HIV Epidemic Among Men Who Have Sex with Men (MSM) and Transgender Women (TGW) in Sarawak, Malaysia: An analysis from the Integrated Biological and Behavioural Surveillance (IBBS) Lite 2024 Introduction Men who have sex with men (MSM) and transgender women (TGW) are among the key populations affected by the HIV epidemic in Sarawak, Malaysia. The objective of this study was to determine HIV prevalence and associated behaviour among MSM and TGW in Sarawak. Methods Respondent-driven sampling (RDS) was used to recruit MSM and TGW between June and August 2024. The study consisted of two components. The first component was a behavioural survey, conducted through a selfadministered online questionnaire via a web-based platform. The second component involved biological testing, where respondents were instructed to visit a community-based testing site of their choice for blood testing after completing the online survey. Statistical analysis was performed in RStudio using the Gile's Successive Sampling Estimator. Results This study recruited 217 MSM and 151 TGW. Consistent condom use among both groups remains low. While most MSM and TGW reported recent HIV testing, Hepatitis C testing and treatment rates are still low. HIV prevalence in Sarawak was 9.5% (95% CI: 2.9, 16.0) among MSM and 10.1% (95% CI: 1.8, 18.5) among TGW, with syphilis prevalence among MSM reaching a concerning 12% (95% CI: 1.8, 22.3). Conclusions In conclusion, improving HIV prevention and care for MSM and TGW in Sarawak requires promoting condom use, increasing awareness of Hepatitis C, and including substance use interventions in HIV programs. Community outreach using culturally sensitive approaches is crucial to improving access to services and building trust. Furthermore, integrating syphilis management into HIV prevention efforts is critical, given its strong association with increased HIV risk. Findings highlight the need for targeted interventions and continued surveillance among key populations in Sarawak to ensure a sustained and effective public health response.

Prevalens Simptom Muskuloskeletal dan Faktor-Faktor Yang Mempengaruhinya dalam kalangan Pegawai Perubatan yang Mengendali Mesin Ultrabunyi Pranatal di Klinik Kesihatan di negeri Selangor pada tahun 2024 Pengenalan Masalah muskuloskeletal dalam kalangan pengendali mesin ultrabunyi merupakan isu yang telah diketengahkan oleh negara-negara luar tetapi kurang mendapat perhatian di Malaysia. Kajian ini dijalankan untuk mendapatkan maklumat prevalens simptom muskuloskeletal dalam kalangan pengendali mesin ultrabunyi dan mengkaji faktor-faktor yang mempengaruhinya. Metodolog iKajian keratan rentas ini melibatkan pegawai perubatan yang bertugas di klinik-klinik kesihatan di negeri Selangor yang melakukan pengimbasan janin untuk pesakit pranatal di unit Kesihatan Ibu dan Anak. Pengumpulan data telah dilakukan antara bulan Mei 2024 sehingga bulan Julai 2024 menggunakan pensampelan mudah yang melibatkan 84 responden yang memberikan persetujuan untuk menjawab kajian soal selidik dalam talian. Hasil Prevalens simptom muskuloskeletal yang berlaku sekurang-kurangnya selama 24 jam dalam 12 bulan yang lalu yang berkait dengan penggunaan mesin ultrabunyi ialah 29.8%, di mana peramal penting dalam model akhir yang dikenal pasti menggunakan model regresi logistik berganda ialah stres tempat kerja bagi domain skala stres tempat kerja (OR 10.95 (95% SK 1.94, 61.69), p = 0.007)); ketidakselesaan transduser bagi domain stesen kerja dan organisasi (OR 7.85 (95% SK 2.17, 28.37), p = 0.002)); dan jumlah pesakit dalam sehari bagi domain tugasan dan beban kerja (OR 4.24 (95% SK 1.15, 15.62), p = 0.030)). Kesimpulan Stres di tempat kerja ialah peramal paling kuat mempengaruhi simptom muskuloskeletal dalam kalangan pengendali mesin ultrabunyi, ini diikuti oleh ketidakselesaan dalam penggunaan transduser ultrabunyi, dan akhir sekali ialah jumlah pesakit yang lebih ramaidiperiksa dalam tempoh sehari

