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.

Background: This study was conducted on 93 volunteers with type 2 diabetes to investigate the ability of acetylated wheat starch cake containing 32.1% resistant starch to control postprandial blood glucose levels. Material and methods: The study was designed using a crossover, double-blind trial method. During each testing day, after a minimum of 12 hours of overnight fasting, each participant consumed two identical cakes containing either 80 g of acetylated wheat starch or 80 g natural wheat starch with 330ml of water within 15 minutes. Blood glucose levels were measured at baseline, 60 mins (G1), and 120 mins (G2) after ingestion. The predictive value of factors that contribute to the ability of resistant starch to control postprandial blood glucose was determined by the area under the receiver operating characteristic (ROC) curve based on the combined effect of the cake weight-to-BMI ratio (g/m²BMI) and HbA1c. Results: 60 mins and 120 mins postprandial capillary glucose levels after consuming acetylated wheat starch cake (10.4 ± 1.2 và 9.2 ± 1.2 mmol/L, respectively) were significantly lower compared with natural wheat starch cake (13.3 ± 1.8 và 11.2 ± 1.8 mmol/L, respectively) (p < 0.05). For good control of postprandial blood glucose levels, a maximum of 80 g of acetylated wheat starch can be used per serving for patients with type 2 diabetes with HbA1c ≤ 7.25 without blood glucose-lowering medication is required. Conclusion: acetylated wheat starch has better ontroled of postprandial blood glucose compared with natural wheat starch in patients with type 2 diabetes. This is very suitable in the processing of diets including resistant starch for patients with type 2 diabetes for the purpose of both supporting treatment and improving quality of life.

Ho Chi Minh City, Viet Nam undertook a series of measures in response to the fourth and largest wave of COVID-19. The care pathway was continuously reconfigured through leadership from all levels of government and engagement of the community. This resulted in a shift towards integrated severity-based care consisting of multiple levels of health-care facilities and home care. This flexible approach based on the rapidly changing local context enabled Ho Chi Minh City to limit the extent to which health-care capacity was overwhelmed.