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Researches
Sexual Risk and
Bridging Behaviors Among Young People in Hai Phong, Vietnam
Cong Thanh Duong,
Tran Hien Nguyen, Thi Thanh Ha Hoang, Van Vi Nguyen, Thi Minh Nguyet Do, Van Han
Pham, Roger Detels
Published
online: 18 July 2007
© Springer
Science+Business Media, LLC 2007
AIDS Behav
(2008) 12:643–651
Abstract: The risk of the HIV
epidemic spreading from high-risk groups to the general population in Vietnam
depends on sexual risk and bridging behaviors between highand low-risk
individuals. A cross-sectional study was used to describe sexual activities of
youth aged 18–29 years. Nearly half (41.4%) were sexually active. Premarital sex
was reported by 43.3% of them; 78.3% of sexually active males and 13.5% of
sexually active females. Multiple sex partners were reported by 31.0%; 56.7% of
males and 9.2% of females. Almost 27% of males and 5% of females engaged in
sexual bridging behaviors. Being unmarried was significantly associated with
having sex with non-regular partners. Being unmarried and early age at first
intercourse were associated with having sex with a sex worker. Consistent condom
use was high with commercial sex workers but low with regular partners.
Education to delay early sexual debut, increased employment, and strategies to
inform young sexually active people to adopt safer behaviors are urgently
needed.
Keywords: Sexual risk _
Bridging behaviors _ Young people _ Hai Phong _ Vietnam
HIV Risk Behaviours
and Determinants Among People Living with HIV/AIDS in Vietnam
Duong Cong Thanh,
Nguyen Tran Hien, Nguyen Anh Tuan, Bui Duc Thang, Nguyen Thanh Long, Knut
Fylkesnes
© Springer
Science+Business Media, LLC 2008
AIDS
Behav
Abstract: There is a
potentially high risk of HIV spreading from people living with HIV/AIDS. We
conducted a cross-sectional study to examine HIV risk behaviours and their
determinants among people living with HIV/AIDS. Eighty-two percent had been
sexually active. Sex with multiple partners was reported by 20% and consistent
condom use by about one third. More than half of the participants (52%) reported
having injected drugs during the previous month, and 35% of those had shared
needles and syringes. Voluntary HIV testing and having received condoms or
injection equipment from the local HIV prevention program, were found to be
significantly associated with fewer HIV risk behaviours. Having learned recently
about personal HIV status, multiple sex partners, low educational attainment and
young age were found to be associated with higher HIV risk behaviours. Giving
high priority to targeted preventive and support programmes is likely to be a
highly cost-effective strategy.
Keywords: Risk behaviours _
HIV/AIDS _People living with HIV/AIDS _ Vietnam
The Context of HIV
Risk Behaviours Among HIV-Positive Injection Drug Users in Viet Nam: Moving
Toward Effective Harm Reduction
Duong Cong Thanh,
Karen Marie Moland and Knut Fylkesnes
Published: 6 April
2009
BMC Public
Health2009,
9:98 doi:10.1186/1471-2458-9-98
Abstract:
Background: Injection drug users
represent the largest proportion of all HIV reported cases in Viet Nam. This
study aimed to explore the perceptions of risk and risk behaviours among HIV
positive injection drug users, and their experiences related to safe injection
and safe sex practices.
Methods:
This study used
multiple qualitative methods in data collection including in-depth interviews,
focus group discussions and participant observation with HIV-positive injection
drug users.
Results:
The informants
described a change in the sharing practices among injection drug users towards
more precautions and what was considered 'low risk sharing', like sharing among
seroconcordant partners and borrowing rather than lending. However risky
practices like re-use of injection equipment and 'syringe pulling' i.e. the use
of left-over drugs in particular, were frequently described and observed. Needle
and syringe distribution programmes were in place but carrying needles and
syringes and particularly drugs could result in being arrested and fined. Fear
of rejection and of loss of intimacy made disclosure difficult and was perceived
as a major obstacle for condom use among recently diagnosed HIV infected
individuals.
Conclusion: HIV-positive
injection drug users continue to practice HIV risk behaviours. The antidrug law
and the police crack-down policy appeared as critical factors hampering ongoing
prevention efforts with needle and syringe distribution programmes in Viet Nam.
Drastic policy measures are needed to reduce the very high HIV prevalence among
injection drug users.
