Disease In Malaysia Research Articles

Delayed diagnosis of Kawasaki disease in Malaysia: Who is at risk and what is the outcome.

Data on the delayed diagnosis of (KD) is limited. This study aimed to determine the prevalence and trend of delayed diagnosis over time and identify the associated risk factors in Malaysia. This retrospective, observational, population-based study involved all children with KD registered in Johor Kawasaki Clinical Registry over 10 years (January 2010 and December 2019). The prevalence of delayed diagnosis and its trend over time was calculated. Multivariable binary logistic regression was used to identify the independent risk factors for delayed diagnosis. There were 556 cases of KD, with 28% having incomplete criteria, 11% atypical presentation, while 10% developed a coronary aneurysm. The overall prevalence of delayed diagnosis was 9.9% (95% confidence interval (CI): 7.6-12.7%). There was a statistically significant decrease in delayed diagnosis over time (P = 0.008), with the latest rate of 4.6%. The majority of delayed diagnoses were due to failure to diagnose the disease during the initial consultation. Independent risk factors for delayed diagnosis were children older than 1 year, diagnosis before 2015, atypical presentation, and incomplete KD, with adjusted odds ratios (ORs) of 2.7, 2.3, 4.3, and 3.6, respectively. Compared to early diagnosis of KD, delayed diagnosis was significantly associated with coronary aneurysms (27.3% vs. 8.2%, P < 0.001, OR 4.2, [95% CI: 2.1-8.3]). One-tenth of cases of KD were diagnosed late, but it has improved over time. Children > 1 year, presenting with atypical presentation, and incomplete criteria are associated with late diagnosis.

Prediction of Intensive Care Cases for COVID-19 Pandemic in Malaysia: An Artificial Neural Networks Approach

Coronavirus 2019 (COVID-19) pandemic in Malaysia is a part of the ongoing worldwide pandemic. The emergence of COVID-19 has led to high demand for intensive care services worldwide. However, the severity of COVID-19 patients that need intensive care unit (ICU) treatments requires details investigation. This study aims to predict the number of ICU cases due to COVID-19 disease in Malaysia. The prediction was done based on the data related to new, recovered, and treated cases which were collected from the website of the Ministry of Health Malaysia started from April until August 2020. Artificial Neural Networks Multilayers Perceptron Backpropagation (ANN-MLP-BPP) model was developed for predicting ICU cases based on the usage of the real set of data. The ANN-MLP-BPP model was validated by splitting the data into 80% for training and 20% for testing. The results show that with the increase in the number of undertreated cases, the number of predicted ICU will also be increased. The predicted ICU admission is almost equivalent to a 1 percent increment of the number of cases undertreated. These findings may help the frontline physicians in planning and handling the facilities management during the COVID-19 pandemic situation in the future.

Diagnostics at admission across EF subgroup – data from the Malaysian Heart Failure (MYHF) Registry

The MYHF Registry is a prospective, observational study of patients admitted with de-novo or decompensated heart failure (HF) to one of 18 participating Malaysian hospitals. It aims to elucidate the epidemiology, management and outcome of the disease in Malaysia.

The first reported cases of elephant endotheliotropic herpesvirus infectious haemorrhagic disease in Malaysia: case report

BackgroundElephant endotheliotropic herpesvirus haemorrhagic disease (EEHV HD) is the leading cause of death in captive Asian elephant calves in Asia, North America, and Europe with a mortality rate of ~ 65% in calves that are under human care. Although EEHV HD was first found in elephant camps, more recently it was identified in wild populations which poses a greater threat to the elephant population. Deaths due to EEHV HD have been seen in wild elephants, but the in-situ prevalence and mortality rate is unknown. We report the first EEHV HD cases in Malaysia from 3 wild born endangered Bornean elephant calves from Sabah with known typical clinical signs.Case presentationThe first calf died within 24 h of the onset of clinical signs; the second calf died within 12 h of the onset of clinical signs. The third calf succumbed within 72 h. Necropsies revealed that all 3 calves had similar presentations of EEHV HD but in the third calf with less severity. We conducted conventional polymerase chain reaction (cPCR) assays and found EEHV DNA at all 7 loci in the 3 calves; it was identified as EEHV1A, the virus type that has been found in most other reported cases.ConclusionTypical EEHV HD clinical signs and the molecular confirmation of EEHV by cPCR and sequencing point to EEHV as the cause of death. Further genetic investigation of the strain is in progress.

