Undernutrition is the result of complex interplay of factors such as household food security, childcare, feeding practices, nutrition and sanitation. Therefore, this study aimed to determine the prevalence of stunting, wasting, underweight based on WHO child growth standards 2006 and undernutrition based on Composite Index Anthropometric Failure (CIAF) and its association with the biological, behavioural, socio-economic and physical environment factors among children under-5 years. This was a cross sectional study involving children aged between 6 and 59 months recruited through stratified random sampling from the Tenom district. Sociodemographic background was obtained from mothers via a questionnaire. Height and weight measurements were measured using standardised instrument. The height-for-age, weight-for-age and BMI-for-age were classified according to the WHO Child Growth Standard 2006. Bivariate analysis and multivariate logistic regression analysis were conducted. The prevalence of undernutrition based on CIAF was 42.3%, underweight 34.7%, stunting 33.3% and wasting 10.0%. After adjusting for all confounders, childhood undernutrition was significantly associated with unimproved sanitation (adjusted OR 2.98, 95% CI: 1.082 to 8.225) and frequent illness (adjusted OR 2.07, 95% CI: 1.015 to 3.274). These findings support the association of biological and physical environmental factors with the nutritional status of children under-5 years old.

Elderly abuse and neglect are among the primary public health problems linked to global demographic changes in the population, impacting not only the well-being of the elderly but also the growth of the nation or economy. This article discusses the effects of elder abuse and neglect on population health from the national and international perspectives through a narrative review of previously published articles on the concept of aging, the prevalence of elderly abuse and neglect, its risk factors and effects, and finally measures, legal perspectives, and recommendations to curb it. Interventions in Malaysia and selected nations, including Indonesia, South Korea, the United States, Australia, and Hong Kong, are examined. This issue is important as the majority of countries are moving toward being elderly populations. Improving global surveillance and the monitoring of instances is essential to inform policy actions to prevent elder abuse. In addition, a thorough assessment of the identified risk factors for violence and steps to prevent violence is required.

Tuberculosis (TB) is a significant public health concern. Globally, TB is among the top 10 and the leading cause of death due to a single infectious agent. Providing standard anti-TB therapy for at least 6 months is recommended as one of the crucial strategies to control the TB epidemic. However, the long duration of TB treatment raised the issue of non-adherence. Non-adherence to TB therapy could negatively affect clinical and public health outcomes. Thus, directly observed therapy (DOT) has been introduced as a standard strategy to improve anti-TB medication adherence. Nonetheless, the DOT approach has been criticized due to inconvenience, stigma, reduced economic productivity, and reduced quality of life, which ultimately could complicate adherence issues. Apart from that, its effectiveness in improving anti-TB adherence is debatable. Therefore, digital technology could be an essential tool to enhance the implementation of DOT. Incorporating the health belief model (HBM) into digital technology can further increase its effectiveness in changing behavior and improving medication adherence. This article aimed to review the latest evidence regarding TB medication non-adherence, its associated factors, DOT’s efficacy and its alternatives, and the use of digital technology and HBM in improving medication adherence. This paper used the narrative review methodology to analyze related articles to address the study objectives. Conventional DOT has several disadvantages in TB management. Integrating HBM in digital technology development is potentially effective in improving medication adherence. Digital technology provides an opportunity to improve medication adherence to overcome various issues related to DOT implementation.

The coronavirus disease (COVID-19) pandemic has led to an alarming increase in domestic violence against women owing to lockdown measures and limited access to support services. This article provides insights into the global prevalence of domestic violence, barriers to seeking help, its impact on women and children, and the best practices implemented worldwide. Domestic violence encompasses various forms of abuse; many young women experience partner violence. Barriers to seeking help include fear, financial constraints, lack of awareness of available services, and distrust among stakeholders. The consequences of domestic violence affect the mental health of both mothers and children. Countries have increased shelter funding and developed innovative protocols to reach survivors and address this issue. However, the healthcare sector’s involvement in addressing domestic violence has been limited. This review advocates collaboration among healthcare institutions and government bodies. Key recommendations include utilizing telehealth services, implementing comprehensive training programs, establishing effective referral systems, enhancing health education, developing a domestic violence registry, improving the responses of law enforcement and justice systems through healthcare integration, promoting data sharing, and conducting further research. Healthcare systems should recognize domestic violence as a public health concern and detect, prevent, and intervene in cases to support survivors.