HIV
Prevention Service Coverage for Men Having Sex with Men in 4 Provinces in Viet
Nam
Duong Cong
Thanh1, Keith Sabin2, David Jacka2, Nguyen
Thanh Long3, Vo Hai Son3, Bui Hoang Duc3,
Nguyen Tran Hien1, and Nguyen Anh Tuan1.
1 National
Institute of Hygiene and Epidemiology, Viet Nam;
2 World Health
Organization Representative Office in Viet Nam;
3 Viet Nam Administration of
HIV/AIDS Control.
Backgrounds
§
HIV
sentinel surveillance is conducted annually among 6 key populations in 39
provinces in Vietnam.
§
To
obtain trends of key national and global indicators and HIV infection, some
behavioral questions were added to the serosurveys in seven provinces in 2010.
§
This
aims to determine HIV prevalence, risk behaviors, and coverage of prevention
services among men who have sex with men (MSM).
Methods
§
Cross-sectional
surveys were conducted. Participants were selected based on geographic mapping
exercise and through peer educators.
§
A short
questionnaire consists of 23 behavioral questions were added to the serosurveys
among MSM in four voluntary provinces including Ha Noi, Hai Duong, Ho Chi Minh
city, and An Giang in 2010.
Results
§
1009
MSM provided blood and interviews.
§
Median
HIV prevalence among MSM and drug injecting-MSM were 6.0% (range: 0.0%-16.0%)
and 11.1% (0.0%-50.0%), respectively.
§
Median
of MSM ever injecting drug was 12.3% (range: 0.0%-20.5%). The proportion of
using clean needles in the most recent injection was low, median of 85.7%
(range: 73.6%-91.6%).
§ Median of MSM
reporting condom use during anal sex with most recently male partner was 73.4%
(range: 66.5%-85.8%). Percentage of consistent condom use through anal sex with
male partners in the past month in Hanoi the highest (72.0%), other provinces
are below 50%, especially in HCMC was only 29.6%.
§
Median
of MSM selling sex in the last 12 months was 35% (range: 0.8%-47.3%).
§
Medians
of MSM receiving free condoms and syringes in the last month were 55.6%
(43.4%-77.7%) and 36.9% (27.8%-86.2%), respectively.
§
Median
of MSM receiving sexually transmitted infections screening in the last 3 months
was 13.2% (6.2%-31.6%).
§
HIV
testing in the past year and knowing the result was a median of 20.7%
(4.4%-39.6%).
Conclusions
§
HIV
prevalence was high among drug injecting-MSM and varying among provinces.
§
MSM
practiced high risk for HIV transmission.
§
Access
to HIV prevention services was very low and varied by service and
province.
§
Although mapping was
recommended, however, this was at core a convenience sample.
§
The
integrating a short behavioral questionnaire into current HIV sentinel
surveillance program can be done and routinely implemented annually.
Recommendations
§
Access
to HIV prevention efforts needs to be broadened with a focus on drug
injecting-MSM to prevent further HIV transmission from injection drug users to
general MSM and their partners.
§
Investigation of
methods to increase accessibility of HIV/STI services to MSM.
§
Increasing services
to address needs of MSM selling sex where it is identified as a significant
issue.
§
Improvement of the
sampling of sentinel surveillance is a key next step to achieve more
representative samples.
§ Expand the
application of the brief behavioral questionnaire to routine sentinel
surveillance.
Poster for ICAAP conference
"The 10th International Congress on AIDS in Asia and the Pacific,
Busan, Korea, 24 August 2011"
Estimating HIV Incidence Among Female Sex Workers: Results from The Pilot of Integrating Short Behavioral Survey into The Routine HIV Sentinel Surveillance in Vietnam
Duong Cong Thanh1, Keith Sabin2, David Jacka2, Nguyen Thanh Long3, Vo Hai Son3, Bui Hoang Duc3, Nguyen Tran Hien1, and Nguyen Anh Tuan1.
1 National Institute of Hygiene and Epidemiology, Viet Nam;
2 World Health Organization Representative Office in Viet Nam;
3 Viet Nam Administration of HIV/AIDS Control.
Backgrounds
§ HIV sentinel surveillance is conducted annually among 6 key populations in 39 provinces in Vietnam.
§ To obtain trends of key national and global indicators and HIV infection, some behavioral questions were added to the serosurveys in seven provinces in 2010.
