Background: : Antimicrobial resistance (AMR) presents an escalating global health concern. Medical students, as future prescribers and stewards of antimicrobials, play a critical role in combating AMR. However, inappropriate antibiotic use, such as unnecessary continuation of prophylaxis for common colds, persists among practitioners. Resistant infections can prolong treatment duration and increase mortality risk, particularly in immunocompromised patients. Objective: : To evaluate the knowledge and attitudes of sixth year medical students regarding antibiotic use before and after exposure to the Lao adult and pediatric Antimicrobial Prescribing guidelines. Methodology: : A before and after study was conducted using a structured questionnaire administered via face-to-face interviews to test student knowledge. Students were exposed to prescribing guidelines by the percentage of students with high or low knowledge scores before and after the intervention were compared. Results: : A total of 134 students participated; 52.2% were female, with a mean age of 20.78 years. Most students (82.8%) had completed high school, and 61.2% resided in Vientiane capital. Pre-intervention assessment revealed that 72.4% of students demonstrated low knowledge of adult antimicrobial prescribing, which improved post intervention, with 65.7% achieving a high knowledge level. Similarly, for pediatrics antimicrobial prescribing, 73.1% exhibited low knowledge pre-intervention, improving to 56.7% with high knowledge post-intervention. Conclusion: The introduction of the Lao antimicrobial prescribing guidelines significantly enhanced sixth year medical students’ knowledge of antimicrobial use. Following over one month of guideline exposure and hospital-based training, most students demonstrated improved knowledge to apply appropriate prescribing practices.

Background: : Pneumonia is an infection of the lungs and lower respiratory system that is the most common cause of death in children under age 5 years old in sub-Saharan Africa. The mortality of pneumonia in children around 18% of mortality rate in under 5 years old, of which 3% occur in newborns. Objective: : To study management outcome of pneumonia among children under 5 years at pediatric ward, Khammouane Hospital, Vientiane Hospital and Paklay Community Hospital, Lao PDR Methodology: : This was retrospective study. Data collection by using questionnaire form by copy data from document of patient. The data entered by Epi-data and analysis by SPSS program. Result: : A total of 173 participants, more than half of the patients are male (55.5%), aged between 1-3 years old (46.8%) and most of them was Lao-Loum group (74.6%). Management outcome almost of all had better/well (93.6%), not better/not well (5.8%) and there is one case of death during treatment (0.6%). Analysis of the association between the management outcome found that fever were associated significant with management outcome (p-value: 0.033), the duration of the fever (p-value: 0.007) and eat-drink were associated significant with management outcome (p-value <0.001). Also, those who had a treatment before admitted to hospital were association significant with management outcome (98.0%, p-value: 0.002). For clinical examination were association significant with management outcome such as mental status (p-vale <0.001), breathing rate (p-value: 0.048) and fluctuating nasal symptoms had management outcome (p-value <0.001). Besides, wheezing symptoms, breathing characteristics, chest-rib sounds and abnormal sounds at the lung point were associated statistically significant with management outcome of pneumonia (p-value <0.05). Conclusion: The outcome of pneumonia among children under 5 years old, most of all patients had better/well. There are only 10 cases where the symptoms did not better and 1 case died. Most of the treatment period is 4-7 days and mild complication in during hospitalization. There should be health education about the symptoms and dangers of the disease to the child's parents to bring the child to the hospital urgently.

Background: : Going to the health service for antenatal help the newborn to be healthy and to reduce the risk factors, especially to reduce the low weight and to help the mother to understand how to live, such as the belief in the consumption of various foods, exercise, rest and behavior. At the same time, customs and social support, especially from the family support, are important in understanding health problems. Objective: : To study the attitude and family support in antenatal the wife's in the Makrong ethnicity in Boualapha District, Khammouane Province, Lao PDR. Methodology: : This was cross-sectional study. Data collection by using questionnaire form by interview face-to-face. The data entered by Epi-data and analysis by SPSS program. Result: : A total of 265 participants, most of them had between 18-35 years old (57.36%), are farmers (76.98%), and have completed primary education (40.75%). Most of the participants were married less than 5 years (85.66%) and the number of pregnancies was less than 3 times (63.77%), and the monthly income was <500,000 kip (63.77%). Most of the participants (54.72%) had a positive attitude towards going to the antenatal of their wife, the most source of information is from medical staff (92.02%), talking about health and children (71.85%). For supporting the wife to go to the antenatal, almost all participants agreed (96.28%). Analysis of the association significant found that farmer is to agree his wife to had an antenatal (p-value: <0.001) and those with an income of less than 500,000 kip (p-value: 0.004). In addition, those who did not finish primary school had a positive attitude about going to the antenatal (p-value: 0.001), those who were farmers (p-value: 0.001) and those who had an income of less than 500,000 kip (p-value: 0.008). Conclusion: More than half of the participant has a positive attitude towards the wife's antenatal visit and almost all of them support the wife to go antenatal at the health service facility, most of them received information from the medical staff talking about the health of the mother and child. The results of the study indicate that there are a number of wife who do not go to have an antenatal. Therefore, more health education should be given to couples about the benefits of having an antenatal to encourage 100% of wife’s to have an antenatal.

