Movement restrictions, vaccine coverage, and reduction of the COVID-19 incidence rate in the fourth wave of the pandemic: Analysis results from 63 provinces in Vietnam.

On April 27, 2021, the fourth wave of the coronavirus disease 2019 (COVID-19) pandemic originating from the Delta variant of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in Vietnam. The adoption of travel restrictions, coupled with rapid vaccination and mask-wearing, is a global strategy to prevent the spread of COVID-19. Although trade-off between health and economic development are unavoidable in this situation, little evidence that is specific to Vietnam in terms of movement restrictions, vaccine coverage, and real-time COVID-19 cases is available. Our research question is whether travel restrictions and vaccine coverage are related to changes in the incidence of COVID-19 in each province in Vietnam. We used Google's Global Mobility Data Source, which reports different mobility types, along with reports of vaccine coverage and COVID-19 cases retrieved from publicly and freely available datasets, for this research. Starting from the 50th case per province and incorporating a 14-day period to account for exposure and illness, we examined the association between changes in mobility (from day 27 to 04-03/11/2021) and the ratio of the number of new confirmed cases on a given day to the total number of cases in the past 14 days of indexing (the potentially contagious group in the population) per million population by making use of LOESS regression and logit regression. In two-thirds of the surveyed provinces, a reduction of up to 40% in commuting movement (to the workplace, transit stations, grocery stores, and entertainment venues) was related to a reduction in the number of cases, especially in the early stages of the pandemic. Once both movement and disease prevalence had been mitigated, further restrictions offered little additional benefit. These results indicate the importance of early and decisive actions during the pandemic.

Clinical characteristics and mortality risk among critically ill patients with COVID-19 owing to the B.1.617.2 (Delta) variant in Vietnam: A retrospective observational study.

BACKGROUND: SARS-CoV-2 Delta variant caused a large number of COVID-19 cases in many countries, including Vietnam. Understanding mortality risk factors is crucial for the clinical management of severe COVID-19. METHODS: We conducted a retrospective study at an intensive care center in Ho Chi Minh City that urgently built by Bach Mai Hospital during the COVID-19 outbreak in Vietnam, when the Delta variant predominated. Participants were laboratory-confirmed patients with SARS-CoV-2 infection, admitted in August 2021. Data on patients' demographic and clinical characteristics, radiographic and laboratory findings, treatment, and clinical time course were compared between survivors and non-survivors. Risk factors to mortality were assessed using logistic regression. RESULTS: Among 504 eligible COVID-19 patients, case fatality was 52.2%. Unvaccinated patients accounted for 61.2% of non-survivors and 43.6% of survivors (p < 0.001). The time from onset to hospital admission was 8 days in non-survivors and 7 days in survivors (p = 0.004). Among non-survivors, 90.2% developed acute respiratory distress syndrome (ARDS). Oxygen therapy was administered for all patients, but antiviral agent was given to 51.7% of non-survivors. 54.2% of non-survivors tested positive for the bacterial infection using blood culture. The risk factors for mortality were diabetes mellitus, respiration rate, oxygen saturation, vaccination status, time from onset to admission, and older age. CONCLUSIONS: Critical patients with COVID-19 owing to the Delta variant in Vietnam had delayed hospital admission, leading to ARDS and death. Early availability of vaccines and preventing bacterial infections are crucial for reducing mortality of COVID-19, especially in low- and middle-income countries.

Preference and Willingness to Pay for the Regular COVID-19 Booster Shot in the Vietnamese Population: Theory-Driven Discrete Choice Experiment.