Introduction: This study aimed to compare the nutritional characteristics and clinical outcomes among critically ill patients with diabetes (DM) and without diabetes (WDM). Methods: Mechanically ventilated, critically ill patients who were admitted into the intensive care unit (ICU) within 48 hours and remained in ICU ≥72 hours were prospectively recruited and followed for up to 12 days. They were stratified to DM or WDM, depending on their diabetes status at ICU admission and comparison were made for nutritional characteristics and clinical outcomes including 60-day mortality. Results: A total of 154 patients were included with 73 (47.4%) DM patients. In comparison to WDM, patients with DM were older, more severely ill, had higher nutritional risk and body mass index, presented with a higher blood glucose level, and required more insulin. DM was fed relatively earlier but had lower energy adequacy. They experienced more frequent EN interruption. Both groups had comparable ICU and hospital stay, ventilation support duration and mortality. In multivariable logistic regression, no association was found between diabetes status and for ICU and hospital mortality. However, There was a trend towards an increase in 60-day mortality in DM patients (Odds Ratio: 2.220, 95% Confidence Interval: 0.764-6.452; p=0.143). Conclusion: Critically ill patients with DM had higher nutritional risks, were fed relatively earlier, but with frequent EN interruption leading to lower energy adequacy than patients WDM. Diabetes status does not affect clinical outcomes.

Introduction: The limited data regarding nutrition characteristics and the delivery of critically ill patients in South Asia is intriguing. This study was conducted to investigate the nutrition characteristics and delivery in relation to 28- day mortality in mechanically ventilated patients. Methods: This prospective observational study was conducted in the intensive care unit (ICU) of the Maldives government referral hospital. Data about nutrition characteristics and delivery were collected from the ICU charts, and each patient was followed for a maximum of 28 days. Results: We recruited a total of 115 patients (mean age: 61.57±17.26 years, 52% females, mean BMI: 25.5±6.19kg/m2), of which 61 (53%) of them died within 28 days of ICU admission. Mean energy intake was 681.15±395.37 kcal per day, and mean protein intake was 30.32±18.97g per day. In the univariate logistic regression analysis, length of stay in ICU (OR = 0.950, 95% CI: 0.908 – 0.994, p = 0.027), and received intervention by a dietitian (OR = 0.250, 95% CI: 0.066 – 0.940, p = 0.040) were associated with 28-day mortality. None of the factors in the multivariate regression analysis remains significant when adjusted for sex, SOFA total score, daily energy and protein dosage. Conclusion: 28-day mortality was much higher in this study than in similar studies in South Asia, Asia and around the globe. None of the variables was significantly associated with 28-day mortality in the multivariate logistic model. However, there was a trend towards higher mortality for patients with shorter length of stay in the ICU, larger mean gastric residual volume, and no intervention by a dietitian.

