affinity. This study presents data for very precious relict groups, who are the earliest inhabitants of Peninsular Malaysia.

Isolation and Quantification of Mimivirus-Like and Marseillevirus-Like Viruses from Soil Samples in An Aboriginal (Orang asli) Village in Peninsular Malaysia.

BACKGROUND: The giant amoebal viruses of Mimivirus and Marseillevirus are large DNA viruses and have been documented in water, soil, and sewage samples. The trend of discovering these giant amoebal viruses has been increasing throughout Asia with Japan, India, and Saudi Arabia being the latest countries to document the presence of these viruses. To date, there have been no reports of large amoebal viruses being isolated in South East Asia. OBJECTIVE: In this study, we aim to discover these viruses from soil samples in an aboriginal village (Serendah village) in Peninsular -Malaysia. METHOD AND RESULTS: We successfully detected and isolated both Mimivirus-like and Marseillevirus-like viruses using Acanthamoeba castellanii. Phylogeny analysis identified them as Mimivirus and Marseillevirus, respectively. CONCLUSION: The ubiquitous nature of both Mimivirus and Marseillevirus is further confirmed in our study as they are detected in higher quantity in soil that is near to water vicinities in an aboriginal village in Peninsular Malaysia. However, this study is limited by our inability to investigate the impact of Mimivirus and Marseillevirus on the aboriginal villagers. More studies on the potential impact of these viruses on human health, especially on the aborigines, are warranted.

Qualitative study on identification of common coping strategies practised by Indigenous Peoples (Orang Asli) in Peninsular Malaysia during periods of food insecurity.

OBJECTIVE: To examine the types of coping strategies practised by Indigenous women or Orang Asli (OA) in Peninsular Malaysia during times of food shortage and to determine the level of severity for food insecurity that will trigger each specific coping strategy. DESIGN: A qualitative case study was conducted. Pertinent information about each type of coping strategy was gathered by in-depth interviews. To gauge the level of severity for each of the coping strategies, focus group discussions (FGD) were held. Thematic analysis was used for data analysis. SETTING: OA villages in the states of Kelantan, Pahang, Perak and Selangor, Malaysia. SUBJECTS: Sixty-one OA women from three ethnic groups (Senoi, Proto-Malay and Negrito) for in-depth interviews and nineteen OA women from the Proto-Malay ethnic group for three FGD. RESULTS: The findings identified twenty-nine different coping strategies and these were divided into two main themes: food consumption (sub-themes of food consumption included dietary changes, diversification of food sources, decreasing the number of people and rationing) and financial management (sub-themes of financial management included increasing household income, reducing expenses for schooling children and reducing expenses on daily necessities). Three levels of severity were derived: less severe, severe and very severe. CONCLUSIONS: This information would enable local authorities or non-governmental organisations to more precisely target and plan interventions to better aid the OA communities needing assistance in the areas of food sources and financial management.

Molecular Characterisation of α- and ß-Thalassaemia among Indigenous Senoi Orang Asli Communities in Peninsular Malaysia.

Thalassaemia is a public health problem in Malaysia, with each ethnic group having their own common mutations. However, there is a lack on data on the prevalence and common mutations among the indigenous people. This cross-sectional study was performed to determine the common mutations of α- and ß-thalassaemia among the subethnic groups of Senoi, the largest Orang Asli group in Peninsular Malaysia. Blood samples collected from six Senoi subethnic groups were analysed for full blood count and haemoglobin analysis (HbAn). Samples with abnormal findings were then screened for α- and ß-globin gene mutations. Out of the 752 samples collected, 255 showed abnormal HbAn results, and 122 cases showing abnormal red cell indices with normal HbAn findings were subjected to molecular screening. DNA analysis revealed a mixture of α- and ß-globin gene mutations with 25 concomitant cases. The types of gene abnormalities detected for α-thalassaemia were termination codon (T>C) Hb CS (αCS α), Cd59 (G>A) haemoglobin Adana (Hb Adana) (αCd59 α), initiation codon (ATG>A-G) (αIniCd α), two-gene deletion (-SEA ), and single-gene 3.7-kb deletion (-α3.7 ). For ß-thalassaemia, there were Cd26 (G>A) Hb E (ßE ), Cd19 (A>G) Haemoglobin Malay (Hb Malay) (ßCd19 ), and IVS 1-5 (G>C) (ßIVS 1-5 ).

