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.Within-household SARS-CoV-2 transmission and vaccine effectiveness in the first three COVID-19 school outbreaks in northern Viet Nam, September–December 2021
Trang Thu Vu ; Tu Huy Ngo ; Khanh Cong Nguyen ; Vu Thi Lan ; Cu Thi Bich Hanh ; Le Hong Son ; Huyen Thi Nguyen ; Hien Thi Nguyen ; Nghia Duy Ngu ; Duong Nhu Tran ; Duc-Anh Dang ; Florian Vogt ; Thai Quang Pham
Western Pacific Surveillance and Response 2024;15(3):19-30
Objective: The risk of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from schoolchildren to their household and the protective effects of vaccination in these settings remain poorly understood. We assessed the transmission dynamics of schoolchildren with SARS-CoV-2 within their households and the protective effects of coronavirus disease (COVID-19) vaccination among household members in Viet Nam.
Methods: We estimated the attack rate, vaccine effectiveness and adjusted risk ratio (aRR) of factors associated with SARS-CoV-2 transmission to household contacts of children confirmed to have COVID-19 who attended three schools in Ha Nam, Phu Tho and Thanh Hoa provinces between September and December 2021 using multivariable regression with household-level random effects.
Results: This retrospective cohort study included 157 children infected with SARS-CoV-2 and their 540 household contacts. The attack rate among household contacts was 24.6% (133/540). Overall, vaccine effectiveness among household contacts was 39% (95% confidence interval [CI]: -1 to -63), higher among males than females and higher in adults aged >40 years. COVID-19 transmission was greater among female household contacts compared with males (aRR: 1.35, 95% CI: 0.94 to 1.95), although not statistically significant, and highest among those aged 19–39 years (aRR: 2.51, 95% CI: 1.50 to 4.21). Fully vaccinated household contacts had significantly lower infection risk (aRR: 0.46, 95% CI: 0.26 to 0.84).
Discussion: We found substantial onward transmission of SARS-CoV-2 from schoolchildren to household members, and older people were more likely to be protected by vaccination. We recommend that schoolchildren and all household members living with schoolchildren receive at least two doses of a COVID-19 vaccine. Recognizing the role of schoolchildren in the onward transmission of COVID-19 is an important lesson learned by Viet Nam that can help not only in managing other outbreaks but also in protecting schoolchildren by predicting the progress of the outbreak and preparing for a timely response.
3.Socioeconomic inequality in health-related quality of life among Korean adults with chronic disease: an analysis of the Korean Community Health Survey
Thi Huyen Trang NGUYEN ; Thi Tra BUI ; Jinhee LEE ; Kui Son CHOI ; Hyunsoon CHO ; Jin-Kyoung OH
Epidemiology and Health 2024;46(1):e2024018-
OBJECTIVES:
Health-related quality of life is crucial for people dealing with chronic illness. This study investigated the quality of life in individuals with 5 common chronic conditions in Korea. We also analyzed socioeconomic factors such as education, income, occupation, and urbanization to identify determinants of inequality.
METHODS:
Using 2016 Korea Community Health Survey data, we examined individuals aged 30 or older with chronic diseases (diabetes, hypertension, cardiovascular disease, hyperlipidemia, arthritis) using the EuroQol 5-Dimension 3 Level tool. We analyzed the associations between socioeconomic factors (education, income, occupation, urbanization) and quality of life using descriptive statistics and regression analysis. Inequality indices (relative inequality index, absolute inequality index) were used to measure inequality in quality of life.
RESULTS:
Individuals with higher income levels showed a 1.95-fold higher likelihood of a better quality of life than those with the lowest income. The lowest income group had higher odds of mobility (adjusted odds ratio [aOR], 2.2), self-care (aOR, 2.1), activity limitations (aOR, 2.4), pain/discomfort (aOR, 1.8), and anxiety/depression (aOR, 2.3). Educational disparities included a 3-fold increase in mobility and daily activity problems for those with elementary or lower education. Well-educated participants had a 1.94 times higher quality of life, with smaller differences in anxiety/depression and self-management. The income gap accounted for 14.1% of variance in quality-of-life disparities.
