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.
CONCLUSIONS: 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.

UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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 (β = -14.274, P < 0.05), KOA Ulu Batu (β = -17.789, P < 0.05), less than four siblings (β = -6.495, P < 0.05), owner of residential property (β = -7.543, P < 0.05), high self-esteem (β = 0.612, P < 0.05) and good relationship and family dynamic (β = 1.391, P < 0.05).
UNASSIGNED: Developing interventions aimed at psychological resilience determinants may assist OA youths in coping with future threats.

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.

Malaria remains a public health problem in many parts of the world. In Malaysia, the significant progress towards the national elimination programme and effective disease notification on malaria has resulted in zero indigenous human malaria cases since 2018. However, the country still needs to determine the extent of malaria exposure and transmission patterns, particularly in high-risk populations. In this study, a serological method was used to measure transmission levels of Plasmodium falciparum and Plasmodium vivax among indigenous Orang Asli communities in Kelantan, Peninsular Malaysia. A community-based cross-sectional survey was conducted in three Orang Asli communities (i.e., Pos Bihai, Pos Gob, and Pos Kuala Betis) in Kelantan from June to July 2019. Antibody responses to malaria were assessed by enzyme-linked immunosorbent assay (ELISA) using two P. falciparum (PfAMA-1 and PfMSP-119) and two P. vivax (PvAMA-1 and PvMSP-119) antigens. Age-adjusted antibody responses were analysed using a reversible catalytic model to calculate seroconversion rates (SCRs). Multiple logistic regression was used to investigate factors associated with malaria exposure. The overall malaria seroprevalence was 38.8% for PfAMA-1, 36.4% for PfMSP-119, 2.2% for PvAMA-1, and 9.3% for PvMSP-119. Between study areas, the proportion of seropositivity for any P. falciparum and P. vivax antigens was significantly highest in Pos Kuala Betis with 34.7% (p < 0.001) and 13.6% (p < 0.001), respectively. For all parasite antigens except for PvAMA-1, the proportion of seropositive individuals significantly increased with age (all p < 0.001). Based on the SCR, there was a higher level of P. falciparum transmission than P. vivax in the study area. Multivariate regression analyses showed that living in Pos Kuala Betis was associated with both P. falciparum (adjusted odds ratio [aOR] 5.6, p < 0.001) and P. vivax (aOR 2.1, p < 0.001) seropositivities. Significant associations were also found between age and seropositivity to P. falciparum and P. vivax antigens. Analysis of community-based serological data helps describe the level of transmission, heterogeneity, and factors associated with malaria exposure among indigenous communities in Peninsular Malaysia. This approach could be an important adjunct tool for malaria monitoring and surveillance in low malaria transmission settings in the country.

The Orang Asli (OA) of Malaysia have been relatively understudied where little is known about their oral and gut microbiomes. As human health is closely intertwined with the human microbiome, this study first assessed the cardiometabolic health in four OA communities ranging from urban, rural to semi-nomadic hunter-gatherers. The urban Temuan suffered from poorer cardiometabolic health while rural OA communities were undergoing epidemiological transition. The oral microbiota of the OA were characterised by sequencing the V4 region of the 16S rRNA gene. The OA oral microbiota were unexpectedly homogenous, with comparably low alpha diversity across all four communities. The rural Jehai and Temiar PP oral microbiota were enriched for uncharacterised bacteria, exhibiting potential for discoveries. This finding also highlights the importance of including under-represented populations in large cohort studies. The Temuan oral microbiota were also elevated in opportunistic pathogens such as Corynebacterium, Prevotella, and Mogibacterium, suggesting possible oral dysbiosis in these urban settlers. The semi-nomadic Jehai gut microbiota had the highest alpha diversity, while urban Temuan exhibited the lowest. Rural OA gut microbiota were distinct from urban-like microbiota and were elevated in bacteria genera such as Prevotella 2, Prevotella 9, Lachnospiraceae ND3007, and Solobacterium. Urban Temuan microbiota were enriched in Odoribacter, Blautia, Parabacetroides, Bacteroides and Ruminococcacecae UCG-013. This study brings to light the current health trend of these indigenous people who have minimal access to healthcare and lays the groundwork for future, in-depth studies in these populations.

