Wan Abdul Hannan Wan Ibadullah

The distribution of measles varies worldwide. Malaysia has seen fluctuating incidence rates of measles across its districts, highlighting the persistent challenge of measles control despite national vaccination efforts. This study aimed to map the incidence rates of measles and identify hotspots areas of measles in Malaysia between 2018 and 2022. The study utilized secondary data from the Disease Control Division, Ministry of Health Malaysia, and was analyzed through spatial autocorrelation techniques. Choropleth map applied to the incidence rate of measles and Global Moran’s I statistics quantified spatial autocorrelation, supplemented by local indicators of spatial association (LISA) for localized analysis. The measles incidence rate exceeded 500 per million population in Bintulu, Marudi, and Miri, Sarawak in 2018 and in Gua Musang, Kelantan in 2019. There is a downward trend in the incidence rate across the districts in Malaysia. The Global Moran’s I statistic revealed significant positive spatial autocorrelation of measles cases in Malaysia from 2018 to 2022. Districts, specifically in Klang Valley, have been identified as persistent hotspot areas. There is a need for continuous surveillance, adequate vaccination coverage, and supplementary public health measures, especially in identified hotspot areas, in order to achieve measles elimination goals in Malaysia.

Measles remains a significant global public health concern, particularly in Malaysia. Despite national vaccination coverage exceeding 90%, measles continues to persist, highlighting the need for a deeper understanding of the multifaceted factors influencing its transmission dynamics. This study aimed to explore the determinants of measles incidence in Malaysia, focusing on local demographic profiles, healthcare-related factors, and environmental factors at the district level from 2018 to 2022. Data for this study were collected from the e-measles database of Malaysia’s Ministry of Health, including statistics on the number of cases reported in each district. Additionally, vaccination coverage data were obtained from the Malaysian Health Informatics Centre. Local demographic profiles, such as median household income, population density, and urbanisation, were sourced from the Department of Statistics Malaysia (DOSM). Data on the number of health and rural clinics were also extracted from DOSM. Environmental data, including relative humidity, temperature, and PM2.5 levels, were obtained from the Department of Environment (DOE). A negative binomial mixed-effects model was employed for data analysis using R software, and the results were interpreted to identify significant determinants of measles incidence. The analysis revealed that median household income (adjusted incidence rate ratio [aIRR] 1.02, 95% confidence interval [CI]: 1.01, 1.03) and the number of health and rural clinics (aIRR 1.02, 95% CI: 1.01, 1.04) were positively associated with measles incidence. Conversely, temperature (aIRR 0.85, 95% CI: 0.74, 0.99) and the year of observation (aIRR 0.51, 95% CI: 0.47, 0.56) were negatively correlated with measles incidence. These findings highlight the complex interplay between socioeconomic, healthcare, and environmental factors in measles transmission, underscoring the need for comprehensive public health strategies to maintain high vaccination rates and adapt to varying local conditions.

Objectives: Despite effective vaccination strategies, measles remains a global public health challenge. The study explored individual and contextual factors associated with measles infection in Malaysia from 2018 to 2022, informing the development of targeted public health interventions.Methods: This cross-sectional study utilised data from the Ministry of Health, the Department of Statistics, and the Department of Environment Malaysia. Multilevel logistic regression analysis was employed to examine individual-level factors, including age, sex, ethnicity, nationality, contact history, travel history, and vaccination status. Concurrently, contextual factors were assessed, encompassing district-level determinants such as population density, median household income, urbanisation, the number of health and rural clinics, vaccination rates, PM2.5 levels, relative humidity, and temperature, to determine their impact on measles infection risk.Results: Measles infection was significantly associated with various individual factors. These included age (adjusted odds ratio [aOR], 1.02; 95% confidence interval [CI], 1.02–1.03), ethnicity, non-Malaysian nationality (aOR, 34.53; 95% CI, 8.42–141.51), prior contact with a measles case (aOR, 2.36; 95% CI, 2.07–2.69), travel history (aOR, 2.30; 95% CI, 1.13–4.70), and vaccination status (aOR, 0.76; 95% CI, 0.72–0.79). Among contextual factors, urbanisation (aOR, 1.56; 95% CI, 1.16–2.10) and the number of clinics (aOR, 0.98; 95% CI, 0.97–0.99) were significant determinants.Conclusion: This multilevel logistic regression analysis illuminates the complexities of measles transmission, advocating public health interventions tailored to individual and contextual vulnerabilities. The findings highlight the need for a synergistic approach that combines vaccination campaigns, healthcare accessibility improvements, and socioeconomic interventions to effectively combat measles.

The trend of global prevalence for hypertension has been dramatically increasing for the past two decades in Southeast Asian countries. A systematic review aiming to assess the prevalence of hypertension and its risk factors among the urban population in Southeast Asian countries was conducted. We performed database searches of PubMed and Web of Science and performed meta-analysis to determine the pooled prevalence estimate. The overall pooled prevalence estimate of hypertension for Southeast Asian urban population was 33.82%. Among this, 33.98% of hypertension was reported in the community and 32.45% among adolescents in school. The common risk factors that we found were male, ethnicity, education and socioeconomic level, body mass index, waist circumference, smoking, and dyslipidaemia. The review indicates an urgent need for primary and secondary prevention activities. Therefore, a multisectoral and intersectoral approach and collaboration should be undertaken to improve the overall health outcomes of all populations in all Southeast Asian countries.

This systemic review summarizes the evidence exploring the determinants of mortality due to snakebite envenomation in Asia. The database PubMed, Web of Science and Science Direct were searched to identify the relevant literatures concerning mortality due to snakebites mortality in Asia. All the articles chosen were critically appraised for its quality using a mixed-method assessment tool by two independent reviewers with discrepancies sorted by a third person. A total of 7 studies were included in the final analysis which was 3 cross-sectional studies, 2 case reports, 1 observation prospective study and 1 randomized control trial study. Two studies were conducted in India and two studies in Sri Lanka while one study was conducted in Taiwan, Vietnam and Nepal respectively. The cases of snakebite victims were retrieved from the year of 1987 until 2017. In total, there were 762 cases of snakebite victims recorded, with 61 of those victims succumbed to death. From the final total of 7 studies, 4 of the studies showed snakebites mortality were related to delayed treatment access and 3 studies due to suboptimal care. Mortality and morbidity can be reduced if there is a quick access for victims to emergency medical care, rapid transfer time to hospital and receiving immediate optimal medical treatment from trained medical staff once in the hospital or dispensary.

The need for assistance among the elderly is rising, which poses challenges for healthcare systems. Thus, this study aims to determine the factors associated with the need for assistance in the daily living activities of Malaysia’s elderly population. A total of 1204 elderly individuals, aged 60 years and above, were recruited. An interview was conducted using the Bahasa Malaysia version of the Japan Gerontological Evaluation Study (JAGES-BM) questionnaire. Overall, 7.7% of the elderly participants required assistance. A logistic regression model showed that difficult financial statuses (aOR 4.56), hearing difficulties (aOR 1.78), and severe limitations in daily activity over the past 6 months (aOR 11.99) were associated with a higher likelihood of needing assistance. In addition, daily activities such as an inability to feed (aOR 8.46), stand without support (aOR 2.06), or walk for 15 min without stopping (aOR 1.99) were significantly associated with the need for assistance. Factors associated with the need for assistance are health status, disability, and the financial status of the elderly. Preventive measures should be included in policies to ensure the sustainability of the care provided to the elderly in terms of promoting healthy ageing and a good quality of life.