Is Weekly Iron Folic Acid Supplementation and Deworming in Vietnamese Women of Reproductive Age Sustainable? The Yen Bai Cohort 6 Years on.

Objectives: Weekly iron-folic acid supplementation (WIFS) and regular deworming for women of reproductive age (WRA) is an effective way of preventing anaemia and iron deficiency in a population but long-term sustainability is challenging. The objectives of this study were to: 1) Determeine the effectiveness of a free WIFS and biannual deworming program for WRA that has been implemented in rural Vietnam for six years. 2) Assess compliance and identify challenges and barriers to ongoing sustainability. Methods: In July 2012, we conducted a follow-up survey in this rural mountainous province to evaluate haematological parameters (haemoglobin and ferritin), soil transmitted helminth burden and compliance in a cohort of women first recruited in 2005, and who have had access to an externally funded WIFS/deworming program since May 2006. Results: Of the original cohort of 389, 256 (65.8%) women attended the survey. Mean haemoglobin had increased to from 122 g/L [95% C.I. 120, 124] to 135g/L [95% C.I. 133g/L, 138g/L] and anaemia prevalence reduced from 37.8% [95% C.I. 31.0%, 44.7%] to 14.3% [95% C.I. 9.5%, 19.1%]. The prevalence of hookworm infection was lower at 10.2% [95% C.I. 5.4%, 15.0%]. Seventy two per cent of survey participants continued to take the weekly supplements regularly. Without further support the WIFS program will cease in 2014. Conclusions: Anaemia rates continued to fall duringr the six year period, and soil transmitted helminth infections have been eliminated as a public health risk. Complianace was well maintained but sustainability is a major challenge. The issues surrounding long term sustainability of WIFS for WRA will be discussed.

Prevalence of polymorphisms in DHFR, DHPS, PFMDR1 and PFCRT genes of Plasmodium falciparum isolates in Quang Tri Province, Vietnam.

In 2002 an antimalarial drug resistance survey was carried out in a seasonally endemic area of Vietnam. Sulfadoxine/pyrimethamine (S/P) was the standard treatment recommended for uncomplicated Plasmodium falciparum malaria in that area at the time. Early or late treatment failure as defined by WHO was observed in 14.9% (7/47) of patients. Molecular analysis of treatment failure isolates identified that 5/6 carried two or more dhfr and dhps polymorphisms associated with S/P resistance. Chloroquine resistance-associated polymorphisms occurred in 38.5% (15/39) of the isolates. These results support the move to artemisinin-based combination therapy for malaria in Vietnam.