ABSTRACT
We aimed to investigate the performance of a chest X-ray (CXR) scoring scale of lung injury in prediction of death and ICU admission among patients with COVID-19 admitted at Vinmec Central Park hospital (HCM City, VN) during the peak epidemic in 2021. X-ray images and clinical data were collected from patients with SARS-CoV-2 PCR positive from July to September 2021. Three radiologists independently assessed the CXR score at admission which is the sum of severity and extent of lung injuries on four lung quadrants (maximum score = 24). Among 219 patients included, 28 died including 25 from 34 patients admitted to the ICU. There was a high consensus for CXR scoring among radiologists (kappa = 0.90;CI95%: 0.89-0.92). CXR score was the strongest predictor of mortality (tdAUC 0.85;CI95%: 0.69-1) within the first 3 weeks after admission. Multivariate model with adjustment for age confirmed a significant effect of increased CXR score on mortality risk (HR = 1.33, CI95%: 1.10 to 1.62). At a threshold of 16 points, the CXR score allows predicting in-hospital mortality and ICU admission with good sensitivity (0.82 (CI95%: 0.78 to 0.87) and 0.86 (CI95%: 0.81 to 0.90)) and specificity (0.89 (CI95%: 0.88 to 0.90) and 0.87 (CI95%: 0.86 to 0.89), respectively). The day-one CXR score is a reliable predictor of the risk of death and ICU admission and could be used to identify high-risk patients in needy countries like Vietnam.
ABSTRACT
Background At least 80% of new cervical cancer cases and deaths occur in low- and middleincome countries. Vietnam is a middle-income country where cervical cancer is the second most common and the deadliest gynecologic cancer. Cervical cancer incidence in Southern Vietnam has been shown to be 1.5-4 times higher than that in Northern Vietnam. However, less than 10% of Southern Vietnamese women have received the Human papillomavirus (HPV) vaccine and only 50% have ever been screened for cervical cancer. No study has examined the perceptions toward cervical cancer prevention and screening in Southern Vietnamese women. Hence, this study aimed to explore cervical cancer awareness, barriers to screening, and acceptability of HPV self-sampling for cervical cancer screening among rural and urban women in Southern Vietnam. Methods In October-November 2021, three focus groups were conducted in the rural district of Can Gio (n=21 participants) and three were conducted in the urban District Four (n=23 participants) in Ho Chi Minh City, Southern Vietnam. All participants were cervical cancer-free women aged 30-65 years. Awareness of, attitudes toward, and experience with cervical cancer prevention and screening were explored using audio-recorded, semi-structured discussions in Vietnamese. During the focus groups, participants also watched four short videos with Vietnamese subtitles and voiceover about cervical cancer screening methods and discussed their views on each. The recordings were transcribed, translated into English, and coded and analyzed using Dedoose 9.0.46. Results Four main themes emerged. First, women showed low awareness, but high acceptance of cervical cancer screening and HPV vaccination. Second, screening barriers were related to logistics (e.g., cost, time, travel distance), psychology (e.g., fear of pain, embarrassment, fear of the test revealing they had cancer), and healthcare providers (e.g., doctors' impolite manners, male doctors). Third, women were concerned about self-sampling incorrectly and pain, but believed HPV self-sampling to be a feasible screening tool in some circumstances (e.g., during the COVID-19 pandemic, those living in remote areas). Fourth, women related cervical cancer prevention to COVID-19 prevention;they believed strategies that have been successful for COVID-19 control in Vietnam could be applied to cervical cancer. No differences in themes emerged by rural/urban areas. Conclusions Southern Vietnamese women showed low awareness but high acceptance of cervical cancer screening despite barriers. Strategies for successful COVID-19 control in Vietnam, including campaigns to increase public awareness, advocacy from the government and doctors, and efforts to increase access to screening and vaccination, should be applied to cervical cancer control. Health education programs to address HPV self-sampling concerns and promote it as a cervical cancer screening tool are warranted given its potential to improve screening uptake in this low-resource setting.
ABSTRACT
Purpose: COVID-19 hits every country’s health-care system and economy. There is a trend toward using automation technology in response to the COVID-19 crisis not only in developed countries but also in those with lower levels of technology development. However, current studies mainly focus on the world level, and only a few ones report deployments at the country level. The purpose of this paper is to investigate the use of automation solutions in Vietnam with locally available materials mainly in the first wave from January to July 2020. Design/methodology/approach: The authors collected COVID-related automation solutions during the first wave of COVID-19 in Vietnam from January to July 2020 through a search process. The analysis and insights of a panel consisting of various disciplines (i.e. academia, health care, government, entrepreneur and media) aim at providing a clear picture of how and to what extent these solutions have been deployed. Findings: The authors found seven groups of solutions from low to high research and development (R&D) levels deployed across the country with various funding sources. Low R&D solutions were widely spread owing to simplicity and affordability. High R&D solutions were mainly deployed in big cities. Most of the solutions were deployed during the first phases when international supply chains were limited with a significant contribution of the media. Higher R&D solutions have opportunities to be deployed in the reopening phase. However, challenges can be listed as limited interdisciplinary research teams, market demand, the local supporting industry, end-user validation and social-ethical issues. Originality/value: To the authors’ best knowledge, this is the first study analyzing the use of automation technology in response to COVID-19 in Vietnam and also in a country in Southeast Asia. Lessons learned from these current deployments are useful for future emerging infectious diseases. The reality of Vietnam’s automation solutions in response to COVID-19 might be a reference for other developing countries with similar social-economic circumstances and contributes to the global picture of how different countries adopt technology to combat COVID-19. © 2020, Emerald Publishing Limited.