CONCLUSIONS
Addressing socioeconomic disparities in the quality of life for individuals with chronic diseases necessitates tailored interventions and targeted health policies. This research informs policymakers in developing focused initiatives to alleviate health inequities. It emphasizes the importance of mental health support and ensuring affordable, accessible healthcare services.
4.Determinants of unhealthy living by gender, age group, and chronic health conditions across districts in Korea using the 2010-2017 Community Health Surveys
Thi Tra BUI ; Thi Huyen Trang NGUYEN ; Jinhee LEE ; Sun Young KIM ; Jin-Kyoung OH
Epidemiology and Health 2024;46(1):e2024014-
OBJECTIVES:
We investigated the prevalence and determinants of unhealthy living by gender, age, and comorbidities across Korean districts.
METHODS:
For 806,246 men and 923,260 women from 245 districts who participated in the 2010-2017 Korean Community Health Surveys, risk scores were calculated based on obesity, physical inactivity, smoking, and high-risk alcohol consumption, each scored from 0 (lowest risk) to 2 (highest risk). A risk score ≥4 was defined as indicating unhealthy living, and weighted proportions were calculated for each district. Using multivariate regression, an ecological model including community socioeconomic, interpersonal, and neighborhood factors was examined by gender, age, and comorbidities.
RESULTS:
The mean age-standardized rate of unhealthy living was 24.05% for men and 4.91% for women (coefficients of variation, 13.94% and 29.51%, respectively). Individuals with chronic diseases more frequently exhibited unhealthy lifestyles. Unhealthy lifestyles were associated with educational attainment (β-coefficients: men, -0.21; women, -0.15), high household income (β=0.08 and 0.03, respectively), pub density (β=0.52 and 0.22, respectively), and fast-food outlet density (β=2.81 and 1.63, respectively). Negative associations were observed with manual labor, social activity participation, and hospital bed density. Unhealthy living was positively associated with living alone among women and with being unemployed among middle-aged men. Access to parks was negatively associated with unhealthy living among young men and women. The ecological model explained 32% of regional variation in men and 41% in women.
CONCLUSIONS
Improving the neighborhood built and socioeconomic environment may reduce regional disparities in lifestyle behaviors; however, the impacts may vary according to socio-demographic traits and comorbidities.
5.Economic Burden of Chronic Obstructive Pulmonary Disease: A Systematic Review
Hai Quang PHAM ; Kiet Huy Tuan PHAM ; Giang Hai HA ; Tin Trung PHAM ; Hien Thi NGUYEN ; Trang Huyen Thi NGUYEN ; Jin-Kyoung OH
Tuberculosis and Respiratory Diseases 2024;87(3):234-251
Globally, providing evidence on the economic burden of chronic obstructive pulmonary disease (COPD) is becoming essential as it assists the health authorities to efficiently allocate resources. This study aimed to summarize the literature on economic burden evidence for COPD from 1990 to 2019. This study examined the economic burden of COPD through a systematic review of studies from 1990 to 2019. A search was done in online databases, including Web of Science, PubMed/Medline, Scopus, and the Cochrane Library. After screening 12,734 studies, 43 articles that met the inclusion criteria were identified. General study information and data on direct, indirect, and intangible costs were extracted and converted to 2018 international dollars (Int$). Findings revealed that the total direct costs ranged from Int$ 52.08 (India) to Int$ 13,776.33 (Canada) across 16 studies, with drug costs rannging from Int$ 70.07 (Vietnam) to Int$ 8,706.9 (China) in 11 studies. Eight studies explored indirect costs, while one highlighted caregivers’ direct costs at approximately Int$ 1,207.8 (Greece). This study underscores the limited research on COPD caregivers’ economic burdens, particularly in developing countries, emphasizing the importance of increased research support, particularly in high-resource settings. This study provides information about the demographics and economic burden of COPD from 1990 to 2019. More strategies to reduce the frequency of hospital admissions and acute care services should be implemented to improve the quality of COPD patients’ lives and reduce the disease’s rising economic burden.