Liver Transplantation in Malaysia: Needs, Obstacles, and Opportunities.

Liver Transplantation in Malaysia: Needs, Obstacles, and Opportunities.

Genetic Diversity, Pathogenicity and Pseudorecombination of Cucurbit-Infecting Begomoviruses in Malaysia.

Cucurbits are important crops in the world. However, leaf curl disease constrains their production. Here, begomovirus diversity and pathogenicity associated with the disease in Malaysia were studied based on 49 begomovirus-detected out of 69 symptomatic plants from seven cucurbit crops in 15 locations during 2016 and 2017. The presence of Squash leaf curl China virus (SLCCNV) and Tomato leaf curl New Delhi virus (ToLCNDV) were confirmed by virus detection by polymerase chain reaction, viral DNA sequence analysis and specific detection of the viral components. ToLCNDV Malaysian isolates were further distinguished into strains A, B, C and D. Virus co-infection was detected in bitter gourd, bottle gourd and squash. Among them, eight bitter gourd samples were detected without SLCCNV DNA-A. However, one bottle gourd and five squash samples were without ToLCNDV DNA-B. Pseudorecombination of ToLCNDV DNA-A and SLCCNV DNA-B was detected in two bitter gourd samples. The pathogenic viruses and pseudorecombinants were confirmed by agroinoculation. The viral DNA-B influencing on symptomology and host range was also confirmed. The results strengthen the epidemic of cucurbit-infecting begomovirus in Malaysia as well as Southeast Asia. Especially, the natural pseudorecombinant of begomovirus that extends host range and causes severe symptom implies a threat to crops.

Knowledge, attitude, and barriers toward polio immunization among pre-clinical students in Malaysia

Background: Polio is reported as reemerging disease in Malaysia after 27 years of being free from it. It is important to identify the awareness towards polio vaccine among the medical students who are the future and the pillars of the nation, to develop a country. Aims and Objectives: This study aims to assess the knowledge, attitude, and barriers toward polio immunization among pre-clinical medical students. Materials and Methods: A cross-sectional study was conducted among 190 pre-clinical students from a private university after obtaining informed consent and institutional ethical clearance. Data collected from Google Forms questionnaire were analyzed using SPSS version 20. Results: Insufficient knowledge, especially on disease nature, transmission, and correct dosage of vaccine, was noticed. Findings revealed that 79.5% of the students showed unfavorable attitude toward polio immunization. Year 2 students are more positive toward the vaccination compared to year 1. Main barriers toward polio immunization selected by the respondents are disagreement from the spouse, insecure about vaccine safety, and distance of the health center. Conclusion: Pre-clinical students should enhance their knowledge to be able to recognize the various barriers of polio immunization in our country and be part of the effort in solving these barriers as polio eradication is critical to ensuring a healthier future for children.

Mathematical epidemiologic and simulation modelling of first wave COVID-19 in Malaysia

Since the first coronavirus disease 2019 (COVID-19) outbreak appeared in Wuhan, mainland China on December 31, 2019, the geographical spread of the epidemic was swift. Malaysia is one of the countries that were hit substantially by the outbreak, particularly in the second wave. This study aims to simulate the infectious trend and trajectory of COVID-19 to understand the severity of the disease and determine the approximate number of days required for the trend to decline. The number of confirmed positive infectious cases [as reported by Ministry of Health, Malaysia (MOH)] were used from January 25, 2020 to March 31, 2020. This study simulated the infectious count for the same duration to assess the predictive capability of the Susceptible-Infectious-Recovered (SIR) model. The same model was used to project the simulation trajectory of confirmed positive infectious cases for 80 days from the beginning of the outbreak and extended the trajectory for another 30 days to obtain an overall picture of the severity of the disease in Malaysia. The transmission rate, β also been utilized to predict the cumulative number of infectious individuals. Using the SIR model, the simulated infectious cases count obtained was not far from the actual count. The simulated trend was able to mimic the actual count and capture the actual spikes approximately. The infectious trajectory simulation for 80 days and the extended trajectory for 110 days depicts that the inclining trend has peaked and ended and will decline towards late April 2020. Furthermore, the predicted cumulative number of infectious individuals tallies with the preparations undertaken by the MOH. The simulation indicates the severity of COVID-19 disease in Malaysia, suggesting a peak of infectiousness in mid-March 2020 and a probable decline in late April 2020. Overall, the study findings indicate that outbreak control measures such as the Movement Control Order (MCO), social distancing and increased hygienic awareness is needed to control the transmission of the outbreak in Malaysia.

