Severity and factors associated with depressive symptoms among type 2 diabetic patients in Vietnam / Journal of the ASEAN Federation of Endocrine Societies

Background@#Diabetes and psychiatric disorders often co-occur. The prevalence of depression in a person with diabetes is two times higher than that of the general population. During the last decade, the prevalence of diabetes in Vietnam has nearly doubled. However, there is little data regarding depressive symptoms among people with diabetes. Therefore, this study aims to explore the level of depressive symptoms and its associated factors among patients with type 2 diabetes mellitus in Hanoi, Vietnam.@*Methodology@#A cross-sectional study was conducted among 519 patients diagnosed with type 2 diabetes at the Agricultural General Hospital, one of the largest primary care hospitals for diabetes in Hanoi, Vietnam. Patient Health Questionnaire-9 (PHQ-9) was used to assess the severity of depressive symptoms. Multivariate Tobit and logistic regression models were applied to examine factors associated with the severity of depressive symptoms and medication adherence@*Results@#Approximately 45.2% of participants were identified as having depressive symptoms at different levels. The proportion of patients with mild, moderate, moderately severe, and severe depressive symptoms is 36.0%, 7.6%, 1.4%, and 0.2% respectively. Regarding the treatment process, patients being treated for their diabetes for a longer time were more likely to have depressive symptoms. DDepression was positively linked to currently drinking alcohol (Coef = 1.04; 95% CI = 0.30-1.78), having comorbidities (Coef = 1.08; 95% CI = 0.15; 2.01) and having irregular physical activities (Coef = -1.28; 95% CI = -2.18; -0.38). Patients with severe depressive symptoms (higher PHQ-9 score) were more likely to be non-adherent to their medications in the last month (AOR = 1.30; 95% CI = 1.17; 1.46).@*Conclusion@#Our study shows that a high percentage of patients with diabetes have depressive symptoms. There is a strong association between having depressive symptoms and non-adherence to medications in the last month. To reduce the risk of developing depressive symptoms, depression should be screened at the initial treatment process and patients should be advised to avoid alcohol and to engage in physical activities regularly.

Multidrug-Resistant Gram-Negative Bacterial Infections in a Tertiary-Care Hospital in Northern Ghana: A Three-Year Retrospective Analysis / 대한임상미생물학회지

Background@#A variety of clinically important pathogens have developed multidrug resistance (MDR), which threatens global public health. This study aimed to determine the incidence, patterns, and trends of MDR of gram-negative bacterial isolates in clinical specimens in the Tamale Teaching Hospital, Ghana. @*Methods@#This retrospective study analyzed gram-negative bacterial isolates and antimicrobial susceptibility test (AST) results of patients who visited the Tamale Teaching Hospital laboratory between 2017 and 2019. @*Results@#A total of 2,779 gram-negative bacterial isolates and their phenotypic AST results were analyzed. From these, 1,297 gram-negative bacteria (46.7%) were isolated from urine samples, while the rest were isolated from sputum (20.9%), wound (14.3%), and swabs (11.7%) samples, etc. Escherichia coli (23.8%) was the most common gram-negative pathogen found predominantly in the urine samples (33.2%). All gram-negative bacteria isolated between 2017 and 2019 showed high MDR. Klebsiella pneumonia gradually increased its MDR from 84.0% in 2017, 89.5% in 2018, to 95.1% in 2019. On the other hand, the MDR rates in Pseudomonas aeruginosa were approximately 65.8%, varying from 59.5% in 2017 to 78.7% in 2019. Among tested antimicrobials, amikacin was the most effective. Resistance to amikacin in Enterobacter spp., E. coli, and K. pneumoniae in vitro were 16.2%, 11.8%, and 17.7%, respectively. @*Conclusion@#The study has shown that the high levels of MDR in gram-negative bacteria isolated may be associated with the infections recorded at the Tamale Teaching Hospital.The major gram-negative pathogens isolated have resistance to penicillins, cephalosporins, and fluoroquinolones. Aminoglycosides can offer high antibiotic activity to overcome gramnegative bacterial resistance. Further studies will be needed to decide policy direction on infection prevention and control, and antimicrobial stewardship programs