§ This aims to determine HIV prevalence, estimated incidence, risk behaviors, and coverage of intervention among female sex workers (FSW).
Methods
§ Cross-sectional surveys were conducted. Participants were selected based on geographic mapping exercise and through peer educators.
§ A short questionnaire consists of 18 behavioral questions were added to the serosurveys among FSW in seven voluntary provinces including Ha Noi, Hai Duong, Thanh Hoa, Hue, Da Nang, Ho Chi Minh city, and An Giang in 2010.
§ Assumptions for HIV incidence density: All sex workers were negative before initiation of selling sex, HIV infection occurred midpoint from initiation of selling to the time of the survey, and ignoring the possibility of being infected through other risks.
Results
§ Median HIV prevalence among overall-FSW and less than 25 years-FSW were 4% (range: 0.0%-29.3%) and 2.4% (0.0%-25%), respectively.
§ Median of FSW those less than 3 years duration of selling sex was 2.8% (range: 0.0%-26.3%).
§ Median estimated HIV incidence density among injecting-FSW and non-injecting-FSW was 0.0 (0.0-16.7) and 0.2 (0.0-1.0) per 100 person-months at risk, respectively.
§ Median of FSW reported ever share needle and inconsistent condom use in the last months was 24.7% (range: 0.0%-60%) and 16.1% (range: 4.1%-46.1%).
§ Medians of FSW receiving free sexually transmitted infections screening including testing and physical examination in the last 3 months were 47.3% (18.6%-75.3%).
§ Medians HIV testing in the past year, more than one year, and never were 50.0% (range: 9.3%-68.6%), 18.6% (4.0%-24.6%), and 35.3% (20.6%-72.0%).
Conclusions
§ Estimated HIV incidence suggests that HIV infection occurs quickly among young FSW and new to sex work.
§ HIV transmission among FSW is closely related to drug injection in some provinces.
§ Access to HIV prevention services was very low and varied by service and province.
§ Although mapping was recommended, however, this was at core a convenience sample. This might capture a very high risk population but it is not necessary representative sample.
§ The integrating a short behavioral questionnaire into current HIV sentinel surveillance program can be done and routinely implemented annually.
Recommendations
§ HIV prevention efforts should increase focus on FSW who are young, new to sex work, and injecting drugs.
§ Improvement of the sampling of sentinel surveillance is a key next step to achieve more representative samples.
§ Expand the application of the brief behavioral questionnaire to routine sentinel surveillance.
Poster for ASHM conference
"Australasian HIV/AIDS Conference 2011 (23rd Annual ASHM Conference)
- Canberra, Australia, 20 September 2011"
Ngô
Tuấn Cường, Nguyễn Đồng Tú, Trần Huy Hoàng, Lê Thanh Hương, Nguyễn Hoài Thu,
Nguyễn Bình Minh, Trần Như Dương, Nguyễn Trần Hiển.
Imported
Dogs as possible vehicles of Vibrio Cholerae 01 causing Cholera Outbreaks in
Northern Vietnam.
The Open
Infectious Diseases Journal 5
(1), pp.127 - 134, 2011-11-02.
Imported
Dogs as Possible Vehicles of Vibrio Cholerae O1 Causing Cholera Outbreaks in
Northern Vietnam
Tuan
Cuong Ngo,
Dong Tu Nguyen, Huy Hoang Tran, Thanh Huong Le, Hoai Thu
Nguyen, Tai
The Diep,
Thi Phuong Lan Nguyen, Binh Minh Nguyen, Nhu Duong
Tran, Tetsu Yamashiro,Kouichi Morita, Tran Hien
Nguyen and Masahiko Ehara
Abstract
Strains
of V. cholerae O1 were isolated from the sewage and a pond near the
first patient’s house and also from domestic vegetables obtained at a
neighboring market. From 24 October 2007 to 25 June 2009, 1,505 cases were
confirmed positive for V. cholerae O1 (biotype El Tor, serotype Ogawa)
in 22 cities and provinces in northern Vietnam. On May 8 and May 12, 2009,
epidemic strains of V. cholerae O1 were isolated from dogs in slaughter
houses in Hanoi and from dogs in cages in Thanh Hoa, respectively. Isolates of
V. cholerae O1 in Laos and Thailand were found to be the same clone as
those isolates from dogs, patients and environmental water samples in northern
Vietnam. Although the transmission routes of cholera differed between the
northern and southern provinces of Vietnam, the same clonality was observed
among isolates from 2007 to 2010.
