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

BackgroundChildhood 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.ObjectivesThis study aims to quantify the burden of anemia and identify its determinants among these vulnerable children.MethodsA 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.ResultsThe 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.ConclusionsAnemia 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.