Novel subtypes of Asian-origin (Goose/Guangdong lineage) H5 highly pathogenic avian influenza (HPAI) viruses belonging to clade 2.3.4, such as H5N2, H5N5, H5N6, and H5N8, have been identified in China since 2008 and have since evolved into four genetically distinct clade 2.3.4.4 groups (A–D). Since 2014, HPAI clade 2.3.4.4 viruses have spread rapidly via migratory wild aquatic birds and have evolved through reassortment with prevailing local low pathogenicity avian influenza viruses. Group A H5N8 viruses and its reassortant viruses caused outbreaks in wide geographic regions (Asia, Europe, and North America) during 2014–2015. Novel reassortant Group B H5N8 viruses caused outbreaks in Asia, Europe, and Africa during 2016–2017. Novel reassortant Group C H5N6 viruses caused outbreaks in Korea and Japan during the 2016–2017 winter season. Group D H5N6 viruses caused outbreaks in China and Vietnam. A wide range of avian species, including wild and domestic waterfowl, domestic poultry, and even zoo birds, seem to be permissive for infection by and/or transmission of clade 2.3.4.4 HPAI viruses. Further, compared to previous H5N1 HPAI viruses, these reassortant viruses show altered pathogenicity in birds. In this review, we discuss the evolution, global spread, and pathogenicity of H5 clade 2.3.4.4 HPAI viruses.
Africa ; Animals ; Asia ; Birds ; China ; Disease Outbreaks ; Epidemiology ; Europe ; Influenza in Birds* ; Japan ; Korea ; Poultry ; Reassortant Viruses ; Seasons ; Vietnam ; Virulence*

PURPOSE: This study aimed to explore the factors associated with the intention to receive a Pap test among married immigrant women of Vietnamese origin living in Taiwan. METHODS: This was a cross-sectional community-based study.We enrolled 281 women aged 30 years and over in the study, from July 2013 to January 2014. The participants' characteristics, cervical cancer knowledge, Pap test knowledge, attitudes toward cervical cancer, barriers to receiving a Pap test, fatalism, and intention to receive a Pap test, were measured using self-report questionnaires. Hierarchical multiple regression analyses were performed to examine the variables associated with participants' intentions to receive a Pap test. RESULTS: Vietnamese women with low scores on the measures of cervical cancer knowledge and perceived barriers to receiving a Pap test were more willing to receive the test, as were those with high scores on the measures of Pap test knowledge and fatalism. Women who received a Pap test in the previous year were more willing to receive a Pap test within the next 3 years. CONCLUSIONS: Preventive healthcare for immigrant women should be a focus of nurses. The development of culturally appropriate health education and strategies should enhance their knowledge of Pap tests and reduce perceived barriers to Pap test participation. This study's results can be a reference for nurses who work with immigrant women.
Adult ; Cross-Sectional Studies ; Emigrants and Immigrants/*psychology ; Emigration and Immigration ; Female ; Humans ; *Intention ; Marriage/psychology ; Papanicolaou Test/*psychology ; Patient Acceptance of Health Care/*psychology ; Self Report ; Socioeconomic Factors ; Taiwan/epidemiology ; Vietnam/ethnology

Health financing has been considered as an important building block of a health system and has a key role in promoting universal health coverage in the Vietnam. This paper aims to describe the pattern of health expenditure, including total health expenditure and composition of health expenditure, over the last two decades in Vietnam. The paper mainly uses the data from Vietnam National Health Account and Vietnam Living Standards Survey. We also included data from other relevant published literature, reports and statistics about health care expenditure in Vietnam. The per capita health expenditure in Vietnam increased from US$ 14 in 1995 to US$ 86 in 2012. The total health expenditure as a share of GDP also rose from 5.2% in 1995 to 6.9% in 2012. Public health expenditure as percentage of government expenditure rose from 7.4% in 1995 to nearly 10% in 2012. The coverage of health insurance went up from 10% in 1995 to 68.5% in 2012. However, health financing in Vietnam was depending on private expenditures (57.4% in 2012). As a result, the proportion of households with catastrophic expenditure in 2012 was 4.2%. The rate of impoverishment in 2012 was 2.5%. To ensure equity and efficient goal of health system, policy actions for containing the health care out-of-pocket payments and their poverty impacts are urgently needed in Vietnam.
Developing Countries/*economics ; Financing, Government/economics/trends ; Health Expenditures/*statistics & numerical data/*trends ; *Healthcare Financing ; Insurance, Health/*economics/*trends ; Vietnam/epidemiology