BACKGROUND: The COVID-19 booster vaccination rate has declined despite the wide availability of vaccines. As COVID-19 is becoming endemic and charges for regular booster vaccination are being introduced, measuring public acceptance and the willingness to pay for regular COVID-19 boosters is ever more crucial. OBJECTIVE: This study aims to (1) investigate public acceptance for regular COVID-19 boosters, (2) assess the willingness to pay for a COVID-19 booster shot, and (3) identify factors associated with vaccine hesitancy. Our results will provide crucial insights into and implications for policy response as well as the development of a feasible and effective vaccination campaign during Vietnam's waning vaccine immunity period. METHODS: A cross-sectional study was conducted among 871 Vietnamese online participants from April to August 2022. An online questionnaire based on the discrete choice experiment (DCE) design was developed, distributed using the snowball sampling method, and subsequently conjointly analyzed on the Qualtrics platform. A history of COVID-19 infection and vaccination, health status, willingness to vaccinate, willingness to pay, and other factors were examined. RESULTS: Among the participants, 761 (87.4%) had received or were waiting for a COVID-19 booster shot. However, the willingness to pay was low at US $8.02, and most participants indicated an unwillingness to pay (n=225, 25.8%) or a willingness to pay for only half of the vaccine costs (n=222, 25.4%). Although information insufficiency and a wariness toward vaccines were factors most associated with the unwillingness to pay, long-term side effects, immunity duration, and mortality rate were the attributes the participants were most concerned with during the vaccine decision-making period. Participants who had children less than 18 years old in their homes infected with COVID-19 had a lower willingness to pay (odds ratio [OR] 0.54, 95% CI 0.39-0.74). Respondents who had children under 12 years old in their family who received at least 1 vaccine dose had a higher willingness to pay (OR 2.03, 95% CI 1.12-3.66). The burden of medical expenses (OR 0.33, 95% CI 0.25-0.45) and fear of the vaccine (OR 0.93, 95% CI 0.86-1.00) were negative factors associated with the level of willingness to pay. CONCLUSIONS: A significant inconsistency between high acceptance and a low willingness to pay underscores the role of vaccine information and public trust. In addition to raising awareness about the most concerning characteristics of the COVID-19 booster, social media and social listening should be used in collaboration with health professionals to establish a 2-way information exchange. Work incentives and suitable mandates should continue to encourage workforce participation. Most importantly, all interventions should be conducted with informational transparency to strengthen trust between the public and authorities.

Impact of COVID-19 Nonpharmaceutical Interventions on Pneumococcal Carriage Prevalence and Density in Vietnam.

Nonpharmaceutical interventions (NPIs) implemented to contain SARS-CoV-2 have decreased invasive pneumococcal disease. Previous studies have proposed the decline is due to reduced pneumococcal transmission or suppression of respiratory viruses, but the mechanism remains unclear. We undertook a secondary analysis of data collected from a clinical trial to evaluate the impact of NPIs on pneumococcal carriage and density, drivers of transmission and disease, during the COVID-19 pandemic in Ho Chi Minh City, Vietnam. Nasopharyngeal samples from children aged 24 months were assessed in three periods - one pre-COVID-19 period (n = 1,537) and two periods where NPIs were implemented with increasing stringency (NPI period 1 [NPI-1, n = 307], and NPI period 2 [NPI-2, n = 262]). Pneumococci were quantified using lytA quantitative PCR and serotyped by DNA microarray. Overall, capsular, and nonencapsulated pneumococcal carriage and density were assessed in each NPI period compared with the pre-COVID-19 period using unadjusted log-binomial and linear regression. Pneumococcal carriage was generally stable after the implementation of NPIs. In contrast, overall pneumococcal carriage density decreased by 0.44 log10 genome equivalents/mL (95% confidence interval [CI]: 0.19 to 0.69) in NPI-1 and by 0.84 log10 genome equivalents/mL (95% CI: 0.55 to 1.13) in NPI-2 compared with the pre-COVID-19 period. Reductions in overall pneumococcal density were driven by reductions in capsular pneumococci, with no corresponding reduction in nonencapsulated density. As higher pneumococcal density is a risk factor for disease, the decline in density provides a plausible explanation for the reductions in invasive pneumococcal disease that have been observed in many countries in the absence of a substantive reduction in pneumococcal carriage. IMPORTANCE The pneumococcus is a major cause of mortality globally. Implementation of NPIs during the COVID-19 pandemic led to reductions in invasive pneumococcal disease in many countries. However, no studies have conducted a fully quantitative assessment on the impact of NPIs on pneumococcal carriage density, which could explain this reduction. We evaluated the impact of COVID-19 NPIs on pneumococcal carriage prevalence and density in 2,106 children aged 24 months in Vietnam and found pneumococcal carriage density decreased up to 91.5% after NPI introduction compared with the pre-COVID-19 period, which was mainly attributed to capsular pneumococci. Only a minor effect on carriage prevalence was observed. As respiratory viruses are known to increase pneumococcal carriage density, transmission, and disease, this work suggests that interventions targeting respiratory viruses may have the added benefit of reducing invasive pneumococcal disease and explain the reductions observed following NPI implementation.

