Do beer and wine respond to price and tax changes in Vietnam? Evidence from the Vietnam Household Living Standards Survey.

OBJECTIVE: To provide the first ever published estimates of the price and expenditure elasticities of demand for beer and wine in Vietnam and thereby contribute to policy initiatives aimed at reducing the excessive consumption of alcohol. METHODS: We use a linear approximation of the Almost Ideal Demand System and data from the Vietnam Household Living Standards Survey for 2010, 2012 and 2014. RESULTS: We find that the demand for beer and wine in Vietnam is price and expenditure inelastic with average price elasticities of -0.283 and -0.317 and average expenditure elasticities of 0.401 and 0.156, respectively. That is, we find that beer and wine consumption decline whenever their respective prices increase and their consumption increases whenever expenditure rises. CONCLUSIONS: The results of the study lend confidence to calls for increased taxation of alcoholic products on public health grounds in Vietnam.

Hepatitis C virus seroprevalence in the general female population from 8 countries.

BACKGROUND: Hepatitis C virus (HCV) infection is a significant global health issue because it is widespread and persistent and can cause serious liver diseases. OBJECTIVES: The aim of this study is to estimate HCV prevalence in women from the general population in different geographical areas worldwide and to assess the potential role of sexual behaviour in the virus transmission. STUDY DESIGN: Each participating centre recruited a random sample of women from the general population aged from less than 20 to more than 75 years. The study included 8130 women from 8 countries with information on sociodemographic factors, reproductive and sexual behaviour, smoking habit and HPV DNA through individual interviews. A blood sample was also collected to perform serological tests. We estimated the prevalence ratios associated to HCV to evaluate the effect of sexual behaviour in viral transmission. RESULTS: Women were reactive to a minimum of two HCV antigens, including at least one non structural protein were considered as positive (33% of the samples were classified as positive, 40% as negative, and 27% as indeterminate (N=402), that were considered as not positive). The age-adjusted HCV seroprevalence varied significantly by regions (0.3% in Argentina to 21.1% in Nigeria). We found no association between HCV prevalence and age, educational level, smoking habit and any of the available variables for sexual behaviour and reproductive history. CONCLUSIONS: This large study showed heterogeneous distribution of HCV seroprevalence in female and provides evidence of the null impact of sexual behaviour in HCV transmission.

The quality of alcohol products in Vietnam and its implications for public health.

Four homemade (artisanally manufactured and unrecorded) and seven commercial (industrially manufactured and taxed) alcohol products from Vietnam were collected and chemically analyzed for toxicologically relevant substances. The majority of both types had alcohol contents between 30 and 40% vol. Two homemade samples contained significantly higher concentrations of 45 and 50% vol. In one of these homemade samples the labeled alcoholic strength was exceeded by nearly 20% vol. All other analyzed constituents of the samples (e.g., methanol, acetaldehyde, higher alcohols, esters, metals, anions) were found in concentrations that did not pose a threat to public health. A peculiarity was a homemade sample of alcohol with pickled snakes and scorpions that contained 77% vol of alcohol, allegedly used as traditional Chinese medicine. Based on this small sample, there is insufficient evidence to conclude that alcohol quality, beyond the effects of ethanol, has an influence on health in Vietnam. However, future research with larger samples is needed.

Geographic variation in the prevalence of Kaposi sarcoma-associated herpesvirus and risk factors for transmission.

