Poverty related diseases amongst Malaysia’s low-income community: a review

@#Poverty, as proven by several studies, is a driving force behind poor health and hygiene practices. This review attempts to outline common communicable and non-communicable diseases that disproportionately affect Malaysia’s 2.91 million low-income households. The current study also looks into the government’s housing and healthcare programmes for this demographic to improve their health and well-being. The initial examination yielded incredibly little research on this marginalised community, with event reporting typically generalised to the Malaysian community as a whole rather than analysing disease incidences based on household income, which would better reflect povertydriven diseases. As a result, there is an acute need for more accurate information on the epidemiology of diseases among the poor in order to address this public health issue and provide conclusions that can drive policy designs.

Public health status of Myanmar refugees in South East Asia: A Malaysian case study

@#The United Nations High Commissioner for Refugees (UNHCR) reports over 80 million people are displaced worldwide with approximately 26.3 million categorized as refugees and over a million residing temporarily in South East Asia. Despite the lack of national legislative framework in place for refugees and asylum seekers (RAS), Malaysia hosts approximately 178,140 as registered with UNHCR and the majority originate from Myanmar. In this review, we examine refugees from South East Asia, particularly from Myanmar that have contributed to the largest influx of refugees to this region with a focus on their health status. The present study traces barriers to the health care of refugees in the country of asylum and also the challenges faced by these communities in accessing health services.

Post-era mass drug administration: an update on intestinal parasitic infections in urban poor communities in Peninsular Malaysia

@#The health impact of a Malaysian national helminth control program which provided school-based anthelmintic chemotherapy from 1974 to 1983 was re-visited after three decades post MDA and associated risk factors amongst urban poor communities identified. Stool samples collected were screened using the formalin ethyl-acetate concentration technique recovered at least one species of helminth and/or protozoan. Despite a steady decline observed between 1974-1983 however, post MDA infections continue to persist in pockets of communities moderately (18.9%; n=39/206) with higher infection recorded amongst PPR flat residents (22.5%, n=16/71). Among risk factors identified, waste management method was the primary factor for Ascaris lumbricoides infections (n=33; 16.0%), whereas age, education, employment and source of drinking water were significant risk factors for cryptosporidiosis. Despite the government’s efforts to improve health through the provision of basic amenities to the general public, higher prevalence values amongst PPR flat dwellers suggests the need to implement targeted chemotherapeutic treatment of, once a year deworming as recommended by World Health Organization when the baseline prevalence of soil-transmitted helminth infections in the community is over 20%, in addition to preventive measures though improvements in health awareness programs and improved waste management methods.

Entamoeba infections and associated risk factors among migrant workers in Peninsular Malaysia

@#The influx of low skilled migrant workers to Malaysia from low socio-economic countries where gastrointestinal parasitic infections are prevalent has raised concerns about transmission to the local population. Three methods for detection (serology, microscopy and molecular techniques) were utilized to identify Entamoeba infections amongst the targeted cohort and determine risk factors associated with infection. Serological screening of 484 migrant workers from five working sectors in Peninsular Malaysia using IgG4 ELISA based on the rPPDK antigen showed an overall seroprevalence of 7.4% (n = 36; CL95 = 5.3–10.1%) with only one factor statistically associated with seropositivity of anti-amoebic antibodies, i.e. years of residence in Malaysia (χ2 1 = 4.007, p = 0.045). Microscopic examination of 388 faecal samples for protozoan cysts and trophozoites showed a slightly higher prevalence (11.6%; n=45; CL95: 8.4–14.8%). Meanwhile, amplification of the 16S rDNA gene detected two species i.e. Entamoeba dispar (23/388; 5.9%; CL95: 3.6–8.3%) and E. histolytica (11/388; 2.8%; CL95: 1.2–4.5%) and mixed infections with both parasites in only three samples (3/388; 0.8%; CL95: 0.2–2.2%). Entamoeba dispar infection was significantly associated with those employed in food and domestic services (χ2 4 = 12.879, p = 0.012). However, none of the factors affected the prevalence of E. histolytica infection. Despite the low prevalence of E. histolytica in faecal samples of the study cohort, the presence of this pathogenic parasite still poses potential public health risks and calls for tighter control strategies based on better availability of chemotherapeutic treatment and accessibility to appropriate health education.