In vitro screening of siderophore-producing rice root endophytic bacteria from up-land paddies in north-western Vietnam for plant growth-promoting activities

Aims@#Endophytic bacteria (EB) living inside plant tissues possess different beneficial traits including siderophore production and other plant growth-promoting (PGP) activities. Siderophore-producing EB promote host plant growth by secreting ferrum in iron-deficient conditions. This study screened 19 siderophore producers in vitro, isolated from upland rice roots grown in mountain farms of Tung Village, Nậm Có Commune, Mù Cang Chải District, Yên Bái Province, Vietnam, for PGP traits, including phosphate solubilisation, indole-3-acetic acid (IAA), ammonia, gelatinase, amylase and catalase production.@*Methodology and results@#The bacteria were identified by Matrix assisted Laser Desorption Ionization Time of Flight mass spectrometry (MALDI-TOF MS). All 19 isolates were identified as genera Pseudomonas, Enterobacter, Pantoe, Bacillus, Burkholderia, Staphylococcus, Ralstonia and Cronotacter. The isolates produced catalase and ammonia. The amount of ammonia ranged from 60.74 ± 0.14 to 466.72 ± 0.18 mg/L. Out of the 19 siderophore producers, 17 (89.47%) were able to solubilise phosphate with solubilisation index (PSI) ranging from 1.12 ± 0.07 to 2.14 ± 0.15. The qualitative assays identified 12 isolates (63.15%) positive for IAA production with a tryptophan concentration of 5 mM, whereas 15 (78.94%) and 17 (89.47%) isolates were positive for gelatin and starch hydrolysis, respectively. Especially, 7 isolates were found to be positive for all tested assays in vitro including Pseudomonas rhodesiae (NC2), Enterobacter asburiae (NC50), Pantoea ananatis (NC63), Bacillus cereus (NC64), Burkholderia cenocepacia (NC110), Staphylococcus sciuri (NC112) and Ralstonia pickettii (NC122).@*Conclusion, significance and impact of study@#This study serves as crucial findings of multi-trait plant growth-promoting endophytic bacteria isolated from upland rice root in north-western Vietnam. The seven potential isolates positive for all tested assays could be effective PGP bacteria for bio-inoculants.

Laboratory Aspects of Donor Screening for Fecal Microbiota Transplantation at a Korean Fecal Microbiota Bank

Fecal microbiota transplantation (FMT) is a widely accepted alternative therapy for Clostridioides difficile infection and other gastrointestinal disorders. Thorough donor screening is required as a safety control measure to minimize transmission of infectious agents in FMT. We report the donor screening process and outcomes at a fecal microbiota bank in Korea. From August 2017 to June 2020, the qualification of 62 individuals as FMT donors was evaluated using clinical assessment and laboratory tests. Forty-six (74%) candidates were excluded after clinical assessment; high body mass index ( > 25) was the most common reason for exclusion, followed by atopy, asthma, and allergy history. Four of the remaining 16 (25%) candidates failed to meet laboratory test criteria, resulting in a 19% qualification rate. FMT donor re-qualification was conducted monthly as an additional safety control measure, and only three (5%) candidates were eligible for repeated donation. As high prevalence of multidrug-resistant organisms (55%) and Helicobacter pylori (44%) were detected in qualified donors during the screening, a urea breath test was added to the existing protocol. The present results emphasize the importance of implementing a donor re-qualification system to minimize risk factors not identified during initial donor screening.

Ethyl acetate extract of Smilax glabra Roxb roots and its major active compound astilbin promote osteoblastogenesis in vitro by upregulating bone cell differentiation- associated genes

