1.Active case finding to detect symptomatic and subclinical pulmonary tuberculosis disease: implementation of computer-aided detection for chest radiography in Viet Nam
Anh L Innes ; Andres Martinez ; Gia Linh Hoang ; Thi Bich Phuong Nguyen ; Viet Hien Vu ; Tuan Ho Thanh Luu ; Thi Thu Trang Le ; Victoria Lebrun ; Van Chinh Trieu ; Nghi Do Bao Tran ; Nhi Dinh ; Huy Minh Pham ; Van Luong Dinh ; Binh Hoa Nguyen ; Thi Thanh Huyen Truong ; Van Cu Nguyen ; Viet Nhung Nguyen ; Thu Hien Mai
Western Pacific Surveillance and Response 2024;15(4):14-25
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.
2.Beyond Medical Bills: High Prevalence of Financial Toxicity and Diverse Management Strategies Among Vietnamese Patients With Cancer
Binh Thang TRAN ; Thanh Gia NGUYEN ; Dinh Duong LE ; Minh Tu NGUYEN ; Nhan P. T. NGUYEN ; Minh Hanh NGUYEN ; The Due ONG
Journal of Preventive Medicine and Public Health 2024;57(4):407-419
Objectives:
This study was conducted to measure financial toxicity (FT) among patients with cancer in Vietnam using the COmprehensive Score for financial Toxicity (COST) and to describe the cost management strategies employed by these patients.
Methods:
This comprehensive cross-sectional study enrolled 634 patients from 2 specialized oncology hospitals in Vietnam. Using COST cut-off scores, FT was classified as none/mild (≥26), moderate (14-25), or severe (≤13). Cost management strategies, or coping mechanisms, were classified into 4 groups: lifestyle changes, financial resource strategies, treatment modifications, and support seeking.
Results:
The prevalence of FT was 91.8%, with 51.7% of participants demonstrating severe and 40.1% exhibiting moderate FT. Severe FT was significantly associated with female, low education level, unstable employment, low household economic status, and advanced cancer stage. The most common coping strategies were as follows: among lifestyle changes, reducing spending on basic items and leisure activities (78.7%) and cutting back on essential household expenses (66.4%); among financial resource strategies, borrowing money from relatives or friends (49.1%) and withdrawing funds from retirement or savings accounts (34.1%); within treatment modifications, switching treatment facilities or doctors due to cost concerns (9.3%); and within support seeking, obtaining help from welfare or community organizations (18.8%). All strategies were significantly more likely to be used by patients with severe FT.
Conclusions
FT was highly prevalent among patients with cancer. Most patients relied on lifestyle adjustments and coping strategies, underscoring the need for improved financial support systems to alleviate the economic burden associated with cancer care.
3.Validation of the Disaster Adaptation and Resilience Scale for Vulnerable Communities in Vietnam’s Coastal Regions
Thanh Gia NGUYEN ; Binh Thang TRAN ; Minh Tu NGUYEN ; Dinh Duong LE
Journal of Preventive Medicine and Public Health 2024;57(3):279-287
Objectives:
This study validated the Vietnamese version of the Disaster Adaptation and Resilience Scale (DARS) for use in vulnerable communities in Vietnam.
Methods:
This was a cross-sectional study involving 595 adults from 2 identified communities. The original DARS assessment tool was translated, and the validity and reliability of the Vietnamese version of DARS (V-DARS) were assessed. The internal consistency of the overall scale and its subscales was evaluated using Cronbach’s alpha and McDonald’s omega reliability coefficients. Confirmatory factor analysis (CFA) was employed to evaluate its construct validity, building upon the factor structure identified in exploratory factor analysis (EFA). Construct validity was assessed based on convergent and discriminant validity.
Results:
Following the established criteria for EFA, 8 items were removed, resulting in a refined V-DARS structure comprising 35 items distributed across 5 distinct factors. Both alpha and omega reliability coefficients indicated strong internal consistency for the overall scale (α=0.963, ω=0.963) and for each of the 5 sub-scales (all>0.80). The CFA model also retained the 5-factor structure with 35 items. The model fit indices showed acceptable values (RMSEA: 0.072; CFI: 0.912; TLI: 0.904; chi-square test: <0.01). Additionally, the convergent and discriminant validity of the V-DARS were deemed appropriate and satisfactory for explaining the measurement structure.
