Objective: In Viet Nam, tuberculosis (TB) prevalence surveys revealed that approximately 98% of individuals with pulmonary TB have TB-presumptive abnormalities on chest radiographs, while 32% have no TB symptoms. This prompted the adoption of the “Double X” strategy, which combines chest radiographs and computer-aided detection with GeneXpert testing to screen for and diagnose TB among vulnerable populations. The aim of this study was to describe demographic, clinical and radiographic characteristics of symptomatic and asymptomatic Double X participants and to assess multilabel radiographic abnormalities on chest radiographs, interpreted by computer-aided detection software, as a possible tool for detecting TB-presumptive abnormalities, particularly for subclinical TB. Methods: Double X participants with TB-presumptive chest radiographs and/or TB symptoms and known risks were referred for confirmatory GeneXpert testing. The demographic and clinical characteristics of all Double X participants and the subset with confirmed TB were summarized. Univariate and multivariable logistic regression modelling was used to evaluate associations between participant characteristics and subclinical TB and between computer-aided detection multilabel radiographic abnormalities and TB. Results: From 2020 to 2022, 96 631 participants received chest radiographs, with 67 881 (70.2%) reporting no TB symptoms. Among 1144 individuals with Xpert-confirmed TB, 51.0% were subclinical. Subclinical TB prevalence was higher in older age groups, non-smokers, those previously treated for TB and the northern region. Among 11 computer-aided detection multilabel radiographic abnormalities, fibrosis was associated with higher odds of subclinical TB. Discussion: In Viet Nam, Double X community case finding detected pulmonary TB, including subclinical TB. Computer-aided detection software may have the potential to identify subclinical TB on chest radiographs by classifying multilabel radiographic abnormalities, but further research is needed.

Objective: Human respiratory syncytial virus (RSV) is a primary cause of paediatric severe acute respiratory infection (SARI) worldwide, especially in developing countries. We investigated the genetic characteristics of RSV in northern Viet Nam to determine the prevalence and distribution of subtypes as well as the diversity and transmission patterns of genotypes. Methods: In two facilities, from January 2017 to December 2020, 1563 clinical specimens were collected from paediatric patients hospitalized with SARI and tested for RSV. Selected positive samples underwent sequencing analysis targeting the second hypervariable region of the G gene using next-generation sequencing. Results: The RSV positivity rate was 28.02% (438/1563 samples), and prevalence was highest in children aged <1 year (43.84%; 192/438). Subtype RSV-A accounted for 53.42% (234/438) of cases, RSV-B for 45.89% (201/438), and there was coinfection in 0.68% (3/438). Both subtypes cocirculated and peaked during August–September in each year of the study. Phylogenetic analysis showed that RSV-A samples belonged to the ON1 genotype, which has three subgenotypes: ON1.1, ON1.2 and ON1.3. However, we did not find the 72-nucleotide duplication in the second hypervariable region of the G gene, a characteristic of genotype ON1, in any RSV-A samples. RSV-B samples belonged to genotype BA9. Discussion: Our results provide additional molecular characterization of RSV infections in Viet Nam. Specially, our study is the first to report the absence of the 72-nucleotide duplication in the G gene of RSV-A genotype ON1 in Viet Nam, which may help in understanding the genetic evolution of RSV and be useful for vaccine development in the future.

