Spatial analysis of dengue fever incidence and serotype distribution in Vientiane Capital, Laos: A multi-year study.

Laos is a hyperendemic country of all 4 dengue serotypes. Various factors contribute to the spread of the disease including viral itself, vectors, and environment. This study aims to analyze dengue data and its incidence in nine districts of Vientiane Capital, Laos spanning from 2019 to 2021 by data collected from Mittaphab Hospital. The Maximum Entropy algorithm (MaxEnt) was applied to assess spatial distribution and identify high-probability locations for dengue occurrence by analyzing crucial environmental and climatic conditions. Dengue cases were more prominent in female (54.88 %) and highest case number was found in worker group (29.02 %) followed by student (28.47 %) and officer (16.92 %). In this study, the age group 21-30 years old had the highest infection rate (42.23 %), followed by 10-20 years old (24.21 %). Most of dengue cases was primary infection (91.61 %). Dengue serotype 2 predominated in 2019 and 2020 and substitute by serotype 1 in 2021. Across the nine districts of Vientiane Capital, the highest incidence of dengue was found in Xaythany district population in 2019, shifting to Chanthabouly district in 2020 and 2021. The MaxEnt revealed potentially most suitable areas for dengue were widely distributed central south part of Vientiane, Laos. Additionally, the best predictive variable for dengue occurrence was normalized difference vegetation index. Understanding of case characteristics and spatial distribution features of dengue will be helpful in effective surveillance and disease control in the future.

Community of Interoperability Labs: Pragmatic Approach to Achieving Interoperability.

To achieve interoperability of health data, stakeholders must overcome various socio-technical challenges. The "Mind the GAPS, Fill the GAPS" framework was created by the Asia eHealth Information Network (AeHIN) in 2017 to help countries with their challenges with interoperability. A year later, AeHIN formed the Community of Interoperability Labs (COIL), a group of labs from six countries to share knowledge and resources. Since interoperability requires data exchange between disparate entities, it is imperative to establish a trustworthy space where stakeholders can come together and solve their common problems. The networked learning approach of the COIL makes possible the potential for interoperability within and between countries contributing to national and international understanding.

First national tuberculosis patient cost survey in Lao People's Democratic Republic: Assessment of the financial burden faced by TB-affected households and the comparisons by drug-resistance and HIV status.

BACKGROUND: Tuberculosis (TB) patients incur large costs for care seeking, diagnosis, and treatment. To understand the magnitude of this financial burden and its main cost drivers, the Lao People's Democratic Republic (PDR) National TB Programme carried out the first national TB patient cost survey in 2018-2019. METHOD: A facility-based cross-sectional survey was conducted based on a nationally representative sample of TB patients from public health facilities across 12 provinces. A total of 848 TB patients including 30 drug resistant (DR)-TB and 123 TB-HIV coinfected patients were interviewed using a standardised questionnaire developed by the World Health Organization. Information on direct medical, direct non-medical and indirect costs, as well as coping mechanisms was collected. We estimated the percentage of TB-affected households facing catastrophic costs, which was defined as total TB-related costs accounting for more than 20% of annual household income. RESULT: The median total cost of TB care was US$ 755 (Interquartile range 351-1,454). The costs were driven by direct non-medical costs (46.6%) and income loss (37.6%). Nutritional supplements accounted for 74.7% of direct non-medical costs. Half of the patients used savings, borrowed money or sold household assets to cope with TB. The proportion of unemployment more than doubled from 16.8% to 35.4% during the TB episode, especially among those working in the informal sector. Of all participants, 62.6% of TB-affected households faced catastrophic costs. This proportion was higher among households with DR-TB (86.7%) and TB-HIV coinfected patients (81.1%). CONCLUSION: In Lao PDR, TB patients and their households faced a substantial financial burden due to TB, despite the availability of free TB services in public health facilities. As direct non-medical and indirect costs were major cost drivers, providing free TB services is not enough to ease this financial burden. Expansion of existing social protection schemes to accommodate the needs of TB patients is necessary.