Objective: To investigate the osteoblastogenic activity of the ethyl acetate (EtOAc) extract of Smilax glabra Roxb roots and its major active compound astilbin. Methods: Astilbin was isolated from EtOAc extract using silica gel chromatography combined with fraction crystallization. Chemical structure of astilbin was determined by analysis of the spectroscopic data in comparison with the literature. MTT method was used to detect the toxicity. Alkaline phosphatase (ALP) activity was determined by the spectrophotometric method at 405 nm using p-nitrophenyl phosphate as a substrate. Calcium deposition was stained with alizarin red-S, distained with cetylpyridium chloride, and quantified at 562 nm. In silico model for astilbin-ALP interaction was analyzed using AutoDock 4.2.6. The changes in expression of osteoblast differentiation related genes were determined using quantitative real-time PCR. Results: Both the EtOAc extract and astilbin had no toxicity toward osteoblast MC3T3-E1 cells at 5.0, 10, 25, and 50 μg/mL. At 25 μg/ mL, they enhanced ALP activity and mineralization of osteoblasts up to 30% and 55% for the EtOAc extract and 22% and 41% for astilbin, respectively. Molecular docking analysis of astilbin-ALP interaction revealed Arg167, Asp320, His324, and His437 were key residues participating in hydrophobic interaction; meanwhile, His434 and Thr436 residues were involved in hydrogen bond formation in the active site of human tissue-nonspecific ALP. Moreover, the expression level of genes opn, col1, osx, and runx2 were up-regulated in astilbin treated samples with the fold changes as 2.2; 3.7; 4.1; 2.3, respectively at 10 μg/mL (P<0.05). Conclusions: The EtOAc extract and its major compound astilbin exhibit osteoblastogenic activity by up-regulating important markers for bone cell differentiation. It could be a new and promising osteogenic agent with dual actions for therapeutic applications.

SP-8356, a (1S)-(-)-Verbenone Derivative, Inhibits the Growth and Motility of Liver Cancer Cells by Regulating NF-κB and ERK Signaling

Liver cancer is a common tumor and currently the second leading cause of cancer-related mortality globally. Liver cancer is highly related to inflammation as more than 90% of liver cancer arises in the context of hepatic inflammation, such as hepatitis B virus and hepatitis C virus infection. Despite significant improvements in the therapeutic modalities for liver cancer, patient prognosis is not satisfactory due to the limited efficacy of current drug therapies in anti-metastatic activity. Therefore, developing new effective anti-cancer agents with anti-metastatic activity is important for the treatment of liver cancer. In this study, SP-8356, a verbenone derivative with anti-inflammatory activity, was investigated for its effect on the growth and migration of liver cancer cells. Our findings demonstrated that SP-8356 inhibits the proliferation of liver cancer cells by inducing apoptosis and suppressing the mobility and invasion ability of liver cancer cells. Functional studies revealed that SP-8356 inhibits the mitogen-activated protein kinase and nuclear factor-kappa B signaling pathways, which are related to cell proliferation and metastasis, resulting in the downregulation of metastasis-related genes. Moreover, using an orthotopic liver cancer model, tumor growth was significantly decreased following treatment with SP-8356. Thus, this study suggests that SP-8356 may be a potential agent for the treatment of liver cancer with multimodal regulation.

First Report of Roseomonas aerofrigidensis Isolated from the Peritoneal Fluid of a Gastric Cancer Patient / 대한임상미생물학회지

Roseomonas aerofrigidensis is a gram-negative, strictly aerobic, non-motile bacterium, which was first isolated in 2017 in South Korea. We present the first report of the isolation of R.aerofrigidensis from the peritoneal fluid of a 38-year-old woman with a history of metastatic gastric cancer with peritoneal carcinomatosis. The isolate was resistant to cotrimoxazole. Further research on clinical and microbiological responses to several antibiotics are warranted.

Trends in Isolation and Antimicrobial Susceptibility of Enteropathogenic Bacteria in 2011-2019 at a Korean Tertiary Care Hospital Compared with Data in the Preceding Reports / 대한임상미생물학회지

