1.'Lessons for Developing Countries From Outlier Country Health Systems'.

  1. Mor. Front Public Health, 10: 870210, 2022. More information http://doi.org/10.3389/fpubh.2022.870210.

 Abstract: Building good health systems is an important objective for policy makers in any country. Developing countries which are just starting out on their journeys need to do this by using their limited resources in the best way possible. The total health expenditure of a country exerts a significant influence on its health outcomes but, given the well-understood failures of price-based market-mechanisms, countries that spend the most money do not necessarily end-up building the best health systems. To help developing country policy makers gain a deeper insight into what factors matter, in this study the contribution of per-capita total, out-of-pocket, and pooled health expenditures, to the cross-country variation in Disability Adjusted Life Years lost per 100,000 population (DALY Rates), a summary measure of health outcomes, is estimated. The country-specific residuals from these analyses are then examined to understand the sources of the rest of the variation. The study finds that these measures are able to explain between 40 and 50% of the variation in the DALY Rates with percentage increases in per-capita out-of-pocket and pooled expenditures being associated with improvements in DALY Rates of about 0.06% and 0.095%, respectively. This suggests that while increases in per-capita total health expenditures do matter, moving them away from out-of-pocket to pooled has the potential to produce material improvements in DALY Rates, and that taken together these financial parameters are able to explain only about half the cross-country variation in DALY Rates. The analysis of the residuals from these regressions finds that while there may be a minimum level of per-capita total health expenditures (> $100) which needs to be crossed for a health system to perform (Bangladesh being a clear and sole exception), it is possible for countries to perform very well even at very low levels of these expenditures. Colombia, Thailand, Honduras, Peru, Nicaragua, Jordan, Sri Lanka, and the Krygyz Republic, are examples of countries which have demonstrated this. It is also apparent from the analysis that while very high rates (> 75%) of pooling are essential to build truly high performing health systems (with DALYRates < 20, 000), a high level of pooling on its own is insufficient to deliver strong health outcomes, and also that even at lower levels of pooling it is possible for countries to out-perform their peers. This is apparent from the examples of Ecuador, Mexico, Honduras, Malaysia, Vietnam, Kyrgyz Republic, and Sri Lanka, which are all doing very well despite having OOP% in the region of 40-60%. The analysis of residuals also suggests that while pooling (in any form) is definitely beneficial, countries with single payer systems are perhaps more effective than those with multiple payers perhaps because, despite their best efforts, they have insufficient market power over customers and providers to adequately manage the pulls and pressures of market forces. It can also be seen that countries and regions such as Honduras, Peru, Nicaragua, Jordan, Sri Lanka, Bangladesh, Kerala, and the Kyrgyz Republic, despite their modest levels of per-capita total health expenditures have delivered attractive DALY Rates on account of their consistent prioritization of public-health interventions such as near 100% vaccine coverage levels and strong control of infectious diseases. Additionally, countries such as Turkey, Colombia, Costa Rica, Thailand, Peru, Nicaragua, and Jordan, have all delivered low DALY Rates despite modest levels of per-capita total health expenditures on account of their emphasis on primary care. While, as can be seen from the discussion, several valuable conclusions can be drawn from this kind of analysis, the evolution of health systems is a complex journey, driven by multiple local factors, and a multi-country cross-sectional study of the type attempted here runs the risk of glossing over them. The study attempts to address these limitations by being parsimonious and simple in its approach toward specifying its quantitative models, and validating its conclusions by looking deeper into country contexts.

2.'Type 2 diabetes and hypertension in Vietnam: a systematic review and meta-analysis of studies between 2000 and 2020'.

  1. Biswas, N. Tran, H. Thi My Hanh, et al. BMJ Open, 12(8): e052725, 2022. More information http://doi.org/10.1136/bmjopen-2021-052725.

 Abstract: OBJECTIVES: The objective of this study was to determine the level of type 2 diabetes (T2DM) and hypertension (HTN) in Vietnam and to assess the trend and recommend the future direction of prevention research efforts. DESIGN: We searched scientific literature, databases including PubMed, EMBASE, CINHAL and Google Scholar; grey literature and reference lists for primary research published, nation database websites between 1 January 2000 and 30 September 2020. We adapted the modified Newcastle Ottawa Scale for assessing the quality of the study, as recommended by the Cochrane Collaboration. RESULTS: In total, 83 studies met our inclusion criteria, representing data of approximately 239 034 population of more than 15 years of age in Vietnam. The findings show that prevalence rates varied widely across studies, from 1.0% to 29.0% for T2DM and 2.0% to 47.0% for HTN. For the total study period, pooled prevalence of T2DM and HTN in Vietnam for all studies was 6.0% (95% CI: 4.0% to 7.0%) and 25% (95% CI: 19% to 31%), respectively. Prevalence rate of both T2DM and HTN was higher among the male population compared with female counterpart. CONCLUSION: There is evidence of a rising trend of HTN and T2DM prevalence in Vietnam. Future research should focus on the major drivers, incidence and prognosis of T2DM and HTN. Policy approaches should base upon the trends of T2DM and HTN in Vietnam over the last 20 years and pay more attention on the effective interventions to combat T2DM and HTN. In our study, we included both English and Vietnamese language articles and seems that majority of the articles came from Vietnamese language. PROSPERO REGISTRATION NUMBER: CRD42020182959.

 3.'Marine fish parasites of Vietnam: a comprehensive review and updated list of species, hosts, and zoogeographical distribution'/ Van Thuong Truong, Huong Thi Thuy Ngo, Te Quang Bui, et al. Parasite, 29: 36, 2022.

Free full text https://doi.org/10.1051/parasite/2022033.

 4. Effect of pneumococcal conjugate vaccine on prevalence of otitis media with effusion among children in Vietnam.

Michiko Toizumi, Chisei Satoh, Billy J. Quilty, et al. Vaccine, 2022. Free full text https://www.sciencedirect.com/science/article/pii/S0264410X22009446.

 Abstract: Purpose Otitis media with effusion (OME) is common in young children and is associated with Streptococcus pneumoniae infection. We aimed to determine the impact of pneumococcal conjugate vaccine (PCV) introduction on the prevalence of OME and OME associated with vaccine-type (VT) or non-VT. Methods Population-based cross-sectional surveys were conducted in pre- (2016) and post-PCV periods (2017, 2018, and 2019) at selected communes in Nha Trang, Vietnam. For each survey, we randomly selected 60 children aged 4–11 months and 60 aged 14–23 months from each commune. Nasopharyngeal sample collection and tympanic membrane examination by digital otoscope were performed. S. pneumoniae was detected and serotyped by lytA qPCR and microarray. Odds ratios (OR) and 95% confidence intervals (CIs) were calculated using Firth’s logistic regression, stratified by age group. Results Over the four surveys, 2089 children had a bilateral ear examination. Compared to pre-PCV, the prevalence of OME reduced in 2018 (OR 0.51, 95 %CI 0.28–0.93) and in 2019 (OR 0.53, 95 %CI 0.29–0.97) among the <12-month-olds, but no significant reduction among the 12–23-month-olds. The prevalence of OME associated with VT pneumococcus decreased in 2018 and 2019 (2018: OR 0.14, 95 %CI 0.03–0.55; 2019: OR 0.20, 95 %CI 0.05–0.69 in the <12-months-olds, 2018: OR 0.05, 95 %CI 0.00–0.44, 2019: OR 0.41, 95 %CI 0.10–1.61 in the 12–23-months-olds). The prevalence of OME associated with non-VT pneumococcus increased in the 12–23-month-olds in 2017 (OR 3.09, 95 %CI 1.47–7.45) and returned to the pre-PCV level of prevalence in 2018 and 2019 (OR 0.94, 95 %CI 0.40–2.43 and 1.40, 95 %CI 0.63–3.49). Conclusion PCV10 introduction was associated with a reduction of OME prevalence in infants but not in older children.


4.'Helicobacter pylori Eradication Efficacy of Therapy Based on the Antimicrobial Susceptibility in Children with Gastritis and Peptic Ulcer in Mekong Delta, Vietnam' / T. T. Le, T. A. Nguyen, N. A. Nguyen, et al. Children (Basel), 9(7), 2022. More information http://doi.org/10.3390/children9071019.

 Abstract: BACKGROUND: The efficacy of Helicobacter pylori (H. pylori) eradication therapy for children is currently low, and antibiotic resistance is a significant cause of treatment failure. The purpose of this study was to evaluate the H. pylori eradication efficacy of therapy based on antimicrobial susceptibility in pediatric patients with gastritis and peptic ulcer. METHODS: This study was conducted at Can Tho Children's Hospital and Can Tho University of Medicine and Pharmacy Hospital between March 2019 and April 2022. We performed an upper gastrointestinal endoscopy, cultured H. pylori from biopsies of gastric mucosa, determined antibiotic sensitivities to H. pylori by the E-test method, and treated eradication based on the antibiotic susceptibilities of bacteria. After at least 4 weeks of eradication therapy, we assessed the effectiveness of treatment with a breath test. RESULTS: Among 237 children recruited in this study, 48.9% were boys and 51.1% were girls, and the mean age was 10.03 ± 2.53 years. We determined that 80.6% of H. pylori were resistant to clarithromycin, as well as amoxicillin, metronidazole, levofloxacin, and tetracycline, at 71.7%, 49.4%, 45.1%, and 11.4%, respectively. The overall eradication rate of H. pylori was 83.1% (172/207). Among therapies tailored to antimicrobial susceptibility, the bismuth quadruple regimen achieved the greatest success, but the efficacy of triple therapy with esomeprazole + AMX + CLR/MTZ was low. CONCLUSIONS: Tailored eradication therapy was highly successful in our study but did not achieve over 90%. We recommend that in countries with a high prevalence of antibiotic resistance in H. pylori strains, particularly where the amoxicillin-resistance rate of H. pylori is high, therapy tailored to antimicrobial susceptibility should be used as first-line therapy, and bismuth and tetracycline should be added to enhance the eradication efficacy in children.


5 .'Adaptation of a school-based mental health program for adolescents in Vietnam'.

Nga Linh La, Ian Shochet, Thach Tran, et al. PLoS ONE, 17(8): e0271959, 2022. More information http://doi.org/10.1371/journal.pone.0271959. Free full text https://doi.org/10.1371/journal.pone.0271959.

 Abstract: Introduction Cultural adaptation of a school-based mental health intervention developed in a high-income country is a cost-effective method to address the mental health needs of adolescents in resource-constrained settings. The aim of this study was to translate and culturally adapt the Resourceful Adolescent Program for Adolescents (RAP-A) for adolescents attending high school in Vietnam. Methods The translation and adaptation were conducted using a five-step process including (1) initial stakeholder consultation, (2) forward translation, (3) backward translation, (4) adaptation, and (5) finalising the adapted version. An adaptation panel was established, including the RAP-A authors and mental health and public health experts from Australia, and psychology and public health experts from Vietnam. The panel collaborated closely with a group of stakeholders, including bilingual psychologists and psychiatrists, high school (grades 10–12) students and teachers throughout the adaptation process. Results The adapted version of RAP-A was named ‘Happy House’. Happy House was adapted to be delivered in larger groups and in longer sessions than the RAP-A. The 11 sessions in RAP-A were restructured to 6 sessions in Happy House. Major changes were not required for any of the materials. However, some content, illustrations and videos were adapted to be more feasible for the school context and to enhance the comprehensibility, acceptability and appropriateness. Conclusion: Happy House has great potential to be relevant, comprehensible and acceptable for Vietnamese adolescents. Further research is warranted to examine the relevance, comprehensibility, acceptability, and effectiveness of this program on adolescents’ mental health before advocating for scaling up program delivery in high schools throughout Vietnam.