Backgroud: The aim of this study is to update on antibiotic resistance of common pathogenical bacteria isolated in Hue University of Medicine and Pharmacy Hospital (Hue UMP Hospital). Methodology: Use of the agar disk diffusion method to test the susceptibility to antimicrobial agents of 3709 bacterial strains from infected patients hospitalized in Hue UMP Hospital in 2020 - 2022. Results: Among 3709 strains of pathogenical bacteria isolated, S.aureus was found with the rate of 29.9%, followed by E. coli (24.5%), Pseudomonas aeruginasa (17.8%), Enterococcus spp. (11.8%), Klebsiella spp (9.7%) and Acinetobacter spp (4.1%). The proportion of bacterial isolates has changed, but Staphylococcus aureus is still highest rate. S.aureus is resistant to many antibiotics, but MRSA strains have decreased significantly, from 73.3% in 2020 to 62.5% in 2022. Pseudomonas aeruginosa was resistant to some of the group A recommended antibiotics such as ceftazidime, piperacillin-tazobactam with the rate of 56.6% and 48.7%. The percentage of E. coli with ESBL strains (+) was at 28.2% - 30.3%. Enterococus spp strains are still sensitive to vancomycin (83.1% - 91.9%). The rate of Klebsiella ESBL (+) is only 6.9% to 8.2%. The strains of Acinetobacter spp were highly resistant to Piperacillin (100%) and Ceftriaxone (96.5%) but they are still sensitive to imipenems 70 - 71%, highly sensitive to Doxycillin (95.2%) and Cefotaxime (88.4%). Conclusion: Many bacterial strains are resistant to many commonly antibiotics. Providing timely, regular, and effective management of antibiotic resistance patterns for common pathogenic bacteria in hospitals, will help reduce the risk of bacterial resistance.

Background: Lung cancer is a common cancer with a high mortality rate. The identification of prognostic factors in lung cancer patients in Vietnam is still limited and inconsistent in clinical practice. Objectives: To describe the clinical, paraclinical characteristics and m-LCPI index in patients with primary non-small cell lung cancer and evaluate the factors affecting overall survival in patients with primary non-small cell lung cancer. Methods: Prospective study of 210 cases of non-small cell lung cancer diagnosed with primary non-small cell lung cancer at the Oncology Department of Hue University of Medicine and Pharmacy Hospital and Hue Central Hospital from February 2020 to February 2023. Results: The majority of hospitalizations were at late stages, from stage IIIA (89%), group 3 and 4 in m-LCPI grading scale constituted the majority (80%). Average overall survival at 3 years was 20.0 ± 14 months, and gradually decreased to 54.8%, 40%, and 38.6% after 1 year, 2 years and 3 years, respectively. Regression analysis of COX model between m-LCPI and OS showed statistical significance with m-LCPI 4 (HR = 3.9, 95%CI = 1.57 - 9.69, p = 0.003), while m-LCPI 3 (HR = 2.44, 95% CI 0.97 - 6.13), p = 0.058) had a weak correlation. Conclusion: Our study shows that 38.6% of patients were still alive after 3 years of diagnosis. m-LCPI index is a good predictor of the patients’ overall survival.

Objectives: The study was conducted to comprehensively assess the status cervical cancer screening registry based on the experience of several countries and the domestic context, to propose related recommendations for Vietnam. Method: The study collected and evaluated the models and induced lessons in implementing and managing cervical cancer recording systems, from four countries/territory namely: Australia, Taiwan-China, Korea, and Thailand. Additionally, a literature review on policies documents and programs related to cervical cancer screening that have been implemented in Vietnam was also conducted. Results and Conclusion: All four selected countries/territory have prioritized to develop their cervical screening data management system with different models, all systems aimed at personalized management and used the data to evaluate the effectiveness of the screening program. Currently, there is no system to record and manage data on cervical screening in Vietnam. However, the country has many strengths and opportunities for the implementation of this program at the national level. The recommendations focus on the preparation and establishment of an integrated system for cervical cancer screening registry data, is suggested as a component of the information system of maternal and child health/ reproductive health, into the existing medical data management system, according to the short-term and long-term roadmap.

Background: and Purpose Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. Methods: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). Results: There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. Conclusions During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.

