Prevalence and Determinants of Anemia among Indigenous Orang Asli Children Under 5 in Rural Peninsular Malaysia

Abstract

Background

Childhood anemia is a major global health issue, disproportionately affecting indigenous communities like the Orang Asli in Peninsular Malaysia. Despite its high prevalence, it remains under-researched and overshadowed by other public health priorities.

Objectives

This study aims to quantify the burden of anemia and identify its determinants among these vulnerable children.

Methods

A cross-sectional study was conducted in 4 rural districts in Peninsular Malaysia, involving 503 Orang Asli children aged ≤ 5 years. The children were purposively sampled from the mobile clinics. Anthropometry was measured and anemia was assessed using point-of-care photometry. Data on sociodemographic, childcare practices, home environment, and food insecurity were collected via structured interviews with parents or caregivers. Multivariate logistic regression was used to determine the factors associated with anemia.

Results

The prevalence of anemia was 86.1% (95% CI: 82.8, 89.0); with 19.5% (95% CI: 16.1, 23.2) classified as mild, 52.1% (95% CI:47.6, 56.5) moderate, and 14.5% (95% CI: 11.6, 17.9) severe. Factors associated with anemia were early initiation of complimentary feeding (aOR: 2.7, 95% CI: 1.0, 7.0) and recent fever or upper respiratory infections (aOR: 2.6, 95% CI: 1.3, 5.3). Geographic variations were observed, with children from Jerantut (aOR: 0.2, 95% CI: 0.1, 0.4) and Lipis (aOR: 0.3, 95% CI: 0.1, 0.9) showing lower odds of anemia.

Conclusions

Anemia prevalence among Orang Asli children is alarmingly high. Targeted interventions should improve feeding practice and enhance health management. Identifying district-specific lower risk characteristics can guide broader strategies to tackle childhood anemia among the indigenous Orang Asli children.

Plain Language Summary

Anemia Among Orang Asli Children in Rural Malaysia: How big is the problem and what can be done?

Why was the study done?: Childhood anemia is a serious but often overlooked health problem, especially among indigenous communities such as the Orang Asli in Malaysia. Many children in these communities suffer from anemia, but there is little research on why it happens and what factors contribute to it. This study examined anemia in children visiting government mobile clinics, who may have greater health needs than the general population.

What did the researchers do?: We studied 503 Orang Asli children under 5 who attended mobile health clinics across 4 rural districts in Penunisular Malaysia. Using finger-prick blood tests and caregiver interviews, we measured anemia prevalence, recorded health and nutrition practices, and compared results across clinic locations.

What did the researchers find?: High anemia rates were observed, with 86.1% of children screened having anemia. Key factors associated with anemia included early introduction of complimentary foods before 6 months, and recent illnesses like fever or cough. We also found variation by clinic location, with lower anemia rates in some areas served by mobile clinics.

What do the findings mean?: The high anemia rates among mobile clinic attendees highlight a potential need for improved infant feeding education and infection management. Anemia prevalence varied across districts, but further research in broader community samples is required to understand the factors contributing to these differences.