Conclusions
Our findings suggest that the V-DARS is a valid and reliable scale for use within vulnerable communities in Vietnam to assess adaptive responses to natural disasters. It may also be considered for use in other populations.
4.Impact of long COVID-19 on posttraumatic stress disorderas modified by health literacy: an observational study inVietnam
Han Thi VO ; Tien Duc DAO ; Tuyen Van DUONG ; Tan Thanh NGUYEN ; Binh Nhu DO ; Tinh Xuan DO ; Khue Minh PHAM ; Vinh Hai VU ; Linh Van PHAM ; Lien Thi Hong NGUYEN ; Lan Thi Huong LE ; Hoang Cong NGUYEN ; Nga Hoang DANG ; Trung Huu NGUYEN ; Anh The NGUYEN ; Hoan Van NGUYEN ; Phuoc Ba NGUYEN ; Hoai Thi Thanh NGUYEN ; Thu Thi Minh PHAM ; Thuy Thi LE ; Thao Thi Phuong NGUYEN ; Cuong Quoc TRAN ; Kien Trung NGUYEN
Osong Public Health and Research Perspectives 2024;15(1):33-44
Objectives:
The prevalence of posttraumatic stress disorder (PTSD) has increased, particularly among individuals who have recovered from coronavirus disease 2019 (COVID-19) infection. Health literacy is considered a “social vaccine” that helps people respond effectively to the pandemic. We aimed to investigate the association between long COVID-19 and PTSD, and to examine the modifying role of health literacy in this association.
Methods:
A cross-sectional study was conducted at 18 hospitals and health centers in Vietnamfrom December 2021 to October 2022. We recruited 4,463 individuals who had recovered from COVID-19 infection for at least 4 weeks. Participants provided information about their sociodemographics, clinical parameters, health-related behaviors, health literacy (usingthe 12-item short-form health literacy scale), long COVID-19 symptoms and PTSD (Impact Event Scale-Revised score of 33 or higher). Logistic regression models were used to examine associations and interactions.
Results:
Out of the study sample, 55.9% had long COVID-19 symptoms, and 49.6% had PTSD.Individuals with long COVID-19 symptoms had a higher likelihood of PTSD (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.63–2.12; p < 0.001). Higher health literacy was associated with a lower likelihood of PTSD (OR, 0.98; 95% CI, 0.97–0.99; p = 0.001). Compared to those without long COVID-19 symptoms and the lowest health literacy score, those with long COVID-19 symptoms and a 1-point health literacy increment had a 3% lower likelihood of PTSD (OR, 0.97; 95% CI, 0.96–0.99; p = 0.001).
Conclusion
Health literacy was found to be a protective factor against PTSD and modified the negative impact of long COVID-19 symptoms on PTSD.
5.Suicidal ideation and adverse experiences among adolescents with their separated/divorced parents in Hue city
Thi Tra My TRAN ; Binh Thang TRAN ; Minh Tam NGUYEN ; Nu Hong Duc VO ; Van Thong NGUYEN ; Ngo Bao Khuyen NGUYEN ; Thi Thu Ha PHAM ; Uyen Phuong HO ; Hoang Linh VO ; Thi Thu Tham LUONG ; Tuan Anh HOANG ; Cao Khoa DANG ; Thanh Gia NGUYEN ; Minh Tu NGUYEN
Hue Journal of Medicine and Pharmacy 2023;13(6):25-
Background: Suicide continues to be a leading cause of death worldwide. Recently, more than 45,000 children in the age group of 10 to 19 years died by suicide, making it the second leading cause of death in the age group of 15 to 19, surpassed only by traffic accidents, tuberculosis, and fighting. Objective: To determine the prevalence of suicidal ideation among adolescents whose parents are separated/divorced; and to explore the factors associated with suicidal ideation and describe adverse experiences among adolescents. Methods: A cross-sectional descriptive study was conducted in 309 adolescents with separated/separated parents in Hue City. Data was collected through direct interviews using a structured questionnaire. Suicidal ideation was defined as the presence of thoughts or plans related to suicide within the last 12 months. Multivariate logistic regression was applied to identify factors associated with suicidal ideation in adolescents with separated/ separated parents. Results: The study found that 15.5% (95% CI:11.7 - 20.1) of adolescents with separated /separated parents reported experiencing suicidal thoughts, in which men accounted 8.4% (95% CI:5.6 – 11.2) and women accounted 7.1% (95% CI:4.5 - 10.6). Several factors were identified as increasing the risk of suicidal ideation, including alcohol use (OR = 3.24; 95% CI:1.42 - 7.42), hyperactivity/inattention (OR = 4.96; 95% CI:1.58 - 15.605), and a poor quality of family relationships (OR = 4.82; 95% CI:1.26 - 18.50). On the contrary, certain factors were found to reduce the risk, including being in the 14-15 age group of 14-15 (OR = 0.26; 95% CI:0.10 - 0.69) and participating in physical activity (OR = 0.44; 95% CI:0.21 – 0.94). Conclusions: The research highlights a significant percentage of adolescents with separated / divided parents who experience suicidal ideation. Therefore, it is imperative for families, schools, and society to develop comprehensive strategies to monitor and address various risky behaviours among students simultaneously.