Silent Scream of Malaysian Elderly: A Case Study in Noble Care Ageing Centres

Ageing is a normal biotic process, which ultimately reaches to every human being. The transitioning of young adult to older people may result as reduction of social, physiological and psychological capacities that bring social and health threats for the older population. The rich tradition of dignified ageing is exceedingly wearied away in developing countries, including Malaysia. The primary purpose of this research is to provide a snapshot of what it means to be living with chronic disease in Malaysia. This study was conducted in Klang Valley, Malaysia, due to the paucity of research in this area. The present study demonstrates the true stories of elderly associated with their physical, psychological and social experiences regarding immediate surroundings, friends, family and the society residing in Noble Care Malaysia, which is an established welfare and human services organisation, helping the deserving members of society. The qualitative research methodology is adopted, and an in-depth life history technique has been used for a deeper picture of the elderly’s memories and experience. The data is collected through five in-depth life history’s narrative of the elderly with chronic diseases. The study explains the true stories of the elderly in connection to familial neglection and abandonment for social awareness about ageing and older citizen feelings. Thus, it is imperative to keep the senior citizen self-esteem positive, along with the mental and physical activity. However, most importantly, the respect and mutual understanding between older citizen and the younger generation are getting worsen which need to be sustained harmoniously. This paper proposes some necessary measures to be addressed for graceful, proactive and gracious ageing.

Hypertension control: lessons from Malaysia, a upper-middle-income country

Hypertension is a major modifiable determinant of the increasing burden of cardiovascular diseases in Malaysia. When not controlled it increases the risk of heart disease, stroke, and renal disease. This paper, a contribution to development of an effective response to this challenge, reviews what is known about the prevalence, awareness, treatment and control of hypertension in Malaysia, identifying the factors contributing to inadequate levels of control and feasible measures to improve it. It reviews published data from Malaysia - with reference to other countries where relevant – to offer a comprehensive understanding of the problem. It is apparent that managing hypertension goes beyond the mere prescription of blood pressure (BP) lowering drugs. It involves a complex interplay of the healthcare delivery system, healthcare providers, and patients, recognising their differing educational, psychosocial, economic and residential status. Thus a one-size-fits-all approach will be patently inadequate to achieve good hypertension control. A paradigm shift towards a precision care for hypertension in Malaysia is needed.

A Survey Of Perceived Barriers And Motivators Towards Exercise Among People With Parkinson’s Disease In Malaysia

INTRODUCTION: Considerable amount of evidence supports that exercise plays a vital role in maintaining and slowing Parkinson's disease (PD) progression. However, some people with PD have remained sedentary for undefined reasons. Therefore, the perceived barriers and motivators towards exercise among people with PD among Malaysian were investigated. METHODS: A cross-sectional survey was conducted using a self-developed and validated questionnaire distributed to forty-seven people with PD in a non[1]governmental organisation to determine exercise barriers and motivators. RESULTS: The exercise motivators in the study were having an exercise instructor (83.0%), exercise makes them feel healthier and more energetic (83.0%), and constant encouragement from family and friends (80.9%). The exercise barriers reported in this study were fatigue (40.4%) fear of falling (34%), bad weather (38.2%), and lack of transportation (31.9%). CONCLUSION: The study concluded that people with PD exercised because it makes them feel healthier and more energetic. Besides that, having an exercise instructor and being encouraged by family and friends reported being exercise motivators among the people in this study. The exercise barriers reported in this study were fatigue, bad weather, fear of falling, and lack of transportation. These findings should be taken into consideration when developing strategies and health interventions to improve exercise participation for people with PD.

Association of sociodemographic and environmental factors with spatial distribution of tuberculosis cases in Gombak, Selangor, Malaysia.