Background@#Environmental sanitation plays a significant role on the prevalence of enteropathogenic bacteria. This study aimed to determine the trends in the prevalence and antimicrobial resistance profiles of enteropathogenic bacteria from 2011 to 2019. @*Methods@#A retrospective analysis was performed using data from stool cultures of Salmonella spp., Shigella spp., Plesiomonas shigelloides , Yersinia spp., Vibrio spp., and Campylobacter spp. Samples were obtained between 2011 and 2019 from Severance Hospital. Antimicrobial susceptibility profile was determined using the disk diffusion method for nontyphoidal Salmonella (NTS) and Campylobacterspp., following the Clinical and Laboratory Standards Institute (CLSI) guidelines. @*Results@#The number of specimens obtained for stool culture increased significantly from 13,412 during the period of 1969–1978, to 48,476 over the past nine years (2011–2019), whereas the ratio of positive specimens decreased significantly from 1,732 (12.9%) to 449 (0.9%). The proportion of samples positive for Salmonella Typhi decreased from 472 (93.6%, 1969–1978) to 4 (1.5%, 2011–2019), whereas the proportion of NTS increased from 14 (2.8%, 1969–1978) to 261 (96.7%, 2011–2019). Among all the enteropathogenic bacteria isolated, Shigella spp. accounted for 60.0% (1,039) isolates from 1969 to 1978, but only 1.6% (7) from 2011 to 2019. Campylobacter was the second most prevalent enteropathogenic bacteria, accounting for 29.4% isolates (132). Among the NTS strains isolated from 2016 to 2019, their susceptibility rates to ampicillin and sulfamethoxazole-trimethoprim were 51.1% and 85.2%, respectively. Additionally, the susceptibility rate of Campylobacter to ciprofloxacin was 15.8%. @*Conclusion@#The prevalence of Salmonella Typhi and Shigella spp. significantly decreased, whereas those of NTS and Campylobacter spp. increased. Therefore, continuous monitoring of ciprofloxacin-resistant Campylobacter spp. is of vital importance.

SP-8356, a (1S)-(-)-Verbenone Derivative, Inhibits the Growth and Motility of Liver Cancer Cells by Regulating NF-κB and ERK Signaling

Liver cancer is a common tumor and currently the second leading cause of cancer-related mortality globally. Liver cancer is highly related to inflammation as more than 90% of liver cancer arises in the context of hepatic inflammation, such as hepatitis B virus and hepatitis C virus infection. Despite significant improvements in the therapeutic modalities for liver cancer, patient prognosis is not satisfactory due to the limited efficacy of current drug therapies in anti-metastatic activity. Therefore, developing new effective anti-cancer agents with anti-metastatic activity is important for the treatment of liver cancer. In this study, SP-8356, a verbenone derivative with anti-inflammatory activity, was investigated for its effect on the growth and migration of liver cancer cells. Our findings demonstrated that SP-8356 inhibits the proliferation of liver cancer cells by inducing apoptosis and suppressing the mobility and invasion ability of liver cancer cells. Functional studies revealed that SP-8356 inhibits the mitogen-activated protein kinase and nuclear factor-kappa B signaling pathways, which are related to cell proliferation and metastasis, resulting in the downregulation of metastasis-related genes. Moreover, using an orthotopic liver cancer model, tumor growth was significantly decreased following treatment with SP-8356. Thus, this study suggests that SP-8356 may be a potential agent for the treatment of liver cancer with multimodal regulation.

First Report of Roseomonas aerofrigidensis Isolated from the Peritoneal Fluid of a Gastric Cancer Patient / 대한임상미생물학회지

Roseomonas aerofrigidensis is a gram-negative, strictly aerobic, non-motile bacterium, which was first isolated in 2017 in South Korea. We present the first report of the isolation of R.aerofrigidensis from the peritoneal fluid of a 38-year-old woman with a history of metastatic gastric cancer with peritoneal carcinomatosis. The isolate was resistant to cotrimoxazole. Further research on clinical and microbiological responses to several antibiotics are warranted.

Ethyl acetate extract of Smilax glabra Roxb roots and its major active compound astilbin promote osteoblastogenesis in vitro by upregulating bone cell differentiation- associated genes