A qualitative study on stress, coping strategies and feasibility of music intervention among women with cancer receiving chemotherapy during COVID-19 pandemic in Vietnam.

Breast and gynaecological cancer (BGC) patients receiving chemotherapy may experience high levels of stress during the COVID-19 pandemic. Music interventions may be effective in lowering their stress levels. This study explored stressors, coping strategies, and the feasibility of music interventions among BGC patients in Vietnam. An exploratory qualitative study with individual face-to-face semi-structured interviews was conducted. A convenience sample of BGC patients receiving chemotherapy was recruited from the oncology centre of a public hospital in Vietnam. Twenty patients were interviewed with open-ended questions developed based on the transactional model of stress and coping to explore stress-causing factors and coping strategies and based on guidelines for music therapy practice to explore their music preferences and perceptions. Field notes and interview transcripts were analysed following the qualitative content analysis approach. Two stressor themes were identified: undesirable experiences during treatment and patients' inability to fulfil their own roles and responsibilities. Our findings revealed a new coping strategy-self-realisation of responsibilities towards the family-that is not listed in the transactional model of stress and coping. Future psychological interventions for stress management among BGC patients should focus on raising the patients' awareness of their values and responsibilities towards their families. Three categories of preferred music genres for stress reduction were identified: religious, softly melodic, and revolutionary music. The patients were aware of the positive effects of music and had different musical preferences. This study also explored the acceptance of music interventions and facilitators and barriers to implementing them among BGC patients in Vietnam. The findings suggest that before implementing music interventions, the musical preferences, religions, and beliefs of each individual should be considered to achieve desirable results. Music interventions for BGC patients receiving chemotherapy in Vietnam are feasible. Further intervention studies are needed to evaluate their effectiveness.

Descriptive epidemiology and spatial analysis of African swine fever epidemics in Can Tho, Vietnam, 2019.

The objectives of this study were to describe the epidemiology of African swine fever (ASF) and to identify factors that increased commune-level risk for ASF in Can Tho, a province in the Mekong River Delta of Vietnam. In 2019, a total of 2377 of the 5220 pig farms in Can Tho were ASF positive, an incidence risk of 46 (95% CI 44-47) ASF positive farms for every 100 farms at risk. Throughout the outbreak ASF resulted in either the death or culling of 59,529 pigs out of a total population size of 124,516 (just under half of the total pig population, 48%). After the first detection in Can Tho in May 2019, ASF spread quickly across all districts with an estimated dissemination ratio (EDR) of greater than one up until the end of July 2019. A mixed-effects Poisson regression model was developed to identify risk factors for ASF. One hundred unit increases in the number of pigs per square kilometre was associated with a 1.28 (95% CrI 1.05-1.55) fold increase in commune-level ASF incidence rate. One unit increases in the number of pig farms per square kilometre was associated with a 0.91 (95% CrI 0.84-0.99) decrease in commune-level ASF incidence rate. Mapping spatially contiguous communes with elevated (unaccounted-for) ASF risk provide a means for generating hypotheses for continued disease transmission. We propose that the analyses described in this paper might be run on an ongoing basis during an outbreak and disease control efforts modified in light of the information provided.

Cardiovascular injury and clinical features of multisystem inflammatory syndrome in children (MIS-C) related to Covid-19 in Vietnam.