6.Clinical and Laboratory Characteristics and Associated Factors to Mortality in Neonates with Birth Asphyxia: A Prospective Observational Study
Thi Thanh Binh NGUYEN ; Thi Dieu Huong VU ; Binh Thang TRAN
Hue Journal of Medicine and Pharmacy 2023;13(6):64-
Aims: To describe the clinical and laboratory characteristics and to investigate associated factors with mortality of birth asphyxia. Methods: This was a prospective observational study conducted on a total of 120 asphyxiated neonates admitted to the Neonatal Intensive Care Unit (NICU). Results: Severe asphyxia was observed in 33.3%, and moderate asphyxia in 66.7% of the cases. The mortality rate was 19.2%. The common clinical features: apnea/gasping (45.8%), hypothermia (37.5%), lethargy (33.0%). The serious clinical signs: abnormal heart rate (15.8%), gastrointestinal bleeding (13.3%), oliguria and anuria (17.5%). The laboratory findings showed hypoglycemia (30.8%), elevated SGOT (45.0%), serum creatinine > 133 µmol/l (31.7%), hyponatremia (35.0%), hypocalcemia (65.8%), elevated lactate > 5mmol/l (53.6%). The factors that increased the risk of mortality in neonatal asphyxia were Apgar score at 5 min ≤ 5, seizure/coma, need for mechanical ventilation, serum creatinine > 133 µmol/l, liver injury, and lactate ≥ 5 mmol/l. Conclusion: The mortality rate is still high, and elevated serum creatinine, elevated liver enzymes, elevated lactate, and low 5-minute Apgar scores increase the risk of death in asphyxiated neonates.
7.Study on the effective control of postpreal blood glucose of resistant starch cakes in patients with type 2 diabetes
Huu Dung TRAN ; Quang Hung LE ; Bao Dung VO ; Hoang Vu NGUYEN ; Thanh Bao Yen LUONG ; That Hy TON ; Phuoc Hieu DOAN ; Thi Bich Hien PHAM ; Huu Tien NGUYEN ; Hai Thuy NGUYEN
Hue Journal of Medicine and Pharmacy 2023;13(7):52-58
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.
8.Update on antibiotic resistance of common pathogenical bacteria isolated in Hue University of Medicine and Pharmacy Hospital
Dinh Binh TRAN ; Viet Quynh Tram NGO ; Thi Bao Chi LE ; Thi Chau Anh NGUYEN ; Hoang Bach NGUYEN ; Van Bao Thang PHAN ; Thi Khanh Linh NGUYEN ; Nu Xuan Thanh LE ; Thi Dang Khoa NGUYEN ; Thi Tuyen NGUYEN ; Thi Thuy UNG ; Thi Hai DINH ; Thi Ngoc Mai DUONG ; Minh Ngoc HOANG ; Viet Tu NGUYEN ; Le Bich Ngoc HOANG ; Tuan Khoi TRAN ; Doan Hieu TRAN ; Thi Tuyet Ngoc TRAN ; Van An LE
Hue Journal of Medicine and Pharmacy 2023;13(7):66-74
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.
