Abstract
Anaemia is a significant public health issue that affects people of all ages globally. According to the 2019 National Health and Morbidity Survey, 20.5% of Malaysian adolescents suffer from anaemia. Among Orang Asli adolescents, the situation is even more severe, with up to 50% affected by anaemia. This study aims to understand the burden of anaemia among the indigenous group in Malaysia and identify the factors associated with anaemia among Orang Asli adolescents in Peninsular Malaysia. The study comprises a systematic review and a cross-sectional study. First, a systematic review was conducted to analyse the literature on the burden and causes of anaemia among Orang Asli in Malaysia. Second, a cross-sectional study was carried out among 404 Orang Asli adolescents in two states, namely Pahang and Perak. The participants were selected using systematic random sampling of the settlements. Adolescents aged 10 to 19 years in the respective settlements were invited to participate and underwent interview-administered questionnaires, 24-hour dietary recalls, anthropometric measurements, and comprehensive blood and stool samples. Anaemia status was defined according to specific WHO guidelines for age and gender. Multiple logistic regression analysis was performed to identify the factors associated with anaemia among Orang Asli adolescents. The systematic review revealed a high prevalence of anaemia among Orang Asli (68.4%), with research primarily focusing on iron-deficiency anaemia and soil-transmitted helminth infections. Other factors contributing to anaemia included malaria, female gender, young age, mothers with low education levels, and low household incomes. Interestingly, no studies were found associating Orang Asli with hereditary anaemia. The cross-sectional study showed that 31.0% of Orang Asli adolescents were affected by anaemia, with 45.5% suffering from moderate to severe anaemia. Anaemia was associated with factors such as chewing betel (aOR=4.080, 95% CI=2.008, 8.285; p=<0.001), having a working father (aOR=3.183, 95% CI=1.607, 6.303; p=0.001), soil transmitted helminth infections (aOR=2.446, 95% CI=1.302, 4.595; p=0.005), hemoglobinopathies (aOR=2.341, 95% CI=1.114, 4.917; p=0.025), living in rural areas (aOR=3.494, 95% CI=1.044, 11.694; p=0.042), being female (aOR=2.195, 95% CI=1.022, 4.711; p=0.044), and using river water (aOR=3.255, 95% CI=1.023, 10.360; p=0.046). Protective factors for anaemia included having a home toilet, taking iron-folate supplementation, weight gain, and using a gravity-feed system for water sources. In
conclusion, this study identified various risk factors associated with anaemia among Orang Asli adolescents, highlighting the complex interplay between socioeconomic determinants, environmental factors, and health outcomes among these marginalised populations. The study suggests that existing strategies should be reviewed and strengthened to address the specific needs of Orang Asli adolescents, requiring collaborative efforts involving government agencies, NGOs, healthcare professionals,
educators, and community leaders for meaningful change.
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@phdthesis{drph-Munazieraa-Ab-Aziz-2024,
title = {Prevalence and Determinants of Anaemia Among Orang Asli Adolescents in Peninsular Malaysia},
author = {Munazieraa Ab Aziz},
year = {2024},
date = {2024-10-11},
urldate = {2024-10-11},
abstract = {Anaemia is a significant public health issue that affects people of all ages globally. According to the 2019 National Health and Morbidity Survey, 20.5% of Malaysian adolescents suffer from anaemia. Among Orang Asli adolescents, the situation is even more severe, with up to 50% affected by anaemia. This study aims to understand the burden of anaemia among the indigenous group in Malaysia and identify the factors associated with anaemia among Orang Asli adolescents in Peninsular Malaysia. The study comprises a systematic review and a cross-sectional study. First, a systematic review was conducted to analyse the literature on the burden and causes of anaemia among Orang Asli in Malaysia. Second, a cross-sectional study was carried out among 404 Orang Asli adolescents in two states, namely Pahang and Perak. The participants were selected using systematic random sampling of the settlements. Adolescents aged 10 to 19 years in the respective settlements were invited to participate and underwent interview-administered questionnaires, 24-hour dietary recalls, anthropometric measurements, and comprehensive blood and stool samples. Anaemia status was defined according to specific WHO guidelines for age and gender. Multiple logistic regression analysis was performed to identify the factors associated with anaemia among Orang Asli adolescents. The systematic review revealed a high prevalence of anaemia among Orang Asli (68.4%), with research primarily focusing on iron-deficiency anaemia and soil-transmitted helminth infections. Other factors contributing to anaemia included malaria, female gender, young age, mothers with low education levels, and low household incomes. Interestingly, no studies were found associating Orang Asli with hereditary anaemia. The cross-sectional study showed that 31.0% of Orang Asli adolescents were affected by anaemia, with 45.5% suffering from moderate to severe anaemia. Anaemia was associated with factors such as chewing betel (aOR=4.080, 95% CI=2.008, 8.285; p=\<0.001), having a working father (aOR=3.183, 95% CI=1.607, 6.303; p=0.001), soil transmitted helminth infections (aOR=2.446, 95% CI=1.302, 4.595; p=0.005), hemoglobinopathies (aOR=2.341, 95% CI=1.114, 4.917; p=0.025), living in rural areas (aOR=3.494, 95% CI=1.044, 11.694; p=0.042), being female (aOR=2.195, 95% CI=1.022, 4.711; p=0.044), and using river water (aOR=3.255, 95% CI=1.023, 10.360; p=0.046). Protective factors for anaemia included having a home toilet, taking iron-folate supplementation, weight gain, and using a gravity-feed system for water sources. In
conclusion, this study identified various risk factors associated with anaemia among Orang Asli adolescents, highlighting the complex interplay between socioeconomic determinants, environmental factors, and health outcomes among these marginalised populations. The study suggests that existing strategies should be reviewed and strengthened to address the specific needs of Orang Asli adolescents, requiring collaborative efforts involving government agencies, NGOs, healthcare professionals,
educators, and community leaders for meaningful change.},
keywords = {},
pubstate = {published},
tppubtype = {phdthesis}
}