BACKGROUND: This study aimed to describe the cardiovascular injury and clinical features of multisystem inflammatory syndrome in children (MIS-C) related to coronavirus disease 2019 (COVID-19) in Ho Chi Minh City, Vietnam. METHODS: This was a retrospective cohort study of children with MIS-C (from September 1, 2021 to February 28, 2022) in Children's Hospital 1, Ho Chi Minh City. Demographics, clinical history, significant underlying conditions, clinical manifestations, laboratory investigations, and medical management were analyzed. RESULTS: A total of 76 patients were included (median age, 5.9 years old, 2 months-16 years). The male/female ratio was 1.6/1. Most patients (75/76) had no previous medical conditions. The mean time from acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to symptom onset was 39 days. During an acute SARS-CoV-2 infection, these patients are either asymptomatic or mildly symptomatic. In addition to fever, gastrointestinal symptoms were also prominent, as observed in our study, with 75%, 73.7%, and 72.3% of patients presenting with abdominal pain, vomiting, and loose stools, respectively. The levels of inflammatory markers increased upon admission and returned to normal levels after treatment. Echocardiography revealed decreased myocardial contractility and coronary injury in 16 (21.1%) and 32 (42.1%) patients, respectively. Most cases (72/76) had no fever within 3 days of intravenous immunoglobulin (IVIG) and methylprednisolone treatment. No deaths occurred in this study. The mean duration of hospitalization was 7.2 days. CONCLUSION: Cardiovascular involvement was observed in approximately 53.9% of the patients. Anti-inflammatory treatment with IVIG and methylprednisolone had a favorable short-term outcome. However, long-term follow-up studies on post-discharge MIS-C cases are needed to make appropriate treatment recommendations in the acute phase.

Factors influencing the E-learning system usage during the COVID-19 pandemic in Vietnam.

The outbreak of the COVID-19 pandemic has brought forward an unprecedented situation, which has forced the educational institutes worldwide to use a propriety "online only" model for teaching and learning. Teachers have been compelled to deliver lectures online using some form of an online delivery platform. In this dilemma situation with the closure of the educational institutes, one of the very basic necessities is to ensure quality features of e-learning systems that are being used for the purpose of education delivery, particularly from the students' perspective. The objective of this study was to identify factors affecting pharmacy students' satisfaction in Vietnam during the COVID 19 pandemic. A cross-sectional survey of a consecutive sample of 1612 valid responses from students who have been in distance learning at Hanoi University of Pharmacy has been conducted. An integrated model with three main dimensions had been developed: learner's characteristics; instructor's characteristics; system, and technology. Data were collected in the field on both online and offline platforms using the questionnaire of 39 items to investigate the critical factors affecting learners' satisfaction in e-learning. The reliability of the questionnaire was measured using Cronbach's alpha on this data. Descriptive statistics, factor analysis, and multiple regression analysis were employed for data analysis. Out of 2491 questionnaires distributed, 1612 questionnaires were completed (respond rate 64.7%). The results revealed that perceived usefulness, perceived ease of use, system and technical dimension and instructors' characteristics are the critical factors affecting learners' perceived satisfaction. The perceived usefulness of the students was the most important factor affecting overall satisfaction (beta coefficient = 0.610). Multiple regression analysis yielded the four main factors explaining 59.9% of total satisfaction. The findings revealed how to improve learners' satisfaction and further strengthen their e-learning implementation. The interventional solutions on students' characteristics, instructors' characteristics and system & technical dimension should be considered and implemented to improve the quality of e-learning and students' satisfaction at Hanoi University of Pharmacy.

Knowledge, attitudes, and practices towards COVID-19 among residents of Quang Binh, Vietnam.

INTRODUCTION: The COVID-19 pandemic is raging worldwide; the number of new cases and deaths is increasing daily. This study aims to examine the knowledge, attitudes, and practices (KAP) toward COVID-19 among residents of Quang Binh, Vietnam. METHODOLOGY: A cross-sectional study was conducted between the 1st and 10th of March 2022 in Quang Binh with 413 participants through convenience sampling. A self-designed questionnaire was used for data collection, using SPSS (IBM Corp, Armonk, NY) version 26.0 for management and analysis. RESULTS: Among the 413 participants, 80.5% of participants had good knowledge about COVID-19. Kinh people and those with a high level of education have higher odds of having good knowledge. 78.2% of participants had a positive attitude and 78.2% had good practice toward COVID-19. Knowledge-Practice scores and Attitude-Practice scores have a positive correlation. TV (65.4%) and the internet (66.6%) are the most popular channels for information about COVID-19. Common barriers for participants taking COVID-19 prevention measures were "due to the demands of life" (61%) or "due to the specificity of the work" (47.7%). CONCLUSIONS: Residents of Quang Binh have a moderate KAP towards COVID-19. Health education programs are needed to improve knowledge about COVID-19 among Quang Binh residents, with a focus on ethnic minorities and people with low levels of education.