Vietnam is undergoing a rapid social and economic developments resulting in speedy urbanization, changes in methods for animal production, food marketing systems, and food consumption habits. These changes will have major impacts on human exposures to food poisoning. The present case study aimed to estimate hospitalization costs of foodborne diarrhea cases in selected health facilities in Vietnam. This is a facility-based cost-of-illness study conducted in seven health facilities in Northern Vietnam. All suspect cases of foodborne diarrhea, as diagnosed by doctors, who admitted to the studied health facilities during June-August, 2013 were selected. Costs associated with hospitalization for foodborne diseases were estimated from societal perspective using retrospective approach. We included direct and indirect costs of hospitalization of foodborne diarrhea cases. During the study period, 87 foodborne diarrhea cases were included. On average, the costs per treatment episode and per hospitalization day for foodborne diarrhea case were US$ 106.9 and US$ 33.6 respectively. Indirect cost (costs of times to patient, their relatives due to the patient's illness) made up the largest share (51.3%). Direct medical costs accounted for 33.8%; direct non-medical costs (patient and their relatives) represented 14.9%. Cost levels and compositions varied by level of health facilities. More attentions should be paid on prevention, control of foodborne diarrhea cases in Vietnam. Ensuring safety of food depends on efforts of everyone involved in food chain continuum, from production, processing, and transport to consumption.
Adolescent ; Adult ; Age Distribution ; Aged ; Child ; Child, Preschool ; *Cost of Illness ; Diarrhea/*economics/epidemiology ; Female ; Foodborne Diseases/*economics/epidemiology ; Health Care Costs/*statistics & numerical data ; Hospitalization/*economics ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Sex Distribution ; Vietnam/epidemiology ; Young Adult

The infection status of fishborne zoonotic trematode (FZT) metacercariae was investigated in fishes from 2 localities of Lao PDR. Total 157 freshwater fishes (17 species) were collected in local markets of Vientiane Municipality and Champasak Province in December 2010 and July 2011, and each fish was examined by the artificial digestion method. Total 6 species of FZT metacercariae, i.e., Opisthorchis viverrini, Haplorchis taichui, Haplorchis yokogawai, Haplorchis pumilio, Centrocestus formosanus, and Procerovum varium, were detected in fishes from Vientiane Municipality. The metacercariae of O. viverrini were detected in 50 (49.5%) out of 101 fishes (6 species), and their average number was 154 per fish infected. The remaining 5 species of heterophyid metacercariae were detected in 36.8%, 65.8%, 9.4%, 23.9%, and 5.1% fishes examined, and their average densities were 12, 1,038, 4, 15, and 13 per infected fish, respectively. In fishes from Champasak Province, 3 species of FZT metacercariae, i.e., O. viverrini, H. taichui, and H. yokogawai, were detected. Only 2 O. viverrini metacercariae were found in only 1 Barbonymus schwanefeldi. The metacercariae of H. taichui and H. yokogawai were detected in 60.0% and 50.0% of fishes examined, and their average densities were 47 and 28 per fish infected. By the present study, it has been confirmed that several species of FZT metacercariae are prevalent in fishes from Vientiane Municipality, with P. varium being a new member of FZT in Lao PDR. In comparison, FZT metacercariae are less prevalent in fishes from Champasak Province.
Animals ; Female ; Fish Diseases/epidemiology/*parasitology ; Laos ; Male ; Metacercariae/classification/genetics/growth & development/*isolation & purification ; Trematoda/classification/genetics/growth & development/*isolation & purification ; Trematode Infections/epidemiology/parasitology/*veterinary ; Vietnam ; Zoonoses/parasitology

