Background: Shigella-induced diarrhea has been considered a major health problem leading to high morbidity and mortality. This disease can lead to dire consequences; however, the true burden of the disease, including the costs and sequalae associated with shigellosis is not yet known. Objectives: (1) To describe the health seeking behavior and the way of payment of population when suffering Shigella; (2) To identify and analyze the direct household costs associated with the treatment of diarrhea due to Shigella. Subjects and method: 290 patients of all ages with positive Shigella diarrhea admitted to public health facilities in Nha Trang, Khanh Hoa province in the period from August 2002 to January 2004 were included in the study. The subjects were divided into three age groups, the first 0-5, second 5-18 and the last one was over 18 years old. Patients and their relatives were interviewed at three stages - day 7, day 14 and day 90 - to obtain all the required information. Results: 134 of 290 patients (47%) paid for using the other health care services before admission to the study\u2019s facilities. The average direct cost per episode for the patients at group aged 0-5 was 129,000 VND, group aged 6-18 was 59,267 VND and over 18 years old was 173,531 VND; it was 131.960 VND for three groups. Comparison with the average household expenditure for health care, it was higher in the poorer group and it was lower three times than the richest group. The average direct medical cost per episode was higher the average direct non-medical cost per episode for all groups. Conclusions: The average direct cost per episode of Shigellosis treatment was rather high especially the average direct cost for the treatment at the health facility. It was also high compared with the average expenditure for health per capita so that it becomes large economic burden for households.
Direct cost ; Shigella ; treatment

BACKGROUND: In order to provide essential scientific evidence on the population's health status and social health determinants as well as the current capacity of the health care system in Vietnam to health policy makers and managers, Vietnam Ministry of Health, Hanoi University of Public Health, Hanoi Medical University, and Ho Chi Minh University of Medicine and Pharmacy collaborated with Seoul National University (Korea) and conducted a health system survey in the Quoc Oai district (of Hanoi capital) that represented northern rural Vietnam. METHODS: The study design was a cross-sectional study. The survey covered different topics (more than 200 questions) and was administered in three separate questionnaires: 1) Basic information of all household members; 2) Household characteristics; and 3) Individual characteristics. Socio-demographic characteristics among the households and individuals were collected from 2,400 households sampled by multi-stage cluster sampling method: more than 200 questions. RESULTS: The household size of Quoc Oai was larger than the national average and there was no significant difference in gender composition. In addition, the proportions of pre-elderly, age 55–64, and elderly group (65 years old and over) were higher than the national population statistics. In this context, demographic transition has begun in Quoc Oai. CONCLUSION: This study design description provides the basic information about a baseline survey of a future prospective cohort (as a part of a collaborative project on strengthening the health system in Vietnam) to the prospective data user of this survey.
Aged ; Cohort Studies ; Cross-Sectional Studies ; Delivery of Health Care ; Family Characteristics ; Health Policy ; Humans ; Methods ; Pharmacy ; Population Characteristics ; Population Dynamics ; Prospective Studies ; Public Health ; Seoul ; Surveys and Questionnaires ; Vietnam

Objective: To describe the burden of severe acute respiratory infection (SARI) and the infrastructure and current practices of SARI management in hospitals in Viet Nam. Methods: We conducted a short observational study at critical care units (CCUs) in 32 district hospitals and 16 provincial hospitals in five provinces in Viet Nam from March to July 2019. We collected data on hospital equipment and medicines used in SARI management. At the patient level, data were collected for 14 consecutive days on all patients presenting to CCUs, including information on demographics, intervention and treatment within 24 hours of CCU admission and 7-day outcome. Results: There were significant differences between district and provincial hospitals in the availability of microbial culture, rapid influenza diagnostic tests, inflammatory markers and mechanical ventilation. Among 1722 eligible patients admitted to CCUs, there were 395 (22.9%) patients with SARI. The median age of SARI patients was 74 (interquartile range: 58–84) years; 49.1% were male. Although systemic antibiotics were available in all hospitals and were empirically given to 93.4% of patients, oseltamivir was available in 25% of hospitals, and only 0.5% of patients received empiric oseltamivir within 24 hours of admission. The 7-day mortality was 6.6% (26/395). Independent factors associated with 7-day mortality were septic shock and requiring respiratory support within 24 hours of admission. Discussion: SARI is a major burden on CCUs in Viet Nam. Barriers to delivering quality care include the limited availability of diagnostics and medication and non-protocolized management of SARI in CCUs.