Background and rationale: Acute otitis externa is a disease that significantly affects the life and health of people, mostly caused by bacteria, fungi, virus and irritation from chemicals. Besides that, it can also be caused by trauma such as ear picking, spinning ears, swimmer’s ear and wiping the ear too hard, and if not treated in time serious complications are possible. Objective: To study the risk factors associated with acute otitis externa at the ENT Department, Mahosot Hospital. Methodology: This study was cross-sectional, descriptive study among patients with ear-ache and acute otitis externa. Data were collected by using questionnaire interviewed face to face and by ear examination. The data were entered into Epi-data and analyzed by using SPSS software. Results: Of 186 participants, 62.9% had otitis externa, with a mean (95%CI) age of 32 (01-76) years. The commonest age group was those aged less than 15 years old with 29%. Males were 1.88 times more likely to present with otitis externa than females. Occupational groups at risk of disease are farmers/laborers/ housewife/others and those living in rural areas was 2.7 times having acute otitis externa. Those who had swum or had travelled in the forest and ear picking had a higher frequency of acute otitis externa (1.6 times) and patients who regularly cleaned their ears with a cotton swab were 1.39 times of having otitis externa and some patients who used hair clip for ear picking had a higher frequency of acute otitis externa (2.44 times). Conclusion Most of patients have common clinical manifestations of which are tinnitus, earache, swelling or redness of the ears, hearing loss and itching. Demographic characteristics, history, and ear health care behaviors are associated with acute otitis external.

Background: Worldwide, diarrhea is a common disease in children and is a problem that causes many children to become sick and die. Diarrhea is found to be the leading cause of death of children under 5 years of age, with 700,000 cases per year worldwide. The incidence of diarrhea is increasing in Laos. Objective: To study oral rehydration and intravenous fluid therapy in children under 5 years of age with acute diarrhea with some dehydration in the Emergency Department of the Children’s Hospital, Vientiane, Lao PDR. Methodology: This was cross-sectional descriptive study; data were collected by using questionnaire interview by doctors. The data entered by Epi-data with analysis by SPSS. Results: Among 90 participants it was found that anxiety or irritability, sunken eyes, nausea, vomiting and flatulence were statistically significantly associated with outcome of treatment (p-value <0.05). More than half of the patients are male (52.2%), aged between 1-2 years and most (83.3%) had normal BMI values. In addition, 44.4% had a history of diarrhea for 2 days with 4 to 5 times a day in 34.4% and stools were watery in 57.8%. A number of participants (47.8%) had a history of previous diarrhea before the current illness and most of them had had it 3 times a year (41.9%). When comparing between oral rehydration and intravenous fluid therapy it was found that the children had no symptoms of anxiety or irritable (in 97.8% vs 77.8%), children with sunken eyes (in 91.1% vs 71.1%), children with vomiting (in 100% vs 64.4%) and children with flatulence (in 97.8% vs 80.0%). Excessive thirst and decreased skin turgor were not statistically different between before and after rehydration therapy (p-value >0.05). Conclusion The outcome of treatment with intravenous fluids was better than oral rehydration since former decreased vomiting, shortened hospital stays, lowered the costs and increase more parents ‘satisfaction. The oral dehydration therapy often increased the symptoms of flatulence.

Background and rationale: The development of skilled staff is the main function of the medical education system, which is the process of building people with knowledge, skills, wisdom, ability to analyze, know how to solve problems, ability to learn by themselves and adapt to changes in the regional-international environment. Objective: The study aimed to evaluate the consistency of context, input, process and product of medical curriculum, Faculty of Medicine, University of Health Sciences by using the Context Input Process and Product (CIPP) model evaluation. Methodology: This study was cross-sectional descriptive study of medical student years 5 to 6, managers and teachers. Data were collected by using questionnaires in face-to-face interviews. The data were entered in Epi-data with analysis by SPSS. Results: 1). Contextually, the curriculum philosophy, objectives of curriculum, structure of curriculum and learning contents of each course were regarded as consistent at high level. 2). Regarding the input teaching, students and learning – teaching materials/equipment, pocket book and places were consistent at moderate levels. 3). Considering the process, the curriculum administration, the learning – teaching management, the evaluation and assessment were consistent at high level and 4). for products, the behavior, attitude, virtue and ethical national of professional, communication skill and relationship, basic knowledge, clinic skill, check-up skill by using basic tools and improve of professional knowledge were consistent at high level. Conclusion The medical curriculum of the Faculty of Medicine at the University of Health Sciences is consistent at high levels. When considering each aspect, it can be seen that: the context, the process and the product are consistent at high levels. In terms of input factors, there is consistency at a moderate level.

Background: Outbreaks of vaccine preventable-disease control and elimination are impeded by impaired focal vaccination uptake. Therefore, we aimed at assessing vaccination uptake and comparing with passive surveillance (PS) report at village level. Methods: A community-based cross-sectional survey was conducted in the villages covered by two health centers in Bolikhamxay province, including non-Hmong and Hmong ethnic groups. Data collection was conducted by interviewing mothers or caregivers of children aged 6 to 23 months. The vaccination status was identified by vaccination cards, and compared with PS report at village level, which was collected from health centers. The Pearson’s chi-square test was used to compare these proportions, and pairwise correlation was used for the correlation of observed vaccination coverage. Finding: Sixteen villages were included, nine were from Luk52 health center area and 7 from Namkhou health center area. There was a significantly strong correlation for pentavalent pneumococcal conjugate vaccine, Japanese encephalitis, Measles and Rubella and full immunization coverage compared to others. This correlation was not observed in the non-Hmong population. Amongst non-Hmong, the recorded coverage was lower in PS than in the survey regardless of type of vaccine. In contrast, amongst Hmong most vaccines had higher recorded coverage in PS than in the survey except Bacillus Calmette–Guérin (BCG) and hepatitis B at birth dose. MR and JEV vaccine, commonly given at the same time, were the only one that did not have significantly different coverage between PS and the survey (p<0.334). Conclusion The mis-estimatation of immunization coverage from the PS reporting system highlights further research needed to determine a better indicator of village-level vaccination coverage, but measles could be an indicator of prioritizing the settings.