Study Design for the 2016 Baseline Survey of a Health System Strengthening Project in Quoc Oai District, Hanoi, Vietnam

BACKGROUND: In order to provide essential scientific evidence on the population's health status and social health determinants as well as the current capacity of the health care system in Vietnam to health policy makers and managers, Vietnam Ministry of Health, Hanoi University of Public Health, Hanoi Medical University, and Ho Chi Minh University of Medicine and Pharmacy collaborated with Seoul National University (Korea) and conducted a health system survey in the Quoc Oai district (of Hanoi capital) that represented northern rural Vietnam. METHODS: The study design was a cross-sectional study. The survey covered different topics (more than 200 questions) and was administered in three separate questionnaires: 1) Basic information of all household members; 2) Household characteristics; and 3) Individual characteristics. Socio-demographic characteristics among the households and individuals were collected from 2,400 households sampled by multi-stage cluster sampling method: more than 200 questions. RESULTS: The household size of Quoc Oai was larger than the national average and there was no significant difference in gender composition. In addition, the proportions of pre-elderly, age 55–64, and elderly group (65 years old and over) were higher than the national population statistics. In this context, demographic transition has begun in Quoc Oai. CONCLUSION: This study design description provides the basic information about a baseline survey of a future prospective cohort (as a part of a collaborative project on strengthening the health system in Vietnam) to the prospective data user of this survey.

Missed detections of influenza A(H1)pdm09 by real-time RT–PCR assay due to haemagglutinin sequence mutation, December 2017 to March 2018, northern Viet Nam

Introduction@#There are two methods of reverse transcription polymerase chain reaction (RT–PCR) that have been the common methods to detect influenza infections: conventional and real-time RT–PCR. From December 2017 to March 2018, several missed diagnoses of influenza A(H1)pdm09 using real-time RT–PCR were reported in northern Viet Nam. This study investigated how these missed detections occurred to determine their effect on the surveillance of influenza.@*Methods@#The haemagglutinin (HA) segments of A(H1N1)pdm09 from both real-time RT-PCR positive and negative samples were isolated and sequenced. The primer and probe sets in the HA gene were checked for mismatches, and phylogenetic analyses were performed to determine the molecular epidemiology of these viruses.@*Results@#There were 86 positive influenza A samples; 32 were A(H1)pdm09 positive by conventional RT–PCR but were negative by real-time RT–PCR. Sequencing was conducted on 23 influenza (H1N1)pdm09 isolates that were recovered from positive samples. Eight of these were negative for A(H1)pdm09 by real-time RT–PCR. There were two different mismatches in the probe target sites of the HA gene sequences of all isolates (n = 23) with additional mismatches only at position 7 (template binding site) identified for all eight negative real-time RT–PCR isolates. The prime target sites had no mismatches. Phylogenetic analysis of the HA gene showed that both the positive and negative real-time RT–PCR isolates were grouped in clade 6B.1; however, the real-time RT–PCR negative viruses were located in a subgroup that referred to substitution I295V.@*Conclusion@#Constant monitoring of genetic changes in the circulating influenza A(H1N1)pdm09 viruses is important for maintaining the sensitivity of molecular detection assays.

Patterns of Health Expenditures and Financial Protections in Vietnam 1992-2012

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.

Studying the therapeutic effects of the traditional remedy of "tu than hoan" in the treatment of irritable bowel syndrome of diarrhea state

Background: Irritable bowel syndrome is a diagnosis of exclusion. It is a functional bowel disorder characterized by chronic abdominal pain, discomfort, bloating, and alteration of bowel habits in the absence of any detectable organic cause."Tu than hoan" is a traditional remedy applied for the treatment of syndromes of traditional medicine which have the similar characteristics to irritable bowel syndrome of diarrhea state of modern medicine. Objectives: The study had two purposes: (1)To evaluate the therapeutic effects of the remedy on the clinical symptoms of patients with irritable bowel syndrome of diarrhea state comparing with Duspatalin; (2)To evaluate the side effects of the remedy. Subjects and method:162 patients diagnosed with irritable bowel syndrome of diarrhea state were treated at Bach Mai hospital from March to August 2005. They divided into 2 groups, the control group included 77 patients and the study group included 85 patients. : clinical test, comparing with controls. Results: 80% of patients recovered from diarrhea; 82.4% of patients with defecation returned to normal; 93.6% stopped mucous feces; 76.5% stopped bellyache. Good therapeutic effect was 61.2% (p < 0.05). Conclusions: Tu than hoan had good therapeutic effects in the treatment of irritable bowel syndrome of diarrhea state. None of patients had to discontinue the medicine due to side effects. \r\n', u' \r\n', u'

Study on influences of the fixed combination anti-malarial drug dihydroartemisinin plus piperaquine in constitutions and some biochemical and haematological indices of rabbits