6.Utility of combining PIVKA-II and AFP in the surveillance and monitoring of hepatocellular carcinoma in the Asia-Pacific region
Do Young KIM ; Bao Nguyen TOAN ; Chee-Kiat TAN ; Irsan HASAN ; Lyana SETIAWAN ; Ming-Lung YU ; Namiki IZUMI ; Nguyen Nguyen HUYEN ; Pierce Kah-Hoe CHOW ; Rosmawati MOHAMED ; Stephen Lam CHAN ; Tawesak TANWANDEE ; Teng-Yu LEE ; Thi Thanh Nguyen HAI ; Tian YANG ; Woo-Chang LEE ; Henry Lik Yuen CHAN
Clinical and Molecular Hepatology 2023;29(2):277-292
Even though the combined use of ultrasound (US) and alpha-fetoprotein (AFP) is recommended for the surveillance of hepatocellular carcinoma (HCC), the utilization of AFP has its challenges, including accuracy dependent on its cut-off levels, degree of liver necroinflammation, and etiology of liver disease. Though various studies have demonstrated the utility of protein induced by vitamin K absence II (PIVKA-II) in surveillance, treatment monitoring, and predicting recurrence, it is still not recommended as a routine biomarker test. A panel of 17 experts from Asia-Pacific, gathered to discuss and reach a consensus on the clinical usefulness and value of PIVKA-II for the surveillance and treatment monitoring of HCC, based on six predetermined statements. The experts agreed that PIVKA-II was valuable in the detection of HCC in AFP-negative patients, and could potentially benefit detection of early HCC in combination with AFP. PIVKA-II is clinically useful for monitoring curative and intra-arterial locoregional treatments, outcomes, and recurrence, and could potentially predict microvascular invasion risk and facilitate patient selection for liver transplant. However, combining PIVKA-II with US and AFP for HCC surveillance, including small HCC, still requires more evidence, whilst its role in detecting AFP-negative HCC will potentially increase as more patients are treated for hepatitis-related HCC. PIVKA-II in combination with AFP and US has a clinical role in the Asia-Pacific region for surveillance. However, implementation of PIVKA-II in the region will have some challenges, such as requiring standardization of cut-off values, its cost-effectiveness and improving awareness among healthcare providers.
7.Assessment of In vitro Antioxidant, Antidiabetic and Cytotoxic Activities of Sphaeranthus africanus Extracts
Tran Thi HUYEN ; Julien DUJARDIN ; Nguyen Thi THU HUONG ; Chung Thi MY DUYEN ; Nguyen Hoang MINH ; Ha Quang THANH ; Dao Tran MONG ; Ly Hai TRIEU ; Nguyen Mai TRUC TIEN ; Mai Thanh CHUNG ; Nguyen Nhat MINH ; Nguyen Thi NGOC DAN ; Huynh LOI
Natural Product Sciences 2023;29(2):98-103
Sphaeranthus africanus is commonly used as a traditional remedy for sore throats and pain treatment in Vietnam. The aerial parts have been studied for its anti-inflammatory and anti-proliferative properties. However, the antioxidant and antidiabetic potential of the plant has not been explored. In this work, hydrophilic extracts of the plant's aerial parts were prepared in order to investigate its antioxidant and anti-diabetic properties. Also, the cytotoxicity of the root was evaluated and compared to that of the aerial parts. All of the extracts inhibited lipid peroxidation with IC 50 values ranging from 2.05 to 3.56 µg/mL, indicating substantial antioxidant activity. At an IC 50 value of 4.80 μg/mL, the 50% ethanol extract exhibited the most potent inhibition of α-glucosidase. The cytotoxic activity of root extracts is 2 to 5-fold less than that of the aerial parts. Nevertheless, dichloromethane and ethyl acetate extracts of the root demonstrated a selective effect on leukemia cells, with no harm towards the normal HEK-293 cell line. This work provides a scientific support for the antioxidant and antidiabetic activity of the plant. Hence, it may find a promising material for the development of novel antioxidant and antidiabetic agents. More research can be conducted on the phytochemistry and anticancer activities of the plant’s root.