Southeast Asia (SEA) has one of the longest records of modern human habitation out-of-Africa. Located at the crossroad of the mainland and islands of SEA, Peninsular Malaysia is an important piece of puzzle to the map of peopling and migration history in Asia, a question that is of interest to many anthropologists, archeologists, and population geneticists. This review aims to revisit our understanding to the population genetics of the natives from Peninsular Malaysia and Borneo over the past century based on the chronology of the technology advancement: 1) Anthropological and Physical Characterization; 2) Blood Group Markers; 3) Protein Markers; 4) Mitochondrial and Autosomal DNA Markers; and 5) Whole Genome Analysis. Subsequently some missing gaps of the study are identified. In the later part of this review, challenges of studying the population genetics of natives will be elaborated. Finally, we conclude our review by reiterating the importance of unveiling migration history and genetic diversity of the indigenous populations as a steppingstone towards comprehending disease evolution and etiology.

BACKGROUND: This paper describes the result of workshops conducted to increase the knowledge and awareness of university students using a multidisciplinary, collaborative, multisectoral and trans-disciplinary approach concerning One Health and the indigenous people of peninsular Malaysia called the Orang Asli.
METHODS: A non-experimental pre and post-test intervention study was carried out among medical, veterinary and allied health students from six public and private universities who attended workshops on One Heath in two Orang Asli communities living by the Temenggor lake in Malaysia as part of the Malaysia One Health University Network (MYOHUN) efforts in training future and present One Health workforce.
RESULTS: There was a significant increase in various aspects of knowledge and interest concerning One Health and the Orang Asli. The mean knowledge scores of One Health (p < 0.001) and Orang Asli (p < 0.001) increased significantly post workshop. A repeated measures ANOVA with a Greenhouse-Geisser correction showed the mean scores of knowledge of One Health F (1, 166) = 127.198, p < 0.001) and Orang Asli F (1, 166) = 214.757, p < 0.001) differed statistically significantly between the two time points. The test revealed that the score differences for knowledge on One Health (mean difference = 1.796, p < 0.001) and Orang Asli (mean difference = 4.940, p < 0.001) were statistically significant. Repeated measures ANOVA showed a significant difference in the knowledge on Orang Asli between the students of different courses F (4,166) = 3.734, p-0.006. The difference in the One Health knowledge scores between the students of different courses was not statistically significant F (4,166) = 0.998, p = 0.410.
CONCLUSIONS: Emphasis on field training in relation to One health can provide university students greater levels of preparedness to combat zoonotic diseases.

UNASSIGNED: This study aimed at exploring the self-perception of Orang Asli (OA) from the Temuan tribe in Jelebu by using the Global Self-rated Oral Health (GSROH) and General Oral Health Assessment Index (GOHAI).
UNASSIGNED: It was a cross-sectional study involving a two-stage sampling to select the district and villages. A total of 325 participants were selected based on convenience sampling.
UNASSIGNED: Almost half of the participants rated their oral health as poor or average. The mean GOHAI score was 52.96 (±7.749), ranging from 29 to 60. The GOHAI score was statistically significantly lower for female gender (P = 0.025), lower education level (P = 0.001), and elderly (P = 0.001). The GSROH score was also statistically significant with GOHAI score (P = 0.001).
UNASSIGNED: A limited number of studies were conducted in this area, particularly in the vulnerable population of OA. Our study found that half of the OA living in the fringe had a poor GOHAI score. It is, therefore, suggested that potential study and intervention programs concentrate on the low GOHAI score group; the male, lower educational context, and the elderly.

A cross-sectional survey was conducted among 1,142 Orang Ali schoolchildren in six states of Peninsular Malaysia to investigate the current prevalence and risk factors of STH infections. Faecal samples were examined using direct smear, formalin-ether sedimentation, Kato-Katz, and Harada-Mori methods. A pre-tested questionnaire was used to collect information on the demographic, socioeconomic, personal hygiene, and health status of the participants. Overall, 70.1% (95% CI = 67.4, 72.7) of the participants were infected with at least one of the STH species. The prevalence of Ascaris lumbricoides, Trichuris trichiura, and hookworm infections was 63.1%, 61.8% and 11.5%, respectively. Moderate-to-heavy STH infections accounted for 61.3% of the total infections. Univariate and logistic regression analyses revealed different sets of risk factors, with age (> 10 years) being the significant risk factor of all three STH species. Moreover, other species-specific risk factors were identified including being a member of the Senoi tribe, family size (≥ 7 members), school size (150-250 pupils), maternal unemployment, unimproved source of drinking water, lacking improved toilet in the house, inadequate WASH facilities at school, not washing hands before eating, and not washing fruits before eating; presence of domestic animals, and not wearing shoes when outside. The high prevalence of STH infections found in the study population exceeds the WHO policy intervention threshold (20% prevalence). Thus, an innovative holistic approach should be adopted to control STH infections among these children as part of the efforts to improve the quality of life of the entire Orang Asli population. .

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.