6.'The impact of Confucianism on social and emotional health of Vietnamese adolescents: A phenomenological study' / T. V. Giang and V. S. Huynh. Acta Psychol (Amst), 229: 103700, 2022a. More information http://doi.org/10.1016/j.actpsy.2022.103700.

 Abstract: Confucianism has become an educational ideology in Vietnam and blended its philosophy with other religious and spiritual doctrines. The current study explores the impact of Confucianism on social and emotional health (SEH), which focuses on the skill-based aspect of Confucian Vietnamese adolescents. A hermeneutic phenomenological study was chosen as an appropriate approach for collecting and interpreting descriptions of 15 Confucian Vietnamese adolescents to explore how these lived experiences have shaped their current perceptions of SEH. We have labeled the two shared common characteristics in the participants' various SEH experiences, including (1) Authentic perception of Confucian philosophy strengthens the self-esteem; (2) Positive practice of the 5-essential human virtues helps establish and maintain healthy, supportive relationships. The two essences reflected the positive impact of Confucianism on SEH of Vietnamese adolescents. The adolescents' SEH experiences are consistent with Confucian philosophy while at the same time not conflicting with other religious doctrines. The findings of this study have broadened our understanding of the applicability of socio-emotional competence models to promote positive psychological development in adolescents, and the feasible goal-setting in counseling and psychotherapy from different psychological theories about the combination of religious and spiritual practices.

7.'Validation of the Behavioral Anger Response Questionnaire for Children (BARQ-C) in a large community sample of Vietnamese middle adolescents in Hanoi'.

  1. Shochet, J. Orr, W. Cockshaw, et al. BMC Psychol, 10(1): 199, 2022.  More information http://doi.org/10.1186/s40359-022-00907-4.

Abstract: BACKGROUND: Depression and other forms of psychological distress are common among Vietnamese adolescents and increase the risk of mental health problems in adulthood. As anger coping is a robust predictor of adolescent mental health difficulties, and there appear to be cultural variations in anger coping, a measure of adolescent anger coping styles that has been validated using a non-Western adolescent sample is required to inform and support early intervention to prevent or treat mental health difficulties in Vietnamese adolescents. This study examined the construct validity (structural and external) of the Behavioral Anger Response Questionnaire for Children in Vietnam (BARQC-V). METHODS: Baseline data sourced from a recent randomised control trial conducted with Grade 10 Vietnamese adolescents aged 14 to 16 (N = 1084) were used to examine multiple aspects of construct validity: factorial structure (evaluated using factor analysis); internal consistency (tested using Cronbach's alpha coefficient); and external aspect (assessed using Pearson's correlation coefficients between the BARQC-V and Vietnamese translations of the Coping Self-Efficacy Scale, Centre for Epidemiologic Studies Depression Scale Revised, Mental Health Continuum Short Form, and the Depression Anxiety and Stress Scale). RESULTS: Evaluating factorial structure using confirmatory factor analysis failed to converge on a solution. Exploratory factor analysis yielded a 5-factor structure model that explained 49.32% of the BARQC-V's total variance and was deemed to be a good fit by the final confirmatory factor analysis. Cronbach's alpha coefficients of the 5 factors demonstrated acceptable internal reliability for the BARQC-V's sub-scales. Concerning concurrent validity, three sub-scales predicted well-being and mental health difficulties: the maladaptive anger coping styles Rumination and Direct Anger-out were positively associated with depression and distress, and negatively associated with coping self-efficacy and mental well-being; and the adaptive anger coping style Assertion was positively associated with coping self-efficacy and mental well-being, and negatively associated with depression. CONCLUSIONS: The BARQC-V provides a validated measure of three anger coping strategies used by adolescents in Vietnam (Rumination, Direct Anger-out, and Assertion) that can be used to improve detection and treatment of mental health difficulties in this population, and as a starting point by future research to develop a much-needed gold standard measure of anger coping for adults, adolescents and children world-wide.

8.'Initial investigation of associations between feeding practices, eating behaviours, and weight status in Vietnamese children using modified questionnaires'.

  1. K. Ayre, E. Jansen, D. Gallegos, et al. Obes Res Clin Pract, 2022. More information http://doi.org/10.1016/j.orcp.2022.07.002.

 Abstract: AIMS: This cross-sectional study aims to extend the preliminary validation of the Feeding Practices and Structure Questionnaire (FPSQ) and Children's Eating Behaviour Questionnaire (CEBQ) in the Vietnamese context by examining associations between maternal feeding practices, child eating behaviours, and child weight status. METHODS: Modified versions of the FPSQ and CEBQ were used to measure maternal feeding practices and child eating behaviours, respectively, in a sample of Vietnamese mothers of children within the age range of two to five years (n = 100). Children's weight-for-height z-scores (WHZs) were calculated using weight and height measurements obtained by clinicians. Pearson's correlation coefficients were used to examine bivariate associations between maternal feeding practices, child eating behaviours, and child WHZs. Significant variables were then entered into a multivariable regression model. RESULTS: Child WHZs were associated with maternal persuasive feeding, and child slowness in eating, enjoyment of food/food responsiveness, and emotional undereating, but in multivariable regression analysis, only persuasive feeding (β = -0.44, p = 0.027) and slowness in eating (β = -0.39, p = 0.036) contributed significantly to the model. CONCLUSIONS: The findings provide some evidence of construct validity for the modified questionnaires. Potential implications of dietary-related behaviours on weight status in preschool-aged children in Viet Nam are evident. However, further validation and analysis in larger datasets must be undertaken in order to examine these associations with increased certainty.


9.'Key Informants' Perspectives on Childhood Obesity in Vietnam: A Qualitative Study'. Nguyen, T. Trat, N. T. Tieu, et al. Matern Child Health J, 2022.   

More information http://doi.org/10.1007/s10995-022-03502-6.

 Abstract: OBJECTIVES: Vietnam's post-war globalization, economic development, and urbanization have contributed to a nutrition transition from traditional diets to highly-processed diets, and increased prevalence of childhood overweight and obesity. Our study aims to explore the attitudes and behaviors driving this epidemic. METHODS: This qualitative study focused on the perspectives and practices of Vietnamese parents, schoolteachers and doctors. Semi-structured interviews were conducted with a convenience sample of 12 regarding the historical, social, and cultural influences contributing to childhood overweight and obesity. Audio-recorded interviews were translated and transcribed, then analyzed using modified ground theory to identify themes and representative quotes. RESULTS: Five themes were identified: (1) Change in diet between generations, (2) Preference for rounder children, (3) Unhealthy feeding practices, (4) Reduced physical activity, and (5) Increasing awareness of childhood obesity. A conceptual map detailed the shift from war-time to post-war economic environment and psycho-social context for raising children to be large, safe and academically-successful. CONCLUSIONS FOR PRACTICE: We found that globalization, urbanization and economic development-in the context of historical, social and cultural attitudes-may contribute to increasing child obesity in Vietnam. Obesity prevention through public health and educational institutions should involve policies and programs for healthy eating and exercise, tailored to address parental figures' concerns.


10.'Relative validity of a mobile AI-technology assisted dietary assessment in adolescent females in Vietnam'.

Phuong Hong Nguyen, Lan Mai Tran, Nga Thu Hoang, et al. The American Journal of Clinical Nutrition, 2022. More information http://doi.org/10.1093/ajcn/nqac216.

 Free full text https://doi.org/10.1093/ajcn/nqac216.

 Abstract: There is a gap in data on dietary intake of adolescents in low- and middle-income countries. Traditional methods for dietary assessment are resource intensive and lack accuracy with regards to portion size estimation. Technology assisted dietary assessment tools have been proposed but few have been validated for feasibility of use in LMICs.We assess the relative validity of FRANI (Food Recognition Assistance and Nudging Insights), a mobile Artificial Intelligence (AI) application for dietary assessment in adolescent females (n = 36) aged 12–18y in Vietnam, against weighed records (WR) standard, and compared FRANI performance to a multi-pass 24-hour recall (24HR).Dietary intake was assessed using 3 methods: FRANI, WRs and 24HRs undertaken on three non-consecutive days. Equivalence of nutrient intakes was tested using mixed effect models adjusting for repeated measures, using 10%, 15% and 20% bounds. The concordance correlation coefficient (CCC) was used to assess the agreement between methods. Sources of errors were identified for memory and portion size estimation bias.Equivalence between FRANI app and WR was determined at the 10% bound for energy, protein and fat and four nutrients (iron, riboflavin, vitamin B6 and zinc), and at 15% and 20% bounds for carbohydrate, calcium, vitamin C, thiamin, niacin, and folate. Similar results were observed for differences between 24HR and WR with 20% equivalent bound for all nutrients except for vitamin A. The CCCs between FRANI and WR (0.60,0.81) were slightly lower CCCs between 24HR and WR (0.70,0.89) for energy and most nutrients. Memory error (food omissions or intrusions) was 21% with no clear pattern apparent on portion size estimation bias for foods.AI assisted dietary assessment and 24HR accurately estimate nutrient intake in adolescent females when compared to WR. Errors could be reduced with further improvements of AI-assisted food recognition and portion estimation.

11.'A community-based intervention to decrease the prevalence of HIV viremia among people who inject drugs in Vietnam'. H. T. Duong, J. P. Moles, K. M. Pham, et al. Lancet Reg Health West Pac, 27: 100538, 2022a.

More information http://doi.org/10.1016/j.lanwpc.2022.100538.

Abstract: BACKGROUND: In most low-to-middle-income countries, HIV control at the population level among people who inject drugs (PWID) remains a major challenge. We aimed to demonstrate that an innovative intervention can identify HIV-positive PWID in the community who are not treated efficiently, and get them treated efficiently. METHODS: Between 2016 and 2020, we implemented an intervention consisting of mass HIV screening of PWID using three annual respondent-driven sampling surveys (RDSS) and a post-intervention evaluation RDSS in community-based organization (CBO) sites, coupled with peer support to facilitate/improve access to antiretroviral and methadone therapy in Haiphong, Vietnam. The primary outcome was the proportion of identified uncontrolled HIV-positive PWID who achieved viral control. We also estimated the potential effect of the intervention on the proportion of PWID with HIV RNA >1000 copies/mL among all PWID during the study period. FINDINGS: Over the three RDSS, 3150 different PWID were screened, i.e. two-thirds of the estimated population size. They all injected heroin, their median age was of 39 years, 95% were male, 26.5% were HIV-infected, and 78.6% of the latter had HIV RNA ≤1000 copies/mL. Among the 177 PWID identified with an unsuppressed viral load, 73 (41.2%) achieved viral suppression at the final visit. HIV viremia decreased from 7.2% at baseline to 2.9% at the final RDSS (p<0.001). Up to 42% of this observed reduction may be explained by the intervention, in the absence of any external intervention targeting PWID during the study period. INTERPRETATION: Mass community-based screening using RDSS coupled with CBO support is a powerful tool to rapidly identify untreated HIV-positive PWID and (re)link them to care. FUNDING: NIDA (USA) and ANRS (France).

12.'Cost-effectiveness of implementing HIV and HIV/syphilis dual testing among key populations in Viet Nam: A modelling analysis'. Coomes, D. Green, R. Barnabas, et al. BMJ Open, 12(8): e056887, 2022.

More information http://doi.org/10.1136/bmjopen-2021-056887.

