Leptospira infection among human-close-contact animals in different geographical areas in Vietnam.

Leptospirosis is a neglected disease in Vietnam. Only a few studies have evaluated the status of Leptospira infection in both humans and animals. To our knowledge, this is the first serological survey of Leptospira in both domestic and wild animals, which may act as reservoirs of this agent. This study aimed to evaluate the seroprevalence of Leptospira in animals that are in close contact with humans in different geographical areas in Vietnam. Sera were collected from 1205 individual animals of six species, including buffaloes, cattle, cats, dogs, swine, and rats. The microscopic agglutination test (MAT) against 25 serovars of Leptospira spp. has been employed to detect serovars of Leptospira among the studied population. Overall, 44.2% of buffaloes, 24.9% of cattle, 10.2% of swine, 32.9% of dogs, 12.2% of cats, and 16% of rats were seropositive. A total of 17 different serovars were detected, of which serovars Hebdomadis and Canicola circulated in all the studied animal species. Variability of the predominant serovars circulating in animal species and in different geographical areas of Vietnam has been noted. We conclude that this study showed a high prevalence of Leptospira circulating in animals that are in close contact with humans, raising an alert of the important sources of pathogenic leptospires transmission to humans in Vietnam. These findings prove an imperative need for effective measures for disease prevention.

Acceptability and Feasibility of Delivering Pentavalent Vaccines in a Compact, Prefilled, Autodisable Device in Vietnam and Senegal.

BACKGROUND: Prefilled syringes are the standard in developed countries but logistic and financial barriers prevent their widespread use in developing countries. The current study evaluated use of a compact, prefilled, autodisable device (CPAD) to deliver pentavalent vaccine by field actors in Senegal and Vietnam. METHODS: We conducted a logistic, programmatic, and anthropological study that included a) interviews of immunization staff at different health system levels and parents attending immunization sessions; b) observation of immunization sessions including CPAD use on oranges; and c) document review. RESULTS: Respondents perceived that the CPAD would improve safety by being non-reusable and preventing needle and vaccine exposure during preparation. Preparation was considered simple and may reduce immunization time for staff and caretakers. CPAD impact on cold storage requirements depended on the current pentavalent vaccine being used; in both countries, CPAD would reduce the weight and volume of materials and safety boxes thereby potentially improving outreach strategies and waste disposal. CPAD also would reduce stock outages by bundling vaccine and syringes and reduce wastage by using a non-breakable plastic presentation. Respondents also cited potential challenges including ability to distinguish between CPAD and other pharmaceuticals delivered via a similar mechanism (such as contraceptives), safety, and concerns related to design and ease of administration (such as activation, ease of delivery, and needle diameter and length). CONCLUSIONS: Compared to current pentavalent vaccine presentations in Vietnam and Senegal, CPAD technology will address some of the main barriers to vaccination, such as supply chain issues and safety concerns among health workers and families. Most of the challenges we identified can be addressed with health worker training, minor design modifications, and health messaging targeting parents and communities. Potentially the largest remaining barrier is the marginal increase in pentavalent cost--if any--from CPAD use, which we did not assess in our study.