Objective: To investigate the osteoblastogenic activity of the ethyl acetate (EtOAc) extract of Smilax glabra Roxb roots and its major active compound astilbin. Methods: Astilbin was isolated from EtOAc extract using silica gel chromatography combined with fraction crystallization. Chemical structure of astilbin was determined by analysis of the spectroscopic data in comparison with the literature. MTT method was used to detect the toxicity. Alkaline phosphatase (ALP) activity was determined by the spectrophotometric method at 405 nm using p-nitrophenyl phosphate as a substrate. Calcium deposition was stained with alizarin red-S, distained with cetylpyridium chloride, and quantified at 562 nm. In silico model for astilbin-ALP interaction was analyzed using AutoDock 4.2.6. The changes in expression of osteoblast differentiation related genes were determined using quantitative real-time PCR. Results: Both the EtOAc extract and astilbin had no toxicity toward osteoblast MC3T3-E1 cells at 5.0, 10, 25, and 50 μg/mL. At 25 μg/ mL, they enhanced ALP activity and mineralization of osteoblasts up to 30% and 55% for the EtOAc extract and 22% and 41% for astilbin, respectively. Molecular docking analysis of astilbin-ALP interaction revealed Arg167, Asp320, His324, and His437 were key residues participating in hydrophobic interaction; meanwhile, His434 and Thr436 residues were involved in hydrogen bond formation in the active site of human tissue-nonspecific ALP. Moreover, the expression level of genes opn, col1, osx, and runx2 were up-regulated in astilbin treated samples with the fold changes as 2.2; 3.7; 4.1; 2.3, respectively at 10 μg/mL (P<0.05). Conclusions: The EtOAc extract and its major compound astilbin exhibit osteoblastogenic activity by up-regulating important markers for bone cell differentiation. It could be a new and promising osteogenic agent with dual actions for therapeutic applications.

The COVID-19 pandemic in the ASEAN: A preliminary report on the spread, burden and medical capacities

Objective: To provide preliminary descriptions of the spread, burden and related medical capacity characteristics of the ASEAN countries. Methods: We utilized the data from four main official databases, including WHO reports, the Statistics and Research of the Coronavirus Disease, and the Southeast Asia Program of the Center for Strategic and International Study. The spread of the COVID- 19 pandemic, current burden and the COVID-19 medical response capacities were extracted before April 11, 2020. Results: As of April 13, 2020, the ASEAN countries reported 19 547 COVID-19 positive cases with 817 deaths (case-facility rate of 4.2%). Thailand was the first country in the region that reported having the COVID-19 cases, while Laos was the last to report confirmed COVID-19 cases. Durations for the number of deaths to double were between 8-12 days. For the testing and treatment capacities, the number of PCR tests provided to the populations was the highest in Vietnam, followed by Singapore, Malaysia, and Thailand. Meanwhile, the percentage of the population being tested was the highest in Brunei (2.31%), followed by Singapore (1.30%). Conclusions: A wide range of interventions were taken into practice in response to the outbreak with an effort of curbing the rise of this pandemic. However, special care should not be overlooked as the pandemic is placing a huge impact on the population and becomes increasingly unpredictable. To tackle the spread of the pandemic in the region, the ASEAN countries should work together as one community to provide better responses to future pandemics and other transboundary public health challenges.

Antibiofilm activity of alpha-mangostin loaded nanoparticles against Streptococcus mutans

Objective: To investigate the antibiofilm activity of alpha- mangostin (AMG) loaded nanoparticle (nanoAMG) against dental caries pathogen Streptococcus mutans. Methods: AMG was isolated from the peels of Garcinia mangostana L. using silica gel columns and chemically analysed by high performance liquid chromatography and nuclear magnetic resonance. NanoAMG was prepared using the solvent evaporation method combined with high-speed homogenization. The nanoparticles were characterized using dynamic light scattering, field emission scanning electron microscopy (FE-SEM) and Fourier transform infrared spectroscopy (FTIR). The toxicity of nanoAMG in fibroblast NIH/3T3 cell line was determined using MTT method. The antibiofilm effect of nanoAMG was determined through the evaluation of biofilm formation by Streptococcus mutans using a 96-well plate. Biofilm biomass was quantified using crystal violet. Cell viability was observed under confocal microscopy using LIVE/DEAD BacLight staining. Moreover, gene expression was determined by quantitative real-time PCR and membrane permeabilization activity by measuring the uptake of o-nitrophenol- β-D-galactoside. Results: NanoAMG size was in a range of 10-50 nm with a polydispersity index of < 0.3 and zeta potential value of -35.2 mV The size and the incorporation of AMG in the nanoparticles were confirmed by FE-SEM and FTIR analyses. The IC