Introduction: Low glycemic index (GI) diet is recommended as part of medical nutrition therapy for the management of gestational diabetes mellitus (GDM). While the clinical benefits are evident, data assessing knowledge of the GI concept among women with GDM are scarce. This was a needs assessment study to determine the level of knowledge about the GI concept among women with GDM. Methods: Using a cross-sectional design, we included 85 women with GDM (mean age: 30.6 ± 4.0, pre-pregnancy BMI: 24.8 ± 4.1 kg/m2, gestational age: 34.0 ± 4.0 weeks) from Hospital Serdang, Malaysia. Knowledge about the GI concept was assessed using a developed questionnaire. Additional questions on GDM were assessed using Gestational Diabetes Mellitus Knowledge Questionnaire (GDMKQ). Subjects with less than 50%, 51-74%, and more than 75% total score were categorized as having poor, fair, and good knowledge levels, respectively. Results: The mean knowledge score obtained by the subjects was 12.8 ± 3.5. More subjects scored correctly for GDM-related knowledge (68.2%). More than half (58.8%) had heard about the GI concept previously and 55.3% understood the definition of GI. The average knowledge score about the GI concept was 55.6%; subjects scored highest on the influence of different carbohydrates (teh tarik versus milk) on blood glucose level (87.1%). However, the majority of the subjects had fair knowledge level (62.4%). Conclusion: Women with GDM had moderate knowledge about the GI concept. Results of the needs assessment served as preliminary data for the development of a GI-based nutrition education program in Malaysia.

Introduction: Sexually transmitted Infections (STIs) are major public health concerns reaching an all-time high, globally. In Malaysia data on the prevalence of STIs remains scarce which limits the understanding of STI transmission dynamics and the role of interventions in the control of STIs. The aim of this study is to determine the epidemiology characteristics of STIs mainly from Malaysian private healthcare institutions. Method: A two years (2016 and 2017) retrospective review was conducted on 160 multiplex RT-PCR STI reports from KPJ hospitals, Malaysia. Results: There were 65 (40.6 %) patients positive STIs [male: 21/65 (32.3 %); female: 44/65 (67.7 %)]. The STIs was prevalent among young adults (56/65; 86.2 %) from the central region (46/65; 70.8 %). Females had 1.7 times greater risk to develop STI (20 per 100) and two times higher chance to have multiple STIs (10 per 100) in comparison to male. The single STIs was caused mainly by U. parvum (N=17). In males, U. urealyticum (N=3) and C. trachomatis (N=3) were prevalent, while U. parvum (N=15) was prevalent in females. There were 19 dual infections of STIs which were commonly caused by U. parvum and M. hominis (N=5). There were seven STIs cases caused by three pathogens concurrently including U. urealyticum, U. parvum and C. trachomatis (N=2) and U. urealyticum, M. genitalium and C. trachomatis (N=2). Females from urban communities have higher risk in comparison to males for developing multiple STIs. Conclusion: This study provides an imperative platform for temporal trends of STIs in Malaysia which reflects the health status of certain populations that warrant immediate public health interventions.

Introduction: Short-term fasting may influence intraocular pressure (IOP) due to alteration of fluid (total body water; TBW, and water intake) and fat (total body fat; TBF). This study aimed: i) to compare IOP values within and between, fasting and non-fasting periods; and ii) to assess the association between IOP and, TBW and TBF. Methods: Thirty healthy participants aged 21.8±1.1 years were assessed on two different periods (fasting vs. non-fasting). During each period, the IOP, TBW and TBF values were assessed for four times (morning, afternoon, evening, late-evening). The IOP was measured using AccuPen® tonopen, while TBW and TBF were assessed by using a Tanita body composition analyser. Results: During fasting, the IOP value in the afternoon (14.53±2.33 mmHg) was significantly higher than in the evening (12.43±2.73 mmHg, p=0.009) and late-evening (12.60±2.44 mmHg, p=0.003). No significant difference in IOP was observed during non-fasting period. The mean of IOP in the evening was significantly lower during fasting compared to non-fasting (12.43±2.73 mmHg vs 13.75±2.53 mmHg, p=0.044). The IOP and TBW were negatively correlated (r=-0.268; p=0.011) during non-fasting and showed no association during fasting period. There was no significant correlation between IOP and TBF during both fasting and non-fasting periods. Conclusion: IOP reduction during short-term fasting, together with the no association with TBF and TBW suggested that IOP is an independent factor that reduces during fasting in healthy population.