Difficulties in tuberculosis infection control in a general hospital of Vietnam: a knowledge, attitude, and practice survey and screening for latent tuberculosis infection among health professionals.

BACKGROUND: In Vietnam, a country with a high tuberculosis (TB) burden, health professionals in both TB-specialized and non-TB-specialized general hospitals have a high risk of acquiring TB. The aims of the present study were to clarify the difficulties in TB infection control at non-TB specialized hospitals and whether any associated risks of latent TB infection exist among health professionals in Vietnam. METHODS: We conducted a cross-sectional study in a national tertiary and general hospital of Hanoi, Vietnam. Participants were health professionals, including physicians, nurses, and other health professionals. We assessed difficulties in TB infection control by conducting a knowledge, attitude, and practice (KAP) survey. We also collected data on the results of tuberculin skin tests (TSTs) conducted during health check-ups for hospital staff to determine whether health professionals had latent TB infection or TB disease. KAP scores were compared among health professional groups (physicians vs. nurses vs. other health professionals). Factors influencing knowledge scores were evaluated using multiple regression analysis. RESULTS: A total 440 health professionals at the study site participated in the KAP survey, and we collected the results of TSTs from a total of 299 health professionals. We observed a high prevalence of latent TB infection (74.2%), especially among participants in the emergency department. Although participants had high KAP scores, some topics were less understood, such as symptoms and risks of TB, proper use of protective equipment such as N95 respirators, and preventing transmission by patients with confirmed or suspected TB. Factors influencing knowledge scores associated with TB were age, a belief that TB is the most important infectious disease, being a medical professional, having previously attended workshops or seminars, and knowing that Vietnam has a high burden of TB. CONCLUSION: In a non-TB specialized hospital of Vietnam, we observed a risk of TB infection among health professionals and difficulties in properly controlling TB infection. Early awareness regarding patients with suspected TB, to apply proper measures and prevent transmission, and education regarding obtaining updated knowledge through scientific information are crucial to enhancing TB infection control in general hospitals of Vietnam.

Characterizations of adenovirus type 41 isolates from children with acute gastroenteritis in Japan, Vietnam, and Korea.

Genetic and antigenic characterizations of 70 strains of adenovirus type 41 (Ad41), isolated between 1998 and 2001 from children in Japan, Vietnam, and Korea, were done by DNA restriction enzyme (RE) analysis, sequencing analysis, and monoclonal antibody (MAb)-based enzyme-linked immunosorbent assay (ELISA). Eight genome types were observed in the present study, among which D25, D26, D27, and D28 were novel genome types. These eight genome types were divided into two genome-type clusters (GTCs) based on phylogenetic analysis of the hypervariable regions (HVRs) of the hexon. GTC1 includes D1, D25, D26, D27, and D28, and the GTC2 contains D4, D12, and D22. The amino acid homologies among the members within a GTC were 97 to 100%, whereas between the members of different GTCs the homologies were 92 to 94%. The specificity of the GTC classification was confirmed by ELISA with MAb 1F, which was selected by the Ad41 prototype Tak strain. It was found that only the isolates of GTC1 but not of GTC2 reacted with MAb 1F. These results suggest that Ad41 isolates from the three countries should be classified into two subtypes. The accumulation of amino acid mutations located in HVRs of hexon are indicative for the classification of Ad41 subtype.

Epidemiological features of rotavirus infection among hospitalized children with gastroenteristis in Ho Chi Minh City, Vietnam.

An epidemiological study of the G serotype and P genotype distribution of group A rotaviruses by using ELISA and/or RT-PCR was conducted in children (aged 1 month to 15 years) with diarrhea that were admitted to the General Children's Hospital No. 1, Ho Chi Minh City, Vietnam from December 1999 to November 2000. The results showed that rotavirus is associated with 65.6% (889/1355) of diarrheal admissions. Rotavirus infection mostly affected children under 2 years of age with a peak incidence in children 1 to 2 years of age (75.7%) and it occurs year round with a slight seasonal pattern; 99.5% of the specimens could be G-typed: G1 was predominant (68.7%), followed by G4 (15.4%), G2 (12.3%), G3 (0.6%), and G9 (0.5%). High identities of VP7 nucleotide (96.3 to 96.9%) and deduced amino acid (98.1 to 98.4%) were found between two Vietnamese G9 strains and also the recent emergence of G9 strains US 1205, Brazilian R143, and Malawian MW69. Mixed infections were identified in 17 (2.0%), and 5 strains (0.5%) remained untypable. The four most common worldwide strains, G1P[8], G2P[4], G3P[8], and G4P[8], constituted 81.1% of all rotaviruses typed with G1P[8] being the most prevalent type (58.2%). Unusual G/P combinations (11 strains) were detected in 11.7% of all strains, of which, G1P[4] was the most prevalent, accounting for 5.6% of the total. Several combinations of G and P types were observed in this study, suggesting a complex rotavirus infection pattern in Vietnam. This study has provided for the first time clear indication on the circulating G and P genotypes among hospitalized children in Ho Chi Minh City, Vietnam. The results suggest that these viral infections are prevalent among hospitalized children and that the four most common worldwide G types as well as the four most common G-P combinations were also infecting children in Ho Chi Minh City, Vietnam. This result could have important implications for rotavirus vaccine programs and for understanding the epidemiological characteristics of human rotavirus in Ho Chi Minh City, Vietnam.