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Effectiveness of the Viet Nam Produced, Mouse Brain-Derived, Inactivated Japanese Encephalitis Vaccine in Northern Viet Nam  [PDF]
Florian Marks ,Thi Thu Yen Nguyen,Nhu Duong Tran,Minh Hong Nguyen,Hai Ha Vu,Christian G. Meyer,Young Ae You,Frank Konings,Wei Liu,Thomas F. Wierzba,Zhi-Yi Xu
PLOS Neglected Tropical Diseases , 2012, DOI: 10.1371/journal.pntd.0001952
Abstract: Background Japanese encephalitis (JE) is a flaviviral disease of public health concern in many parts of Asia. JE often occurs in large epidemics, has a high case-fatality ratio and, among survivors, frequently causes persistent neurological sequelae and mental disabilities. In 1997, the Vietnamese government initiated immunization campaigns targeting all children aged 1–5 years. Three doses of a locally-produced, mouse brain-derived, inactivated JE vaccine (MBV) were given. This study aims at evaluating the effectiveness of Viet Nam's MBV. Methodology A matched case-control study was conducted in Northern Viet Nam. Cases were identified through an ongoing hospital-based surveillance. Each case was matched to four healthy controls for age, gender, and neighborhood. The vaccination history was ascertained through JE immunization logbooks maintained at local health centers. Principal Findings Thirty cases and 120 controls were enrolled. The effectiveness of the JE vaccine was 92.9% [95% CI: 66.6–98.5]. Confounding effects of other risk variables were not observed. Conclusions Our results strongly suggest that the locally-produced JE-MBV given to 1–5 years old Vietnamese children was efficacious.
Iodine status in late pregnancy and psychosocial determinants of iodized salt use in rural northern Viet Nam
Fisher,Jane; Tran,Thach; Biggs,Beverley; Tran,Tuan; Dwyer,Terry; Casey,Gerard; Tho,Dang Hai; Hetze,Basil;
Bulletin of the World Health Organization , 2011, DOI: 10.1590/S0042-96862011001100011
Abstract: objective: to establish iodine status among pregnant women in rural northern viet nam and explore psychosocial predictors of the use of iodized salt in their households. methods: this prospective study included pregnant women registered in health stations in randomly-selected communes in ha nam province. at recruitment (< 20 weeks of gestation), sociodemographic factors, reproductive health, intimate partner relationship, family violence, symptoms of common mental disorders and use of micronutrient supplements were assessed. during a second assessment (> 28 weeks of gestation) a urine specimen was collected to measure urinary iodine concentration (uic) and iodized salt use was assessed. predictors were explored through univariable analyses and multivariable linear and logistic regression. findings: the 413 pregnant women who provided data for this study had a median uic of 70 μg/l; nearly 83% had a uic lower than the 150 μg/l recommended by the world health organization; only 73.6% reported using iodized salt in any form in their households. iodized salt use was lower among nulliparous women (odds ratio, or: 0.56; 95% confidence interval, ci: 0.32-0.96); less educated women (or: 0.34; 95% ci: 0.16-0.71); factory workers or small-scale traders (or: 0.52; 95% ci: 0.31-0.86), government workers (or: 0.35; 95% ci: 0.13-0.89) and women with common mental disorders at recruitment (or: 0.61; 95% ci: 0.38-0.98). conclusion: the decline in the use of iodized salt in viet nam since the national iodine deficiency disorders control programme was suspended in 2005 has placed pregnant women and their infants in rural areas at risk of iodine deficiency disorders.