Porcine epidemic diarrhea virus (PEDV), an Alphacoronavirus in the family Coronaviridae, causes acute diarrhea, vomiting, dehydration, and high mortality rates in neonatal piglets. PEDV can also cause diarrhea, agalactia, and abnormal reproductive cycles in pregnant sows. Although PEDV was first identified in Europe, it has resulted in significant economic losses in many Asian swine-raising countries, including Korea, China, Japan, Vietnam, and the Philippines. However, from April 2013 to the present, major outbreaks of PEDV have been reported in the United States, Canada, and Mexico. Moreover, intercontinental transmission of PEDV has increased mortality rates in seronegative neonatal piglets, resulting in 10% loss of the US pig population. The emergence and re-emergence of PEDV indicates that the virus is able to evade current vaccine strategies. Continuous emergence of multiple mutant strains from several regions has aggravated porcine epidemic diarrhea endemic conditions and highlighted the need for new vaccines based on the current circulating PEDV. Epidemic PEDV strains tend to be more pathogenic and cause increased death in pigs, thereby causing substantial financial losses for swine producers. In this review, we described the epidemiology of PEDV in several countries and present molecular characterization of current strains. We also discuss PEDV vaccines and related issues.
Asian Continental Ancestry Group ; Canada ; China ; Coronaviridae ; Dehydration ; Diarrhea* ; Disease Outbreaks ; Epidemiology* ; Europe ; Genetics ; Humans ; Japan ; Korea ; Mexico ; Mortality ; Philippines ; Porcine epidemic diarrhea virus ; Swine ; United States ; Vaccines* ; Vietnam ; Vomiting

Several reports on taeniasis and cysticercosis in Vietnam show that they are distributed in over 50 of 63 provinces. In some endemic areas, the prevalence of taeniasis was 0.2-12.0% and that of cysticercosis was 1.0-7.2%. The major symptoms of taeniasis included fidgeted anus, proglottids moving out of the anus, and proglottids in the feces. Clinical manifestations of cysticercosis in humans included subcutaneous nodules, epileptic seizures, severe headach, impaired vision, and memory loss. The species identification of Taenia in Vietnam included Taenia asiatica, Taenia saginata, and Taenia solium based on combined morphology and molecular methods. Only T. solium caused cysticercosis in humans. Praziquantel was chosen for treatment of taeniasis and albendazole for treatment of cysticercosis. The infection rate of cysticercus cellulosae in pigs was 0.04% at Hanoi slaughterhouses, 0.03-0.31% at provincial slaughterhouses in the north, and 0.9% in provincial slaughterhouses in the southern region of Vietnam. The infection rate of cysticercus bovis in cattle was 0.03-2.17% at Hanoi slaughterhouses. Risk factors investigated with regard to transmission of Taenia suggested that consumption of raw meat (eating raw meat 4.5-74.3%), inadequate or absent meat inspection and control, poor sanitation in some endemic areas, and use of untreated human waste as a fertilizer for crops may play important roles in Vietnam, although this remains to be validated.
Albendazole/*therapeutic use ; Animals ; Anthelmintics/therapeutic use ; Antiprotozoal Agents/therapeutic use ; Cattle/parasitology ; Cattle Diseases/parasitology ; Cysticercosis/*drug therapy/*epidemiology/parasitology/transmission ; Feces/parasitology ; Humans ; Meat/parasitology ; Praziquantel/*therapeutic use ; Raw Foods/adverse effects ; Risk Factors ; Swine/parasitology ; Swine Diseases/parasitology ; Vietnam/epidemiology

BACKGROUND/OBJECTIVES: High sensitivity C-reactive protein (hsCRP) is a strong independent predictor of future cardiovascular disease (CVD) risk. We evaluated the relationship between hsCRP and dietary intake in apparently healthy young women living in southern Vietnam. SUBJECTS/METHODS: Serum hsCRP was measured and dietary intake data were obtained using the 1-day 24-hour recall method in women (n = 956; mean age, 25.0 +/- 5.7 years) who participated in the International Collaboration Study for the Construction of Asian Cohort of the Korean Genome and Epidemiology Study (KoGES) in 2011. RESULTS: Women in the high risk group (> 3 mg/L) consumed fewer fruits and vegetables, total plant food, potassium, and folate than those in the low risk group (< 1 mg/L). A multiple regression analysis after adjusting for covariates revealed a significant negative association between hsCRP and fruit and vegetable consumption. A logistic regression analysis showed that the odds ratio (OR) of having a high hsCRP level in women with the highest quartiles of consumption of fruits and vegetables [OR, 0.391; 95% confidence interval (CI), 0.190-0.807], potassium [OR, 0.425; 95% CI, 0.192-0.939] and folate [OR, 0.490; 95% CI, 0.249-0.964] were significantly lower than those in the lowest quartiles. CONCLUSIONS: These results suggest that, in young Vietnamese women, an increased consumption of fruit and vegetables might be beneficial for serum hsCRP, a risk factor for future CVD events.
Asian Continental Ancestry Group* ; C-Reactive Protein* ; Cardiovascular Diseases ; Cohort Studies ; Cooperative Behavior ; Epidemiology ; Female ; Folic Acid ; Fruit ; Genome ; Humans ; Logistic Models ; Odds Ratio ; Plants ; Potassium ; Risk Factors ; Vegetables ; Vietnam