Vũ Đình
Thiểm, Lin
FY, Đỗ Gia
Cảnh, Nguyễn
Hồng Sơn, Đặng
Đức Anh, Mao
ND, Chu
C, Hunt
SW, Robbins
JB, Schneerson
R, Szu
SC.
The
Vi conjugate typhoid vaccine is safe, elicits protective levels of IgG anti-Vi,
and is compatible with routine infant vaccines.
Clinical
and Vaccine Immunology. 2011
May; 18(5): p.730-735. Epub 2011 Mar 16.
The
Vi conjugate typhoid vaccine is safe, elicits protective levels of IgG anti-Vi,
and is compatible with routine infant vaccines
Thiem VD,
Lin FY, Canh do G, Son NH, Anh DD, Mao ND, Chu C, Hunt SW, Robbins JB, Schneerson R, Szu SC.
Abstract
Typhoid
fever remains a serious problem in developing countries. Current vaccines are
licensed for individuals who are 5 years old or older. A conjugate of the
capsular polysaccharide (CP) of Salmonella enterica serovar Typhi (Vi) bound to
recombinant exoprotein A of Pseudomonas aeruginosa (Vi-rEPA) enhanced Vi
immunogenicity and protected 2- to 5-year-olds in Vietnam. In this study,
Vi-rEPA was evaluated for use in infants. A total of 301 full-term Vietnamese
infants received Expanded Program on Immunization (EPI) vaccines alone or with
Vi-rEPA or Haemophilus influenzae type b-tetanus toxoid conjugate (Hib-TT) at 2,
4, and 6 months and Vi-rEPA or Hib-TT alone at 12 months. Infants were visited
6, 24, and 48 h after each injection to monitor adverse reactions. Maternal,
cord, and infant sera were assayed for IgG anti-Vi and for IgG antibodies to Hib
CP and the diphtheria, tetanus, and pertussis toxins at 7, 12, and 13 months. No
vaccine-related serious adverse reactions occurred. In the Vi-rEPA group, the
IgG anti-Vi geometric mean (GM) increased from the cord level of 0.66 to 17.4
enzyme-linked immunosorbent assay units (EU) at 7 months, declined to 4.76 EU at
12 months, and increased to 50.1 EU 1 month after the 4th dose (95% of infants
had levels of ≥ 3.5 EU, the estimated protective level). Controls had no
increase of the IgG anti-Vi GM. Infants with cord anti-Vi levels of <3.5 EU
responded with significantly higher IgG anti-Vi levels than those with levels of
≥ 3.5 EU. Anti-diphtheria, -tetanus, and -pertussis toxin levels were similar in
all groups. Vi-rEPA was safe, induced protective anti-Vi levels, and was
compatible with EPI vaccines, and it can be used in infants. High cord IgG
anti-Vi levels partially suppressed infant responses to Vi-rEPA.
Animal
livestock and the risk of hospitalized diarrhoea in children under 5 years in
Vietnam
Abstract
To
investigate the association between environmental exposure to Objective A livestock
and incidence of diarrhoea among Vietnamese children. Methods 828 households
in 525
individuals, living in 75 population-based
cohort of 353 Khanh Hoa Province, Vietnam, with baseline data covering
geo-referenced information on demography, socio-economic status and household
animals was investigated. Geographic information system was applied to calculate
the density of livestock. The data were linked to hospitalized diarrhoea cases
of children years recorded at two hospitals treating patients from the area
as under
5 Overall, 3116 children with diarrhoea inpatients
in the study area. Results were hospitalized during the study period. The
incidence of diarrhoea hospitalization was 60.8/1000 child-years. Male gender,
age <years, higher 2
number of household members and lack of tap water were significantly associated
with an increased risk of diarrhoea. There was no evidence that ownership of
livestock increased the risk of diarrhoea. In spatial analysis, we found no
evidence that a high density of any animals was associated with an increased
risk of diarrhoea. Conclusions Exposure to animals near or in households does
not seem to constitute a major risk for diarrhoea in children under the age of 5
in Vietnam. Public health interventions to reduce childhood diarrhoea burden
should focus on well-recognized causes such as sanitation, personal hygiene,
access to adequate clean water supply and vaccination.