Evidence-based practice in neonatal health: knowledge among primary health care staff in northern Viet Nam
Leif Eriksson, Nguyen Nga, Mats M?lqvist, Lars-?ke Persson, Uwe Ewald, Lars Wallin
Human Resources for Health , 2009, DOI: 10.1186/1478-4491-7-36
Abstract: The aim of this survey was to assess the knowledge of primary health care practitioners regarding basic, evidence-based procedures in neonatal care in a Vietnamese province. A further aim was to investigate whether differences in level of knowledge were linked to certain characteristics of community health centres, such as access to national guidelines in reproductive health care, number of assisted deliveries and geographical location.This cross-sectional survey was completed within a baseline study preparing for an intervention study on knowledge translation (Implementing knowledge into practice for improved neonatal survival: a community-based trial in Quang Ninh province, Viet Nam, the NeoKIP project, ISRCTN44599712). Sixteen multiple-choice questions from five basic areas of evidence-based practice in neonatal care were distributed to 155 community health centres in 12 districts in a Vietnamese province, reaching 412 primary health care workers.All health care workers approached for the survey responded. Overall, they achieved 60% of the maximum score of the questionnaire. Staff level of knowledge on evidence-based practice was linked to the geographical location of the CHC, but not to access to the national guidelines or the number of deliveries at the community level. Two separated geographical areas were identified with differences in staff level of knowledge and concurrent differences in neonatal survival, antenatal care and postnatal home visits.We have identified a complex pattern of associations between knowledge, geography, demographic factors and neonatal outcomes. Primary health care staff knowledge regarding neonatal health is scarce. This is a factor that is possible to influence and should be considered in future efforts for improving the neonatal health situation in Viet Nam.The former executive director of UNICEF, James Grant, said: "The most urgent task before us is to get medical and health knowledge to those most in need of that knowledge. Of
Common perinatal mental disorders in northern Viet Nam: community prevalence and health care use
Fisher,Jane; Tran,Thach; thi La,Buoi; Kriitmaa,Kelsi; Rosenthal,Doreen; Tran,Tuan;
Bulletin of the World Health Organization , 2010, DOI: 10.1590/S0042-96862010001000010
Abstract: objective: to establish the prevalence of common perinatal mental disorders their determinants, and their association with preventive health care use among women in one rural and one urban province in northern viet nam. methods: we conducted a cross-sectional survey of cohorts of pregnant women and mothers of infants recruited systematically in 10 randomly-selected communes. the women participated in psychiatrist-administered structured clinical interviews and separate structured interviews to assess sociodemographic factors, reproductive health, the intimate partner relationship, family violence and the use of preventive and psychiatric health care. associations between these variables and perinatal mental disorders were explored through univariate analyses and multivariable logistic regression. findings: among women eligible for the study (392), 364 (93%) were recruited. of these, 29.9% (95% confidence interval, ci: 25.20-34.70) were diagnosed with a common perinatal mental disorder (cpmd). the frequency of such disorders during pregnancy and in the postpartum period was the same. their prevalence was higher among women in rural provinces (odds ratio, or: 2.17; 95% ci: 1.19-3.93); exposed to intimate partner violence (or: 2.11; 95% ci: 1.12-3.96); fearful of other family members (or: 3.36; 95% ci: 1.05-10.71) or exposed to coincidental life adversity (or: 4.40; 95% ci: 2.44-7.93). fewer women with a cpmd used iron supplements than women without a cpmd, but the results were not statistically significant (p = 0.05). none of the women studied had ever received mental health care. conclusion: perinatal depression and anxiety are prevalent in women in northern viet nam. these conditions are predominantly determined by social factors, including rural residence, poverty and exposure to family violence. at present the needs of women with common perinatal mental disorders are unrecognized and not attended to and their participation in essential antenatal preventive care ap
Characteristics of tuberculosis patients at intake in Cambodia, two provinces in China, and Viet Nam
Nguyen B Hoa, Chen Wei, Chay Sokun, Jens M Lauritsen, Hans L Rieder
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-367
