This paper aims to describe the development of an inventory of chronic ambulatory care sensitive conditions (ACSCs) relevant to the Malaysian context and identify potentially preventable hospitalisations in the Malaysian Ministry of Health (MOH) facilities based on the developed list.

Consultative panel discussion, multi-panel modified Delphi and secondary health data analysis.

Setting: Malaysian MOH healthcare facilities.

42 experts from the family medicine and internal medicine specialties (modified Delphi), and 2022 inpatient data from MOH hospitals (secondary health data analysis).

A list of chronic ACSCs tailored to the Malaysian context and the proportion of potentially preventable hospitalisation in MOH hospitals.

10 conditions were identified as chronic ACSCs for Malaysia, namely angina, asthma, chronic kidney disease, convulsions and epilepsy, chronic obstructive pulmonary disease, diabetes mellitus, heart failure, hypertension, iron deficiency anaemia and ischaemic heart disease. In 2022, these conditions accounted for 8.6% of potentially preventable hospitalisations among the total hospitalisations in MOH hospitals.

This study provides a base list of chronic ACSCs tailored to the Malaysian context, which enables monitoring of potentially preventable hospitalisations due to chronic conditions. The findings underscore a proportion of hospital admissions that could potentially be avoided through interventions that enhance outpatient care. The conditions identified as ambulatory care sensitive provide specific targets for policy action and resource allocation to optimise outpatient health services and thus reduce the burden of hospitalisations in the country.

Malaysian National Medical Research Register, NMRR ID-23–02149-TBZ (https://nmrr.gov.my/research-directory/45c901d6-f121-4e79-9f38-dd7d283ec9a6).

Although low-density lipoprotein cholesterol (LDL-C) is established as the primary cardiovascular disease (CVD) risk factor, some individuals with LDL-C within desirable limits still develop coronary artery disease (CAD). Lipoprotein(a) (Lp(a)) has emerged as a genetically determined independent risk factor for CVD. This study aims to investigate Lp(a) by determining its association with coronary artery stenosis severity, identifying its ethnic-specific genetic determinants and assessing its relationship with an energy-dense dietary pattern.

The PUTRA-CV study is a 3-year, multicentre, case-control observational study involving adult patients who have undergone coronary angiography. The primary outcome is the association between Lp(a) levels and the severity of angiographic CAD (assessed by Gensini or Syntax score). Secondary outcomes include the frequencies of Lp(a)-associated single nucleotide polymorphisms (SNPs) (rs10455872 and rs3798220) and the association between dietary patterns and Lp(a) levels. Lp(a) will be measured using a particle-enhanced immunoturbidimetric method, and SNPs will be genotyped using high-resolution melting. Dietary intake will be assessed using a validated semiquantitative food frequency questionnaire. Data will be analysed using SPSS. Descriptive statistics will be used to summarise population characteristics. Bivariate analyses will use chi-square (2), independent t-tests or Mann-Whitney U tests as appropriate. The independent association between Lp(a) and coronary artery stenosis severity will be determined using multivariable logistic regression, adjusting for confounders. Empirically driven dietary patterns will be derived using reduced rank regression, and their association with Lp(a) will be assessed. For genetic analysis, allele frequencies of the LPA SNPs rs10455872 and rs3798220 will be calculated and compared between cases and controls.

Ethical approval has been obtained from the ethics committees of the Ministry of Health Malaysia (NMRR ID-24-00877-2ID-IIR), Universiti Putra Malaysia (JKEUPM-2024–246), Universiti Teknologi MARA (REC/07/2024-OT/FB/2) and Universiti Malaya Medical Centre (MREC ID NO: 2 02 453–13692). The findings will be disseminated via peer-reviewed journals and conferences.

To determine the prevalence and its associated factors of dual tobacco use among Malaysian adolescents in developing effective public health strategies.

Cross-sectional study.

This study analysed data from the National Health and Morbidity Survey (NHMS) 2022: Adolescent Health Survey (AHS), a nationwide cross-sectional survey conducted among secondary school students across Malaysia.

This cross-sectional study used data from the NHMS 2022: AHS, which included a representative national sample of Malaysian adolescents between the ages of 13 and 17. Using a two-stage stratified sampling approach, this study included participation from 33 523 adolescents from 240 schools nationwide.

The primary outcome was the prevalence of dual tobacco use among Malaysian school-going adolescents aged 13–17, defined as self-reported concurrent use of conventional cigarettes and e-cigarettes in the past 30 days. Secondary outcomes included the factors associated with dual tobacco use, such as sociodemographic characteristics, dual tobacco use behaviour, marital status of parents, tobacco use of parent or guardian, supervision, connectedness, bonding and respect for privacy of parent or guardian, along with peer support and truancy. A complex sample analysis was performed using SPSS V.27.0, maintaining a 95% CI and multiple logistic regression was applied.

Out of 33 380 Malaysian adolescents surveyed, 1728 (5.5%; 95% CI: 4.88% to 6.28%) reported dual tobacco use. The prevalence was significantly higher among males (9.7%; 95% CI: 8.54% to 10.98%) compared with females (1.4%; 95% CI: 1.15% to 1.70%) and highest among 17 years (8.6%; 95% CI: 7.05% to 10.41%), with a decreasing trend in younger age groups. Predominant vapers constituted the largest proportion (9.9%, 95% CI: 8.66% to 10.13%) among adolescents who reported dual tobacco use, followed by predominant smokers (6.2%, 95% CI: 5.53% to 7.06%), dual daily users (4.5%, 95% CI: 3.18% to 5.64%) and non-daily dual users (3.9%, 95% CI: 2.79% to 4.39%). Dual tobacco use was more prevalent among adolescents whose parents or guardians used tobacco (8.1%; 95% CI: 7.10% to 9.20%). Multiple logistic regression analysis suggested that significant predictors of dual tobacco use included older age (adjusted OR (AOR) for 17 years: 2.92; 95% CI: 2.19 to 3.89), male sex (AOR: 8.53; 95% CI: 6.78 to 10.74), ‘others’ ethnicity (AOR: 1.82; 95% CI: 1.40 to 2.35), predominant vapers (AOR 2.65, 95% CI: 1.96 to 2.72), separated or widowed parental status (AOR: 1.69; 95% CI: 1.42 to 2.02), parental or guardian tobacco use (AOR: 2.47; 95% CI: 2.08 to 2.94), lack of bonding (AOR: 1.79; 95% CI: 1.49 to 2.14), lack of privacy respect (AOR: 1.53; 95% CI: 1.29 to 1.81), lack of peer support (AOR: 1.65; 95% CI: 1.39 to 1.96) and truancy (AOR: 1.81; 95% CI: 1.55 to 2.10).

This study highlights a concerning prevalence of dual tobacco use (5.5%) among Malaysian adolescents, which is notably higher than the current prevalence of exclusive cigarette smoking (6.2%) and closely approaches that of e-cigarette use (14.9%). Compared with previous national surveys and international benchmarks, the prevalence of dual use among Malaysian youth appears to be rising and represents a significant public health concern. These findings underscore the urgent need for targeted prevention and control strategies addressing both conventional and emerging tobacco products in this population.