{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T13:16:03Z","timestamp":1777641363183,"version":"3.51.4"},"reference-count":56,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Food Nutr Bull"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aims to quantify the burden of anemia and identify its determinants among these vulnerable children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional study was conducted in 4 rural districts in Peninsular Malaysia, involving 503 Orang Asli children aged\u2009\u2264\u20095 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03795721251383205","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T09:39:20Z","timestamp":1768815560000},"page":"41-50","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and Determinants of Anemia among Indigenous Orang Asli Children Under 5 in Rural Peninsular Malaysia"],"prefix":"10.1177","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6141-0949","authenticated-orcid":false,"given":"Mohamad Borhanuddin Helmy","family":"Bin Zanail","sequence":"first","affiliation":[{"name":"Centre of Epidemiology &amp; Evidence Based Practice, Department of Social and Preventative Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia"},{"name":"Ministry of Health, Kuantan, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Foong Ming","family":"Moy","sequence":"additional","affiliation":[{"name":"Centre of Epidemiology &amp; Evidence Based Practice, Department of Social and Preventative Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tharani","family":"Loganathan","sequence":"additional","affiliation":[{"name":"Centre of Epidemiology &amp; Evidence Based Practice, Department of Social and Preventative Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"e_1_3_3_2_2","volume-title":"Guideline on hemoglobin cutoffs to define anemia in individuals and populations","author":"WHO","year":"2024","unstructured":"WHO. Guideline on hemoglobin cutoffs to define anemia in individuals and populations. World Health Organization; 2024."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2017.1354696"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.14092"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)62304-5"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1590\/1984-0462\/2020\/38\/2019031"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/rsp3.12512"},{"issue":"1","key":"e_1_3_3_8_2","first-page":"40","article-title":"Distribution and demography of the Orang Asli in Malaysia","volume":"6","author":"SyedHussain TPR","year":"2017","unstructured":"SyedHussain TPR, Krishnasamy DS, Hassan AAG. Distribution and demography of the Orang Asli in Malaysia. Int J Human Social Sci Invent. 2017;6(1):40-45.","journal-title":"Int J Human Social Sci Invent"},{"issue":"7","key":"e_1_3_3_9_2","first-page":"1157","article-title":"The Orang Asli profile in peninsular Malaysia: Background & challenges","volume":"8","author":"Shah NM","year":"2018","unstructured":"Shah NM, Rus RC, Mustapha R, Hussain MAM, Wahab NA. The Orang Asli profile in peninsular Malaysia: Background & challenges. Int J Acad Res Busin Soc Sci. 2018;8(7):1157-1164.","journal-title":"Int J Acad Res Busin Soc Sci"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gene.2016.04.008"},{"issue":"2","key":"e_1_3_3_11_2","first-page":"88","article-title":"Khazanah Tersembunyi Yang Semakin Lenyap: Seni Ukiran Patung Kayu Suku Kaum Jah Hut","volume":"3","author":"Sani NEA","unstructured":"Sani NEA, Arif HA. Khazanah Tersembunyi Yang Semakin Lenyap: Seni Ukiran Patung Kayu Suku Kaum Jah Hut. J Human Soc Sci. 2021;3(2):88-97.","journal-title":"J Human Soc Sci"},{"key":"e_1_3_3_12_2","first-page":"75","article-title":"Orang Asli in Peninsular Malaysia: Population, spatial distribution and socio-economic condition","volume":"6","author":"Masron T","year":"2013","unstructured":"Masron T, Masami F, Ismail N. Orang Asli in Peninsular Malaysia: Population, spatial distribution and socio-economic condition. J Ritsumeikan, Soc Sci Human. 2013;6:75-115.","journal-title":"J Ritsumeikan, Soc Sci Human"},{"key":"e_1_3_3_13_2","doi-asserted-by":"crossref","unstructured":"Endicott K Gomes A Hooker MJP. 2016. Present Asli FotO. Malaysia\u2019s Original People.","DOI":"10.2307\/j.ctv1qv35n"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-022-03532-7"},{"key":"e_1_3_3_15_2","unstructured":"MOH. Laporan Tahunan Kementerian Kesihatan Malaysia 2019. In: Malaysia MoH ed. Putra Jaya: MOH; 2019:60."},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.21315\/mjms2022.29.2.3"},{"key":"e_1_3_3_17_2","first-page":"1","volume-title":"Malaysia's Original People: Past, Present and Future of the Orang Asli","author":"Endicott K","year":"2016","unstructured":"Endicott K. Introduction - The Orang Asli. In: Endicott K, ed. Malaysia's Original People: Past, Present and Future of the Orang Asli. Nus Press Pte Ltd; 2016:1-10."},{"key":"e_1_3_3_18_2","first-page":".","article-title":"Identification of wild edible plants used by the Orang Asli, indigenous peoples of the Malay Peninsula","volume":"7","author":"Tharmabalan RT","year":"2023","unstructured":"Tharmabalan RT. Identification of wild edible plants used by the Orang Asli, indigenous peoples of the Malay Peninsula. Front Susta Food Systems. 2023;7.","journal-title":"Front Susta Food Systems"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.3390\/nu15061493"},{"key":"e_1_3_3_20_2","doi-asserted-by":"crossref","unstructured":"Rahim MAFA Munajat MB Wahid W et al. 2021. Anemia Prevalence Severity and Associated Risk Factors Among Indigenous Temiar Orang Asli Community in Kelantan Peninsular Malaysia.","DOI":"10.21203\/rs.3.rs-709980\/v1"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0245377"},{"key":"e_1_3_3_22_2","unstructured":"Dean A Sullivan K Soe M. OpenEpi: Open Source Epidemiologic Statistics for Public Health. https:\/\/www.openepi.com\/Menu\/OE_Menu.htm. Published 2013. Updated 6\/4\/2013. Accessed 12 Dec 2019."