Treatment Costs of Pneumonia, Meningitis, Sepsis, and Other Diseases among Hospitalized Children in Viet Nam.

The aim of this study was to estimate the costs of treatment of children who present with the signs and symptoms of invasive bacterial diseases in Khanh Hoa province, Viet Nam. The study was an incidencebased cost-of-illness analysis from the health system perspective. The hospital costs included labour, materials and capital costs, both direct and indirect. Costs were determined for 980 children, with an average age of 12.67 months (standard deviation±11.38), who were enrolled in a prospective surveillance at the Khanh Hoa General Hospital during 2005-2006. Of them, 57% were male. By disease-category, 80% were suspected of having pneumonia, 8% meningitis, 3% very severe disease consistent with pneumococcal sepsis, and 9% other diseases. Treatment costs for suspected pneumonia, meningitis, very severe disease, and other diseases were US$ 31, US$ 57, US$ 73, and US$ 24 respectively. Costs ranged from US$ 24 to US$ 164 across different case-categories. Both type of disease and age of patient had statistically significant effects on treatment costs. The results showed that treatment costs for bacterial diseases in children were considerable and might differ by as much as seven times among invasive pneumococcal diseases. Changes in costs were sensitive to both age of patient and case-category. These cost-of-illness data will be an important component in the overall evidence base to guide the development of vaccine policy in Viet Nam.

Reliability and validity of the Vietnamese version of the Pregnancy Physical Activity Questionnaire (PPAQ).

This study aimed to translate the Pregnancy Physical Activity Questionnaire (PPAQ) into Vietnamese, and test its reliability and validity among Vietnamese pregnant women. Intraclass correlation (ICC) and the Bland and Altman method were used to assess the test-retest reliability of the PPAQ. The Pearson correlations coefficient between the PPAQ measurements and those obtained from a pedometer that measured step counts (10-day averages) were used to determine the validity of the questionnaire. The PPAQ was successfully translated from English into Vietnamese with face validity through a rigorous process of the cross-cultural validation. For the analysis of reliability, the ICC value was 0.88 (95% CI 0.83-0.94) for total activity, 0.94 for sedentary, 0.88 for light, 0.90 for moderate, and 0.87 for vigorous activities. The Bland and Altman analysis showed that the first and second PPAQ total scores did not significantly differ from zero, and mostly fell within the range of 0 +/- 1.96 SD. The analysis of validity showed that there were moderate correlations with statistically significance (p = 0.02) between the step counts and PPAQ total. Our study indicates that the Vietnamese PPAQ is within acceptable reliability and validity.

The feasibility of a school-based VI polysaccharide vaccine mass immunization campaign in Hue City, central Vietnam: streamlining a typhoid fever preventive strategy.

We report the coverage, safety, and logistics of a school-based typhoid fever immunization campaign that took place in Hue City, central Vietnam; a typhoid fever endemic area. A cluster-randomized evaluation-blinded controlled trial was designed where 68 schools (cluster) were randomly allocated the single dose Vi polysaccharide vaccine (Typherix) or the active control hepatitis A vaccine (Havrix). A safety surveillance system was implemented. A total of 32,267 children were immunized with a coverage of 57.5%. Strong predictors for vaccination were attending primary schools, peri-urban location of the school, and low family income. Human resources were mainly schoolteachers and the campaign was completed in about 1 month. Most adverse events reported were mild. Safe injection and safe sharp-waste disposal practices were followed. A typhoid fever school-based immunization campaign was safe and logistically possible. Coverage was moderate and can be interpreted as the minimum that could have been achievable because individual written informed consent procedures were sought for the first time in Hue City and the trial nature of the campaign. The lessons learned, together with cost-effectiveness results to be obtained by the end of follow-up period, will hopefully accelerate the introduction of Vi typhoid fever vaccine in Vietnam.