Tuberculosis (TB) cases have increased drastically over the last two decades and it remains as one of the deadliest infectious diseases in Malaysia. This cross-sectional study aimed to establish the spatial distribution of TB cases and its association with the sociodemographic and environmental factors in the Gombak district. The sociodemographic data of 3325 TB cases such as age, gender, race, nationality, country of origin, educational level, employment status, health care worker status, income status, residency, and smoking status from 1st January 2013 to 31st December 2017 in Gombak district were collected from the MyTB web and Tuberculosis Information System (TBIS) database at the Gombak District Health Office and Rawang Health Clinic. Environmental data consisting of air pollution such as air quality index (AQI), carbon monoxide (CO), nitrogen dioxide (NO2), sulphur dioxide (SO2), and particulate matter 10 (PM10,) were obtained from the Department of Environment Malaysia from 1st July 2012 to 31st December 2017; whereas weather data such as rainfall were obtained from the Department of Irrigation and Drainage Malaysia and relative humidity, temperature, wind speed, and atmospheric pressure were obtained from the Malaysia Meteorological Department in the same period. Global Moran’s I, kernel density estimation, Getis-Ord Gi* statistics, and heat maps were applied to identify the spatial pattern of TB cases. Ordinary least squares (OLS) and geographically weighted regression (GWR) models were used to determine the spatial association of sociodemographic and environmental factors with the TB cases. Spatial autocorrelation analysis indicated that the cases was clustered (p<0.05) over the five-year period and year 2016 and 2017 while random pattern (p>0.05) was observed from year 2013 to 2015. Kernel density estimation identified the high-density regions while Getis-Ord Gi* statistics observed hotspot locations, whereby consistently located in the southwestern part of the study area. This could be attributed to the overcrowding of inmates in the Sungai Buloh prison located there. Sociodemographic factors such as gender, nationality, employment status, health care worker status, income status, residency, and smoking status as well as; environmental factors such as AQI (lag 1), CO (lag 2), NO2 (lag 2), SO2 (lag 1), PM10 (lag 5), rainfall (lag 2), relative humidity (lag 4), temperature (lag 2), wind speed (lag 4), and atmospheric pressure (lag 6) were associated with TB cases (p<0.05). The GWR model based on the environmental factors i.e. GWR2 was the best model to determine the spatial distribution of TB cases based on the highest R2 value i.e. 0.98. The maps of estimated local coefficients in GWR models confirmed that the effects of sociodemographic and environmental factors on TB cases spatially varied. This study highlighted the importance of spatial analysis to identify areas with a high TB burden based on its associated factors, which further helps in improving targeted surveillance.

Ficus deltoidea: Potential inhibitor of pro-inflammatory mediators in lipopolysaccharide-induced activation of microglial cells

Ethnopharmacological relevanceFicus deltoidea Jack (FD) is widely consumed in traditional medicine as a treatment for various diseases in Malaysia. Each part of the plant such as its leave, stem, fruit and root are used traditionally to treat different types of diseases. Vitexin and isovitexin are bioactive compounds abundantly found in the leaves of FD that possessed many pharmacological properties including neuroprotection. Nonetheless, its effects on key events in neuroinflammation are unknown.Aim of the study: To determine the inhibitory properties of FD aqueous extract on pro-inflammatory mediators involved in lipopolysaccharide (LPS)-induced microglial cells. MethodsVitexin and isovitexin in the extract were quantified via high performance liquid chromatography (HPLC). The extract was evaluated for its cytotoxicity activity via 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Pre-treatment with the extract on LPS-induced microglial cells was done to determine its antioxidant and anti-neuroinflammatory properties by measuring the level of reactive oxygen species (ROS), nitric oxide (NO), tumour necrosis factor alpha (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) via 2′-7′-dichlorofluorescin diacetate (DCFDA) assay, Griess assay and Western blot respectively. ResultsThe extract at all tested concentrations (0.1 μg/mL, 1 μg/mL, 10 μg/mL, 100 μg/mL) were not cytotoxic as the percentage viability of microglial cells were all above ~80%. At the highest concentration (100 μg/mL), the extract significantly reduced the formation of ROS, NO, TNF-α, IL-1β and IL-6 in microglial cells induced by LPS. ConclusionThe extract showed neuroprotective effects by attenuating the levels of pro-inflammatory and cytotoxic factors in LPS-induced microglial cells, possibly by mediating the nuclear factor-kappa B (NF-κB) signalling pathway.

Current Classification of the Bacillus pumilus Group Species, the Rubber-Pathogenic Bacteria Causing Trunk Bulges Disease in Malaysia as Assessed by MLSA and Multi rep-PCR Approaches.