Absence of SARS-CoV-2 antibodies in pre-pandemic plasma from children and adults in Vietnam.

We tested pre-pandemic (2015--2019) plasma samples from 148 Vietnamese children and 100 Vietnamese adults at high risk of zoonotic infections for antibodies against SARS-CoV-2 nucleocapsid and spike proteins. None was positive. The data thus demonstrated no evidence of prior serological cross-reactivity with SARS-CoV-2 that might explain the low numbers of COVID-19 in Vietnam. No pre-existing cross-reactivity might explain Vietnam success of COVID-19 control.

Students' Perceived Well-Being and Online Preference: Evidence from Two Universities in Vietnam during COVID-19.

University education is still being impacted two years after the COVID-19 outbreak. We performed a rapid survey in February 2022 at two public universities in Vietnam to examine the effects of the pandemic on well-being and the factors that may associate with online class preference among university students as well as to investigate the need for support to improve resilience. A web-based survey included 1589 undergraduate students in total. Both quantitative and qualitative data analysis was carried out. Overall, approximately a quarter of respondents said that they perceived an influence on their health, 42.9% expressed stress, and more than 70% reported worrying about the future. In total, 61.9% of the respondents reported having satisfaction with online classes, while over half of them preferred a program of 50% online classes. Students who live in an urban area, are female, have had pre-COVID-19 campus life experience, have decreased income, and/or experience low online satisfaction and over-information may be in need of more support. The results show implications for universities to consider policies addressing well-being and post-pandemic online education. Providing support to university students to improve their resilience against the impact on their studying, campus life, health, and well-being should be prioritized during and post-pandemic.

An instrument for measuring job satisfaction (VIJS): A validation study for community pharmacists in the context of the COVID-19 pandemic in Vietnam.

BACKGROUND: Job satisfaction is one of the main factors creating and bringing about work motivation, productivity, and efficiency as well as decreasing job-hopping and job turnover. No previous studies have been conducted to assess job satisfaction for community pharmacists in Vietnam. OBJECTIVE: This research was conducted to develop and validate an instrument used to measure community pharmacists' job satisfaction in the context of the COVID-19 pandemic in Vietnam. METHODS AND RESULTS: A total of 351 pharmacists participated in this survey. Data were analyzed using R software version 4.2.0. The final instrument (VIJS) has 34 items divided into six factors which were determined via a parallel analysis (including physical working conditions, work nature, income and other benefits, management policies and managers, relationships with coworkers and customers, and learning and advancement opportunities). VIJS's internal consistency was excellent (Cronbach's alpha = 0.97, Omega total = 0.98, split-half reliability = 0.985, and composite reliability>0.8). Two-week test-retest reliability results (intraclass correlation coefficient for the overall instrument: 0.97, for six factors: 0.865-0.938) demonstrated the consistency of the VIJS when the same test was repeated on the same sample (62 pharmacists) at different points in time. The Confirmatory Factor Analysis was employed to assess the construct validity. The VIJS was a good fit to a six-factor model (Chisq/df = 2.352, Comparative Fit Index = 0.937, Tucker-Lewis Index = 0.929, Standardized Root Mean Square Residual = 0.042, and Root Mean Square Error of Approximation = 0.062). VIJS's good convergent and discriminant validity was demonstrated via Average Variance Extrated>0.5 and the Heterotrait-Monotrait ratio of correlations<0.85. CONCLUSIONS: The VIJS possesses good reliability and validity and can be used to measure community pharmacists' job satisfaction.

Knowledge, attitudes, and practices of university students regarding COVID-19: a cross-sectional study in Vietnam.