Factors Influencing Excessive Gestational Weight Gain Among Pregnant Women in Urban Malaysia Introduction Excessive gestational weight gain (GWG) is a growing public health concern due to its association with higher risk of adverse maternal and perinatal outcomes. Recognising the key factors of underlying GWG incidence is thus crucial for developing targeted interventions. This study aims to determine the prevalence of excessive GWG and its associated factors among pregnant women in an urban district of Klang Valley, Malaysia. Methods A retrospective cross-sectional study was conducted (betweenNovember 2017 and October 2018) among 472 pregnant women who gave birth between January 2015 and December 2016. Data on sociodemographic characteristics, medical illnesses, and pre-pregnancy body mass index (BMI) were retrieved from the birth registry and maternal health records. The classification of GWG is based on the Institute of Medicine's recommendation Results The classification of GWG is based on the Institute of Medicine's recommendation. A total of 113 (23.9%) pregnant women had excessive GWG. Multiple logistic regression showed the odds of getting excessive GWG were higher among those with lower education levels (Adj. OR = 1.85; 95% CI = 1.084, 3.147), being employed (Adj. OR = 2.30; 95% CI = 1.342, 3.928), nulliparous (Adj. OR = 2.46; 95% CI = 1.450, 4.164), and having pre-pregnancy BMI of ≥25kg/m2(Adj. OR = 6.47; 95% CI = 3.909, 10.721). Conclusions Lifestyle interventions, such as weight reduction programs and health education, should focus on women with high pre-pregnancy BMI, nulliparous women, working women and women with low education levels. Pre-pregnancy clinics and workplaces can serve as platforms to promote healthy dietary choices and encourage regular physical exercise.

Key Factors In The Quality Of Life Of The Elderly: Empirical Evidence From North Sumatra Through Social Network Analysis Introduction The aging population in Indonesia continues to increase, including in North Sumatra which has the potential to enter the phase of an aging population. However, a comprehensive study of multidimensional factors that affect the quality of life of the elderly is still limited. This study aims to identify key factors in the quality of life of the elderly with a multivariate approach and Social Network Analysis (SNA). Methodology The study used a quantitative design with an explanatory approach on 268 elderly people aged 60–64 years in Medan and Deli Serdang. The measurement instrument is a validated WHOQOL-OLD questionnaire. The analysis was carried out with logistical regression of the Backward LR model to determine significant predictors, followed by SNA analysis using UCINET to measure the connectivity and centrality of variables. This study obtained ethical permission and participant consent. Results Nine significant variables (p < 0.05) were found that affected the quality of life of the elderly. The strongest predictors were the ownership of non-government insurance (OR = 19.58), the existence of Posyandu for the Elderly (OR = 13.73), and the activeness of Posyandu cadres (OR = 5.32). On the other hand, the frequency of Posyandu visits showed a negative relationship (OR = 0.035). The results of SNA place the existence of the Elderly Posyandu as the central node with a degree value = 0.750; closeness = 0.800; betweenness = 63.99; then eigenvector = 0.514. Conclusions The results confirm that the Posyandu Lansia is a multifunctional intervention center that connects the health, social and economic aspects of the elderly. Reforming and strengthening Posyandu, expanding health insurance and providing an elderly-friendly environment are important strategies to improve the quality of life. These findings underscore the importance of community-based interventions with local cultural approaches.