Bacillus pumilus is the causal agent of trunk bulges disease affecting rubber and rubberwood quality and yield production. In this study, B. pumilus and other closely related species were included in B. pumilus group, as they shared over 99.5% similarity from 16S rRNA analysis. Multilocus sequence analysis (MLSA) of five housekeeping genes and repetitive elements-based polymerase chain reaction (rep-PCR) using REP, ERIC, and BOX primers conducted to analyze the diversity and systematic relationships of 20 isolates of B. pumilus group from four rubber tree plantations in Peninsular Malaysia (Serdang, Tanah Merah, Baling, and Rawang). Multi rep-PCR results revealed the genetic profiling among the B. pumilus group isolates, while MLSA results showed 98-100% similarity across the 20 isolates of B. pumilus group species. These 20 isolates, formerly established as B. pumilus, were found not to be grouped with B. pumilus. However, being distributed within distinctive groups of the B. pumilus group comprising of two clusters, A and B. Cluster A contained of 17 isolates close to B. altitudinis, whereas Cluster B consisted of three isolates attributed to B. safensis. This is the first MLSA and rep-PCR study on B. pumilus group, which provides an in-depth understanding of the diversity of these rubber-pathogenic isolates in Malaysia.

A fuzzy graph approach analysis for COVID-19 outbreak

Complex systems require rigorous analysis using effective method, in order to handle and interpret their information. Spectrum produced from Fourier transform infrared (FTIR) instrument is an example of a complex system, due to their overlapped bands and interactions within the spectrum. Thus, chemometrics techniques are required to further analyze the data, in particular, chemometrics fuzzy autocatalytic set (c-FACS). The c-FACS is initially used to analyze the FTIR spectra of gelatins. However, in this study, the c-FACS is generalized and implemented for analysis of Coronavirus disease 2019 (Covid-19), particularly, the pandemic outbreak in Malaysia. The daily Covid-19 cases in states in Malaysia are modeled and analyzed using c-FACS, to observe the trend and severity of the disease in Malaysia. As a result, the classification of severity of zones in Malaysia are identified. The obtained results offer descriptive insight for strategizing purposes in combating the Covid-19 outbreak in Malaysia.

High sodium food consumption pattern among Malaysian population

BackgroundSodium is an essential mineral needed by the human body that must be obtained from food. An excess intake, however, can lead to many diseases. As food is the main source of sodium, this study aims to provide information on high sodium food consumption patterns in the Malaysian adult population.MethodsThe Malaysian Community Salt Study (MyCoSS) was a nationwide cross-sectional study, conducted between October 2017 and March 2018. A multistage complex sample was applied to select a nationally representative sample of respondents aged 18 years and above. Face to face interview by a validated Food Frequency Questionnaire (FFQ) comprising 104 food items was used to gain information on high sodium food consumption patterns.ResultsA total of 1047 respondents were involved in this study, with 1032 (98.6%) answering the FFQ. From the number, 54.1% exceed the recommendation of sodium intake <2000mg/day by FFQ assessment. The results also demonstrated that fried vegetables (86.4%) were the most common high sodium food consumed, followed by bread (85.9%) and omelet (80.3%). In urban areas, bread was the most common while fried vegetables took the lead in rural areas. By sex, bread was most commonly eaten by males and fried vegetables by females. The results also found that kolok mee/kampua mee contributed the highest sodium, 256.5mg/day in 9.0% adult population, followed by soy sauce 248.1mg/day in 33.2% adult population, and curry noodles 164.2mg/day in 18.5% adult population.ConclusionFried vegetables, bread, and soy sauce were the main source of sodium consumption among adult. Reducing the amount of sodium added to these foods should be the top priority to reduce population sodium intake and thereby prevent sodium-related diseases in Malaysia.

Food Poisoning Outbreaks among School Children in Terengganu and their Associated Factors

Food poisoning is a public health problem in Malaysia and among the top five communicable diseases in Malaysia. This study aimed to determine the proportion of food poisoning cases involving schoolchildren in Terengganu in 2016 and their associated factors. This was a cross-sectional study using secondary data collected from 21 food poisoning outbreaks among schoolchildren in Terengganu in 2016. The proportion of food poisoning outbreaks involving schoolchildren in Terengganu in 2016 was 63.6%. Ministry of Education (MOE) school had contributed to 95.3% of outbreak cases, 81% occurred at secondary school and 57.1% involved school located in urban district. Poultry (61.9%) was the most common food vehicle, and Salmonella spp. (52.4%) was the most common microbial etiological agent. Urban district schools had the adjusted odds (aOR=1.803; 95% CI: 1.435,2.267; p &lt; 0.001) compared with rural district schools. Non-MOEschoolchildren were more likely to be involved in school food poisoning (aOR= 4.439; 95% CI: 2.690,7.177; p &lt;0.001) compared with MOE schoolchildren. Moreover, egg consumption was 4.6 times (aOR=4.627; 95% CI: 1.779,12.035; p=0.002) more likely to be associated with school food poisoning outbreaks in Terengganu in 2016 compared with rice consumption. Cross-contamination (aOR=0.445; 95% CI: 0.445,0.231; p=0.015) was less likely to be linked to school food poisoning compared with inadequate cooking and reheating. Food poisoning among schoolchildren in Terengganu has been associated with non-modifiable factors, such as school district location, and modifiable factors, such as food vehicles and critical control points. Health education on food safety, food handling, strict hygiene practice and clean canteen environment need to be strengthened.