Abstract: Based on the electronic database we created, our objectives were to provide a detailed description of age and sex characteristics of tuberculosis patients at registration and to provide a comparison of age-specific sex characteristics among incident and prevalent sputum smear-positive cases.A representative sample of tuberculosis case registers from 1 January 2003 to 31 December 2005 was selected in Cambodia, two provinces in China and Viet Nam. Age and sex characteristics of cases in the three separate prevalence surveys in the three jurisdictions (Cambodia: year 2002; China: year 2000; and Viet Nam: year 2006-2007) were obtained for comparison.A total 37,635 patients had been registered during the period in the selected units in the three countries. Cases were more frequently male in all three countries with 53%, 71%, and 69% in Cambodia, China, and Viet Nam, respectively.The ratios of the female-to-male odds in the notification system to that in the prevalence survey in smear-positive cases in Cambodia, China and Viet Nam were 2.1, 0.9, and 1.8, respectively. Because of the small proportion of extrapulmonary tuberculosis registered in China, we limited the analysis on age and sex distribution for extrapulmonary cases to Cambodia and Viet Nam. The proportion with extrapulmonary tuberculosis among all cases was 18.5% in Cambodia and 15.7% in Viet Nam, decreasing in frequency with increasing age.Characteristics of patients greatly differed between countries and between patient categories. In Cambodia and Viet Nam, efforts should be made for improved case-finding of sputum smear-positive tuberculosis among males.The tuberculosis register is a critical data source for the information system of national tuberculosis control programs. This tool is used for routine quarterly reporting on case finding and treatment outcome.It is of epidemiologic interest to national programs to know the characteristics of patients who are diagnosed, registered, and treated. As a routine,
National survey of tuberculosis prevalence in Viet Nam
Hoa,Nguyen Binh; Sy,Dinh Ngoc; Nhung,Nguyen Viet; Tiemersma,Edine W; Borgdorff,Martien W; Cobelens,Frank GJ;
Bulletin of the World Health Organization , 2010, DOI: 10.1590/S0042-96862010000400013
Abstract: objective: to estimate the prevalence of tuberculosis in viet nam with data from a population-based survey, compare it with the prevalence estimated by the world health organization, and identify major demographic determinants of tuberculosis prevalence. methods: a cross-sectional survey with multistage cluster sampling, stratified by urban, rural and remote areas, was done in 2006-2007 in 70 communes. all inhabitants aged > 15 years were invited for cough and chest x-ray examination. participants with findings suggestive of tuberculosis provided sputum specimens for smear examination and culture. point prevalence estimates, 95% confidence intervals and design effects were calculated. confidence intervals and p-values were adjusted for the cluster design. findings: of 114 389 adult inhabitants, 94 179 (82.3%) were screened. of 87 314 (92.7%) screened by both questionnaire and chest x-ray, 3522 (4.0%) had productive cough, 518 (0.6%) had a recent history of tuberculosis and 2972 (3.4%) had chest x-ray abnormalities suggestive of tuberculosis. sputum tests were done for 7648 participants. sputum test, bacterial culture or both confirmed 269 tuberculosis cases, 174 of which were smear-positive. the prevalence rate of smear-positive tuberculosis was 145 per 100 000 (95% confidence interval: 110-180) assuming no tuberculosis in persons aged < 15 years. prevalence was 5.1 times as high in men as in women, increased with age, was higher in rural than in urban or remote areas and showed a north-to-south gradient. conclusion: in viet nam, the tuberculosis prevalence rate based on positive sputum smear tests was 1.6 times as high as previously estimated. age and sex patterns were consistent with notification data. tuberculosis control should remain a high priority in viet nam.
Dengue Virus in Sub-tropical Northern and Central Viet Nam: Population Immunity and Climate Shape Patterns of Viral Invasion and Maintenance  [PDF]
Maia A. Rabaa,Cameron P. Simmons,Annette Fox,Mai Quynh Le,Thuy Thi Thu Nguyen,Hai Yen Le,Robert V. Gibbons,Xuyen Thanh Nguyen,Edward C. Holmes,John G. Aaskov
PLOS Neglected Tropical Diseases , 2013, DOI: 10.1371/journal.pntd.0002581
Abstract: Dengue virus transmission occurs in both epidemic and endemic cycles across tropical and sub-tropical regions of the world. Incidence is particularly high in much of Southeast Asia, where hyperendemic transmission plagues both urban and rural populations. However, endemicity has not been established in some areas with climates that may not support year-round viral transmission. An understanding of how dengue viruses (DENV) enter these environments and whether the viruses persist in inapparent local transmission cycles is central to understanding how dengue emerges in areas at the margins of endemic transmission. Dengue is highly endemic in tropical southern Vietnam, while increasingly large seasonal epidemics have occurred in northern Viet Nam over the last decade. We have investigated the spread of DENV-1 throughout Vietnam to determine the routes by which the virus enters northern and central regions of the country. Phylogeographic analysis of 1,765 envelope (E) gene sequences from Southeast Asia revealed frequent movement of DENV between neighboring human populations and strong local clustering of viral lineages. Long-distance migration of DENV between human population centers also occurred regularly and on short time-scales, indicating human-mediated viral invasion into northern Vietnam. Human populations in southern Vietnam were found to be the primary source of DENV circulating throughout the country, while central and northern Vietnam acted as sink populations, likely due to reduced connectedness to other populations in the case of the central regions and to the influence of temperature variability on DENV replication and vector survival and competence in the north. Finally, phylogeographic analyses suggested that viral movement follows a gravity model and indicates that population immunity and physical and economic connections between populations may play important roles in shaping patterns of DENV transmission.