OBJECTIVE: This cross-sectional study investigated the knowledge, attitudes, and practices (KAP) of Vietnamese university students regarding COVID-19. METHODS: A validated questionnaire (Cronbach's alpha = 0.71) was used to survey 1,025 students. A convenience sampling method was used for recruiting students from April to May 2022. The Wilcoxon rank-sum test and the Kruskal-Wallis rank-sum test/Dunn test for multiple comparisons were employed to compare students' KAP scores between two groups and among three groups or more, respectively. Factors associated with students' COVID-19 KAP scores were determined via univariate and multivariate linear regression models. Variables in the multivariate linear regression models were chosen using the Bayesian Model Averaging method in R software version 4.2.0. RESULTS: A majority of students had good knowledge (75.61%), positive attitudes (98.24%), and good practices toward COVID-19 (94.93%). Regarding the COVID-19 knowledge, the proportions of students who knew that mosquito bites and exposure to/eating wild animals would not lead to COVID-19 infection were not high (47.22 and 34.34%, respectively). More importantly, 70.34% of students thought that vitamins and minerals could help prevent or cure COVID-19. Antibiotics were the first choice for COVID-19 treatment of 438 students (42.73%). Nearly half of students (48.0%) bought antibiotics to keep at home in case of COVID-19 infection. The average KAP scores of medical students (19.97 ± 3.99, 45.10 ± 3.94, 9.72 ± 1.78) and females (18.67 ± 4.44, 44.79 ± 3.79, 9.36 ± 1.84) were significantly higher than those of non-medical students (16.48 ± 4.37, 43.33 ± 4.03, 8.68 ± 1.87) and males (17.01 ± 4.55, 42.79 ± 4.39, 8.77 ± 1.97), respectively (p < 0.001). Older students were more likely to have good knowledge and practices than the younger ones (p < 0.001). In addition, students using websites of the World Health Organization/the Ministry of Health and scientific articles to seek COVID-19 information were significantly associated with higher KAP scores when compared with those not using these sources (p < 0.001, p < 0.001, and p = 0.00139, respectively). CONCLUSION: Students' KAP scores significantly varied by age, sex, major, and sources of COVID-19 information. Although many students had sufficient knowledge, positive attitudes, and good preventive practices toward COVID-19, additional education and training strategies are paramount, especially for non-medical students and males.

Occurrence of the Omicron variant of SARS-CoV-2 in northern Viet Nam in early 2022.

The Omicron variant caused a surge of infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Viet Nam in early 2022, signalling community transmission. We report on active whole-genome sequencing surveillance of positive SARS-CoV-2 samples collected at that time in northern Viet Nam from international arrivals and community clusters. We used an amplicon protocol developed with 14 polymerase chain reaction products and the Illumina iSeq 100 platform. Overall, 213 nasopharyngeal or throat swabs were analysed, of which 172 samples were identified with the Omicron variant. Of these, 80 samples were collected from community cases in February 2022, among which 59 samples were sublineage BA.2 and one sample was the recombinant XE variant. Our results indicated that Omicron had replaced Delta as the dominant variant in a very short period of time and that continuously conducting active whole-genome sequencing surveillance is necessary in monitoring the evolution and genomic diversity of SARS-CoV-2 in Viet Nam.

Host Genetic Risk Factors Associated with COVID-19 Susceptibility and Severity in Vietnamese.

Since the emergence and rapid transmission of SARS-CoV-2, numerous scientific reports have searched for the association of host genetic variants with COVID-19, but the data are mostly acquired from Europe. In the current work, we explored the link between host genes (SARS-CoV-2 entry and immune system related to COVID-19 sensitivity/severity) and ABO blood types with COVID-19 from whole-exome data of 200 COVID-19 patients and 100 controls in Vietnam. The O blood type was found to be a protective factor that weakens the worst outcomes of infected individuals. For SARS-CoV-2 susceptibility, rs2229207 (TC genotype, allele C) and rs17860118 (allele T) of IFNAR2 increased the risk of infection, but rs139940581 (CT genotype, allele T) of SLC6A20 reduced virus sensitivity. For COVID-19 progress, the frequencies of rs4622692 (TG genotype) and rs1048610 (TC genotype) of ADAM17 were significantly higher in the moderate group than in the severe/fatal group. The variant rs12329760 (AA genotype) of TMPRSS2 was significantly associated with asymptomatic/mild symptoms. Additionally, rs2304255 (CT genotype, allele T) of TYK2 and rs2277735 (AG genotype) of DPP9 were associated with severe/fatal outcomes. Studies on different populations will give better insights into the pathogenesis, which is ethnic-dependent, and thus decipher the genetic factor's contribution to mechanisms that predispose people to being more vulnerable to COVID-19.