Abstract: OBJECTIVES: Key populations, including sex workers, men who have sex with men, and people who inject drugs, have a high risk of HIV and sexually transmitted infections. We assessed the health and economic impacts of different HIV and syphilis testing strategies among three key populations in Viet Nam using a dual HIV/syphilis rapid diagnostic test (RDT). SETTING: We used the spectrum AIDS impact model to simulate the HIV epidemic in Viet Nam and evaluated five testing scenarios among key populations. We used a 15-year time horizon and a provider perspective for costs. PARTICIPANTS: We simulate the entire population of Viet Nam in the model. INTERVENTIONS: We modelled five testing scenarios among key populations: (1) annual testing with an HIV RDT, (2) annual testing with a dual RDT, (3) biannual testing using dual RDT and HIV RDT, (4) biannual testing using HIV RDT and (5) biannual testing using dual RDT. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome is incremental cost-effectiveness ratios. Secondary outcomes include HIV and syphilis cases. RESULTS: Annual testing using a dual HIV/syphilis RDT was cost-effective (US$10 per disability-adjusted life year (DALY)) and averted 3206 HIV cases and treated 27 727 syphilis cases compared with baseline over 15 years. Biannual testing using one dual test and one HIV RDT (US$1166 per DALY), or two dual tests (US$5672 per DALY) both averted an additional 875 HIV cases, although only the former scenario was cost-effective. Annual or biannual HIV testing using HIV RDTs and separate syphilis tests were more costly and less effective than using one or two dual RDTs. CONCLUSIONS: Annual HIV and syphilis testing using dual RDT among key populations is cost-effective in Vietnam and similar settings to reach global reduction goals for HIV and syphilis.


13.'A pretest-posttest design to assess the effectiveness of an intervention to reduce HIV-related stigma and discrimination in healthcare settings in Vietnam'.

  1. M. Pollack, H. T. Duong, D. T. Nhat Vinh, et al. J Int AIDS Soc, 25 Suppl 1(Suppl 1): e25932, 2022. More information http://doi.org/10.1002/jia2.25932.

 Abstract: INTRODUCTION: Stigma and discrimination are important barriers to HIV epidemic control. We implemented a multi-pronged facility-level intervention to reduce stigma and discrimination at health facilities across three high-burden provinces. Key components of the intervention included measurement of stigma, data review and use, participatory training of healthcare workers (HCWs), and engagement of people living with HIV and key populations in all stigma reduction activities. METHODS: From July 2018 to July 2019, we assessed HIV-related stigma and discrimination among patients and HCWs at 10 facilities at baseline and 9 months following an intervention. A repeated measures design was used to assess the change in stigma and discrimination among HCWs and a repeated cross-sectional design assessed the change in stigma and discrimination experienced by PLHIV. HCWs at target facilities were invited at random and PLHIV were recruited when presenting for care during the two assessment periods. McNemar's test was used to compare paired proportions among HCWs, and chi-square test was used to compare proportions among PLHIV. Mixed models were used to compare outcomes before and after the intervention. RESULTS: Semi-structured interviews were conducted with 649 and 652 PLHIV prior to and following the intervention, respectively. At baseline, over the previous 12 months, 21% reported experiencing discrimination, 16% reported self-stigma, 14% reported HIV disclosure without consent and 7% had received discriminatory reproductive health advice. Nine months after the intervention, there was a decrease in reported stigma and discrimination across all domains to 15%, 11%, 7% and 3.5%, respectively (all p-values <0.05). Among HCWs, 672 completed the pre- and post-intervention assessment. At baseline, 81% reported fear of HIV infection, 69% reported using unnecessary precautions when caring for PLHIV, 44% reported having observed other staff discriminate against PLHIV, 54% reported negative attitudes towards PLHIV and 41% felt uncomfortable working with colleagues living with HIV. The proportions decreased after the intervention to 52%, 34%, 32%, 35% and 24%, respectively (all p-values <0.05). CONCLUSIONS: A multi-pronged facility-level intervention was successful at reducing healthcare-associated HIV-related stigma in Vietnam. The findings support the scale-up of this intervention in Vietnam and highlight key components potentially applicable in other settings.


14.'Assessment of Insomnia and Associated Factors Among Patients Who Have Recovered from COVID-19 in Vietnam'.

  1. Huynh, H. V. Nguyen, L. Y. Vo, et al. Patient Prefer Adherence, 16: 1637-47, 2022. More information http://doi.org/10.2147/ppa.S371563.

 Abstract: INTRODUCTION: The COVID-19 pandemic has been affecting the lives of millions of people globally. Patients recovering from COVID-19 are facing not only the symptom of long COVID, but also psychological problems, such as sleep disturbance. This study aims to assess the proportion of COVID-19 recovered adult patients that suffer from insomnia and associated factors in Vietnam. METHODS: A cross-sectional study was performed between January and March 2022 among patients who have recovered from a COVID-19 infection. Data were collected based on a self-administered questionnaire that included sociodemographic and standardized questionnaires from the Hospital Anxiety and Depression Scale (HADS), the Perceived stress scale (PSS) and the dependent variable using Insomnia Severity Index (ISI). Multivariable logistic regression was conducted to explore factors associated with the patients' insomnia disorder. RESULTS: A total of 325 participants were included in this analysis, 34.5% of participants had insomnia. According to multivariable logistic regression, participants who were equal to and over 50 years of age, feeling alienated from others, and were not supported by families or relatives, reported significantly higher levels of insomnia disorders over those aged under 50 years, having closer ties with family and had received support from family or relatives. Besides, respondents who recorded mental health problems that included anxiety, depression and stress were more likely to get insomnia disorders than those without mental health symptoms (OR 2.7, 95% CI 1.1-6.6) (OR 4.5, 95% CI 2.3-8.9) (OR 2.3, 95% CI 1.1-5.3), respectively, all p < 0.05. CONCLUSION: There was a remarkable rate of COVID-19 recovered patients experiencing insomnia disorders. Older age, alienated relationships and not being supported by families or relatives, as well as had mental health problems, are factors that affected the patients' insomnia, which showed that these sleep issues need to be screened and managed among adults who have recovered from COVID-19.


15.'The COVID-19 Pandemic and the Emergence of Vietnam as a Middle Power'.

Le Dinh Tinh and Vu Thi Thu Ngan. Journal of Current Southeast Asian Affairs, 41(2): 303-25, 2022. More information http://doi.org/10.1177/18681034211057569.

Free full text https://journals.sagepub.com/doi/abs/10.1177/18681034211057569.

 Abstract: Limited capability and political will have caused the great powers to fail to demonstrate their global leadership in the fight against the COVID-19 pandemic, which has created greater room to manoeuvre for other countries to influence international affairs. Preliminary achievements in the fight against the COVID-19 crisis have buttressed the rising global status of small and medium-sized states, including Vietnam. Although Vietnam has recently been recognised as an emerging middle power, scepticism looms regarding whether this higher international status is beyond its capacity. We argue that the pandemic may act as a catalyst for Vietnam to further elevate its strategic role as a middle power on the international stage in the medium and long term.


16.'Cardiovascular injury and clinical features of multisystem inflammatory syndrome in children (MIS-C) related to Covid-19 in Vietnam'.

  1. T. N. Phung, T. T. Tran, T. H. Nguyen, et al. Pediatr Neonatol, 2022. More information http://doi.org/10.1016/j.pedneo.2022.05.009.

 Abstract: BACKGROUND: This study aimed to describe the cardiovascular injury and clinical features of multisystem inflammatory syndrome in children (MIS-C) related to coronavirus disease 2019 (COVID-19) in Ho Chi Minh City, Vietnam. METHODS: This was a retrospective cohort study of children with MIS-C (from September 1, 2021 to February 28, 2022) in Children's Hospital 1, Ho Chi Minh City. Demographics, clinical history, significant underlying conditions, clinical manifestations, laboratory investigations, and medical management were analyzed. RESULTS: A total of 76 patients were included (median age, 5.9 years old, 2 months-16 years). The male/female ratio was 1.6/1. Most patients (75/76) had no previous medical conditions. The mean time from acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to symptom onset was 39 days. During an acute SARS-CoV-2 infection, these patients are either asymptomatic or mildly symptomatic. In addition to fever, gastrointestinal symptoms were also prominent, as observed in our study, with 75%, 73.7%, and 72.3% of patients presenting with abdominal pain, vomiting, and loose stools, respectively. The levels of inflammatory markers increased upon admission and returned to normal levels after treatment. Echocardiography revealed decreased myocardial contractility and coronary injury in 16 (21.1%) and 32 (42.1%) patients, respectively. Most cases (72/76) had no fever within 3 days of intravenous immunoglobulin (IVIG) and methylprednisolone treatment. No deaths occurred in this study. The mean duration of hospitalization was 7.2 days. CONCLUSION: Cardiovascular involvement was observed in approximately 53.9% of the patients. Anti-inflammatory treatment with IVIG and methylprednisolone had a favorable short-term outcome. However, long-term follow-up studies on post-discharge MIS-C cases are needed to make appropriate treatment recommendations in the acute phase.


17.'Impact of COVID-19 on the HIV care continuum in Asia: Insights from people living with HIV, key populations, and HIV healthcare providers'.

  1. C. Hung, S. Banerjee, I. Gilada, et al. PLoS ONE, 17(7): e0270831, 2022. More information http://doi.org/10.1371/journal.pone.0270831.

 Abstract: BACKGROUND: The COVID-19 pandemic has threatened continued access to public health services worldwide, including HIV prevention and care. This study aimed to evaluate the impact of the COVID-19 pandemic on HIV service access and delivery in the Asia region. METHODS: A descriptive, cross-sectional, online study, conducted between October-November 2020, assessed the impact of COVID-19 on HIV prevention and care among people living with HIV (PLHIV), key populations (KPs), and healthcare providers (HCPs). The study populations were recruited across ten Asian countries/territories, covering Hong Kong, India, Japan, Malaysia, Philippines, Singapore, Korea, Taiwan, Thailand, and Vietnam. RESULTS: Across the region, 702 PLHIV, 551 KPs, and 145 HCPs were recruited. Both PLHIV and KPs reported decreased or had yet to visit hospitals/clinics (PLHIV: 35.9%; KPs: 57.5%), reduced HIV RNA viral load testing (21.9%; 47.3%), and interruptions in antiretroviral therapy (ART) (22.3%) or decreased/complete stop of HIV prevention medication consumption (40.9%). Travel constraints (40.6%), financial issues (28.9%), and not receiving prescription refills (26.9%) were common reasons for interrupted ART access, whereas reduced engagements in behaviours that could increase the risks of HIV acquisition and transmission (57.7%), travel constraints (41.8%), and less hospital/clinic visits (36.7%) underlie the disruptions in HIV preventive medications. Decreased visits from PLHIV/KPs and rescheduled appointments due to clinic closure were respectively reported by 50.7%-52.1% and 15.6%-17.0% of HCPs; 43.6%-61.9% observed decreased ART/preventive medication refills. Although 85.0% of HCPs adopted telemedicine to deliver HIV care services, 56.4%-64.1% of PLHIV/KPs were not using telehealth services. CONCLUSIONS: The COVID-19 pandemic substantially disrupted HIV prevention to care continuum in Asia at the time of the study. The findings highlighby PLHIV, KPs, and HCPs. Efforts are needed to optimise infrastructure and adapt systems ted differences in HIV prevention to care continuum via telehealth services utilisation for continued HIV care with minimal disruptions during health emergency crises.


18.'The prevalence of self-reported anxiety, depression, and associated factors among Hanoi Medical University's students during the first wave of COVID-19 pandemic'.

  1. T. Nguyen, T. M. Ngo, H. L. T. Nguyen, et al. PLoS ONE, 17(8): e0269740, 2022. More information http://doi.org/10.1371/journal.pone.0269740.