Nguyễn
Đồng Tú,
Ngô Tuấn Cường, Trần Huy Hoàng, Lê Thanh
Hương, Nguyễn Hoài Thu, Nguyễn Bình Minh, Trần Như
Dương,
Tetsu
Yamashiro and
Masahiko Ehara.
Characterization
of Vibrio cholerae O139 of an Aquatic Isolate in Northern Vietnam.
The
Open Microbiology Journal.
2012,
Vol
6, p.14-21.
1874-2858/12
2012 Bentham Open.
Characterization of
Vibrio cholerae O139 of an Aquatic Isolate in Northern Vietnam
Dong Tu
Nguyen,
Tuan Cuong Ngo, Huy Hoang Tran, Thanh Huong Le, Hoai Thu
Nguyen, Binh Minh Nguyen, Nhu Duong Tran,
Tetsu Yamashiro and Masahiko Ehara
Abstract
During the cholera
survey in Namdinh province (northern Vietnam) in July, 2010, one strain of
Vibrio cholerae O139 was isolated from 7 environmental water samples
positive for ctxA, toxR, VCO139 genes and named as V. cholerae
O139, ND1 strain. This strain was lysogenic harbouring a genome similar to
the filamentous phage fs1. The replicativeform DNA of this phage (named as
ND1-fs1, 6856 bp) was sequenced and compared with the other filamentous
phages.The filamentous phage ND1-fs1 integrates into the region between ctxB
and rtxA genes. The genetic organization of theCTX of V.
cholerae O139, strain ND1 was determined and the schematic representation
of the genetic organization wasshown together with the
ND1-fs1 prophage.
Nguyễn Bình Minh, Lee JH, Ngô Tuần Cường, Choi SY, Nguyễn Trần Hiển, Đặng Đức Anh, Lee HR, Ansaruzzaman M, Endtz HP, Chun J, Lopez AL, Czerkinsky C, Clemens JD, Kim DW. Cholera outbreaks caused by an altered Vibrio cholerae O1 El Tor biotype strain producing classical cholera toxin B in Vietnam in 2007 to 2008. J Clin Microbiol. 2009 May;47(5):1568-71. Epub 2009 Mar 18.
Cholera Outbreaks Caused by an Altered Vibrio Cholerae O1 El Tor Biotype Strain Producing Classical Cholera Toxin B in Vietnam in 2007 to 2008.
Nguyen BM, Lee JH, Cuong NT, Choi SY, Hien NT, Anh DD, Lee HR, Ansaruzzaman M, Endtz HP, Chun J, Lopez AL, Czerkinsky C, Clemens JD, Kim DW.
Abstract
Vibrio cholerae O1 isolates collected during cholera outbreaks occurring from late 2007 to early 2008 in northern Vietnam were revealed to represent an altered strain containing the RS1 element followed by a CTX prophage harboring El Tor type rstR and classical ctxB on the large chromosome.
Đặng Đức Anh, Kilgore PE, Slack MP, Nyambat B, Tho le H, Yoshida LM, Nguyễn Hiền Anh, Nguyen CD, Chong CY, Nguyen D, Ariyoshi K, Clemens JD, Jodar L. Surveillance of pneumococcal-associated disease among hospitalized children in Khanh Hoa Province, Vietnam. Clin Infect Dis. 2009 Mar 1; 48 Suppl 2:S57-64.
Surveillance of Pneumococcal-Associated Disease among Hospitalized Children in Khanh Hoa Province, Vietnam
Anh DD, Kilgore PE, Slack MP, Nyambat B, Tho le H, Yoshida LM, Nguyen HA, Nguyen CD, Chong CY, Nguyen D, Ariyoshi K, Clemens JD, Jodar L.
Abstract
BACKGROUND: To understand the epidemiology of childhood bacterial diseases, including invasive pneumococcal disease, prospective surveillance was conducted among hospitalized children in Nha Trang, Vietnam.
METHODS: From April 2005 through August 2006, pediatricians at the Khanh Hoa General Hospital used standardized screening criteria to identify children aged <5 years who had signs and symptoms of invasive bacterial disease. All cerebrospinal fluid (CSF) and blood specimens collected were tested by bacterial culture. Selected culture-negative specimens were tested for Streptococcus pneumoniae by antigen detection or for Haemophilus influenzae, Moraxella catarrhalis, Neisseria meningitidis, and S. pneumoniae by polymerase chain reaction (PCR).
