Man power and organization of provincial preventive medicine centers in the northern provinces

Background: Investment to meet the man power requirements are recognized as urgent; especially to efficiently implement the National Strategy of Preventive Medicine. To strengthen the capability of provincial preventive medicine centers, the Ministry of Health has approved Decision No 05/2006QD-BYT for functions, tasks, authorization and organizational structure of Provincial Preventive Medicine Centers (PPMCs). Objectives: The study was conducted to evaluate the manpower and organization structure of northern PPMCs and provide recommendations for policy makers. Subjects and method: Using the cross-sectional descriptive method, the study covered the preventive medicine centers of 29 northern provinces between Jan to Jun 2007. The information was collected by interviews and self-reported questionnaires. Results:23/29 PPMCs have not met the criteria of man power stated in the Circular 08/2007/TTLB-BYT-BNV. Only 9/29 PPMCs were well organized in accordance with Decision 05/2006/QD-BYT of the Ministry of Health. The average number of staffs in PPMCs was 50+15. Medical staffs accounted for 53%, out of which 21.1% had postgraduate degrees; 32.2% had graduate degrees and 23.3% had been trained in preventive care. Conclusion: To meet the requirements provided by the Decision No05/2006QD-BYT, the man power and training for staffs in PPMCs should be improved and strengthened.

Assessment of child health care services in Bac Giang and Ha Nam provinces

Background: The strategy of Integrated Management of Childhood Illness (IMCI) was developed as an approach/tool for reducing the childhood mortality in developing countries. IMCI was approved by the Ministry of Health of Viet Nam and has been implemented in more than 3500 communal health centers nationwide. Aims: 1) To discover the quality of health care services for children under-5 and the situation of IMCI in health facilities. 2) To propose solutions to improve the quality of health care services for children. Materials and method: The cross-sectional study using quantitative and qualitative approaches conducted 58 direct observations in health workers, interviewed 58 caretakers, comprehensively interviewed 20 local leaders and technical staffs, facilitated 12 focal group discussions and reviewed 120 records of 12 commune health centers. Results: IMCI was considered by all of the participants as a comprehensive approach to improving the quality of childhood health care at first-level health facilities. IMCI contributed towards improved case management skills of health workers, improved the supply of essential drugs and supplies for child health care. As a result, the quality of health services for children under-5 has been promoted (93% of illness children were correctly assessed and classified, 84.6% of them were correctly treated and counseled). Health workers in Ly Nhan district, Ha Nam province adhered to 8.4+/-1.5 out of 10 essential steps of comprehensive child health care. Contrarily, this indicator was low in the districts of Bac Giang province (4.8+/-1.5), not much different to untrained IMCI health workers. Conclusion: IMCI is a useful strategy to improving the quality of child health care. But there were some difficulties that affected the implementation of this strategy in first-level health facilities.

Capacity for microbiological diagnosis the etiology of communicable disease at provincial centers for preventive medicine

Background: Like other countries in the world, Vietnam has seen the appearance of many infectious diseases such as SARS, influenza A/H1N1. Therefore, monitoring and quick response to infectious diseases, increasingly require enhancing the capacity of test systems. \r\n', u'Objectives: To determine the capacity for microbiological diagnosis and etiology of communicable diseases at the provincial centers for preventive medicine.\r\n', u'Subjects and methods: With the application of the cross-sectional approach, the study was conducted on microbiology diagnostic capacity for communicable diseases surveillance and response system in 55 Provincial Preventive Medicine Centers (PPMCs)\r\n', u'Results: Laboratory testing and confirmation (isolation and bio-chemical tests, gram stain) are only available for common nitrobacteria such as Escherichia coli, Vibrio cholera, Shigella, Salmonella, and some of the respiratory bacteria as streptococcus, meningococcus, etc... in most PPMCs. ELISA/MACELISA technique for detecting virus pathogen such as Arbo viruses (Dengue, Japanese B encephalitis) and Hepatitis B, HIV is also a focus of these PPMCs. However, for diseases caused by other viruses like Polio, Rota, measles, influenza, PPMCs have only the ability to collect specimens. \r\n', u'Conclusions: Most of the cases reported in the surveillance reports are based on clinical signs, only. Case confirmation was done by hospital/regional or national laboratory. \r\n', u'\r\n', u'