 Abstract: BACKGROUND: Medical students are known to have higher levels of these issues than the general population but in Vietnam the effects of the pandemic on medical student mental health was not documented. OBJECTIVES: To estimate the prevalence and identify factors associated with self-reported anxiety disorder, depression, and perception of worsening mental health among Vietnamese medical students during the COVID-19 pandemic. METHOD: A cross-sectional study was conducted from April 7th to 29th, 2020. All students in Doctor of General Medicine, Doctor of Preventive Medicine, and Bachelor of Nursing tracks at Hanoi Medical University (3672 students) were invited to participate. Data were collected using an online questionnaire including demographic characteristics, Generalized Anxiety Disorder 7 items, Patient Health Questionnaire 9 items, Fear of COVID-19 scale, and question about worsening mental health status. Robust Poisson regression was used to assess the association between mental health status and associated factors. RESULTS: Among 1583 students (43.1% response rate), the prevalence of students screened positive for anxiety disorder was 7.3%(95%C.I.:6.0-8.7), depression was 14.5%(95%C.I.:12.8-16.3), and perceiving worsening mental health was 6.9%(95%C.I.:5.7-8.3). In multivariable regression models, significant factors associated with self-reported anxiety disorder included being male (PR = 1.99,95%C.I.:1.35-2.92), difficulty in paying for healthcare services (PR = 2.05,95%C.I.:1.39-3.01), and high level of fear of COVID-19 (Q3:PR = 2.36,95%C.I.:1.38-4.02 and Q4:PR = 4.75,95%C.I.:2.65-8.49). Significant factors associated with self-reported depression were difficulty in paying for healthcare services (PR = 1.78,95%C.I.:1.37-2.30), and high level of fear of COVID-19 (Q3:PR = 1.41,95%C.I.:1.02-1.95 and Q4:PR = 2.23,95%C.I.:1.51-3.29). Significant factors associated with perceived worsening mental health status included having clinical experience (PR = 1.83,95%C.I.:1.17-2.88) and having atypical symptoms of COVID-19 (PR = 1.96,95%C.I.:1.31-2.94). CONCLUSION: The prevalence of self-reported depression, anxiety disorder, and worsening mental health among Vietnamese students during the first wave of COVID-19 was lower than in medical students in other countries. Further investigation is needed to confirm this finding.


19. 'The COVID-19 pandemic's effects on SMEs and travel agencies: The critical role of corporate social responsibility' / Wang and T. T. Le. Econ Anal Policy, 76: 46-58, 2022. More information http://doi.org/10.1016/j.eap.2022.07.008.

 Abstract: This study is based on the system resilience framework, which outlines the aspects of community behavior, employees, the environment, history, and corporate social responsibility. We used a partial least squares structural equation model to evaluate a sample of 300 Vietnamese SMEs and travel agencies. We discovered that SMEs' strategies positively influence performance and are co-created with corporate social responsibility. The dependability of internal integrity was then determined. The empirical results showed that the overall confidence index for all facilities ranged from 0.70 to 0.95, with values ranging from 0.809 to 0.931. Furthermore, the A and Cronbach's alpha reliability values ranged from 0.70 to 0.90. As a result, the reliability of internal consistency was established. The convergence validity of the configurations was assessed by comparing the extracted mean values of variance (AVE), which, for all configurations, exceeded the limit of 0.50. This approach emphasizes the impact of corporate social responsibility practices on communities, the environment, and heritage.

 20. 'The COVID-19 pandemic and the livelihood of a vulnerable population: Evidence from women street vendors in urban Vietnam' / P. T. Thanh and P. B. Duong. Cities, 130: 103879, 2022.  

Free full text https://www.sciencedirect.com/science/article/pii/S0264275122003183?via%3Dihub

Abstract: The COVID-19 pandemic has caused enormous detrimental impacts on a global scale. Street vendors are one of the most heavily affected groups since they lack the skills and resources to overcome shocks. This study examines the economic burden facing this group during the pandemic and their coping strategies and mitigation mechanisms in response to these adverse effects. We utilized a mixed-methods approach, wherein 91 women vendors completed a survey questionnaire and 15 women vendors were interviewed. These vendors were found to experience a large reduction in business and consumption. The businesses of immigrant vendors suffered more adverse effects than those of local vendors. Also, the vendors selling in wet market areas incurred greater economic burdens than those selling near schools or recreation centers. The vendors lacked coping strategies to sustain their businesses and adopted various mitigation mechanisms to ensure essential consumption. This study highlights the need for urban social policies that can support this vulnerable group amid a pandemic. We also discuss policy implications for cities and economic development with a focus on street vendors.

21.'Confronting Rapid Reemergence of COVID-19 in Metropolitans of Vietnam: Updated Vietnam's Policies and Response Measures'.

  1. M. Le, N. G. Dao, C. A. Latkin, et al. Front Public Health, 10: 790370, 2022. More information http://doi.org/10.3389/fpubh.2022.790370.

 22. 'Investigating Linkages Between Spatiotemporal Patterns of the COVID-19 Delta Variant and Public Health Interventions in Southeast Asia: Prospective Space-Time Scan Statistical Analysis Method' / Luo, Z. Liu, Y. Zhou, et al. JMIR Public Health Surveill, 8(8): e35840, 2022. More information http://doi.org/10.2196/35840.

 Abstract: BACKGROUND: The COVID-19 Delta variant has presented an unprecedented challenge to countries in Southeast Asia (SEA). Its transmission has shown spatial heterogeneity in SEA after countries have adopted different public health interventions during the process. Hence, it is crucial for public health authorities to discover potential linkages between epidemic progression and corresponding interventions such that collective and coordinated control measurements can be designed to increase their effectiveness at reducing transmission in SEA. OBJECTIVE: The purpose of this study is to explore potential linkages between the spatiotemporal progression of the COVID-19 Delta variant and nonpharmaceutical intervention (NPI) measures in SEA. We detected the space-time clusters of outbreaks of COVID-19 and analyzed how the NPI measures relate to the propagation of COVID-19. METHODS: We collected district-level daily new cases of COVID-19 from June 1 to October 31, 2021, and district-level population data in SEA. We adopted prospective space-time scan statistics to identify the space-time clusters. Using cumulative prospective space-time scan statistics, we further identified variations of relative risk (RR) across each district at a half-month interval and their potential public health intervention linkages. RESULTS: We found 7 high-risk clusters (clusters 1-7) of COVID-19 transmission in Malaysia, the Philippines, Thailand, Vietnam, and Indonesia between June and August, 2021, with an RR of 5.45 (P<.001), 3.50 (P<.001), 2.30 (P<.001), 1.36 (P<.001), 5.62 (P<.001), 2.38 (P<.001), 3.45 (P<.001), respectively. There were 34 provinces in Indonesia that have successfully mitigated the risk of COVID-19, with a decreasing range between -0.05 and -1.46 due to the assistance of continuous restrictions. However, 58.6% of districts in Malaysia, Singapore, Thailand, and the Philippines saw an increase in the infection risk, which is aligned with their loosened restrictions. Continuous strict interventions were effective in mitigating COVID-19, while relaxing restrictions may exacerbate the propagation risk of this epidemic. CONCLUSIONS: The analyses of space-time clusters and RRs of districts benefit public health authorities with continuous surveillance of COVID-19 dynamics using real-time data. International coordination with more synchronized interventions amidst all SEA countries may play a key role in mitigating the progression of COVID-19.

 23. 'Enhancing hospital quality management and patient safety in Vietnam: a technical assistance project utilizing online solutions during COVID-19 pandemic'.

Jun Moriyama, Tomoo Ito, Masahiko Doi, et al. Tropical Medicine and Health, 50(1): 45, 2022. More information http://doi.org/10.1186/s41182-022-00435-2

Free full text https://doi.org/10.1186/s41182-022-00435-2.

 Abstract: Since 2015, the National Center for Global Health and Medicine in Japan has been conducting a technical assistance project for improving patient safety in Vietnamese hospitals. During the COVID-19 pandemic, the project conducted a patient safety training program utilizing online solutions for participants from Vietnam. This resulted in an increase in the number of participants, and ensured access from remote locations. The convenience of easy access from smartphones encouraged further participation. In addition to online training, the utilization of platforms such as Facebook, a common social networking service in Vietnam, contributed to the dissemination of good practices.

 24.'Cross-Sectional Analysis of Oral Healthcare vs. General Healthcare Utilization in Five Low- and Middle-Income Countries'.

  1. M. Susarla, M. Trimble and K. Sokal-Gutierrez. Front Oral Health, 3: 911110, 2022. More information http://doi.org/10.3389/froh.2022.911110.

 Abstract: Oral health is integral to overall health and is often neglected, especially in low- and middle-income countries (LMICs). Oral disease, including untreated dental caries, affects nearly 3.5 billion people globally, contributing to poor health and quality of life. To examine the relationship between the utilization of general healthcare and oral healthcare, we conducted an exploratory cross-sectional study of first-visit interview data collected from a convenience sample of 3,422 low-income mothers and 4,324 children aged 6 months through 6 years participating in a community-based oral health and nutrition program in five LMICs (Ecuador, El Salvador, India, Nepal, and Vietnam) from 2006-2015. We used descriptive and exploratory association analysis to identify patterns of oral healthcare utilization for mothers and children compared to medical care utilization, specifically maternal prenatal care and child immunizations. Overall, 89.6% of the mothers had received prenatal care for at least one child, but only 76.4% had ever received dental care and 50% were currently suffering from oral health symptoms, primarily oral pain. are compared to those who had not received prenatal care (OR = 2.62, 95% CI: 2.06, 3Mothers who received prenatal care were significantly more likely to have accessed dental c.32). Overall, 95.4% of the children had current immunizations, but only 30.1% had ever received dental care, and 32.4% were currently suffering from oral pain. Children whose immunizations were up-to-date were more likely to have received dental care, with a significant association in Ecuador (OR = 3.29, 95% CI: 2.06, 5.30). Compared to utilization of general healthcare, oral healthcare was under-utilized by mothers and children in our sample from five LMICs. Integration of prevention- and treatment-oriented oral health care into primary medical care services, particularly prenatal care and child immunizations, could help increase access to oral healthcare and improve women's and children's oral health.    

 25.'Implementation and Evaluation of Clinical Pharmacy Services on Improving Quality of Prescribing in Geriatric Inpatients in Vietnam: An Example in a Low-Resources Setting'.

  1. T. X. Dong, V. T. T. Pham, C. T. Dinh, et al. Clin Interv Aging, 17: 1127-38, 2022. More informationhttp://doi.org/10.2147/cia.S368871.

 Abstract: PURPOSE: Geriatric inpatients generally have a high risk of drug-related problems (DRP) in prescribing following hospital admission, which are likely to cause negative clinical consequences. This is particularly evident in developing countries such as Vietnam. Therefore, clinical pharmacy service (CPS) aims to identify and resolve these DRPs to improve the quality use of medicines in the older population following hospital admission. PATIENTS AND METHODS: The study was conducted as a prospective, single-center study implemented at a general public hospital in Hanoi. Patients aged ≥60 years with at least three chronic diseases admitted to the Internal Medicine Department between August 2020 and December 2020 were eligible to be enrolled. A well-trained clinical pharmacist provided a structured CPS to identify any DRP in prescribing for each patient in the study. Clinical pharmacist interventions were then proposed to the attending physicians and documented in the DRP reporting system. RESULTS: A total of 255 DRP were identified in 185 patients during the study period. The most frequent types of DRP were underuse (21.2%), dose too high (12.2%), and contraindication (11.8%). There was a very high rate of approval and uptake by the physicians regarding the interventions proposed by the clinical pharmacist (82.4% fully accepted and 12.5% partially accepted). Of the interventions, 73.4% were clinically relevant (pADE score ≥0.1). In general, 9 out of 10 physicians agreed that CPS has significant benefits for both patients and physicians. CONCLUSION: Improving clinical pharmacy services can potentially have a positive impact on the quality of prescribing in elderly inpatients. These services should officially be implemented to optimize the quality use of medicines in this population group in Vietnam.

  26.'Vitamin D intake and gastric cancer in Viet Nam: a case-control study'.

Minh Thien Nguyen, Nhi Ngoc Yen Huynh, Dai Duc Nguyen, et al. BMC Cancer, 22(1): 838, 2022. More information http://doi.org/10.1186/s12885-022-09933-2. Free full text https://doi.org/10.1186/s12885-022-09933-2.