BACKGROUND: The aim of the present study was to estimate the prevalence of Kaposi sarcoma-associated herpesvirus (KSHV) in the female general population, to define geographic variation in and heterosexual transmission of the virus. METHODS: The study included 10,963 women from 9 countries for whom information on sociodemographic characteristics and reproductive, sexual, and smoking behaviors were available. Antibodies against KSHV that encoded lytic antigen K8.1 and latent antigen ORF73 were determined. RESULTS: The range of prevalence of KSHV (defined as detection of any antigen) was 3.81%-46.02%, with significant geographic variation noted. In Nigeria, the prevalence was 46.02%; in Colombia, 13.32%; in Costa Rica, 9.81%; in Argentina, 6.40%; in Ho Chi Minh City, Vietnam, 15.50%; in Hanoi, Vietnam, 11.26%; in Songkla, Thailand, 10%; in Lampang, Thailand, 8.63%; in Korea, 4.93%; and in Spain, 3.65%. The prevalence of KSHV slightly increased with increasing age among subjects in geographic areas where the prevalence of KSHV was high, such as Nigeria and Colombia, and it significantly decreased with increases in the educational level attained by subjects in those areas. KSHV was not statistically associated with age at first sexual intercourse, number of sex partners, number of children, patterns of oral contraceptive use, presence of cervical human papillomavirus DNA, or smoking status. CONCLUSIONS: The study provides comparable estimates of KSHV prevalence in diverse cultural settings across 4 continents and provides evidence that sexual transmission of KSHV is not a major source of infection in the general population.

Cervical infection with Chlamydia trachomatis and Neisseria gonorrhoeae in women from ten areas in four continents. A cross-sectional study.

OBJECTIVES: Better information on the prevalence of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infection is needed in many world areas. STUDY DESIGN: Cross-sectional study of population-based samples of nonpregnant women aged 15 to 44 years in Nigeria, Colombia, Argentina, Vietnam (2 areas), China, Thailand (2 areas), Korea, and Spain. 5,328 consenting women aged 15 to 44 years participated. Exfoliated cervical cells were collected and testing for CT and NG and human papillomavirus (HPV) was done using PCR-based assays. RESULTS: Age-standardized CT prevalence ranged between 0.2% (95% confidence interval, CI: 0.0-0.7%) in Spain and 5.6% (95% CI: 3.4-7.8%) in Nigeria. NG ranged between 0% (with broad CIs) in several areas and 2.6% (95% CI: 1.0-4.2%) in Nigeria. Prevalence of CT in all areas combined was greater in women aged 15 to 24 (4.5; 95% CI: 3.4-5.8%) than 25 to 44 (2.6; 95% CI: 2.1-3.1%), whereas NG prevalence was similar in the 2 age groups (0.3%). The only significant risk factors were NG infection (for CT), CT infection (for NG) and infection with high-risk HPV types (for both). CONCLUSIONS: The prevalence of CT and, most notably, NG was relatively low in a variety of countries. Our findings, however, do not apply to subsets of high-risk women who are likely to be underrepresented in our population-based samples.

Variations in the age-specific curves of human papillomavirus prevalence in women worldwide.

An inverse relationship between age and human papillomavirus (HPV) prevalence has been reported in many developed countries, but information on this relationship is scarce in many other parts of the world. We carried out a cross-sectional study of sexually active women from the general population of 15 areas in 4 continents. Similar standardised protocols for women's enrolment, cervical specimen collection and PCR-based assays for HPV testing were used. HPV prevalence in different age groups was compared by study area. 18,498 women aged 15-74 years were included. Age-standardised HPV prevalence varied more than 10-fold between populations, as did the shape of age-specific curves. HPV prevalence peaked below age 25 or 35, and declined with age in Italy, the Netherlands, Spain, Argentina, Korea and in Lampang, Thailand and Ho Chi Minh, Vietnam. This was not the case in Songkla, Thailand nor Hanoi, Vietnam, where HPV prevalence was low in all age groups. In Chile, Colombia and Mexico, a second peak of HPV prevalence was detected among older women. In the poorest study areas in Asia (Shanxi, China and Dindigul, India), and in Nigeria, HPV prevalence was high across all age groups. The substantial differences observed in age-specific curves of HPV prevalence between populations may have a variety of explanations. These differences, however, underline that great caution should be used in inferring the natural history of HPV from age-specific prevalences.

Sexual behavior, condom use, and human papillomavirus: pooled analysis of the IARC human papillomavirus prevalence surveys.