Purpose: Laparoscopic surgery is considered a promising approach for Hartmann reversal but is also a complicated major surgical procedure. We conducted a retrospective analysis at a city hospital in Vietnam to evaluate the treatment technique and outcomes of laparoscopic Hartmann reversal (LHR). Methods: A colorectal surgery database in 5 years between 2015 and 2019 (1,175 cases in total) was retrieved to collect 35 consecutive patients undergoing LHR. Results: The patients had a median age of 61 years old. The median operative time was 185 minutes. All the procedures were first attempted laparoscopically with a conversion rate of 20.0% (7 of 35 cases). There was no intraoperative complication. Postoperative mortality and morbidity were 0 and 11.4% (2 medical, 1 deep surgical site infection, and 1 anastomotic leak required reoperation) respectively. The median time to first bowel activity was 2.8 days and median length of hospital stay was 8 days. Conclusion When performed by skilled surgeons, LHR is a feasible and safe operation with acceptable morbidity rate.

The Omicron variant caused a surge of infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Viet Nam in early 2022, signalling community transmission. We report on active whole-genome sequencing surveillance of positive SARS-CoV-2 samples collected at that time in northern Viet Nam from international arrivals and community clusters. We used an amplicon protocol developed with 14 polymerase chain reaction products and the Illumina iSeq 100 platform. Overall, 213 nasopharyngeal or throat swabs were analysed, of which 172 samples were identified with the Omicron variant. Of these, 80 samples were collected from community cases in February 2022, among which 59 samples were sublineage BA.2 and one sample was the recombinant XE variant. Our results indicated that Omicron had replaced Delta as the dominant variant in a very short period of time and that continuously conducting active whole-genome sequencing surveillance is necessary in monitoring the evolution and genomic diversity of SARS-CoV-2 in Viet Nam.

Objective: Female sex workers (FSWs) are at high risk of human papillomavirus (HPV) infections and cervical cancer due to their high number of sexual partners. The objectives of this study were to determine the prevalence of HPV and identify risk factors for high-risk HPV infection among FSWs in Hanoi and Ho Chi Minh City (HCMC), Viet Nam. Methods: A cross-sectional study was conducted in Hanoi and HCMC between December 2017 and May 2018. We surveyed and screened 699 FSWs aged ≥18 years for HPV infection and abnormal cytology. A multivariable modified Cox regression model was used to determine risk factors for high-risk HPV infection. Results The overall prevalence of any HPV, high-risk HPV and HPV-16/18 infection in the 699 FSWs was 26.3%, 17.6% and 4.0%, respectively, and were similar in both cities. Multiple infections were identified in 127 participants (69.0%).HPV-52 was the most prevalent (7%), followed by HPV-58 (6%). Abnormal cytology was detected in 91 participants (13.0%). FSWs who are divorced (adjusted prevalence ratio [aPR]: 1.96, 95% confidence interval [CI]: 1.01–3.81), widowed (aPR: 3.26, 95% CI: 1.49–7.12) or living alone (aPR: 1.85, 95% CI: 1.01–3.39) were associated with a higher prevalence of high-risk HPV infection.

Objective: At the time of this study, the prevention of novel coronavirus disease 2019 (COVID-19) relied solely on nonpharmaceutical interventions. Implementation of these interventions is not always optimal and, consequently, several cases were imported into non-epidemic areas and led to large community outbreaks. This report describes the characteristics of the first community outbreak of COVID-19 in Viet Nam and the intensive preventive measures taken in response. Methods: Cases were detected and tested for SARS-CoV-2 by real-time reverse transcriptase polymerase chain reaction. Contact tracing and active surveillance were conducted to identify suspected cases and individuals at risk. Clinical symptoms were recorded using a standardized questionnaire. Results: In Vinh Phuc province from 20 January to 3 March 2020, there were 11 confirmed cases among 158 suspected cases and 663 contacts. Nine of the confirmed cases (81.8%) had mild symptoms at the time of detection and two (18.2%) were asymptomatic; none required admission to an intensive care unit. Five prevention and control measures were implemented, including quarantining a community of 10 645 individuals for 20 days. The outbreak was successfully contained as of 13 February 2020. Discussion: In the absence of specific interventions, the intensive use of combined preventive measures can mitigate the spread of COVID-19. The lessons learned may be useful for other communities.