 Abstract: Background: Most recent laboratory studies have suggested a promising role of vitamin D and its analogs as novel chemotherapeutic agents for cancer treatment. However, epidemiological evidence, especially regarding the effects of vitamin D on gastric cancer is still inconsistent. --- Objectives: Our research aimed to evaluate the associations between vitamin D intake and the risk of developing gastric cancer through a case-control study in North Vietnam. --- Methods: We accessed databases of the previous completed case-control studies to derive 1182 incident gastric cancer cases and 2995 hospital controls selected from hospitals in Hanoi from 2003 to 2019. Vitamin D intake was computed by multiplying the food frequency intake with nutrient content based on the Viet Nam Food Composition Tables. Data were collected through face-to-face interviews by trained interviewers using the validated semi-quantitative food frequency and demographic lifestyle questionnaires. The odds ratio and 95% confidence interval (OR and 95%CI) were estimated using unconditional logistic regression analysis. --- Results: We observed a continual decline in gastric cancer risk according to the level-up of vitamin D intake in both genders, men, and women [Fifth vs. bottom quintile, OR, 95%CI: 0.68 (0.53, 0.86), OR, 95%CI: 0.72 (0.53, 0.97), OR, 95%CI: 0.58 (0.38, 0.89), respectively. Per increment quintile, the statistically significant decreased risk was seen by 7% in men and 13% in women. The significant inverse association between vitamin D intake remained in the subgroups of ever and never tobacco smoking; negative and positive H. pylori infection. --- Conclusion: The findings suggested that sufficient vitamin D intake was associated with a lower risk of Gastric Cancer in the Vietnamese population.

27.'Private Sector Contributions to National Malaria Surveillance Systems in Elimination Settings: Lessons Learned from Cambodia, Lao PDR, Myanmar, and Vietnam'.

  1. Potter, K. Tesfazghi, S. Poyer, et al. Am J Trop Med Hyg, 2022. More information http://doi.org/10.4269/ajtmh.22-0147.

 Abstract: Comprehensive malaria case surveillance is necessary to achieve and sustain malaria elimination. In the Greater Mekong Subregion (GMS), the private sector plays a substantial role in malaria treatment. Yet, none of the six GMS countries collects complete case data from private sector points-of-care. Between 2016 and 2019, the GMS Elimination of Malaria through Surveillance program supported national malaria programs in Cambodia, Lao PDR, Myanmar, and Vietnam to execute elimination strategies by engaging the private sector in malaria case management, generating private sector case data, and integrating these data into national surveillance systems. The project enrolled 21,903 private sector outlets, covering between 52% and 80% of the private sector in targeted geographies, which were trained and equipped to perform rapid diagnostic tests (RDTs) and report malaria case data. By 2019, the private providers enrolled in the program reported a total of 3,521,586 suspected cases and 96,400 confirmed malaria cases into national surveillance systems, representing 16% of the total reported caseload by these countries (Cambodia, 25%; Lao PDR, 5%; Myanmar, 12%; Vietnam, 8%). Results demonstrated that with comprehensive support, such as training, provision of free or subsidized RDTs, first-line treatments, and routine supportive supervision, private providers can provide quality malaria case management and achieve high reporting rates.

 28.'A case-control study of agricultural and behavioral factors associated with leptospirosis in Vietnam'.

  1. P. Dung, P. T. Hai, L. M. Hoa, et al. BMC Infect Dis, 22(1): 583, 2022. More information http://doi.org/10.1186/s12879-022-07561-6.

 Abstract: INTRODUCTION: Leptospirosis is a neglected disease in Vietnam. Until now, there has been limited knowledge about risk factors of this disease in Vietnam. The study was carried out to identify agricultural and behavioral factors associated with the transmission of leptospirosis in Vietnam. METHODS: This matched retrospective hospital-community-based case-control study was conducted from 1 October 2018 to 31 October 2019. We recruited cases from 11 selected government hospitals in three provinces of Vietnam, while controls were selected from the same communes of cases and matched by age (± 2 years) and sex. Microscopic agglutination test (MAT) and enzyme-linked immunosorbent assay (ELISA) were applied to determine confirmed cases, while only MAT was used to identify controls with a single high MAT titer < 1:100. RESULTS: 504 participants (252 cases and 252 controls) were identified. Cultivating (OR 2.83, CI 1.38-5.79), animal farming (OR 8.26, CI 2.24-30.52), pig owners (OR 10.48, CI 5.05-21.73), cat owners (OR 2.62, CI 1.49-4.61) and drinking unboiled water (OR 1.72, CI 1.14 -2.59, p = 0.010) were significantly associated with human leptospirosis in Vietnam. Hand washing after farming/ gardening (OR 0.57, CI 0.38-0.86, p = 0.007) and bathing after farming, gardening, contact with cattle and poultry (OR 0.33, CI 0.19-0.58, p = 0.000) were determined as protective factors for this disease. CONCLUSIONS: In short, the case-control study has revealed the risks in agricultural and animal practices and protective behavioral factors related to human leptospirosis in Vietnam. The findings suggested promotion of communication and health education programs targeting health behaviors in daily life and agricultural practices. Using personal protective equipment such as gowns, gloves, and boots during agricultural practices, especially cultivating and animal farming, is most recommended.

29.'Lessons for improved COVID-19 surveillance from the scale-up of malaria testing strategies'.

  1. Kerr, L. J. Robinson, T. L. Russell, et al. Malar J, 21(1): 223, 2022. More information http://doi.org/10.1186/s12936-022-04240-4.

 Abstract: Effective control of infectious diseases is facilitated by informed decisions that require accurate and timely diagnosis of disease. For malaria, improved access to malaria diagnostics has revolutionized malaria control and elimination programmes. However, for COVID-19, diagnosis currently remains largely centralized and puts many low- and middle-income countries (LMICs) at a disadvantage. Malaria and COVID-19 are infectious diseases that share overlapping symptoms. While the strategic responses to disease control for malaria and COVID-19 are dependent on the disease ecologies of each disease, the fundamental need for accurate and timely testing remains paramount to inform accurate responses. This review highlights how the roll-out of rapid diagnostic tests has been fundamental in the fight against malaria, primarily within the Asia Pacific and along the Greater Mekong Subregion. By learning from the successful elements of malaria control programmes, it is clear that improving access to point-of-care testing strategies for COVID-19 will provide a suitable framework for COVID-19 diagnosis in not only the Asia Pacific, but all malarious countries. In malaria-endemic countries, an integrated approach to point-of-care testing for COVID-19 and malaria would provide bi-directional benefits for COVID-19 and malaria control, particularly due to their paralleled likeness of symptoms, infection control strategies and at-risk individuals. This is especially important, as previous disease pandemics have disrupted malaria control infrastructure, resulting in malaria re-emergence and halting elimination progress. Understanding and combining strategies may help to both limit disruptions to malaria control and support COVID-19 control.

30.'Population benefits of addressing programmatic and social determinants of gender disparities in tuberculosis in Viet Nam: A modelling study'.

Katherine C. Horton, Richard G. White, Nguyen Binh Hoa, et al. PLOS Global Public Health, 2(7): e0000784, 2022. More information http://doi.org/10.1371/journal.pgph.0000784. Free full text ttps://doi.org/10.1371/journal.pgph.0h000784.

 Abstract: High prevalence of infectious tuberculosis among men suggests potential population-wide benefits from addressing programmatic and social determinants of gender disparities. Utilising a sex-stratified compartmental transmission model calibrated to tuberculosis burden estimates for Viet Nam, we modelled interventions to increase active case finding, to reduce tobacco smoking, and to reduce alcohol consumption by 2025 in line with national and global targets. For each intervention, we examined scenarios differentially targeting men and women and evaluated impact on tuberculosis morbidity and mortality in men, women, and children in 2035. Active case finding interventions targeting men projected greater reductions in tuberculosis incidence in men, women, and children (16.2%, uncertainty interval, UI, 11.4–23.0%, 11.8%, UI 8.0–18.6%, and 21.5%, UI 16.9–28.5%, respectively) than those targeting women (5.2%, UI 3.8–7.1%, 5.4%, UI 3.9–7.3%, and 8.6%, UI 6.9–10.7%, respectively). Projected reductions in tuberculosis incidence for interventions to reduce male tobacco smoking and alcohol consumption were greatest for men (17.4%, UI 11.8–24.7%, and 11.0%, UI 5.4–19.4%, respectively), but still substantial for women (6.9%, UI 3.8–12.5%, and 4.4%, UI 1.9–10.6%, respectively) and children (12.7%, UI 8.4–19.0%, and 8.0%, UI 3.9–15.0%, respectively). Comparable interventions targeting women projected limited impact, with declines of 0.3% (UI 0.2%-0.3%) and 0.1% (UI 0.0%-0.1%), respectively. Addressing programmatic and social determinants of men’s tuberculosis burden has population-wide benefits. Future interventions to increase active case finding, to reduce tobacco smoking, and to reduce harmful alcohol consumption, whilst not ignoring women, should focus on men to most effectively reduce tuberculosis morbidity and mortality in men, women, and children.

 31.'Understanding the transmission dynamics of a large-scale measles outbreak in Southern Vietnam'.

  1. H. T. Nguyen, T. V. Nguyen, Q. C. Luong, et al. Int J Infect Dis, 2022. More information http://doi.org/10.1016/j.ijid.2022.07.055.

 Abstract: OBJECTIVES: During 2018-2020, Southern Vietnam experienced a large measles outbreak of over 26,000 cases. We aimed to understand and quantify the measles spread in space-time dependence and the transmissibility during the outbreak. METHODS: Measles surveillance reported cases between 1/2018 and 6/2020, vaccination coverage, and population data at provincial level were used. To illustrate the spatiotemporal pattern of disease spread, we employed the endemic-epidemic multivariate time series model decomposing measles risk additively into autoregressive, spatiotemporal, and endemic component. Likelihood-based estimation procedures were performed to determine the time-varying reproductive number R(e) of measles. RESULTS: Our analysis shows that measles incidence was associated with vaccination coverage heterogeneity and spatial interaction between provincial units. The risk of infections was dominated by between-province transmission (36.1% to 78.8%), followed by local endogenous transmission (4.1% to 61.5%) whereas the endemic behavior had a relatively small contribution (2.1% to 33.4%) across provinces. In the exponential phase of the epidemic, R(e) was above the threshold with a maximum value of 2.34 (95%CI: 2.20-2.46). CONCLUSION: Local vaccination coverage and human mobility are important factors contributing to the measles dynamics in Southern Vietnam and the high risk of inter-provincial transmission is of most concern. Strengthening disease surveillance is recommended, and further research is essential to understand the relative contribution of population immunity and control measures in measles epidemics.

32.'Assessing changes in nicotine consumption over two years in a population of Hanoi by wastewater analysis with benchmarking biomarkers'.

  1. X. Thanh, G. T. Vu, T. T. T. Hue, et al. The Science of the total environment: 157310, 2022. More information http://doi.org/10.1016/j.scitotenv.2022.157310.