Human papillomavirus (HPV) is a sexually transmitted infection but it is unclear whether differences in transmission efficacy exist between individual HPV types. Information on sexual behavior was collected from 11 areas in four continents among population-based, age-stratified random samples of women of ages > or = 15 years. HPV testing was done using PCR-based enzyme immunoassay. Unconditional logistic regression was used to estimate odds ratios (OR) of being HPV positive and corresponding 95% confidence intervals (95% CI). Variables were analyzed categorically. When more than two groups were compared, floating confidence intervals were estimated by treating ORs as floating absolute risks. A total of 11,337 women (mean age, 41.9 years) were available. We confirmed that lifetime number of sexual partners is associated with HPV positivity (OR for > or = 2 versus 1, 1.86; 95% CI, 1.63-2.11) but the association was not a linear one for HPV18, 31, and 33 (i.e., no clear increase for > or = 3 versus 2 sexual partners). Women who had multiple-type infection and high-risk HPV type infection reported a statistically nonsignificant higher number of sexual partners than women who had single-type and low-risk type infections, respectively. Early age at sexual debut was not significantly related to HPV positivity. Husband's extramarital sexual relationships were associated with an OR of 1.45 (95% CI, 1.24-1.70) for HPV positivity in their wives after adjustment for age and lifetime number of women's sexual partners. We did not observe a significant association with condom use. Our study showed an effect of both women's and their husbands' sexual behavior on HPV positivity. Furthermore, it suggests some differences in the pattern of the association between sexual behavior and different HPV types.

Duration of signs and survival in premenopausal women with breast cancer.

UNLABELLED: CONDENSED: Among 550 women reporting a lump as the first sign of breast cancer, those with this sign for 6-29 months compared to those with 1-6 months, had bigger tumors and more frequent axillary node involvement. Overall survival, however, was not significantly different in these two groups. BACKGROUND: The relationship of delay in diagnosis of breast cancer to survival is uncertain. METHODS: We evaluated the relationship of patient-reported duration of signs of breast cancer to survival in participants in a clinical trial of adjuvant hormonal therapy in Vietnam and China. RESULTS: Among 550 women reporting a lump as the first sign of breast cancer and information on when this appeared, the median duration of this sign before diagnosis was 6 months. Comparing two groups of patients with durations of lumps 1-6 months and 6-29 months, the group with longer duration of lumps had larger tumors clinically and pathologically (p = 0.0006, and p = 0.004), more frequent axillary node involvement (p = 0.008), and shorter but not statistically different disease-free and overall survival from the time of diagnosis (p = 0.09 and 0.35, respectively). CONCLUSIONS: Breast cancer evolves slowly in the detectable period of its natural history. The impact of delays in diagnosis of less than 6 months is likely to be very limited; delays more than 6 months appear to have some, but marginal impact on survival.

The situation with cancer control in Vietnam.

Vietnam is one of the poor, developing countries. Malnutrition and infectious diseases are still major health problems. Cancer ranks in a relatively modest position of priority. The reason is partly explained by a shortage of treatment facilities and poor quality of health and vital statistics. The leading cancers in the country are lung, liver, stomach, colon-rectum and nasopharynx in males and breast, cervix, stomach, liver, colon-rectum and lung in females. Although the country has some common patterns of cancer such as a relatively high incidence of nasopharynx, liver and stomach and a relatively low incidence of breast and prostate cancer compared with international data, the geographical distribution of cancer is not homogenous within the country. The most remarkable difference is observed in cancer of the cervix uteri, of which the incidence in the South is, at least four times higher than that in the North. Other less extensive differences are observed in cancer of the lung, stomach, nasopharynx and breast, the incidence of which seems to be higher in the North than in the South, and the liver, which seems to be more frequent in the South than in the North. It was estimated that in 1990 the cancer incidence in Vietnam was about 133 per 100 000 in males and 91.7 per 100 000 in females and that the mortality was 105.9 and 58.5 per 100 000, respectively (standardization to the world's population). In that year, Vietnam had at least 52 700 new cancer cases and 37 700 dead from cancer. Although the National Cancer Control Program is still in preparation, some efforts by the government have already been made with tobacco control, improving the cancer treatment net, mass media education and production of vaccine against HBV. Cancer control in Vietnam still has to deal with challenges such as poor quality of cancer morbidity and mortality data, shortage of resources for establishing a comprehensive cancer control network from the center to the peripheries, lack of data for an anti-tobacco program and misunderstanding or limited knowledge of general practitioners and the public about the disease.