RESULTS: A total of 987 children were enrolled (794 with pneumonia, 76 with meningitis, and 117 with other syndromes consistent with invasive bacterial disease); 84% of children were aged 0-23 months, and 57% were male. Seven (0.71%) of 987 blood cultures and 4 (15%) of 26 CSF cultures were positive for any bacterial pathogen (including 6 for H. influenzae type b and 1 for S. pneumoniae). Pneumococcal antigen testing and PCR identified an additional 16 children with invasive pneumococcal disease (12 by antigen testing and 4 by PCR). Among children aged <5 years who lived in Nha Trang, the incidence rate of invasive pneumococcal disease was at least 48.7 cases per 100,000 children (95% confidence interval, 27.9-85.1 cases per 100,000 children).
CONCLUSIONS: S. pneumoniae and H. influenzae type b were the most common causes of laboratory-confirmed invasive bacterial disease in children. PCR and antigen testing increased the sensitivity of detection and provided a more accurate estimate of the burden of invasive bacterial disease in Vietnam.
Đặng Đức Anh, Riewpaiboon Arthorn, Le Tho Huu, Kim Soon Ae, Nyambat Batmunkh, Kilgore Paul. Treatment costs of pneumonia, meningitis, sepsis, and other diseases among hospitalized children in Viet Nam. Journal of health, population, and nutrition 2010 Oct; 28(5): 436-442.
Treatment Costs of Pneumonia, Meningitis, Sepsis, and Other Diseases among Hospitalized Children in Viet Nam
Anh Dang Duc; Riewpaiboon Arthorn; Tho Le Huu; Kim Soon Ae; Nyambat Batmunkh; Kilgore Paul
Abstract
The aim of this study was to estimate the costs of treatment of children who present with the signs and symptoms of invasive bacterial diseases in Khanh Hoa province, Viet Nam. The study was an incidence-based cost-of-illness analysis from the health system perspective. The hospital costs included labour, materials and capital costs, both direct and indirect. Costs were determined for 980 children, with an average age of 12.67 months (standard deviation +/- 11.38), who were enrolled in a prospective surveillance at the Khanh Hoa General Hospital during 2005-2006. Of them, 57% were male. By disease-category, 80% were suspected of having pneumonia, 8% meningitis, 3% very severe disease consistent with pneumococcal sepsis, and 9% other diseases. Treatment costs for suspected pneumonia, meningitis, very severe disease, and other diseases were US$ 31, US$ 57, US$ 73, and US$ 24 respectively. Costs ranged from US$ 24 to US$ 164 across different case-categories. Both type of disease and age of patient had statistically significant effects on treatment costs. The results showed that treatment costs for bacterial diseases in children were considerable and might differ by as much as seven times among invasive pneumococcal diseases. Changes in costs were sensitive to both age of patient and case-category. These cost-of-illness data will be an important component in the overall evidence base to guide the development of vaccine policy in Viet Nam.
Use of Oral Cholera Vaccines in an Outbreak in Vietnam: A Case Control Study
Abstract
BACKGROUND: Killed oral cholera vaccines (OCVs) are available but not used routinely for cholera control except in Vietnam, which produces its own vaccine. In 2007-2008, unprecedented cholera outbreaks occurred in the capital, Hanoi, prompting immunization in two districts. In an outbreak investigation, we assessed the effectiveness of killed OCV use after a cholera outbreak began.
METHODOLOGY/PRINCIPAL FINDINGS: From 16 to 28 January 2008, vaccination campaigns with the Vietnamese killed OCV were held in two districts of Hanoi. No cholera cases were detected from 5 February to 4 March 2008, after which cases were again identified. Beginning 8 April 2008, residents of four districts of Hanoi admitted to one of five hospitals for acute diarrhea with onset after 5 March 2008 were recruited for a matched, hospital-based, case-control outbreak investigation. Cases were matched by hospital, admission date, district, gender, and age to controls admitted for non-diarrheal conditions. Subjects from the two vaccinated districts were evaluated to determine vaccine effectiveness. 54 case-control pairs from the vaccinated districts were included in the analysis. There were 8 (15%) and 16 (30%) vaccine recipients among cases and controls, respectively. The vaccine was 76% protective against cholera in this setting (95% CI 5% to 94%, P = 0.042) after adjusting for intake of dog meat or raw vegetables and not drinking boiled or bottled water most of the time.
