Building the hospital event-based surveillance system in Viet Nam: a qualitative study to identify potential facilitators and barriers for event reporting

@#Introduction: Hospitals are a key source of information for the early identification of emerging disease outbreaks and acute public health events for risk assessment, decision-making and public health response. The objective of this study was to identify potential facilitators and barriers for event reporting from the curative sector to the preventive medicine sector in Viet Nam. Methods: In 2016, we conducted 18 semi-structured, in-depth interviews, as well as nine focus group discussions, with representatives from the curative and preventive medicine sectors in four provinces. We transcribed the interviews and focus group discussions and used thematic analysis to identify the factors that appeared to affect public health event reporting. Results: We identified five major themes. First, the lack of a legal framework to guide reporting meant hospital staff relied on internal procedures that varied from hospital to hospital, which sometimes delayed reporting. Second, participants stated the importance of an enabling environment, such as leadership support and having focal points for reporting, to facilitate reporting. Third, participants described the potential benefits of reporting, such as support provided during outbreaks and information received about local outbreaks. Fourth, some challenges prohibited timely reporting such as not perceiving reporting to be the task of the curative sector and hesitancy to report without laboratory confirmation. Finally, limited resources and specialist capacities in remote areas hindered timely detection and reporting of unusual events. Discussion: This study identified potential opportunities to promote the detection and reporting of unusual events from health-care workers to the public health sector, and thus to improve the overall health security system in Viet Nam.The influenza virus is a respiratory pathogen that is transmitted through respiratory droplets.1 During seasonal influenza epidemics, high attack rates cause a significant public health burden.2 The infection is usually self-limited in young adults but can lead to severe infections in people in high-risk groups, including elderly people (> 65 years old), pregnant women, children aged 6–59 months and adults with chronic illnesses.3

Effect of nutrients and fermentation conditions on the production of biosurfactants using rhizobacteria isolated from fique plants / Efecto de los nutrientes y las condiciones de fermentación en la producción de biosurfactantes con rizobacterias aisladas de fique / Efeito dos nutrientes e as condições de fermentação na produção de biossurfactantes com rizobacté rias isoladas da piteira

Objective. To isolate biosurfactant-producing microorganisms from the rhizosphere of fique and to select the best genus to evaluate the effect of nutritional and fermentation conditions on the production of rhamnolipids. Materials and methods. Rhizospheric soil was sampled in three areas of Cauca. The best genus was selected for the experimental designs (Plackett Burman and 2² factorial) and to find the production conditions for the growth kinetics at an Erlenmeyer flask scale. Results. Isolates from the rhizosphere of fique plants were from groups (or genera) of Bacillus, Pseudomonas and Actinomycetes, being Pseudomonas the more responsive in preliminary testing for emulsification. From the results of the experimental designs and the kinetics of production, we found that rhamnose synthesis associated with rhamnolipids (3.2 g/l) and emulsification (68% EC24) was significantly favored (p <0.0001) by cultivating an inoculum of 10% v/v of Pseudomonas fluorescens in a medium composed of: soybean oil 2% (v/v), K2HPO4 0.2% (w/v), yeast extract 0.4 g/l, NH4NO3 3.7 g/l, 1 ml trace elements (CoCl3 20 mg/l, H3BO(3)30 mg/l, ZnSO(4)10 mg/l, Cu2SO(4)1 mg/l, Na2MoO(4)3 mg/l, FeSO (4)10 mg/l MnSO(4)2,6 mg/l) and pH 7.2. Conclusion. Of all the microbial genera isolated from the rhizosphere of fique, Pseudomonas fluorescens had the greatest potential in the production of biosurfactants of the rhamnolipids family.

Objetivo. Aislar microorganismos de la rizosfera de fique capaces de producir biosurfactantes y seleccionar el mejor gé nero para evaluar el efecto de las condiciones nutricionales y de fermentación en la producción de ramnolípidos. Materiales y mé todos. Se realizaron muestreos de suelos rizosfé ricos en tres zonas del Cauca. El mejor gé nero fue seleccionado para realizar los diseños experimentales (Plackett Burman y factorial 2²) y establecer las condiciones de producción para las ciné ticas de crecimiento a escala de Erlemeyer. Resultados. Se aislaron bacterias del gé nero Bacillus, Pseudomonas y del grupo Actinomycetes, siendo Pseudomonas el grupo con mayor respuesta en las pruebas preliminares de emulsificación. A partir de los resultados obtenidos en los diseños experimentales y ciné ticas de producción, se estableció que la síntesis de ramnosa asociada con ramnolípidos (3,2 g/l) y la emulsificación (68% EC24) se favorecieron significativamente (p<0.0001) al cultivar un inoculo de 5% v/v de Pseudomonas fluorescens en un medio compuesto por: aceite de soya 2% (v/v), K2HPO4 0,2% (p/v), extracto de levadura 0,4 g/l, NH4NO(3)3,7 g/l, 1 ml de elementos traza (CoCl(3)20 mg/l, H3BO(3)30 mg/l, ZnSO(4)10 mg/l, Cu2SO4 1 mg/l, Na2MoO(4)3 mg/l, FeSO(4)10 mg/l MnSO(4)2,6 mg/l) y pH 7.2. Conclusión. Se aislaron 3 gé neros microbianos a partir de rizosfera de fique, siendo Pseudomonas fluorescens la bacteria con mayor potencial en la producción de biosurfactantes de la familia de los ramnolípidos.

Objetivo. Isolar microorganismos da rizosfera da piteira capazes de produzir biossurfactantes, selecionar o melhor gênero para avaliar o efeito das condições nutricionais e de fermentação na produção de rhamnolipídeos. Materiais e mé todos. Foram realizadas amostragem de solos rizosfé ricos em três á reas do Cauca. O melhor gênero foi selecionado para realizar desenhos experimentais (Plackett Burman e fatorial 2²) e definir as condições de produção para as ciné ticas em escala de erlenmeyer. Resultados. Foram isoladas bacté rias do gênero Bacillus, Pseudomonas e grupo de Actinomycetes. As Pseudomonas foram o grupo com maior resposta nos testes preliminares de emulsificação. A partir dos resultados obtidos nos desenhos experimentais e ciné ticas de produção foi estabelecido que a síntese de ramnose associados com rhamnolipídeos (3,2 g/l) e a emulsificação (68% EC24) foram favorecidos significativamente (p<0,0001) ao cultivar um inoculo de 5% v/ v de Pseudomonas fluorescens em um meio composto por: óleo de soja 2% (v/v), K2HPO(4)0,2% (p/v), extrato de levedura 0,4 g/l, NH4NO3 3,7 g/l, 1 ml de oligoelementos (CoCl(3)20 mg/l, H3BO(3)30 mg/l, ZnSO(4)10 mg/l, Cu2SO(4)1 mg/l, Na2MoO(4)3 mg/l, FeSO(4)10 mg/l MnSO4 2,6 mg/l) e pH 7,2. Conclusão. Três gêneros microbianos foram isolados da rizosfera da piteira, sendo Pseudomonas fluorescens a bacté ria com maior potencial na produção de biossurfactantes da família dos rhamnolipídeos.