Adjustment of Modified Carbapenem Inactivation Method Conditions for Rapid Detection of Carbapenemase-Producing Acinetobacter baumannii

BACKGROUND: The existing modified carbapenem inactivation methods (mCIMs) recommended by the CLSI for detecting carbapenemase production have not been applicable for Acinetobacter baumannii. We evaluated the influence of matrices used in mCIMs and CIMTris on the stability of the disks for detecting carbapenemase producers and suggested optimal mCIM conditions for detecting carbapenemase-producing A. baumannii. METHODS: Seventy-three A. baumannii isolates characterized for antimicrobial susceptibility and carbapenemase encoding genes were tested for carbapenemase production using mCIM and CIMTris. The influence of the matrices (Tryptic soy broth [TSB] and Tris-HCl) used in these methods on the stability of the meropenem (MEM) disk was also evaluated. The mCIM conditions were adjusted to enhance screening sensitivity and specificity for detecting carbapenemase-producing A. baumannii. RESULTS: The matrices had an impact on the stability of the MEM disk after the incubation period (two or four hrs). TSB nutrient broth is an appropriate matrix for mCIM compared with Tris-HCl pH 7.6, which leads to the loss of MEM activity in CIMTris. The sensitivity and the specificity of the optimal mCIM were both 100%. CONCLUSIONS: We established optimal mCIM conditions for simple, accurate, and reproducible detection of carbapenemase-producing A. baumannii.

Antidiabetic and antioxidant activities of red seaweed Laurencia dendroidea

Objective: To investigate antidiabetic and antioxidant activities of the extract and fractions from Vietnamese red seaweed Laurencia dendroidea. Methods: The seaweed Laurencia dendroidea was extracted by using microwave-assisted extraction method in 80％ methanol. The seaweed extract was then fractionated using different solvents (n-hexane, chloroform, ethyl acetate, butanol and water). These obtained fractions were evaluated for α-glucosidase inhibitory and antioxidant activities. Antioxidant activities were tested using DPPH, nitric oxide radical scavenging and metal chelating assays. The enzyme inhibition mode was determined using Lineweaver-Burk plot. For acidic and thermal stabilities, the ethyl acetate fraction was treated at pH 2.0 and 100 ℃, respectively. The residual inhibitory activity of the fraction was calculated based on the initial inhibitory activity. For in vivo antidiabetic activity, mice were divided into four groups, including normal control, diabetic control, diabetic mice treated with ethyl acetate fraction and diabetic mice treated with gliclazide. Blood glucose level of treated mice during acute and prolonged treatments was measured. To evaluate the toxicity of the ethyl acetate fraction, the body weight changes and activities of liver function enzymes (aspartate transaminase, alanine transaminase and gammaglutamyl transferase) were carried out. Results: The extract of Laurencia dendroidea showed strong α-glucosidase inhibitory and DPPH radical scavenging activities. Methanolic concentrations affected both α-glucosidase inhibitory and antioxidant activities. A 80％ aqueous methanol was the suitable solvent for extraction of enzyme inhibitors and antioxidants. Among solvent fractions, ethyl acetate fraction had the highest inhibitory activities against α-glucosidase with a mixed type of inhibition and the strongest antioxidant activities, and was stable under acidic and thermal conditions. The ethyl acetate fraction treated diabetic mice significantly reduced blood glucose level compared with the diabetic control group (13.16 mmol/L vs. 22.75 mmol/L after 3 hours of treatment). Oral administration of ethyl acetate fraction did not exhibit toxicity at a dose of 100 mg/kg body weight as determined by body weight changes and liver biochemical parameters. Conclusions: Laurencia dendroidea could be a potential source for production of antidiabetic and antioxidative agents.

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.