8.NO Production Inhibition of Lignans from Vietnamese Schisandra sphenanthera Rehd. et Wils. Fruits
Hong Khuyen THI PHAM ; Phu Chi Hieu TRUONG ; Khanh Huyen THI PHAM ; Dao Cuong TO ; Manh Hung TRAN ; Tu Nguyen THI THANH
Natural Product Sciences 2023;29(4):312-322
In the present study, bioactivity-guided extraction and isolation of the n-hexane fraction of the fruits of Vietnamese Schisandra sphenanthera led to the isolation of five dibenzocyclooctadiene lignans as gomisin N (1), schisandrin C (2), gomisin H (3), gomisin D (4), and gomisin C (5). All the isolates were tested for their inhibition of NO production in LPS-induced RAW 264.7 cells. Among them, compounds 4 and 5 showed weak inhibition of NO production with IC 50 values of 25.0 ± 1.6 and 24.8 ± 2.0 µM, respectively. Compound 1 exhibited NO production inhibition with an IC 50 value of 15.8 ± 2.1 µM, meanwhile, schisandrin C (2) showed the most potent inhibition with an IC 50 value of 8.5 ± 0.5 µM. In addition, compound 2 had a concentrationdependent inhibitory effect on the protein expression of the inflammatory enzymes iNOS and COX-2. Their physicochemical properties and ADMET data were predicted by in silico, indicating favorable drug-like properties as well as low acute oral toxicity. The results suggest that the fruit of S. sphenanthera and its phytochemical constituents might be used as anti-inflammatory agents.
9.THE PERCEPTION OF IMPLEMENTING SOCIAL-EMOTIONAL LEARNING IN SOFT SKILLS AMONG VIETNAMESE HIGH SCHOOL STUDENTS
Vinh-Long Tran-Chi ; Son Van Huynh ; Huan Thanh Nguyen ; Thien-Vu Giang ; Huyen- Trang Luu-Thi
ASEAN Journal of Psychiatry 2023;24(9):1-12
Although the need for social and emotional development has existed for decades,
implementing Social-Emotional Learning (SEL) in schools continues to get considerable
attention as newer generations enter the educational system. The demand for development
is presently increasing daily. No one challenges the significance of social-emotional learning
and the influence of organizations on adolescent development today. Social-emotional
learning matches accurately with the priorities in modern schools. In Vietnam, quantitative
research was conducted on 350 high school students. This research aimed to determine how
students evaluate the implementation of the Social-emotional learning model in soft skills
education. The results revealed students’ interest in implementing the social-emotional
learning model into soft skills education. In addition, the results indicated the obstacles
to implementing the social-emotional learning model in soft skills education. This study’s
findings suggested that school leaders and background educators should implement the
social-emotional learning model and support, monitor, and evaluate program efficacy to
ensure program objectives are reached and students acquire social and emotional abilities.
In addition, the study suggested that specific strategies are necessary to limit the factors
that prevent the implementation of the social-emotional learning model in high schools.
10.Comparing multiplex and multiplex real-time polymerase chain reaction with traditional blood culture in bacterial detection among patients with septicemia
Loan Thi Nguyen ; Linh Trong Nguyen ; Trang Thu Nguyen ; Hien Minh Nguyen ; Thuy Thi Pham ; Huyen Thi La
Malaysian Journal of Microbiology 2022;18(3):242-250
Aims:
This study was aimed to test the specificity of primers and probes with target genes by using multiplex PCR and multiplex real-time PCR methods. These methods were compared with traditional blood culture methods in detecting five bacteria causing sepsis, including Acinetorbacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli and Staphylococcus aureus.
Methodology and results:
A total of 587 blood samples from patients diagnosed with sepsis and septic shock were collected at Thanh Nhan Hospital, Hanoi, Vietnam. Each sample was divided into three parts for bacterial culture, multiplex PCR and multiplex real-time PCR to detect the similarity of the two PCR methods with the bacterial culture method. Conditions in multiplex PCR and multiplex real-time PCR were optimized to ensure the successful amplification of target genes. Results showed that the primers and probes were tested completely specific to the target genes and using multiplex PCR and multiplex real-time PCR techniques could detect five pathogens causing sepsis, including A. baumannii, K. pneumoniae, P. aeruginosa, E. coli and S. aureus.
Conclusion, significance and impact of study
Both multiplex PCR and multiplex real-time PCR methods have high similarities with the culture method, showing potential in the application of bacteria detection in sepsis.
Multiplex Polymerase Chain Reaction
;
Sepsis--microbiology


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