Recent Increase in Sex Ratio at Birth in Viet Nam  [PDF]
Christophe Z. Guilmoto, Xuyên Hoàng, Toan Ngo Van
PLOS ONE , 2009, DOI: 10.1371/journal.pone.0004624
Abstract: Introduction Since the 1980s, sex ratio at birth (male births per 100 female births) has increased in many Asian countries as a result of selective abortions, but to date there has been no such evidence for Viet Nam. Our aim in this paper is to ascertain the situation with respect to sex ratio at birth in Viet Nam over the past five years. Materials and Methods Original data were obtained from sample population surveys in Viet Nam recording annual birth rates since 2000 of about 450,000 women, as well as from two successive birth surveys conducted for the first time in 2007 (1.1 million births). The annual population surveys include specific information on birth history and mothers' characteristics to be used for the analysis of trends and differentials in sex ratio at birth. Results and Discussion Birth history statistics indicate that the SRB in Viet Nam has recorded a steady growth since 2001. Starting from a level probably close to the biological standard of 105, the SRB reached 108 in 2005 and 112 in 2006, a value significantly above the normal level. An independent confirmation of these results comes from the surveys of births in health facilities which yielded a SRB of 110 in 2006–07. High SRB is linked to various factors such as access to modern health care, number of prenatal visits, level of higher education and employment status, young age, province of residence and prenatal sex determination. These results suggest that prenatal sex determination followed by selective abortion has recently become more common in Viet Nam. This recent trend is a consequence of various factors such as preference for sons, declining fertility, easy access to abortion, economic development as well as the increased availability of ultrasonography facilities.
The use of a computerized database to monitor vaccine safety in Viet Nam
Ali,Mohammad; Canh Gia Do,; Clemens,John D.; Park,Jin-Kyung; von Seidlein,Lorenz; Truong,Minh Tan; Thiem Dinh Vu,; Le,Tho Huu; Dang,Trach Duc; ,;
Bulletin of the World Health Organization , 2005, DOI: 10.1590/S0042-96862005000800014
Abstract: health information systems to monitor vaccine safety are used in industrialized countries to detect adverse medical events related to vaccinations or to prove the safety of vaccines. there are no such information systems in the developing world, but they are urgently needed. a large linked database for the monitoring of vaccine-related adverse events has been established in khanh hoa province, viet nam. data collected during the first 2 years of surveillance, a period which included a mass measles vaccination campaign, were used to evaluate the system. for this purpose the discharge diagnoses of individuals admitted to polyclinics and hospitals were coded according to the international classification of diseases (icd)-10 guidelines and linked in a dynamic population database with vaccination histories. a case-series analysis was applied to the cohort of children vaccinated during the mass measles vaccination campaign. the study recorded 107 022 immunizations in a catchment area with a population of 357 458 and confirmed vaccine coverage of 87% or higher for completed routine childhood vaccinations. the measles vaccination campaign immunized at least 86% of the targeted children aged 9 months to 10 years. no medical event was detected significantly more frequently during the 14 days after measles vaccination than before it. the experience in viet nam confirmed the safety of a measles vaccination campaign and shows that it is feasible to establish health information systems such as a large linked database which can provide reliable data in a developing country for a modest increase in use of resources.
Harm reduction and “Clean” community: can Viet Nam have both?
Thu Khuat, Van Anh Nguyen, Melissa Jardine, Timothy Moore, Thu Bui, Nick Crofts
Harm Reduction Journal , 2012, DOI: 10.1186/1477-7517-9-25
Abstract: The history of drug use and the evolution of discourses on drug use in Viet Nam have created these conflicting pressures on police, and thus created contradictory expectations and led to different views and attitudes of police regarding various harm reduction measures. This might aid understanding why, despite the comprehensive and progressive policies on HIV/AIDS and harm reduction in Viet Nam, it is not easy for police to actively and effectively support and be involved in harm reduction at the ground level.To promote the wider acceptance of harm reduction the concept of community safety must be expanded to include community health; harm reduction must be integrated into the “new society” movement; and laws and policies need further revision to reduce contradiction between current drug laws and HIV laws.Harm reduction guidelines for police and other actors need to be disseminated and supported, embodying better ways of working between sectors, and all sectors in the partnership require support for building capacity to contribute to the overall goal.Viet Nam has had a major concentrated epidemic of HIV, from detection of the first case in 1990 to an estimated 280,000 infected in 2012, approximately 0.47% of the population. Around 65% of those infected have histories of injecting drug use (IDU), and among them HIV prevalence has reached 70% or more [1]. As detailed elsewhere in this volume, Viet Nam has responded with development of comprehensive and progressive policies on HIV and AIDS, including policy and legal support for harm reduction [2].How effectively do these policies translate to street level; and do they actually enable the work of implementers of harm reduction approaches? And more specifically, given that the major mechanism of implementation of laws is through law enforcement, especially by police: how effectively is law enforcement, especially community-level policing, involved in harm reduction in Viet Nam, and how can this involvement be improved?W
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