Risk factors associated with hemoglobin levels and nutritional status among Brazilian children attending daycare centers in Sao Paulo city, Brazil / Factores de riesgo asociados al nivel de hemoglobina y estado nutricional de niños que asisten a jardines de la infancia en el municipio de Sao Paulo, Brasil

Like many other developing countries, Brazil has been going a nutritional transition which presence both malnutrition and overweight. Stunting and overweight are the major public health problems in Brazilian children. The objective of this study was to document the prevalence of stunting, overweight and anemia in preschool children and examine if those nutritional problems are related; also identify if these nutritional problems have the same risk factors. Data from the “Efficient Daycare Center Project” which include 270 children attending nurseries of eight daycare centers in Sao Paulo city, Brazil were used for this study. Data on height and weight were converted to z-scores using WHO anthro software. Hemoglobin (Hb) concentrations were determined on finger-prick blood samples. The co-occurrence of stunting, overweight and anemia was investigated by contingency tables a log-linear model. Univariate and multiple regression analyses were performed to estimate the association of HAZ, WAZ, WHZ and Hb levels with their risk factors. The results showed high prevalence of overweight (22.2 percent), risk of stunting (22.6 percent) and anemia (37 percent). Percent of daycare attendance, age, number of siblings under 5 years old and per capita income are associated with Hb levels. This study provides evidence that Brazil is going through a nutritional transition and suggest that the adoption of public policies to expand and improve services in daycare centers may help to prevent multi-nutritional problems in preschool children.

Como muchos otros países en desenvolvimiento Brasil esta pasando por la transición nutricional, la cual tiene presente a la desnutrición y sobrepeso. Este estudio tuvo como objetivo mostrar la prevalencia de baja estatura, sobrepeso y anemia en niños en edad preescolar y analizar si esos problemas nutricionales están relacionados; también identificar si esos problemas nutricionales presentan los mismos factores de riesgo. Fueron utilizados datos del “Proyecto CrechEficiente” el cual estudio 270 niños que asisten a cunas de ocho jardines de la infancia en la ciudad de Sao Paulo, Brasil. Los datos de peso y estatura fueron convertidos en z-escore utilizando el software WHO Anthro. La extracción de sangre para la determinación de hemoglobina (Hb) se realizó por punción digital. La co-ocurrencia de baja estatura, sobrepeso y anemia fue investigada a tráves de tablas de contingencia y modelo log-linear. Fueron realizados análisis univariados y regresión múltiple para determinar la asociación entre TEZ, PEZ, PTZ y niveles de hemoglobina con sus factores de riesgo. Los resultados mostraran elevada prevalencia de sobrepeso (22,2 por ciento), riesgo para baja estatura (22,6 por ciento) y anemia (37 por ciento). El porcentaje de frecuencia a los jardines infantiles, edad, número de hermanos menores de 5 años y renta per cápita están asociados con los niveles de hemoglobina. Este estudio muestra evidencia de que el Brasil esta pasando por una transición nutricional y sugiere adopción de políticas públicas para difundir y mejorar los servicios de los jardines infantiles pudiendo ayudar a prevenir varios problemas nutricionales en niños en edad preescolar.

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'

Knowledge, attitude and practice towards cervical cancer and its preventive measures among parents of young adolescent girls in Tuliem district, Hanoi city and Cuchi district, Ho Chi Minh city

Background: Cervical cancer is one of the leading cancers in women worldwide.\r\n', u'Objectives: To evaluate the knowledge, attitude and practice towards cervical cancer and its preventive measures among the parents of young adolescent girls. \r\n', u'Subjects and methods: The cross-sectional survey was conducted in Tuliem District, Hanoi and Cu Chi District, Ho Chi Minh city. By employing a structured interview there have been 218 fathers/mothers of young adolescent girls at secondary school age (11to14 years old) participated in the survey. \r\n', u"Results: There was a limitation in the respondents' understanding about cervical cancer. Although 83% parents have been aware of cervical cancer and 89% considered it as a fatal disease, nearly a half of them does not know any symptoms of the disease. Similarly, inadequate knowledge on causes and risk factors of the disease has been common among respondents. Only 25% of parents are aware of HPV and few knew about the transmission route of this virus. HPV vaccines are still very new for parents. Only 29.8% of interviewees have heard about HPV vaccines. However, 74.3% parents have expressed a wish to have their daughters vaccinated, once HPV vaccines are introduced in Vietnam. \r\n", u'Conclusions: Knowledge, attitude and practice towards cervical cancer among parents of young adolescent girls in these district were quite limited\r\n', u'\r\n', u'

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.