Musculoskeletal Disorders (MSDs) and Their Related Factors Among Nurses in a Private Hospital in Muar District, Johor Introduction MSDs are a major occupational health concern among nurses due to the physically demanding nature of their work. Despite global recognition, local data in private hospitals in Malaysia remains scarce. This study aims to address this gap by assessing the prevalence of MSDs among nurses in a private hospital setting. Additionally, it intends to examine the associations between MSDs and various sociodemographic, lifestyle, occupational, and psychosocial factors, while also exploring the potential mitigating role of ergonomic awareness in reducing MSD-related risks. Methods A cross-sectional study was conducted from June to July 2024 among nurses at a private hospital in Muar, Johor. A total of 103 nurses (n=103) who met the inclusion criteria were recruited using universal sampling (73% response rate). Data were collected using a set of validated, self-administered questionnaires, including the Modified Nordic Questionnaire (MNQ), the Occupational Factor Questionnaire (OFQ), the Workplace Stress Scale (WSS), and the Ergonomic Knowledge Questionnaire (EKQ). All data were analysed using IBM SPSS Statistics version 27.0 with simple and multiple logistic regression to identify significant associations (p<0.25). Results The 12-month prevalence of MSDs was 90.3%, with the lower back (86.7%), neck (86.0%), and shoulder (85.0%) being the most affected regions. In simple logistic regression, repetitive tasks were significantly associated with MSDs, and this association remained significant in the multiple logistic regression model (adjusted OR=4.50, 95% CI: 1.11–18.30, p=0.036). Conclusions Stress at work is the strongest determinant of musculoskeletal pain among the ultrasound machine operators, this is followed by uncomfortable use of ultrasound transducers, and lastly the higher number of patients examined in one day.

Visual Status of Private Vehicle Drivers in Klang Valley, Malaysia Introduction Vision play an important role during driving and many driving related injuries have been connected with visual problems. However, there is little information in profiling visual status among private vehicle drivers in rural area of Malaysia. The aim of this study is to determine visual function and binocular function status among private vehicle drivers in Klang Valley, Malaysia Methods A descriptive cross-sectional study was conducted in the major towns within the Klang Valley of Malaysia. Participants were taken through a comprehensive eye examination after the administration of a structured questionnaire Results Fifty private vehicle drivers (52% males and 48% females) participated in this study with mean age of 26±7 year. The mean of visual acuity and contrast sensitivity is 0.03±0.1 logMAR and 0.2±0.1 at 2.5% respectively. This study also found 2% of subject with colour deficiency and 4% of subjects had constricted visual field. The mean value for amplitude of accommodation, facility of accommodation, and stereopsis is 10.16±2.11 D, 8±1 cycle per minute (cpm), and 46 second of arc respectively. Based on chi square test, there is a significant association (p=0.018) between reduced binocular vision function and history of road traffic accident (RTA). Conclusions Fifty private vehicle drivers (52% males and 48% females) participated in this study with mean age of 26±7 year. The mean of visual acuity and contrast sensitivity is 0.03±0.1 logMAR and 0.2±0.1 at 2.5% respectively. This study also found 2% of subject with colour deficiency and 4% of subjects had constricted visual field. The mean value for amplitude of accommodation, facility of accommodation, and stereopsis is 10.16±2.11 D, 8±1 cycle per minute (cpm), and 46 second of arc respectively. Based on chi square test, there is a significant association (p=0.018) between reduced binocular vision function and history of road traffic accident (RTA).

Knowledge, Attitude, and Practice Towards Safety ; Health Risks ; Food Manufacturing Introduction Food manufacturing in Malaysia exposes workers to numerous potential hazards and health risks throughout the work process. This study aimed to determine the level of knowledge, attitude, and practice (KAP) towards safety and health risks among food manufacturing workers and to examine the relationship between these domains. Methods A cross-sectional study was performed involving 80 workers from three food manufacturing factories in Negeri Sembilan. KAP was assessed through a validated questionnaire adapted from a previous study. Results All workers (100%) demonstrated a positive attitude, 98.7% show good practice, and 93.8% exhibit a good level of knowledge towards safety and health risks. The correlation study showed significant positive correlations between gender and attitude, and between education level and attitude, indicating that these sociodemographic factors influence safety attitudes. Work experience is significantly associated with knowledge, suggesting that work experience enhances knowledge. The study also reveals weak positive correlations among knowledge, attitude, and practice (KAP) regarding safety and health risk, but a significant correlation is observed between knowledge and practice. Conclusions These findings suggest that fostering practical knowledge is essential for ensuring safe work behaviors. Prioritizing hands-on safety training can help bridge the gap between theoretical attitude and daily operational safety, ultimately reducing occupational health risks among food manufacturing workers.