CONCLUSIONS/SIGNIFICANCE: This is the first study to explore the effectiveness of the reactive use of killed OCVs during a cholera outbreak. Our findings suggest that killed OCVs may have a role in controlling cholera outbreaks.
Vũ Thị Thu Hường; Yoshida, Lay Myint; Suzuki, Motoi; Nguyễn Thị Hiền Anh; Cat Dinh Lien; Nguyen Ai Thi Thuy; Oishi Kengo; Yamamoto Takeshi; Watanabe Kiwao; Vũ Đình Thiểm; Schmidt Wolf-Peter; Phan Lê Thanh Hương; Morimoto Konosuke; Le Huu Tho; Yanai Hideki; Kilgore Paul E; Đặng Đức Anh; Ariyoshi, Koya MD, PhD. Association Between Nasopharyngeal Load of Streptococcus pneumoniae, Viral Coinfection, and Radiologically Confirmed Pneumonia in Vietnamese Children. The Pediatric Infectious Disease Journal:January 2011. Volume 30 - Issue 1. pp 11-18.
Association Between Nasopharyngeal Load of Streptococcus pneumoniae, Viral Coinfection, and Radiologically Confirmed Pneumonia in Vietnamese Children
Abstract
BACKGROUND: The interplay between nasopharyngeal bacterial carriage, viral coinfection, and lower respiratory tract infections (LRTIs) is poorly understood. We explored this association in Vietnamese children aged less than 5 years.
METHODS: A hospital-based case-control study of pediatric LRTIs was conducted in Nha Trang, Vietnam. A total of 550 hospitalized children (274 radiologically confirmed pneumonia [RCP] and 276 other LRTIs) were enrolled and 350 healthy controls were randomly selected from the community. Polymerase chain reaction-based methods were used to measure bacterial loads of Streptococcus pneumoniae (SP), Haemophilus influenzae, and Moraxella catarrhalis and to detect 13 respiratory viruses and bacterial serotypes in nasopharyngeal samples of study participants.
RESULTS: The median nasopharyngeal bacterial load of SP was substantially higher in children with RCP compared with healthy controls or children with other LRTIs (P < 0.001). SP load was 15-fold higher in pneumonia children with viral coinfection compared with those children without viral coinfection (1.4 x 10⁷/mL vs. 9.1 x 10⁵/mL; P 0.0001). SP load was over 200-fold higher in serotypeable SP compared with nontypeable SP (2.5 x 10⁶/mL vs. 1 x 10⁴/mL; P < 0.0001). These associations were independent of potential confounders in multiple regression models. No clear association was found between nasopharyngeal load of Haemophilus influenzae or Moraxella catarrhalis and viral coinfection in either RCP or other LRTIs groups.
Rapid Assessment of Hib Disease Burden in Vietnam
Abstract
BACKGROUND: Several countries have applied the Haemophilus influenzae type b (Hib) rapid assessment tool (RAT) to estimate the burden of Hib disease where resources for hospital- or population-based surveillance are limited. In Vietnam, we used the Hib RAT to estimate the burden of Hib pneumonia and meningitis prior to Hib vaccine introduction.
METHODS: Laboratory, hospitalization and mortality data were collected for the period January 2004 through December 2005 from five representative hospitals. Based on the WHO Hib RAT protocol, standardized MS Excel spreadsheets were completed to generate meningitis and pneumonia case and death figures.
RESULTS: We found 35 to 77 Hib meningitis deaths and 441 to 957 Hib pneumonia deaths among children < 5 years of age annually in Vietnam. Overall, the incidence of Hib meningitis was estimated at 18/100,000 (95% confidence interval, CI, 15.1-21.6). The estimated Hib meningitis incidence in children < 5 years age was higher in Ho Chi Minh City (22.5/100,000 [95% CI, 18.4-27.5]) compared to Hanoi (9.8/100,000 [95% CI, 6.5-14.8]). The Hib RAT suggests that there are a total of 883 to 1,915 cases of Hib meningitis and 4,414 to 9,574 cases of Hib pneumonia per year in Vietnam.
CONCLUSIONS: In Hanoi, the estimated incidence of Hib meningitis for children < 5 years of age was similar to that described in previous population-based studies of Hib meningitis conducted from 1999 through 2002. Results from the Hib RAT suggest that there is a substantial, yet unmeasured, disease burden associated with Hib pneumonia in Vietnamese children.
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