Introduction: Dyslipidaemia is one of the established risk factors for cardiovascular disease. Evidence from large-scale trials showed that effective treatment of dyslipidaemia can reduce all-cause and coronary mortality. To date, there is no published systematic review on the worldwide prevalence of dyslipidaemia in adults. We propose to perform a systematic review on the global prevalence of dyslipidaemia in adults 18 years and older. Methods and analysis: We will identify observational studies through comprehensive literature searches. We will search: MEDLINE, Cochrane Central Register of Controlled Trials for published studies and trial registries including the WHO International Trial Registry Platform and ClinicalTrials.gov. Two reviewers will independently screen the titles and abstracts, attain full text of eligible articles, extract data, and appraise the quality and bias of the included studies. Disagreement among the authors will be resolved by discussion leading to a consensus. Next, we will perform a narrative synthesis of the study results. Study heterogeneity will be assessed using I ² statistics. If I ² is high (≥75%), and plausible heterogeneity contributors are found, we will divide the studies into appropriate subgroups for pooling of results or assess the association of plausible covariates and the prevalence estimates using meta-regression. If I ² <75%, we will undertake meta-analysis using the random-effects model and transform all prevalence estimates using the Freeman-Tukey transformation for pooling, to obtain a synthesised point estimate of prevalence with its 95% confidence. We will then back-transform the point estimate, and report our results using the back-transformed figures. Ethics and dissemination: Ethics approval is not a requirement as this study is based on available published data. Results of this systematic review will be presented at conferences, shared with relevant health authorities, and published in a peer-reviewed journal. These results may help quantify the magnitude of dyslipidaemia globally, and guide preventative and therapeutic interventions. PROSPERO registration number: CRD42020200281

Screening mammograms have resulted in a reduction in breast cancer mortality, yet the uptake in Malaysia was low. This study aimed to determine the prevalence and factors associated with screening mammogram uptake among women attending a Malaysian primary care clinic. A cross-sectional study was conducted among 200 women aged 40 to 74 attending the clinic. The data was collected using questionnaires assessing sociodemographic, clinical characteristics, knowledge and health beliefs. Multiple logistic regression was used to identify factors associated with mammogram uptake. The prevalence of screening mammograms was 46.0%. About 45.5% of women with high breast cancer risk had never undergone a mammogram. Older participants, aged 50 to 74 (OR = 2.57, 95% CI: 1.05, 6.29, p-value = 0.039) and those who received a physician’s recommendation (OR = 7.61, 95% CI: 3.81, 15.20, p-value < 0.001) were more likely to undergo screening mammography. Significant health beliefs associated with mammogram uptake were perceived barriers (OR = 0.81, 95% CI: 0.67, 0.97, p-value = 0.019) and cues to action (OR = 1.30, 95% CI: 1.06, 1.59, p-value = 0.012). Approximately half of the participants and those in the high-risk group had never undergone a mammogram. Older age, physician recommendation, perceived barriers and cues to action were significantly associated with mammogram uptake. Physicians need to play an active role in promoting breast cancer screening and addressing the barriers.

Limited health literacy (HL) is linked to many negative health outcomes, including poor self-management of chronic diseases and medication adherence among patients. There are a lack of data regarding HL in the elderly population in Malaysia. This study aimed to determine the prevalence of limited HL levels and its associated factors among elderly patients in an urban academic primary care clinic in Selangor, Malaysia. A cross-sectional study was conducted among 413 elderly patients (≥60 years old) who attended this academic primary care clinic between January 2020 and January 2021. Sociodemographic data, clinical characteristics, and health literacy scores were collected. Descriptive statistics (median with interquartile ranges (IQR), frequency, and percentages) and multiple logistic regression were utilized. The prevalence of limited HL in our population was 19.1% (95% CI: 15.3, 23). The middle-old (70–79 years) and very-old (≥80 years) age groups were more likely to have limited HL (aOR 4.05; 95% CI: 2.19, 7.52 and aOR 4.36; 95% CI: 1.02, 18.63, respectively). Those with at least secondary school education (aOR 0.06; 95% CI: 0.02, 0.24) and those who found medical information via the internet/television (aOR 0.21; 95% CI: 0.05, 0.93) had lower odds of having limited HL. In conclusion, having limited HL levels was not common among elderly patients in this primary care clinic. Further studies involving rural and larger primary care clinics in Malaysia are required to support these findings.