Fungi associated with the blighted leaf symptoms of Hevea brasiliensis in Malaysia

AbstractThis article describes the fungi isolated from the blighted leaf of rubber (Hevea brasiliensis) tree in Malaysia. Previously, Neofusicoccum ribis (Family Botryosphaeriaceae) was reported as the causal agent of rubber leaf blight in Malaysia. To date, there are limited studies on this particular disease in Malaysia and worldwide. The current study was carried out on rubber leaves displaying leaf blight symptoms caused by N. ribis from different locations to discover the fungi that reside in the blighted leaves. Rubber leaf samples with blight symptoms were collected from two different locations in Malaysia. The fungal isolates were isolated following the agar plate method and subjected to cultural and morphological characterization. Based on the cultural and morphological characterization, eight fungal isolates were further subjected to molecular identification. Five fungal isolates namely SBI, SB2, SB3, SB6 and SPKT1 were identified as N. ribis, one fungus (SB4) as Diaporthe drenthii, and another two fungi namely SB5 and SPKT2 were identified as Lasiodiplodia pseudotheobromae. Based on the morphological and molecular identification, all the N. ribis isolates demonstrated similar characteristics of the rubber leaf blight pathogen as documented in a previous study.

Spatial and Temporal Patterns of Plasmodium knowlesi Malaria in Sarawak from 2008 to 2017.

Zoonotic knowlesi malaria has replaced human malaria as the most prevalent malaria disease in Malaysia. The persistence of knowlesi malaria in high-risk transmission areas or hotspots can be discouraging to existing malaria elimination efforts. In this study, retrospective data of laboratory-confirmed knowlesi malaria cases were obtained from the Sarawak Health Department to investigate the spatiotemporal patterns and clustering of knowlesi malaria in the state of Sarawak from 2008 to 2017. Purely spatial, purely temporal, and spatiotemporal analyses were performed using SaTScan software to define clustering of knowlesi malaria incidence. Purely spatial and spatiotemporal analyses indicated most likely clusters of knowlesi malaria in the northern region of Sarawak, along the Sarawak-Kalimantan border, and the inner central region of Sarawak between 2008 and 2017. Temporal cluster was detected between September 2016 and December 2017. This study provides evidence of the existence of statistically significant Plasmodium knowlesi malaria clusters in Sarawak, Malaysia. The analysis approach applied in this study showed potential in establishing surveillance and risk management system for knowlesi malaria control as Malaysia approaches human malaria elimination.

Patient pathways for cardiovascular diseases in Malaysia and the Philippines: a systematic review

Background: Cardiovascular diseases (CVDs) are the leading cause of premature mortality in the world and are a growing public health concern in low- and middle-income countries (LMICs), including those in South East Asia. Their management requires coordinated responses by a range of healthcare providers, which should preferably be based on knowledge of the national context. We systematically review evidence on the pathways followed by patients with CVD in Malaysia and the Philippines to understand patient journeys, along with the barriers at each stage. Methods: We searched seven bibliographic databases and grey literature sources to identify material focused on the pathways followed by patients with CVD in Malaysia and the Philippines, and performed a narrative synthesis. Results: The search yielded 25 articles, 3 focused on the Philippines and 22 on Malaysia. Most articles were quantitative analyses that focused on hypertensive patients. Three examined secondary prevention post myocardial infarction, and one each examined acute myocardial infarction, heart failure, and atrial fibrillation. Reported barriers reflected capability (knowledge of behaviours to achieve control or the capacity to conduct these behaviours), intention (attitudes or motivations toward the behaviours to achieve control), and aspects of the health care system (availability, accessibility, affordability and acceptability of services). Conclusions: There are large gaps in our understanding of patient pathways in Malaysia and the Philippines that limit the development of evidence-based strategies to effectively address the CVD burden in South East Asian countries and in LMICs more broadly. Addressing these evidence gaps will require longitudinal mixed-methods studies following patients from initial diagnosis to long-term management.