},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.21767\/1791-809X.1000627"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-020-01371-x"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-14449-2"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0265917"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1080\/09581596.2018.1438588"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.4103\/2224-3151.358074"},{"issue":"1","key":"e_1_3_3_29_2","first-page":"328","article-title":"Healthcare access experiences among indigenous women in northern rural Thailand: A focused ethnographic study","volume":"7","author":"Thummapol O","year":"2018","unstructured":"Thummapol O, Barton S, Park T. Healthcare access experiences among indigenous women in northern rural Thailand: A focused ethnographic study. Cent Asian J Glob Health. 2018;7(1):328.","journal-title":"Cent Asian J Glob Health"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.advnut.2024.100290"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.14996"},{"issue":"6","key":"e_1_3_3_32_2","first-page":"180","article-title":"Nutritional Status of orang Asli children in Sungai Berua, Terengganu","volume":"16","author":"Yee SK","year":"2021","unstructured":"Yee SK, Asma\u2019Ali NSZ, Yusof HM. Nutritional Status of orang Asli children in Sungai Berua, Terengganu. J Sust Sci Manag. 2021;16(6):180-190.","journal-title":"J Sust Sci Manag"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.3390\/nu6010190"},{"issue":"4","key":"e_1_3_3_34_2","first-page":"724","article-title":"Serum iron status in Orang Asli children living in endemic areas of soil-transmitted helminths","volume":"16","author":"Aini U","year":"2007","unstructured":"Aini U, Al-Mekhlafi H, Azlin M, et al. Serum iron status in Orang Asli children living in endemic areas of soil-transmitted helminths. Asia Pac J Clin Nutr. 2007;16(4):724-730.","journal-title":"Asia Pac J Clin Nutr"},{"key":"e_1_3_3_35_2","unstructured":"WHO. Global Health Observatory Data Repository\/World Health Statistics. Prevalence of anemia among children (% of children ages 6\u201359 months) - Malaysia 2019 Web site. https:\/\/ourworldindata.org\/micronutrient-deficiency#citation. Published 2019. Accessed 15 Nov 2022."},{"key":"e_1_3_3_36_2","volume-title":"The Prevalence and Risk Factors of Iron Deficiency Anemia Among Rural Schoolchildren in Kudat","author":"Roslie RB","year":"2019","unstructured":"Roslie RB, Yusuff ASM, Parash MTH. The Prevalence and Risk Factors of Iron Deficiency Anemia Among Rural Schoolchildren in Kudat. Fakulti Sains dan Sumber Alam, Universiti Malaysia Sabah; 2019."},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0170174"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajr.12338"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.3109\/03014460902991979"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.3402\/ijch.v68i5.17378"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1590\/S0021-75572006000600013"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03405171"},{"key":"e_1_3_3_43_2","unstructured":"Marku M Kraja J Shala I Abazaj E Zallari K. 2016. Prevalence of anemia in Shkodra district."},{"key":"e_1_3_3_44_2","unstructured":"Tang A Smit E Semba RD. 2021. Nutrition and Infectious Diseases."},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17238829"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-019654"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020006479"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21186976"},{"key":"e_1_3_3_49_2","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.03.010402"},{"key":"e_1_3_3_50_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-015-1534-7"},{"key":"e_1_3_3_51_2","doi-asserted-by":"publisher","DOI":"10.1590\/1806-9282.60.01.006"},{"issue":"2","key":"e_1_3_3_52_2","first-page":"68","article-title":"Meta-analysis: Early weaning and its relationship with malnutrition and reduced physical activity","volume":"11","author":"Salem Abshan MA","year":"2017","unstructured":"Salem Abshan MA. Meta-analysis: Early weaning and its relationship with malnutrition and reduced physical activity. EC Microbiol. 2017;11(2):68-74.","journal-title":"EC Microbiol"},{"key":"e_1_3_3_53_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ejcn.1600645"},{"issue":"1","key":"e_1_3_3_54_2","article-title":"Approaches to infant weaning and the issues caregivers face: a rapid review","volume":"2","author":"Prescott A","year":"2024","unstructured":"Prescott A. Approaches to infant weaning and the issues caregivers face: a rapid review. Norland Educare Res J. 2024;2(1);8.","journal-title":"Norland Educare Res J"},{"key":"e_1_3_3_55_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajhb.1053"},{"key":"e_1_3_3_56_2","doi-asserted-by":"publisher","DOI":"10.1006\/jhge.1998.0105"},{"key":"e_1_3_3_57_2","first-page":"66","article-title":"The ecology of health and nutrition of Orang Asli (indigenous people) women and children in Peninsular Malaysia","volume":"2","author":"Khor GL","year":"2008","unstructured":"Khor GL, Zalilah M. The ecology of health and nutrition of Orang Asli (indigenous people) women and children in Peninsular Malaysia. Tribes and Tribals. 2008;Special Volume 2:66-77.","journal-title":"Tribes and Tribals"}],"container-title":["Food and Nutrition Bulletin"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03795721251383205","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/03795721251383205","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03795721251383205","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:20:08Z","timestamp":1777443608000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/03795721251383205"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,19]]},"references-count":56,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1177\/03795721251383205"],"URL":"https:\/\/doi.org\/10.1177\/03795721251383205","relation":{},"ISSN":["0379-5721","1564-8265"],"issn-type":[{"value":"0379-5721","type":"print"},{"value":"1564-8265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,19]]}}}