Paragonimiasis is a food-borne parasitic zoonosis caused by infection with lung flukes of the genus Paragonimus. In Vietnam, research on Paragonimus and paragonimiasis has been conducted in northern and central regions of the country. Using a combination of morphological and molecular methods, 7 Paragonimus species, namely P. heterotremus, P. westermani, P. skrjabini, P. vietnamensis, P. proliferus, P. bangkokenis and P. harinasutai, have been identified in Vietnam. Of these, the first 3, P. heterotremus, P. westermani and P. skrjabini, are known to infect humans in other countries. However, in Vietnam, only P. heterotremus, found in some northern provinces, has been shown to infect humans. Even nowadays, local people in some northern provinces, such as Lai Chau and Yen Bai, are still suffering from P. heterotremus infection. In some provinces of central Vietnam, the prevalence and infection intensity of P. westermani metacercariae in freshwater crabs (the second intermediate hosts) are extremely high, but human cases have not been reported. Likewise, although P. skrjabini was found in Thanh Hoa Province, its pathogenicity to humans in Vietnam still remains uncertain. The results of molecular phylogenetic analyses of Vietnamese Paragonimus species provides new insights on the phylogeny and taxonomy of the genus Paragonimus. Comprehensive molecular epidemiological and geobiological studies on the genus in Vietnam and adjacent countries are needed to clarify the biodiversity and public health significance of the lung flukes.
Animals ; Humans ; Paragonimiasis/*epidemiology ; Paragonimus/classification/genetics/*isolation & purification ; Phylogeny ; Prevalence ; Sequence Analysis, DNA ; Shellfish/parasitology ; Vietnam/epidemiology

OBJECTIVES: The aim of this study was to examine the levels of serum 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and evaluate their association with age, body mass index, smoking, military record-based variables, and estimated exposure to Agent Orange in Korean Vietnam veterans. METHODS: Serum levels of TCDD were analyzed in 102 Vietnam veterans. Information on age, body mass index, and smoking status were obtained from a self-reported questionnaire. The perceived exposure was assessed by a 6-item questionnaire. Two proximity-based exposures were constructed by division/brigade level and battalion/company level unit information using the Stellman exposure opportunity index model. RESULTS: The mean and median of serum TCDD levels was 1.2 parts per trillion (ppt) and 0.9 ppt, respectively. Only 2 Vietnam veterans had elevated levels of TCDD (>10 ppt). The levels of TCDD did not tend to increase with the likelihood of exposure to Agent Orange, as estimated from either proximity-based exposure or perceived self-reported exposure. The serum TCDD levels were not significantly different according to military unit, year of first deployment, duration of deployment, military rank, age, body mass index, and smoking status. CONCLUSIONS: The average serum TCDD levels in the Korean Vietnam veterans were lower than those reported for other occupationally or environmentally exposed groups and US Vietnam veterans, and their use as an objective marker of Agent Orange exposure may have some limitations. The unit of deployment, duration of deployment, year of first deployment, military rank, perceived self-reported exposure, and proximity-based exposure to Agent Orange were not associated with TCDD levels in Korean Vietnam veterans. Age, body mass index and smoking also were not associated with TCDD levels.
2,4,5-Trichlorophenoxyacetic Acid/*poisoning ; 2,4-Dichlorophenoxyacetic Acid/*poisoning ; Adult ; Age Factors ; *Body Mass Index ; Defoliants, Chemical/*poisoning ; Humans ; Male ; Middle Aged ; Questionnaires ; Regression Analysis ; Republic of Korea/epidemiology ; Self Report ; Smoking/*blood ; Tetrachlorodibenzodioxin/*blood/poisoning ; Time Factors ; Veterans/*statistics & numerical data ; Vietnam Conflict ; Young Adult