 Abstract: Monitoring the actual consumption of nicotine in the population is essential for formulating tobacco control policies. In recent years, wastewater-based epidemiology (WBE) has been applied as an alternative method to estimate the overall tobacco consumption in different communities around the world, with the potential to be used in resource-scarce settings to cost-effectively monitor nicotine consumption. This study aimed to conduct a WBE analysis in Hanoi, Vietnam, a lower-middle-income-country setting known for high smoking prevalence. Composite wastewater samples were collected at two sites in Hanoi during three periods: Period 1 (September 2018), Period 2 (December 2018-January 2019), and Period 3 (December 2019-January 2020). Concentrations of cotinine, 3-hydroxycotinine, and nicotine ranged from 0.73 μg/L to 3.83 μg/L, from 1.09 μg/L to 5.07 μg/L, and from 0.97 μg/L to 9.90 μg/L, respectively. The average mass load of cotinine estimated for our samples was 0.45 ± 0.09 mg/day/person. The daily nicotine consumption was calculated to be 1.28 ± 0.25 mg/day/person. No weekly trend was detected over the three monitoring periods. We found the amount of nicotine consumption in Period 1 to be significantly lower than in Period 2 and Period 3. Our WBE estimates of smoking prevalence were slightly lower than the survey data. The analysis of benchmarking biomarkers confirmed that cotinine was stable in the samples similar to acesulfame, even though that paracetamol degraded along the sewer canal. Further refinement of the WBE approach may be required to improve the accuracy of analyzing tobacco consumption in the poor sewer infrastructure setting of Vietnam.

 33.'Impoverishing effect of tobacco use in Vietnam'.

Minh Ngoc Nguyen, Anh Ngoc Nguyen, Ha Thu Bui, et al. Tobacco Control: tobaccocontrol-2022-057299, 2022. More information http://doi.org/10.1136/tc-2022-057299

Freefull text https://tobaccocontrol.bmj.com/content/tobaccocontrol/early/2022/07/29/tc-2022-057299.full.pdf.

 Abstract: Background Tobacco consumption places a significant economic burden on households, which is particularly severe in developing countries like Vietnam. In a country where the social insurance system is weak and healthcare is often expensive, tobacco-consuming households may face a higher risk of living in poverty. Some evidence on the social consequences of tobacco consumption suggests that it might aggravate poverty and inequality in Vietnam; however, to the best of our knowledge, no research provides a reliable estimate of the impoverishing effect of tobacco use in the country thus far.Objectives This study quantifies the direct impact of tobacco use on poverty, measured by a poverty head count and the total size of the poverty gap in Vietnam in 2018.Methods By deducting tobacco-related expenditure from the total household income, the authors recalculate the actual household disposable income and examine whether the households suffer from the state of secondary poverty. Data from the 2018 Vietnam Household Living Standards Survey were used for calculation.Results (1) Total tobacco-related expenditure increased the number of poor people by 305 090 (0.31% of the country’s population) in 2018. More than one-third of those impoverished people are children, who should be considered victims of adults’ tobacco use. (2) Tobacco use increased the poverty gap by 0.08 percentage points from 2.20% to 2.28%. (3) The impoverishment effects of tobacco consumption vary across groups in society and appear to be more intense in rural areas, among ethnic minorities and in the two lowest quintiles of consumption.Conclusion This study confirms the impoverishing effect of tobacco use in Vietnam (305 090 people) and that the effects are heterogeneous across population groups. Therefore, controlling tobacco use should be a part of the broader poverty reduction strategy in Vietnam and should be wisely targeted so as to reduce poverty effectively.Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available.

34.'A prospective cohort study on the association between waterpipe tobacco smoking and gastric cancer mortality in Northern Vietnam'.

Hung Xuan Le, Dung Thi Thuy Truong, Long Bao Tran, et al. BMC Cancer, 22(1): 803, 2022. More information http://doi.org/10.1186/s12885-022-09894-6. Free full text https://doi.org/10.1186/s12885-022-09894-6.

 Abstract: Tobacco consumption, as a worldwide problem, is a risk factor for several types of cancer. In Vietnam, tobacco consumption in the form of waterpipe tobacco smoking is common. This prospective cohort study aimed to study the association between waterpipe tobacco smoking and gastric cancer mortality in Northern Vietnam. A total of 25,619 eligible participants were followed up between 2008 and 2019. Waterpipe tobacco and cigarette smoking data were collected; semi-quantitative food frequency and lifestyle questionnaires were also utilized. Gastric cancer mortality was determined via medical records available at the state health facilities. A Cox proportional hazards model was used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI). During 314,992.8 person-years of follow-up, 55 men and 25 women deaths due to gastric cancer were identified. With never-smokers as the reference, the risk of gastric cancer mortality was significantly increased in participants who were ever-smoking (HR = 2.43, 95% CI = 1.35–4.36). The positive risk was also observed in men but was not significantly increased in women. By types of tobacco use, exclusive waterpipe smokers showed a significantly increased risk of gastric cancer mortality (HR = 3.22, 95% CI = 1.67–6.21) but that was not significantly increased in exclusive cigarette smokers (HR = 1.90, 95% CI = 0.88–4.07). There was a significant positive association between tobacco smoking and gastric cancer death for indicators of longer smoking duration, higher frequency per day, and cumulative frequency of both waterpipe and cigarette smoking. Waterpipe tobacco smoking would significantly increase the risk of gastric cancer mortality in the Vietnamese population. Further studies are required to understand the waterpipe tobacco smoking-driven gastric cancer burden and promote necessary interventions.

 35.'The Association Between Ambient Temperatures and Hospital Admissions Due to Respiratory Diseases in the Capital City of Vietnam'.

  1. A. Tran, V. T. H. Le, V. T. Ngo, et al. Front Public Health, 10: 903623, 2022. More information http://doi.org/10.3389/fpubh.2022.903623.

 Abstract: This study aimed to examine the short-term effects of ambient temperature on hospital admissions due to respiratory diseases among Hanoi residents. We collected 34,653 hospital admissions for 365 days (November 1, 2017, to November 31, 2018) from two hospitals in Hanoi. A quasi-Poisson regression model with time series analysis was used to explore the temperature-health outcome relationship's overall pattern. The non-linear curve indicated the temperatures with the lowest risk range from 22 degrees (Celcius) to 25 degrees (Celcius). On average, cold temperatures showed a higher risk than hot temperatures across all genders and age groups. Hospital admissions risk was highest at 13 degrees (Celcius) (RR = 1.39; 95% CI = 1.26-1.54) for cold effects and at 33 degrees (Celcius) (RR = 1.21, 95% CI = 1.04-1.39) for the hot effects. Temporal pattern analysis showed that the most effect on respiratory diseases occurred at a lag of 0 days for hot effect and at a lag of 1 day for cold effect. The risk of changing temperature among women and people over 5 years old was higher than other groups. Our results suggest that the risk of respiratory admissions was greatest when the temperature was low. Public health prevention programs should be enhanced to improve public awareness about the health risks of temperature changes, especially respiratory diseases risked by low temperatures.

 36.'Characteristics and health impacts of PM(2.5)-bound PCDD/Fs in three Asian countries'.

  1. H. Chi, Y. T. Huang, H. M. Nguyen, et al. Environ Int, 167: 107441, 2022. More information http://doi.org/10.1016/j.envint.2022.107441.

 Abstract: Polychlorinated dibenzo-p-dioxins/dibenzofurans (PCDD/Fs) were ubiquitous, persistent chemical compounds attached to particulate matter in the atmosphere. We aimed to study the characteristics of these pollutants in atmospheric PM(2.5) of three Asian countries, including Taiwan (Taipei), Thailand (Chiang Mai), and Vietnam (Hanoi). We carried out a source apportionment analysis to determine significant PCDD/F contributors in these areas. Multiple media model was conducted to access the health impact assessment. The PM(2.5) concentration in Taipei (n = 7), Chiang Mai (n = 20), and Hanoi (n = 10) were 18.4 ± 6.21 μg/m(3), 133 ± 49.5 μg/m(3), and 88.1 ± 12.6 µg/m(3), respectively. The PCDD/Fs level in Hanoi was 92.4 ± 67.3 fg I-TEQ/m(3,) and in Taipei and Chiang Mai was 5.01 ± 2.39 fg I-TEQ/m(3) and 14.4 ± 13.1 fg I-TEQ/m(3), respectively, which showed that the higher PM(2.5) concentration was not necessary to follow with higher PCDD/Fs level. In all three cities, the effect of traffic on ambient PCDD/F level was significant (23-25 %). However, we also observed the specific sources of PCDD/Fs in each city during the sampling periods, namely long-range transport (Taipei, 55 %), Biomass/open burning (Chiang Mai, 77 %), and industrial activities (Hanoi, 34 %). In the carcinogenic risk estimation, the highest median total carcinogenic risk was in Hanoi (5.87 × 10(-6)), followed by Chiang Mai (1.06x10(-6)), and Taipei (2.95 × 10(-7)). Although diet was the major absorption pathway, the food contributor of exposure differed among the three areas due to the difference in food consumption composition.

37.'Direct Medical Costs of Tetanus, Dengue, and Sepsis Patients in an Intensive Care Unit in Vietnam'.

  1. M. Hung, N. Van Hao, L. M. Yen, et al. Front Public Health, 10: 893200, 2022. More information http://doi.org/10.3389/fpubh.2022.893200.

 Abstract: BACKGROUND: Critically ill patients often require complex clinical care by highly trained staff within a specialized intensive care unit (ICU) with advanced equipment. There are currently limited data on the costs of critical care in low-and middle-income countries (LMICs). This study aims to investigate the direct-medical costs of key infectious disease (tetanus, sepsis, and dengue) patients admitted to ICU in a hospital in Ho Chi Minh City (HCMC), Vietnam, and explores how the costs and cost drivers can vary between the different diseases. METHODS: We calculated the direct medical costs for patients requiring critical care for tetanus, dengue and sepsis. Costing data (stratified into different cost categories) were extracted from the bills of patients hospitalized to the adult ICU with a dengue, sepsis and tetanus diagnosis that were enrolled in three studies conducted at the Hospital for Tropical Diseases in HCMC from January 2017 to December 2019. The costs were considered from the health sector perspective. The total sample size in this study was 342 patients. RESULTS: ICU care was associated with significant direct medical costs. For patients that did not require mechanical ventilation, the median total ICU cost per patient varied between US$64.40 and US$675 for the different diseases. The costs were higher for patients that required mechanical ventilation, with the median total ICU cost per patient for the different diseases varying between US$2,590 and US$4,250. The main cost drivers varied according to disease and associated severity. CONCLUSION: This study demonstrates the notable cost of ICU care in Vietnam and in similar LMIC settings. Future studies are needed to further evaluate the costs and economic burden incurred by ICU patients. The data also highlight the importance of evaluating novel critical care interventions that could reduce the costs of ICU care.


38.'The impact of health insurance on households’ financial choices: Evidence from Vietnam'.

Truong Anh Tuan, Pham Khanh Nam and Le Thanh Loan. Research in Economics, 2022. More information. Free full text https://www.sciencedirect.com/science/article/pii/S1090944322000266.

 Abstract: This paper investigates the impact of health insurance on families' financial service choices in Vietnam using TVSEP data from three waves in 2013, 2016, and 2017. The endogeneity is handled via a recursive multivariate probit model. The findings indicate that while health insurance has no effect on private health insurance, it has a positive effect on savings and investments and a negative effect on credit choice. The multivariate probit model's results are robust to both the instrumental variable two-stage least squares model and the bivariate probit model. In addition, correlations between error components in financial service choice equations indicate a possible pattern of household financial usage. The results suggest that health insurance improves households' financial well-being. The implication of the findings is that when developing social security policies aimed at achieving universal health insurance, the influence of health insurance on household finances should not be underestimated.


39.'Factors affecting consumers’ food safety behavior in Vietnam'.

Hong Phuc Luu, Thi Tuyet Hanh Tran and Thi Xuan Truong. Food Control: 109294, 2022. .Free full text https://www.sciencedirect.com/science/article/pii/S095671352200487X.

