This study aimed to explore the socio-demographic characteristics, mental health status, and perceived causes of pandemic fatigue with COVID-19 pandemic fatigue among the general population of Malaysia. The data was collected online during the transition from the COVID-19 pandemic phase to the endemic phase in Malaysia from 1 to 30 April 2022. Sociodemographic data, Depression Anxiety Stress Scale-21 (DASS-21), perceived causes of pandemic fatigue, and the Fatigue Assessment Scale (FAS) were included in the survey. The chi-square test and a simple logistic regression analysis were used to identify predictors of pandemic fatigue. The completed survey (N = 775) included individuals aged 18 years or above [mean 31.98 (SD = 12.16)] from all states in Malaysia. Pandemic fatigue prevalence was 54.2%. Severe to extremely severe depression, anxiety, and stress symptoms were detected in 11.2%, 14.9%, and 9.1% of the participants, respectively. Younger age, non-Malay ethnicity, living alone, and higher income categories were significantly higher in the fatigued group. Higher DASS-21 scores on all domains were associated with higher FAS scores. Meanwhile, high scores for perceived tiredness from complying with the COVID-19 Standard Operating Procedure (SOP), perceived risk of infection from COVID-19, perceived hardship due to the pandemic, perceived public complacency during the pandemic, and perceived changes due to the pandemic were associated with a higher FAS score. This study provides valuable information for policymakers and mental health professionals worldwide on pandemic fatigue and its associated factors, including mental health status in Malaysia.

Introduction. Type 2 diabetes mellitus (T2DM) is a major global health issue projected to exceed 700 million cases by 2045. In Malaysia, T2DM prevalence has risen, with notable ethnic disparities. Gap statement. The gut microbiota’s role in T2DM pathogenesis is well recognized, yet its composition in Malaysia’s ethnically diverse population remains underexplored. Aim. This study aimed to characterize gut microbiota composition among T2DM and ethnicity-matched adults without diabetes (nonDM) in Malaysia. Methodology. A case–control study was conducted with 45 T2DM and 45 nonDM participants matched by ethnicity from a primary care clinic in Klang Valley, Malaysia. Faecal DNA was subjected to 16S rRNA sequencing to identify microbiota diversity and composition differences and compare predicted functional capabilities. Correlations between bacterial taxa, clinical characteristics and dietary intake were analysed. Results. T2DM participants showed decreased alpha diversity (observed, P-value=0.002, r=0.69; Shannon, P-value<0.001, r=0.73) and significant differences in beta diversity (permutational multivariate ANOVA, R²=0.036, P-value=0.001). Linear discriminant analysis effect size and multiple regression analysis, adjusted for covariates age, gender, BMI and intakes of protein, fat, carbohydrate and fibre, identified the phylum Proteobacteria and genera Escherichia–Shigella to be increased, while the genera Anaerostipes and Romboutsia decreased in T2DM. These bacteria were associated with various clinical characteristics and dietary intake. However, these ‘potential biomarkers’ were not uniformly present across all participants, suggesting that individual bacterial taxa may not serve as universal biomarkers. Conclusion. Significant gut microbiota differences exist between T2DM and nonDM individuals in Malaysia, indicating a dysbiosis characterized by increased pro-inflammatory bacteria and reduced short-chain fatty acid-producing bacteria in T2DM. While these findings highlight the potential functional relevance of gut microbiota in T2DM pathogenesis, addressing limitations such as participant matching for confounding factors in future studies could uncover additional significant differences in microbiota composition. Furthermore, the variability in taxa prevalence across individuals suggests that targeting microbial metabolic products may offer more promising strategies to inform microbiota-targeted interventions than relying solely on specific bacterial taxa as biomarkers.

The prevalence of mental health problems among antenatal women has escalated during the COVID-19 pandemic compared to the pre-pandemic period. Physical activity palys role to reduce depression and anxiety, which required to be studied further. This study aimed to assess the association between physical activity with depression and anxiety among antenatal women during the COVID-19 pandemic. This cross-sectional study applied convenience sampling to recruit 544 antenatal women from March to June 2021. Questionnaires including the Edinburgh postnatal depression scale (EPDS), state-trait anxiety inventory (STAI), and pregnancy physical activity questionnaire (PPAQ) were distributed via social media to determine the prevalence of depression, anxiety, and physical activity level. Data were analysed using descriptive statistics, chi-square, mann-whitney, and kruskal wallis tests. Out of 544 antenatal women, 24.1% of them had depressive symptoms and 82.4% had anxiety. Only 12.1% of the women were sufficiently active during the pandemic. There was no association between physical activity, depression, and anxiety. The high prevalence of depression and anxiety during the COVID-19 pandemic among Malaysian antenatal women underscores the urgent need for addressing this public health burden. Interventions to alleviate the symptoms should include strategies beyond physical activity, for example, a mobile application or telephone-delivered social support that is made easily accessible throughout the pandemic.

The emergence of COVID-19 has affected people worldwide from all angles, from the aspects of health, wealth, emotional and also human interactions. This study aimed to look at the attributes such as positive behaviour, awareness, preparedness and relationships among Malaysians during the implementation of movement control order (MCO), and the predictors of preparedness in facing the COVID-19 pandemic. A cross-sectional study was conducted online involving 317 respondents above the age of 18 years old. A self-administered questionnaire was developed in both Malay and English languages to assess the level of positive behaviour, awareness, preparedness and relationships, as well as their main source of information retrieval regarding COVID-19. Overall, the measured attributes in this study showed the highest level in behaviour (84.2%), followed by awareness (73.5%), preparedness (62.5%) and relationships (60.6%). Multiple regression on preparedness revealed that all variables (behaviour, awareness, and relationships) are significant (p<0.05), while gender is not. The top two sources of information the respondents refer to during the MCO are social and broadcast media. This marks the influence of social and broadcast media in an Industrial Revolution 4.0 era. Despite having good awareness and positive behaviour, the MCO may also have caused relationship issues as well as lower preparation levels in facing a deadly pandemic. It is suggested that future research to look into whether this would have any association with the mental health of Malaysians facing the pandemic. By understanding the attributes related to the MCO during the COVID-19 pandemic, it would help the government in the implementation of policies and procedures in any future pandemic.