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.

Sexual behaviors of alcohol drinkers and non-drinkers among adolescents and young adults in Nha Trang, Vietnam.

A cross-sectional quantitative survey was conducted during August to November 2005 with 880 youths (16-24 years-old), including 412 males and 468 females in Nha Trang city, Vietnam. It aimed to examine the association between alcohol use and sexual behaviors by gender difference. The data revealed that the majority of respondents (65.9%) had consumed alcohol, 25.8% had sexual touching with boy/girl friends, and 10.1% of respondents had engaged in sexual experiences including vaginal sex, anal sex, and/or oral sex. Young men were significantly more likely to drink than young women were (p < 0.001), and alcohol use was significantly associated with engagement in sexual experiences (p < 0.001). There was a strong significant different between sexual touching and alcohol drinking among males (p < 0.001) and females (p < 0.001). Forty percent of young men who did not use condom in last sex and 45% of young men who had multiple sex partners were drinkers compared to 4.8% and 1.6% of non-drinkers, respectively. These significant findings will be baseline data for integrating and adapting into intervention programs for alcohol and HIV among Vietnamese youth.

Acceptability and accessibility of a Shigellosis vaccine in Nha Trang city of Viet Nam.

The acceptability and accessibility of a hypothetical Shigella vaccination campaign was explored. A household survey was conducted with 539 randomly-selected residents of six communes in Nha Trang city of Viet Nam. Four categories of acceptability, such as refusers, low acceptors, acceptors, and high acceptors, were established, Refusers were significantly more likely to be elderly women and were less likely to know the purpose of vaccinations. Low acceptors tended to be male, elderly, and live in urban areas. Low acceptors perceived the disease as less serious and themselves as less vulnerable than acceptors and high acceptors. In terms of accessing vaccination, the commune health centre workers and commune leaders were the preferred sources of information and commune health centres the preferred location for vaccination. Direct verbal information from healthcare providers and audio-visual media were preferred to written information. The respondents expressed a desire for knowledge about the side-effects and efficacy of the vaccine. These findings are significant for targeting specific messages about shigellosis and vaccination to different populations and maximizing informed participation in public-health campaigns.

Healthcare use for diarrhoea and dysentery in actual and hypothetical cases, Nha Trang, Viet Nam.

To better understand healthcare use for diarrhoea and dysentery in Nha Trang, Viet Nam, qualitative interviews with community residents and dysentery case studies were conducted. Findings were supplemented by a quantitative survey which asked respondents which healthcare provider their household members would use for diarrhoea or dysentery. A clear pattern of healthcare-seeking behaviours among 433 respondents emerged. More than half of the respondents self-treated initially. Medication for initial treatment was purchased from a pharmacy or with medication stored at home. Traditional home treatments were also widely used. If no improvement occurred or the symptoms were perceived to be severe, individuals would visit a healthcare facility. Private medical practitioners are playing a steadily increasing role in the Vietnamese healthcare system. Less than a quarter of diarrhoea patients initially used government healthcare providers at commune health centres, polyclinics, and hospitals, which are the only sources of data for routine public-health statistics. Given these healthcare-use patterns, reported rates could significantly underestimate the real disease burden of dysentery and diarrhoea.