 Abstract: To improve food safety interventions and policy actions, it is important to investigate factors that affect the food safety behavior of consumers in the domestic environment. This study is the result of a combination of two other studies. The Expert Study applied the Delphi method to organize responses and opinions of food safety experts in Vietnam to investigate critical factors affecting food safety behavior. The Disadvantaged People Study was implemented to investigate potential factors from the perspectives of disadvantaged people preparing meals for their families or feeding themselves. The final set of factors was compiled when both studies had been completed, and includes demographic factors, motivation factors (knowledge about causes of food-borne illness and safe food handling practices; perceived risk of food-borne illness and safe food handling practices), enabling factors (being informed with food safety guidance; availability of appropriate tools, space, and resources; and lifestyle), and maintaining factors (habits and heuristics; food preferences; and societal and social influences). Efforts to improve consumers’ food safety behavior should pay more attention to contextual factors to be in line with local norms, and address various factors preventing food-borne diseases in the domestic environment.


40.'Involvement of pharmacy students in scientific research activities in Vietnam'.

  1. Tran, D. T. Pham, H. T. T. Nguyen, et al. Curr Pharm Teach Learn, 14(6): 737-46, 2022. More information http://doi.org/10.1016/j.cptl.2022.06.004.

Abstract: INTRODUCTION: Scientific research is a crucial section of health-related student education to ensure the competence of graduates. This study is the first to explore attitudes on research, willingness and motivation to conduct research, and barriers preventing this amid pharmacy students in Can Tho, Vietnam. METHODS: A cross-sectional online survey was performed on undergraduate pharmacy students (years four and five) from three public and private universities in Can Tho, Vietnam between April and May 2021. RESULTS: Of the 576 respondents, the majority accredited the significance of conducting research to the field of pharmacy (85.9%) with the motivation of improving the profession (81.6%). Public university respondents were more than twice as likely to have a positive attitude toward research (odds ratio [OR] = 2.88, 95% CI = 1.32-6.27) and be willing to conduct research (OR = 5.73, 95%CI = 3.5-9.37) than their private university counterparts. Very good or excellent academic performance was associated with a positive attitude (OR = 3.09, 95% CI = 1.46-6.53), willingness (OR = 3.2, 95%CI = 1.7-6.03), and increased motivation (OR = 2.42, 95% CI = 1.26-4.64) toward conducting research compared to respondents with average or lower academic performance. A lack of experience (63.5%), knowledge and skills (46%), and research training (51.7%) were the most common personal and systemic barriers to conducting research. CONCLUSIONS: Most students reported having a positive attitude and strong motivation toward research. These findings revealed an opportunity for pharmacy policymakers and educators to utilize national strategy to improve pharmacy education and the profession.


41.'Transforming medical education to strengthen the health professional training in Viet Nam: A case study'.

Tuan D. Tran, Phuc M. Vu, Hong T. M. Pham, et al. The Lancet Regional Health - Western Pacific, 27: 100543, 2022. Free full text https://www.sciencedirect.com/science/article/pii/S2666606522001584.

 Abstract: Summary The competency-based undergraduate curriculum reform at the University of Medicine and Pharmacy at Ho Chi Minh City, Faculty of Medicine (UMP-FM) is detailed and reviewed in reference to the instructional and institutional reforms, and enabling actions recommended by the Lancet 2010 Commission for Health Professional Education. Key objectives are to: revise the overall 6-year curriculum to be more integrated and competency-based; reinforce students’ knowledge application, problem-solving, clinical competence, self-directed learning and soft skills; develop a comprehensive and performance-based student assessment programme; and establish a comprehensive quality monitoring programme to facilitate changes and improvements. New features include early introduction to the practice of medicine, family- and community-based medicine, professionalism, interprofessional education, electives experiences, and a scholarly project. Institutional reform introduces a faculty development programme, joint planning mechanism, a “culture of critical inquiry”, and a transparent faculty reward system. Lessons learnt from the curriculum reform at UMP-FM could be helpful to medical schools from low- and middle-income countries considering transitioning from a traditional to a competency-based curriculum. Funding This work receives no external funding.

 42.'Human trichinellosis in Southeast Asia, 2001-2021'.

  1. Yera, S. Bory, V. Khieu, et al. Food Waterborne Parasitol, 28: e00171, 2022. More information http://doi.org/10.1016/j.fawpar.2022.e00171.

 Abstract: To present the situation of human trichinellosis in Southeast Asia in the last 20th years we analyzed outbreak data and seroprevalence studies from 2001 to 2021 for this region. We queried PubMed (https://pubmed.ncbi.nlm.nih.gov) using keywords "Trichinella", "human" and "Southeast Asia". In addition, we described Trichinella species circulating in this region. In Southeast Asia, in communities eating pork, several cultural factors play important roles in the transmission of Trichinella to humans. The seroprevalences of Trichinella infection in humans are known for Laos and Vietnam to be 0-10.5% in some villages. Also, in Cambodia, Laos, Malaysia, Thailand and Vietnam relatively few human outbreaks (13) and cases (1604) have been recorded during the last 21st years. Their associated mortality rates were low (0.75%). Trichinella spiralis and T. papuae were transmitted after consumption of raw or undercooked pork from domesticated and wild pigs. T. papuae transmission was related to consumption of wild boar. In this region, trichinellosis was frequently subclinical and clinical or severe cases were sporadic and occurred more in male patients. Nevertheless, it is likely that trichinellosis is widely under-diagnosed and is an endemic disease.

 43.'Investigating Stable and Dynamic Aspects of the Vietnamese Self-Compassion Scale using Generalisability Theory'.

  1. C. Truong, T. M. Nguyen, A. H. Nguyen, et al. Mindfulness (N Y): 1-12, 2022. More information http://doi.org/10.1007/s12671-022-01950-3.

 Abstract: OBJECTIVES: Evaluating comprehensive reliability of the Vietnamese Self-Compassion Scale (VSCS) and its ability to distinguish between trait (stable) vs state (dynamic) aspects of self-compassion using Generalisability Theory (G-Theory) is necessary. This investigation contributes to both reliability and validity of research that uses the VSCS to measure self-compassion in Vietnamese adults. METHODS: In a sample of 155 Vietnamese adults who completed the VSCS at three occasions that were each 2 weeks apart, a G-study was conducted to measure reliability and trait vs state aspects of each VSCS subscale and the short-form VSCS, and a D-study was conducted to examine the effects of removing subscales on overall scale reliability as well as evaluate trait vs state aspects of each item. RESULTS: With G-coefficients of 0.93-0.98, both the complete and short-form VSCS (VSCS-SF) demonstrated excellent reliability in measuring trait self-compassion. Three of the six subscales-self-judgement, mindfulness, and kindness-also demonstrated excellent reliability, with G-coefficients of 0.82-0.85. Eighteen of the 26 items measured trait more than state. The remaining eight items reflected a mixture of trait and state, but this did not affect overall reliability. CONCLUSIONS: This study indicated that the VSCS, VSCS-SF, and three VSCS subscales reliably measured trait self-compassion, with scores generalisable across the Vietnamese population and occasions. Thus, overall self-compassion levels remained stable over time, which is useful for evaluating the effectiveness of an intervention because significant changes of self-compassion are likely to be long-lasting. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12671-022-01950-3.

 44.'Challenges and Lessons Learned in the Development of a Participatory Learning and Action Intervention to Tackle Antibiotic Resistance: Experiences From Northern Vietnam'.

  1. T. N. Cai, H. T. Tran, Y. H. T. Nguyen, et al. Front Public Health, 10: 822873, 2022. More information http://doi.org/10.3389/fpubh.2022.822873.

 Abstract: Antibiotic use in the community for humans and animals is high in Vietnam, driven by easy access to over-the counter medicines and poor understanding of the role of antibiotics. This has contributed to antibiotic resistance levels that are amongst the highest in the world. To address this problem, we developed a participatory learning and action (PLA) intervention. Here we describe challenges and lessons learned while developing and testing this intervention in preparation for a large-scale One Health trial in northern Vietnam. We tested the PLA approach using community-led photography, and then reflected on how this approach worked in practice. We reviewed and discussed implementation documentation and developed and refined themes. Five main themes were identified related to challenges and lessons learned: understanding the local context, stakeholder relationship development, participant recruitment, building trust and motivation, and engagement with the topic of antibiotics and antimicrobial resistance (AMR). Partnerships with national and local authorities provided an important foundation for building relationships with communities, and enhanced visibility and credibility of activities. Partnership development required managing relationships, clarifying roles, and accommodating different management styles. When recruiting participants, we had to balance preferences for top-down and bottom-up approaches. Building trust and motivation took time and was challenged by limited study team presence in the community. Open discussions around expectations and appropriate incentives were re-visited throughout the process. Financial incentives provided initial motivation to participate, while less tangible benefits like collective knowledge, social connections, desire to help the community, and new skills, sustained longer-term motivation. Lack of awareness and perceived importance of the problem of AMR, affected initial motivation. Developing mutual understanding through use of common and simplified language helped when discussing the complexities of this topic. A sense of ownership emerged as the study progressed and participants understood more about AMR, how it related to their own concerns, and incorporated their own ideas into activities. PLA can be a powerful way of stimulating community action and bringing people together to tackle a common problem. Understanding the nuances of local power structures, and allowing time for stakeholder relationship development and consensus-building are important considerations when designing engagement projects.


45.'Identification, serotyping, and antimicrobial susceptibility of Riemerella anatipestifer isolated from ducks in Vietnam'.

  1. T. Vo, V. T. Dang, D. H. Le, et al. Open Vet J, 12(3): 391-98, 2022. More information http://doi.org/10.5455/OVJ.2022.v12.i3.13.

 Abstract: BACKGROUND: Septicemia caused by Riemerella anatipestifer (R. anatipestifer) is a serious problem in the duck industry worldwide, and it is currently one of the major concerns for duck farming in Vietnam.. AIM: This study was conducted to identify the causative agent of septicemia in ducks in Vietnam. The antimicrobial susceptibility and serotypes of R. anatipestifer isolates were also determined to provide valuable information for disease treatment and vaccine development. METHODS: Riemerella anatipestifer was isolated using blood agar and chocolate agar media. The commercial API 20NE microtest system and the partial nucleotide sequence analysis of the 16s rRNA were used to identify R. anatipestifer strains. Serotypes were determined by slide agglutination test using standard antisera against R. anatipestifer. The disk diffusion method was utilized to investigate the antimicrobial susceptibility of R. anatipestifer isolated strains. RESULTS: A total of 408 samples were collected from ducks with typical symptoms of septicemia for R. anatipestifer isolation. Sixty-nine R. anatipestifer strains were identified. Serotyping results showed that 30 out of 69 bacterial strains were classified as serotypes 1, 6, 8, 10, and 20, with serotype 10 being the most prevalent. The antimicrobial susceptibility test revealed that 100% of the bacterial isolates were susceptible to Amoxicillin/clavulanic acid and Imipenem. On the contrary, the majority of R. anatipestifer strains were resistant to Nalidixic acid (89.9%), Streptomycin (75.4%), and Norfloxacin (72.5%). CONCLUSION: This is the first ever report in terms of identification, serotyping, and antimicrobial susceptibility tests of R. anatipestifer causing septicemia in ducks of Vietnam, providing useful scientific information for treatment as well as vaccine development to control the disease.

  1. 'Implementing clinical pharmacy activities in hospital setting in Vietnam: current status from a national survey' / T. X. Dong, H. T. Trinh, D. H. Nguyen, et al. BMC Health Serv Res, 22(1): 878, 2022. More information http://doi.org/10.1186/s12913-022-08242-5.

