Neurological status of low-risk Vietnamese newborns: a comparison with a British newborn cohort.

A shortened version of the Dubowitz newborn neurological examination, recently reassessed in rural Thailand, was applied to a group of 58 Vietnamese newborns. The aim was to establish the neurological status of newborns in this population for use in further studies and to compare with groups previously studied. Compared to the original British cohort, the Vietnamese newborns showed significantly lower scores in 10 of 25 items, including several related to truncal tone. Evidence was sought of thiamine and long-chain fatty acid deficiency as a possible cause for these findings, but no correlation was found between the neurological status and the maternal or infant blood levels of these nutritional indicators. The findings suggest that the neurological status of low-risk Vietnamese newborns appears to lie between that of British newborns and those ethnic minority Karen newborns in refugee camps on the Thai-Burmese border tested previously. Although no specific nutritional cause has been identified in the study, the findings may still reflect sub-optimal intake of some important nutrients.

Factors associated with carriage of penicillin-resistant Streptococcus pneumoniae among Vietnamese children: a rural-urban divide.

This study examined the relationship between antimicrobial resistance in Streptococcus pneumoniae and patterns of antimicrobial usage and over-the-counter dispensing by pharmacies in urban and rural districts of Vietnam. The antimicrobial susceptibility of S. pneumoniae carried by healthy urban and rural school children was determined. Questionnaires were distributed to parents to describe their healthcare-seeking behaviour. Mock parents presented standardized cases of mild respiratory infection and acute watery diarrhoea to pharmacies in the district surrounding each school. Penicillin resistance was significantly more common in S. pneumoniae carried by urban children compared to rural children as was recent antibiotic usage. Both urban and rural pharmacies showed high rates of dispensing inadequate antimicrobial regimens. The high level of antimicrobial resistance in S. pneumoniae may be related to greater antimicrobial usage. This may result from the much easier access to healthcare providers in urban areas and may suggest that relying solely on education without limiting access to outlets may have only limited impact. The results suggest a greater understanding of the subtleties of healthcare-seeking behaviour, and access to healthcare is needed to help refine and guide rationale suggestions to reduce the continued spread of drug resistance.