Background: The combination of dihydroartemisinin and piperaquine is interested because of its efficiency and safety in treating malaria. Objective: To evaluate the influences of the fixed combination anti-malarial drug dihydroartemisinin plus piperaquine in constitutions and some biochemical and haematological indices of rabbits. Subject and Method: The sub-chronic toxicity of the fixed combination anti-malarial drug of 40 mg dihydroartemisinin plus 320 mg piperaquine phosphate (DHA-PQP), with the materials produced by Institute of Chemistry, in rabbits was investigated. Rabbits were treated daily by oral route with DHA-PQP at the dose regimens of 64 and 100 mg/kg per day for 28 consecutive days. Result and Conclusion: DHA-PQP did not affect on rabbits' constitutions. Generally, all rabbits had normal ingestions, activities, and defecations. Rabbits' body weights increased regularly along the study period and significantly increased between day 28 and day 0 (P < 0.05). At the dose regimen of 64 mg/kg per day for 28 consecutive days, DHA-PQP did not change significantly rabbits' biochemical indices (including GOT, GPT, bilirubin, creatinine and protein) and haematological. These changes were insignificantly different between the treated and control groups at the same study points (P > 0.05). With the dose regimen of 100 mg/kg, the combination did not affect significantly (P>0.05) on some rabbits' biochemical and haematological indices. But hemoglobin, erythrocyte count and rate of monocytes increased significantly on day 14 comparing to that the control group (P < 0.05) and became in normal limits on day 29 (P > 0.05). Protein concentration also increased significantly on days 14 and 29 comparing to that of day 0 (P < 0.05).

Study on acute oral toxicities of Piperaquine phosphate and the fixed combination anti-malarial drug Dihydroartemisinin plus Piperaquine in mice

Background: Piperaquin (PQ) is an anti-malaria drug, which belong to bisquinoline class. Vietnam has successfully produced PQ (both base and phosphate) since 2004. Objective: To evaluate acute oral toxicities of Piperaquine phosphate and the fixed combination anti-malarial drug Dihydroartemisinin plus Piperaquine in mice. Subject and Method: This study was conducted at National Institute of Malariology, Parasitology and Entomology between June and October, 2005. The acute oral toxicities of piperaquine phosphate (PQP) and the fixed combination anti-malaria drug (40 mg dihydroiutemisinin plus 320 mg piperaquine phosphate (DHA-PQP), with the materials produced by Institute of chemistry) in mice were investigated. Result: PQP had a medium toxicity. Inhibition of mice's central nervous systems was the main toxicity exhibition. At the high doses of PQP, mice's convulsion was observed before their deaths. The infralethal dose (LDo), absolute lethal dose (LD100) and mean lethal dose (LD50) of PQP were 900, 2300 and 1643.98 (1537.6 \u2013 1758.92) mg/kg, respectively. The fixed combination DHA-PQP had a less toxicity than PQP powder, with LDo, LD100 and LD50 were 1400, 2800 and 2050.06 (1943.63 \u2013 2157.14) mg per kg of body weight, respectively. Conclusion: At the high doses of DHA-PQP, this combination also inhibited mice's central nervous systems. Mice convulsed strongly before their deaths. All died mice were operated for observing visually their organs such as hearts, livers, kidneys, lungs, vesicles and intestines. No abnormal signals were found.

Study on influences of the fixed combination antimalaria drug dihydroartemisinin plus piperaquine in reproductive progress of mice

Background: Dihydroartemisinin 40mg and piperaquine phosphate 320mg (DHA-PQP) drug combination and piperaquin phosphate (PQP) material was first successfully produced in Vietnam \r\n', u'Objective: to study influences of the fixed combination antimalaria drug dihydroartemisinin plus piperaquine in reproductive progress of mice\r\n', u"Subjects and methods: This study was carried out at the Department of Malaria treatment and research, National Institute of Malariology, Parasitology and Entomology (NIMPE), between September, 2006 and March, 2007. The influences of the fixed combination antimalarial drug 40 mg dihydroartemisinin (DHA) plus 320 mg piperaquine phosphate (PQP), with PQP produced firstly in Vietnam, in mice's reproductive progresses were investigated in three generations (including the parent and FI, F2 child generations). \r\n", u'Results: In all three generations, study indices among the treated and control groups were not significantly different (the values P > 0.05). These indices included the rate of fecundation, numbers of fetuses of each mother mouse, numbers of offspring of each mother mouse, mean body weights of offspring. Early lethal fetuses, lately lethal fetuses, monsters and innate abnormally offspring were not found in P, FI and F2 generations. The necessary feeding - day numbers that offspring of P and F 1 generations reached their body weights about 20g were different insignificantly (the values P> 0.05) among the treated and control groups. \r\n', u'Conclusion: The combination DHA-PQP was found to cause no genome mutations in mice at the oral dose of 120 mg per kg per day for 5 consecutive days. \r\n', u'

Investigation of anti acute inflammatory activity of beta-aminoceton which is derivative of anilin

Healthy rats with weight of 120-180 g were randomly divided into 4 groups. They tested the anti-acute inflamatory activity of T1 (3 -methoxy 4 hydroxy-5 bromobenzylidien para bromo anilin) and T2 (3-methoxy 4 hydroxy-5 nitrobenzylidien p-nitro anilin). The results have shown that T1 had a significant antiinflamatory activity after 2 h and 4 h of the test but had no antiflamatory activity after 6 h of the test comparing with the control. While the anti-inflamatory activity of T2 was not different from this in the control. This study concluded that the anti-inflamatory activity of derivatives of 5 bromo vanilin was better than this of derivatives of 5 -nitroanilin.