Assessment of knowledge and practices related to biosafety of researchers in microbiological laboratories of provincial centers for preventive medicine

Background: In recent years, due to the outbreak of new infectious diseases, re-emerging diseases and bio-terrorist threats, the biological safety for laboratories is essential\r\n', u'Objectives: to evaluate knowledge and practices related to biosafety of researchers in microbiological laboratories\r\n', u'Subjects and method: The study was carried out in the period 2006-2007. Questionnaires and checklists were used for the direct interview the knowledge and observe the practices related to biological safety of 97 laboratory technicians from microbiology laboratories of 22 provincial centers for preventive medicine, which represent for all areas in Vietnam.\r\n', u'Results: The percentage of technicians defines correctly the hazardous groups of some common pathogens are 8.2-33%. The percentage of technicians define correctly the transmission routes of Bacillus anthracis, Staphylococus, Streptococcus are 1%, 15% and 19.6%, respectively. The opinion that thay can wear the laboratory blouse out of laboratories, bring personal belongings into the laboratory and pipeting by mouth are 21.6%, 50.5% and 23.7%, respectively. Regarding laboratory practices: The percentage of technicians does not use gloves is 37.8%; pipeting by mouth: 22.6%. Over 40% technicians do not disinfect working area or washing hands with alcohol after experiments\r\n', u'Conclusion: The results of this study are a basis for planning programs to train, supervise and improve the operational quality of the microbiological laboratory of the provincial preventive health care centers.\r\n', u'\r\n', u'\r\n', u'

Surveillance of rats and fleas at Noi Bai international airport, 2006

Backgound: Plague disease is one of three most seriously infectious diseases (plague, yellow fever and cholera disease). In Vietnam, this condition has been obviously controlled. The number of new cases and deaths of plague disease have decreased significantly: from 439.6 patients between 1991 and 1995 to 161.2 patients between 1996 and 2000. However, the disease is still circulating in some areas in the world. Objective: To survey plague disease related factors (rats and fleas) at Noi Bai international airport. Subjects and method: A surveillance to inspect plague disease related factors (rats and fleas) was conducted at Noi Bai international airport, Ha Noi, from January/2006 to December/2006. Results and Conclusion: There were two types of rats: R. flavipectus in majority and R. norvegicus. The enrichment index of the two kinds of rats had increased in April and May. R. flavipectus disposed at flat form T1 and R. norvegicus disposed at store area. The only flea species found at the surveillance site was X.cheopis. Bacterial isolation of 236 specimens of liver and spleen, and ELISA tests of 180 blood samples were performed. All of the specimens were negative to Yersinia pestis. The study suggests that the rat populations at Noi Bai airport have not been infected with Yesinia pestis.

Perforated gastroduodenal ulceration saturation via abdominal endoscopy

Remarks on laparoscopic suture of perforated peptic ulcer. Objectives: to evaluate the early result of laparoscopic repair of perforated peptic ulcer. Method: prospective study. The outcome of 26 patients having the lararoscopic repair of perforated peptic ulcer was compared with the outcome of 26 patients treated with suture via laparotomy during the same period – from Sept 1995 to Dec 1998. Results: the average operative time of laparoscopic suture was longer than for open suture (69.6 min Vs. 48.7 min; T test, p<0.05). There was no difference of the time between the laparoscopic and the open groups to resume normal diet (3.8 days). The everage hospitalization days for laparoscopic repair was shorter than for open repair (6 days; T test, p < 0.05). Conclusions: laparoscopic repair of perforated peptic ulcer is feasible, safe and effictive, has the additional and well – known advantages of minimally invasive surgery.

Dosage of metronidazole in tablets by HPLC in reverted phase:

Quantitation of Metronidazole by reversed phase liquid chromatography using Supelco LC-ABZ column and a mobile phase containing an acid aqueous phase (pH