9.Mental health and its determinants among adolescents living in families with separated or divorced parents in an urban area of Vietnam
Binh Thang TRAN ; Minh Tu NGUYEN ; Minh Tam NGUYEN ; Thanh Gia NGUYEN ; Vo Nu Hong DUC ; Thi Tra My TRAN
Osong Public Health and Research Perspectives 2023;14(4):300-311
Objectives:
We assessed the prevalence of stress, anxiety, and depression among adolescents living in families with separated or divorced parents in Hue City, Vietnam and identified factors associated with these conditions.
Methods:
This cross-sectional study enrolled 309 adolescents, aged 12 to 17 years, living in families with separated or divorced parents in Hue City, Vietnam. The depression anxiety stress scale-21 (DASS-21) was used to measure stress, anxiety, and depression. Predictors of overall and individual mental health problems were identified using ordered and binary logistic regression, respectively.
Results:
The DASS-21 scale revealed a 49.2% prevalence of stress, while anxiety and depression had s prevalence rates of 61.5%. Among participants, 42.4% experienced all 3 mental health issues. Several factors were identified as significant predictors of mental health problems, including poor to average economic status (adjusted odds ratio [aOR], 2.00; 95% confidence interval [CI], 1.21–3.31; p=0.007); being in high school (aOR, 5.02; 95% CI, 2.93–8.60; p<0.001); maternal occupation of teacher, healthcare professional, or official (aOR, 2.39; 95% CI, 1.13–5.03; p=0.022); longer duration of family separation or divorce (aOR, 1.24; 95% CI, 1.05–1.45; p=0.009); living with one’s mother (aOR, 1.69; 95% CI, 1.03–2.76; p=0.04); alcohol consumption (aOR, 1.70; 95% CI, 0.99–2.92; p=0.050); and being bullied (aOR, 5.33; 95% CI, 1.10–25.69; p=0.037). Most of these factors were associated with stress, anxiety, and depression. Additionally, smoking was associated with stress.
Conclusion
Adolescents with separated or divorced parents were at increased risk of stress, anxiety, and depression. The findings of this study provide important implications for prevention programs.
10.Sleep Quality and Poor Sleep-related Factors Among Healthcare Workers During the COVID-19 Pandemic in Vietnam
Thang PHAN ; Ha Phan Ai NGUYEN ; Cao Khoa DANG ; Minh Tri PHAN ; Vu Thanh NGUYEN ; Van Tuan LE ; Binh Thang TRAN ; Chinh Van DANG ; Tinh Huu HO ; Minh Tu NGUYEN ; Thang Van DINH ; Van Trong PHAN ; Binh Thai DANG ; Huynh Ho Ngoc QUYNH ; Minh Tran LE ; Nhan Phuc Thanh NGUYEN
Journal of Preventive Medicine and Public Health 2023;56(4):319-326
Objectives:
The coronavirus disease 2019 (COVID-19) pandemic has increased the workload of healthcare workers (HCWs), impacting their health. This study aimed to assess sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and identify factors associated with poor sleep among HCWs in Vietnam during the COVID-19 pandemic.
Methods:
In this cross-sectional study, 1000 frontline HCWs were recruited from various healthcare facilities in Vietnam between October 2021 and November 2021. Data were collected using a 3-part self-administered questionnaire, which covered demographics, sleep quality, and factors related to poor sleep. Poor sleep quality was defined as a total PSQI score of 5 or higher.
Results:
Participants’ mean age was 33.20±6.81 years (range, 20.0-61.0), and 63.0% were women. The median work experience was 8.54±6.30 years. Approximately 6.3% had chronic comorbidities, such as hypertension and diabetes mellitus. About 59.5% were directly responsible for patient care and treatment, while 7.1% worked in tracing and sampling. A total of 73.8% reported poor sleep quality. Multivariate logistic regression revealed significant associations between poor sleep quality and the presence of chronic comorbidities (odds ratio [OR], 2.34; 95% confidence interval [CI], 1.17 to 5.24), being a frontline HCW directly involved in patient care and treatment (OR, 1.59; 95% CI, 1.16 to 2.16), increased working hours (OR, 1.84; 95% CI,1.37 to 2.48), and a higher frequency of encountering critically ill and dying patients (OR, 1.42; 95% CI, 1.03 to 1.95).
Conclusions
The high prevalence of poor sleep among HCWs in Vietnam during the COVID-19 pandemic was similar to that in other countries. Working conditions should be adjusted to improve sleep quality among this population.


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