Background: Lipid-lowering medications (LLM) are commonly used for secondary prevention, as well as for primary prevention among patients with high global cardiovascular risk and with diabetes. This study aimed to determine the prevalence of LLM use among high-risk individuals [participants with diabetes, high Framingham general cardiovascular (FRS-CVD) score, existing cardiovascular disease (CVD)] and the factors associated with it. Methods: This is a cross-sectional analysis from the baseline recruitment (years 2007 to 2011) of an ongoing prospective study involving 11,288 participants from 40 rural and urban communities in Malaysia. Multiple logistic regression was used to identify characteristics associated with LLM use. Results: Majority (74.2%) of participants with CVD were not on LLM. Only 10.5% of participants with high FRS-CVD score, and 17.1% with diabetes were on LLM. Participants who were obese (OR = 1.80, 95% CI: 1.15–2.83), have diabetes (OR = 2.38, 95% CI: 1.78–3.19), have hypertension (OR = 2.87, 95% CI: 2.09–3.95), and attained tertiary education (OR = 2.25, 95% CI: 1.06–4.78) were more likely to be on LLM. Rural residents had lower odds of being on LLM (OR = 0.58, 95% CI: 0.41–0.82). In the primary prevention group, participants with high FRS-CVD score (OR = 3.81, 95% CI: 2.78–5.23) and high-income earners (OR = 1.54, 95% CI: 1.06–2.24) had higher odds of being on LLM. Conclusions: LLM use among high CVD-risk individuals in the primary prevention group, and also among individuals with existing CVD was low. While CVD risk factors and global cardiovascular risk score were positively associated with LLM use, sociodemographic disparities were observed among the less-educated, rural residents and low-income earners. Measures are needed to ensure optimal and equitable use of LLM.

Dyslipidaemia is an established cardiovascular risk factor. This study aimed to determine the pooled prevalence of dyslipidaemia in Malaysian adults. A systematic review and meta-analysis of all cross-sectional, longitudinal observational studies which reported the prevalence of elevated total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), triglycerides (TG), and reduced high-density lipoprotein cholesterol (HDL-c) in adults 18 years old and older, was conducted. A comprehensive search of PubMed and Cochrane Central Register of Controlled Trials (which included Medline, EMBASE and major trial registers) from inception to October 18, 2022, was performed. Risk-of-bias was evaluated using the Johanna-Briggs Institute Prevalence Critical Appraisal Tool, while certainty of evidence was assessed using an adapted version of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Random-effects meta-analyses were performed using MetaXL. This report follows the PRISMA reporting guidelines. The protocol was registered with PROSPERO (CRD42020200281). 26 556 studies were retrieved and 7 941 were shortlisted initially. From this, 70 Malaysian studies plus two studies from citation searching were shortlisted; 46 were excluded, and 26 were included in the review (n = 50 001). The pooled prevalence of elevated TC (≥ 5.2 mmol/L), elevated LDL-c (≥ 2.6 mmol/L), elevated TG (≥ 1.7 mmol/L), and low HDL-c (< 1.0 mmol/L in men and < 1.3 mmol/L in women) were 53% (95% CI 39–67%, I² = 100%), 73% (95% CI 50–92%, I² = 100%), 36% (95% CI 32–40%, I² = 96%), and 40% (95% CI 25–55%, I² = 99%), respectively. This review found that the prevalence of all dyslipidaemia subtypes is high in Malaysian adults. Ongoing efforts to reduce cardiovascular diseases in Malaysia should integrate effective detection and treatment of dyslipidaemia.

Primary care doctors (PCDs) play an important role in the early diagnosis and management of dementia. This study aimed to determine the knowledge, attitude, and confidence in managing dementia among PCDs in Malaysia. It also aimed to determine the factors associated with higher confidence levels in dementia management. An online-based cross-sectional study using Google Forms^TM was performed. Sociodemographic and work-related data were collected, and Dementia Knowledge among General Practitioners & General Practitioners Attitude and Confidence Scale for Dementia questionnaires were utilized to assess the knowledge, attitude, and confidence scores. Multiple linear regression was conducted to determine the association between sociodemographic factors, knowledge, and attitude with the confidence in dementia management score. A total of 239 PCDs participated, with the majority being female (72.4%) and Malay (64.4%) and working in public primary care clinics (67.4%). The mean (±SD) score for confidence was 2.96 (±0.76). Among the factors associated with higher confidence levels in managing dementia were higher dementia knowledge scores, higher attitude towards dementia scores, prior dementia education, and the availability of nearby referral services for dementia. Malaysian PCDs’ confidence in dementia management was comparable to the PCDs of other countries. Strategies addressing these factors should be implemented to improve the confidence of PCDs in managing dementia.