Increased risks of cardiovascular diseases and insulin resistance among the Orang Asli in Peninsular Malaysia.

BACKGROUND: Despite the strategic development plan by the authorities for the Orang Asli, there are six subtribes of which their population numbers are small (less than 700). These minorities were not included in most of the health related studies published thus far. A comprehensive physiological and biomedical updates on these small subtribes in comparison to the larger subtribes and the urban Malay population is timely and important to help provide appropriate measures to prevent further reduction in the numbers of the Orang Asli. METHODS: A total of 191 Orang Asli from different villages in Peninsular Malaysia and 115 healthy urban Malays were recruited. Medical examinations and biochemical analyses were conducted. Framingham risk scores were determined. Data was analyzed using IBM SPSS Statistics, Version 20.0. RESULTS: A higher percentage of the Orang Asli showed high insulin levels and hsCRP compared to the healthy Malays denoting possible risk of insulin resistance. High incidences of low HDL-c levels were observed in all the Orang Asli from the six subtribes but none was detected among the urban Malays. A higher percentage of inlanders (21.1% of the males and 4.2% of the females) were categorized to have high Framingham Risk Score. CONCLUSIONS: Orang Asli staying both in the inlands and peripheries are predisposed to cardiovascular diseases and insulin resistance diabetes mellitus. The perception of Orang Asli being healthier than the urban people no longer holds. We believed that this information is important to the relevant parties in strategizing a healthier community of the Orang Asli to avoid the vanishing of the vulnerable group(s).

Poverty within watershed and environmentally protected areas: the case of the indigenous community in Peninsular Malaysia.

"Indigenous people" have been acknowledged as among the poorest and most socio-economically and culturally marginalized all over the world. This paper explores the socio-economic status of the indigenous people and their poverty profile within watershed and environmentally protected areas in Peninsular Malaysia. The findings of the study indicate that the "indigenous community" is likely to be poor if they live in environmentally sensitive and unprotected areas as compared to families under the new resettlement scheme. Inadequate access to basic education and employment contributed significantly to their poor economic status. The findings further reveal that the indigenous community is facing difficulties in receiving access and support in terms of basic needs such as housing, education, economic livelihood, and other social infrastructure. Moreover, the regulatory structure for the management of watershed areas as well as the emphasis for commodity crops such as palm oil and natural rubber have indirectly contributed toward the poverty level of the indigenous people.

Knowledge, attitudes, and practices towards COVID-19 prevention among indigenous population in Malaysia: A cross-sectional study.

The COVID-19 pandemic has become a significant challenge to humanity, especially marginalized groups such as indigenous people. This study aimed to assess the knowledge, attitude, and practice towards COVID-19 prevention among the indigenous population in Lipis district, Pahang, Malaysia. A cross-sectional study was conducted among the indigenous population and the data were collected through face-to-face interviews using a validated questionnaire. The mean score of knowledge, attitude, and practice were 2.35 (SD 1.104), 32.84 (SD 4.756), and 9.64 (SD 3.227), respectively. In the bivariable analysis, the younger the age (p < 0.001), and the higher the education level (p = 0.001) of the participants, the higher the knowledge score on COVID-19. Meanwhile, the female participants (p = 0.043) and the higher the household income, the higher the attitude score of the participants (p = 0.006). Factors that contributed to a higher score of practice towards COVID-19 prevention were younger age (p = 0.013), female (p < 0.001), no religion (p = 0.026), unemployed (p < 0.001), and higher household income (p = 0.012). There was a positive correlation between knowledge score and practice score (p = 0.001) and a positive correlation between attitude score and practice score (p < 0.001), respectively. Multivariable regression analysis showed that the younger age (p < 0.001) was significantly associated with a higher knowledge score. Furthermore, female (p = 0.018), unemployed (p = 0.001), higher knowledge score (p < 0.001), and higher attitude score (p < 0.001) were significantly associated with a higher score of practice towards COVID-19 prevention among the participants, respectively. Indigenous people in Malaysia have a good knowledge, attitude, and practice towards COVID-19. However, strategic planning and programmes related to preventive practices against infectious disease outbreaks need to be conducted continuously to reduce the outbreaks in the future.