 Abstract: BACKGROUND: Clinical pharmacy activities have evolved over the past decades contributing to all stages of the patient care process, especially in the hospital setting. However, these practice roles may differ to a significant extent depending on the healthcare policy of countries. In Vietnam, the magnitude of adopting clinical pharmacy activities in hospital settings throughout the country is still unknown since these activities have been implemented. This study aimed to ascertain the current status of clinical pharmacy activities performed within the Vietnamese hospital setting. METHODS: A nation-wide survey was conducted from December 2017 to January 2018. Two online questionnaires, one for the Heads of Pharmacy Department and one for clinical pharmacists, were designed based on the national legal regulations about implementing clinical pharmacy activities in the hospital setting. These questionnaires were sent to all hospitals and healthcare facilities with a department of pharmacy. RESULTS: A total of 560 Heads of Pharmacy and 574 clinical pharmacists participated in the study, representing a response rate of 41.2%. Among the participating hospitals, non-patient specific activities were implemented widely across all hospital classes, with pharmacovigilance, medication information, and standard operating procedures development implemented in ≥88% of all hospitals. In contrast, there was a significant variation in the level of implementation of patient-specific activities among hospital classes. With activities such as medication counselling, monitoring of adverse drug reactions, and obtaining patient's medication histories provided at a considerably lower level in between 49 and 57% of hospitals. CONCLUSION: Clinical pharmacy activities have been initiated in most of the surveyed hospitals. In general, clinical pharmacy is more established in higher-class hospitals in Vietnam. However, the current implementation status is focused on non-patient-specific activities, while patient-oriented activities remained insufficiently established.

 47.'Willingness to participate in clinical trials: A cross-sectional analysis in Ho Chi Minh City, Vietnam'.

Thoai N. Dang, Tran T.T. Bao, Chau N.D. Quynh, et al. Journal of Pharmacy & Pharmacognosy Research, 10(5), 2022. Free full text https://jppres.com/jppres/pdf/vol10/jppres22.1403_10.5.791.pdf.

 Abstract: Context: Clinical trial is an experiment on comparable groups of human beings which evaluates the efficacy of a treatment or medical intervention by comparing the effects with other testing treatments or control treatments. Clinical trials help develop alternative treatment solutions or a preventative method for disease as well as support participants with medical and healthcare services during the trial period. Other benefits of clinical trials include gaining information, ensuring health issues, detecting early disease symptoms, and reducing medical services costs. --- Aims: To evaluate willingness to participate (WTP) in clinical trials (CT) in Ho Chi Minh city and examine the factors associated with it. --- Methods: A cross-sectional study was conducted through the online sampling method and gathered 581 valid responses during two weeks in February 2022. --- Results: Among 581 respondents, 71.6% stated they were willing to participate in CT, while 48.2% stated that they would let their family enroll. WTP in CT was higher in participants of younger age, single, not having children, healthy, and without chronic disease. Vietnamese age was associated with WTP in CT. --- Conclusions: Assessing WTP in CT helps state management agencies, organizations and research institutes design suitable CT models and increase the voluntary participation rate in CT.

 48.'Evaluating the gap of integrated behavioral health programs for NCDs in China, Vietnam, Cambodia and Thailand'.

Jennifer Rolfes, Shiyou Wu, Mohamed Abdalla, et al. Asian Journal of Health Sciences, 8(1): ID39-ID39, 2022. Free full text http://ajhs.biomedpress.org/index.php/ajhs/article/view/510.

 Abstract: The rates of non-communicable diseases (NCD's) such as diabetes and hypertension are reaching epidemic proportions in Asia. Behavioral conditions are frequently comorbid with NCD's, contribute to poor clinical outcomes, and are under detected and untreated in many Asian nations. This article reports the findings of a study examining the level of behavioral and non-behavioral care integration in clinics and hospitals in China, Cambodia, Vietnam, and Thailand. It assessed providers' ratings of patients' prevalence of behavioral conditions, the need for behavioral health consultants, and patients' self-reported health risk assessments (HRA) of their lifestyle and behavioral problems. The results show low levels of available behavioral care in the participating Asian countries in comparison with the United States. The HRA results showed high rates of patients' reported tobacco use, high-risk levels for alcohol use in men, and low levels of healthy foods intake and physical activity for men and women. The provider survey results showed moderate perceived prevalence of lifestyle and behavioral conditions and moderate perceived need for integrated behavioral care. These results suggest a need to develop and evaluate integrated healthcare services in Asia in order to address the epidemic of NCD's.

 49.'The willingness to perform first aid among high school students and associated factors in Hue, Vietnam'.

Le Duc Huy, Pham Thanh Tung, Le Nguyen Quynh Nhu, et al. PLoS ONE, 17(7): e0271567, 2022. More information http://doi.org/10.1371/journal.pone.0271567. Free full text https://doi.org/10.1371/journal.pone.0271567.

 Abstract: Background Adolescents who are willing to perform first aid can help prevent injuries and ultimately death among themselves and others involved in accidents or injuries. This study aims to estimate the prevalence of students’ willingness to perform first aid procedures and additionally examine associated factors among high school students in Hue, Vietnam. Methods A cross-sectional study utilizing multi-stage stratified random sampling was conducted between April to July 2020 by investigating 798 high school students in Hue, Vietnam. Participants were invited to complete a self-reported questionnaire pertaining to individual demographic characteristics, personal perception of self-efficacy, and willingness to perform first aid. To better interpret these findings, both multivariable linear and Poisson regression models were fitted to evaluate the association between individual student characteristics and the willingness to perform first aid. Results The prevalence of having willingness to perform first aid (defined as ≥4 points out of 5 to all three questions) was 49.9% (95%CI:28.6–71.2%). The major reported barriers in performing first aid were fear of making mistakes and hurting victims (34.4%, 95%CI:31.9–37.0%), no prior first aid training (29.8%, 95%CI:25.9–33.9%), and forgetting first aid steps (23.0%, 95%CI:15.8–32.2%). By employing the multivariable linear regression model, it was identified that students with high (β = 0.614, 95%CI:0.009–1.219) or very high (β = 1.64, 95%CI:0.857–2.422) levels of self-efficacy appeared to be more willing to perform first aid. Similarly, in the Poisson regression models, compared to neutral students, students who reported high (PR = 1.214, 95%CI:1.048–1.407) or very high (PR = 1.871, 95%CI:1.049–3.337) levels of self-efficacy were more willing to perform first aid. Conclusions The level of willingness to perform first aid among high school students in this study population was found to be moderate. Therefore, integrating activities to promote self-efficacy in first aid training could be considered a progressive step towards improving a student’s willingness to provide such life-saving procedures.

 50.'Women's holistic self-care behaviors during pregnancy and associations with psychological well-being: implications for maternal care facilities'.

  1. D. Nguyen, L. H. Nguyen, L. T. Ninh, et al. BMC Pregnancy Childbirth, 22(1): 631, 2022. More information http://doi.org/10.1186/s12884-022-04961-z.

 Abstract: BACKGROUND: Self-care behaviors during pregnancy significantly impacts mother and children's health. This study aimed to explore the self-care behaviors and the associations of these behaviors with the psychological well-being of women during pregnancy, as well as the mediating effects of different social support with these associations. METHODS: A cross-sectional data of 562 pregnant women at Hanoi Obstetrics & Gynecology Hospital and Ca Mau Obstetrics & Pediatrics in Vietnam were analyzed. Questions about self-care behaviors, pregnancy characteristics, social support, and psychological well-being were asked. Multivariate regression models were performed. Structural Equation Modeling (SEM) was employed to test the mediating effects of different social support with the association between self-care behaviors and psychological well-being. FINDINGS: Only 13% of pregnant women often or always did physical exercise at least three times a week, and 40% consumed enough fiber and five servings of vegetables a day. Only 78.7% always avoided alcohol drinking, and 53.9% of pregnant women avoided being exposed to second-hand smoking and 71,7% avoided using traditional medicine without physicians' prescriptions. Around 66% of pregnant women always or often had prenatal care checkups as scheduled. Information sources, social support and childbirth expectation were major drivers for self-care practices. SEM model showed that social support mediated the relationship between maternal health behaviors and mental well-being. CONCLUSION: This study highlighted the remarkable gaps in self-care practices among our pregnant women, which were significantly associated with their mental well-being. Social support-oriented consultancy and interventions should be warranted for improving behaviors and the mental well-being of pregnant women in Vietnam.

 51.'Bringing Sectors Together in Da Nang, Vietnam: Participatory Systems Mapping'.

Thi Kinh Kieu, Karen Grattan, Bailey Goldman, et al. Journal of Urban Health, 99(4): 760-69, 2022. More information http://doi.org/10.1007/s11524-022-00650-6. Free full text https://doi.org/10.1007/s11524-022-00650-6.

Abstract: The USAID-funded Building Healthy Cities (BHC) work in Da Nang, Vietnam, engaged 108 multi-sector stakeholders to gather qualitative data across two workshops and three citizen town halls from 2019 to 2021. These data were synthesized with the results from BHC’s seven other activities in Da Nang to build systems maps. Contextual findings showed that multi-sector, multi-level participation and collaboration have been the key to moving the city toward their smart and livable city goals. Currently, citizen, nongovernmental organization, and private sector collaboration are low for many government sectors, which results in policy and programs that are mismatched to actual needs and therefore have less powerful impacts. When these policies and programs are implemented, they struggle to demonstrate strong benefits to these stakeholder groups, further decreasing participation. This is central to the systems map that BHC developed, and is expanded upon through additional patterns that fall within four main areas: management quality; vision and leadership; workforce capacity; and community engagement. Stakeholders found four key leverage points within this context that, if included in every action, could help overcome barriers. These leverage opportunities are: (1) investing at all levels; (2) improving function and innovation of information technology; (3) increasing participation and feedback; and (4) creating more responsive policy. As BHC concludes activities in Da Nang, local university students will be trained on systems mapping techniques to embed systems thinking skills into the next generation of workforce, and a set of recommendations will be developed to share with the government to act on these findings.

 52.'Inactivated Poliovirus Vaccine Closing the Type 2 Immunity Gap in Vietnam'.

  1. T. T. Huyen, D. D. Anh, N. T. Trung, et al. J Pediatric Infect Dis Soc, 2022. More information http://doi.org/10.1093/jpids/piac046.

 Abstract: This was a cross-sectional community-based serological survey of polio antibodies assessing the immunogenicity of inactivated poliovirus vaccine (IPV) focusing on poliovirus serotype 2. IPV was administered to 5-month-old children. Type 2 antibody seroprevalence when measured 1 month after IPV administration was >95%. One IPV dose successfully closed the immunity gap.

53.'Understanding Vaccine Hesitancy in Vietnamese Fish Farmers'.

  1. A. Chambers, M. Crumlish, D. A. Comerford, et al. Antibiotics (Basel), 11(7), 2022. More information http://doi.org/10.3390/antibiotics11070878.

 Abstract: (1) Background: Antibiotic (AB) usage in food animals is a significant contributor to antimicrobial resistance (AMR). Vaccination can reduce the over-use of AB treatment. Little is known about farmers' attitudes and beliefs about AB and vaccine usage in developing countries, especially in aquaculture. (2) Methods: We used the necessity/concerns framework to guide our research, where vaccine hesitancy is viewed as a function of the perceived necessity versus the perceived concerns about treatment. We measured disease and treatment perceptions in 400 Vietnamese farmers of Pangasius catfish, specifically regarding (a) chemical treatment of water, (b) antibiotic usage, and (c) vaccination of fish. (3) Results: Although farmers' concerns about AB usage outweighed necessity beliefs, 86.5% reported having used ABs on their farm. Knowledge and attitudes towards vaccination were positive, with views of its necessity outweighing concerns. However, if available, only 67.6% said they would definitely use vaccines in the future. Farmers were more likely to use vaccines if they reported having fewer problems with fish disease, felt that any concerns about vaccines were outweighed by their perceived benefits, had less mistrust of vaccination, and had fewer concerns about commercial profiteering. (4) Conclusion: Interventions that highlight concerns about continued antibiotic use, reduce concerns, and mistrust and increase the perceived necessity of vaccines combined with greater availability of vaccines may be the most effective way of overcoming vaccine hesitancy and increase appropriate use of vaccines by Vietnamese fish farmers.