The Management of Infectious Waste Behavior, Health Literacy and Quality of Life Among People in Nakhon Ratchasima Province, Thailand Introduction The management of infectious waste has become increasingly important, especially during public health crises like the COVID-19 pandemic, to mitigate the risks of pathogen spread and the adverse impacts on public health and the environment. Methods This study explored waste management and behavior, the health status, health literacy, and quality of life among 381 residents in Nakhon Ratchasima province, Thailand, using a cross-sectional design with multistage random sampling. Data were collected through self-administered structured questionnaires and analyzed using multiple logistic regression to identify factors associated with quality of life. Results Results showed that the majority of participants were female (74.28%) with an average age of 38.59 years (S.D. = 14.07). While 66.93% had a high knowledge of infectious waste management, only 49.61% demonstrated moderate waste management behavior, and 46.69% possessed interactive health literacy. Alarmingly, 62.20% of communities lacked designated areas for infectious waste disposal, and just 24.41% of participants reported a good quality of life. The factor significantly associated with good quality of life is health literacy with interactive level and critical level (AOR=2.87; 95% CI:1.53 – 7.66; p-value = 0.014, AOR=2.93; 95% CI:1.92 – 10.03; p-value = 0.018) when controlling for other covariates. Conclusions These study findings indicate that health literacy is significantly associated with a good quality of life, emphasizing the importance of empowering individuals with the knowledge and skills necessary to make informed health decisions. This can be achievedthrough public education, community engagement, and the enforcement of waste disposal policies. These actions aim to mitigate health risks and enhance the overall quality of life, thereby contributing significantly to sustainable public health and environmental safety.

Perception of Urban Air Pollution Among Working Individuals During Work-Related Commute in the Klang Valley Introduction Malaysia’s rapid economic growth, urbanization and motorization cause air pollution problems in addition to intense regional transboundary air pollution. The Klang Valley is often plagued by low-visibility air pollution, which has a negative impact on the physical and mental well-being of the public. This study aims to explore the commuters’ perception of air quality during their daily commute to work. Methods A self-administered questionnaire was used to collect data on air quality perception and travel behavior among working adults (N = 197). Pearson’s Chi-Square analysis was used to analyse public perceptions on air quality with demographic data, transportation modes and health concerns. Sixty-seven percent of the respondents perceived that the air quality was unhealthy. Results There were no significant associations between air quality perception with gender, age, or health status. However, air quality perception was significantly associated with educational background (p<0.05). A very small number (9.1%) of respondents checked the air quality status daily prior to leaving their dwelling. Conclusions There was widespread awareness of the health concerns posed by air pollution when commuting to work, however, none of the respondents significantly altered their commuting route. Our findings are broadly consistent with those of others and underscore a need for improved communication to the public of risks posed by air pollution.

Sociodemographic and Environmental Factor of Tuberculosis: Retrospective Study in Penampang, Sabah Introduction Tuberculosis (TB) remains a critical global and national public health concern, with Penampang, Sabah experiencing a continuous burden and increasing case trends. Existing literature lacks localized research on the connection between environmental factors, particularly air quality, and TB incidence in specific district-level contexts like Penampang. Methods This retrospective cross-sectional study aimed to investigate the association of sociodemographic factors and Air Pollution Index (API) with TB cases in Penampang from 2019-2023, utilizing data from the National Tuberculosis Registry and Department of Environment. Results Results indicated a statistically significant association between age and TB cases (p<0.001), while no significant association was found for gender or nationality. While Moran’sI measures global spatial clustering, LISA identifies local clusters of TB cases, spatial analysis identified Donggongon as a localized TB hotspot, alongside an overall dispersed distribution across Penampang (Moran's I = -0.143, p<0.001). Furthermore, statistically, API showed no overall significant correlation with TB cases (p=0.070) and also no global spatial autocorrelation was observed between TB cases and the API in Penampang (Moran's I = 0); however, LISA analysis identified specific local clusters (p=0.01) where a significant spatial correlation between TB incidence and API levels was present allowing the study to distinguish between overall and localized spatial patterns. Conclusions The study shows that Sociodemographic, environmental, and spatial factors are all linked in the spread of TB. Effective public health measures must be tailored to these specific contexts. Future research should collect more detailed environmental and individual-level data to create better-targeted interventions.