Endotracheal intubation performance at a large obstetric hospital delivery room, Hanoi, Vietnam.

Introduction: Intrapartum-related events account for nearly 700,000 neonatal deaths globally yearly. Endotracheal intubation is a cornerstone in preventing many of these deaths, but it is a difficult skill to acquire. Previous studies have described intubation performances in high-income countries, but data from low- and middle-income countries are lacking. We aimed to assess the performance of delivery room intubation in a lower middle-income country. Methods: This prospective observational study was conducted at the Phu San Hanoi Hospital, Vietnam, from September 2020 to January 2021. Video cameras were positioned above the resuscitation tables and data were extracted using adopted software (NeoTapAS). All neonates requiring positive pressure ventilation were included. Our main variables of interest were time to first intubation attempt, first intubation attempt duration, and successful first intubation attempt. Results: 18,107 neonates were born during the five months. Of these, 75 (0.4%) received positive pressure ventilation, and 36 (0.2%) required endotracheal intubation of whom 24 were captured on video. The median time to the first intubation attempt was 252 seconds (range 91-771 seconds), the median first attempt duration was 49 seconds (range 10-105 seconds), and the first attempt success rate was 75%. Conclusion: Incidences of positive pressure ventilation and endotracheal intubation were low in comparison to global estimates. Three out of four intubations were successful at the first attempt and the procedural duration was often longer than recommended. Future studies should focus on how to achieve and maintain intubation skills and could include considering alternative devices for airway management at birth.

The Association Between Ambient Temperatures and Hospital Admissions Due to Respiratory Diseases in the Capital City of Vietnam.

This study aimed to examine the short-term effects of ambient temperature on hospital admissions due to respiratory diseases among Hanoi residents. We collected 34,653 hospital admissions for 365 days (November 1, 2017, to November 31, 2018) from two hospitals in Hanoi. A quasi-Poisson regression model with time series analysis was used to explore the temperature-health outcome relationship's overall pattern. The non-linear curve indicated the temperatures with the lowest risk range from 22 degrees (Celcius) to 25 degrees (Celcius). On average, cold temperatures showed a higher risk than hot temperatures across all genders and age groups. Hospital admissions risk was highest at 13 degrees (Celcius) (RR = 1.39; 95% CI = 1.26-1.54) for cold effects and at 33 degrees (Celcius) (RR = 1.21, 95% CI = 1.04-1.39) for the hot effects. Temporal pattern analysis showed that the most effect on respiratory diseases occurred at a lag of 0 days for hot effect and at a lag of 1 day for cold effect. The risk of changing temperature among women and people over 5 years old was higher than other groups. Our results suggest that the risk of respiratory admissions was greatest when the temperature was low. Public health prevention programs should be enhanced to improve public awareness about the health risks of temperature changes, especially respiratory diseases risked by low temperatures.

Incidence of Intrapartum-Related Events at the Largest Obstetric Hospital in Hanoi, Vietnam: A Retrospective Study.

Every year, 2.4 million neonates die during their first month of life and even more suffer permanent injury. The main causes are intrapartum-related events, prematurity, and infection, with sub-Saharan Africa and southern Asia being the worst affected regions. With a focus on intrapartum-related events, we aimed to assess the neonatal demographic characteristics, clinical management, and outcomes among neonates born at the largest obstetric hospital in Hanoi, Vietnam. This was a retrospective cross-sectional study that included all the inborn neonates in November 2019, which was selected as a representative month. A total of 4554 neonates were born during the study period. Of these, 1.0% (n = 44) were stillbirths, 0.15% (n = 7) died in hospital, 0.61% (n = 28) received positive pressure ventilation at birth, and 0.15% (n = 7) were diagnosed with hypoxic ischemic encephalopathy. A total of 581 (13%) neonates were admitted to the neonatal unit, among which the most common diagnoses were prematurity (37%, n = 217) and infection (15%, n = 89). Except for the intrapartum-related events, our findings are consistent with the previously documented data on neonatal morbidity. The intrapartum-related events, however, were surprisingly low in number even in comparison to high-income countries. Research on the current clinical practice at Phu San Hanoi Hospital may bring further clarity to identify the success factors.

Environmental behaviour of radioactive particles from chernobyl.

Long-term environmental behaviour of radioactive particles released during the Chernobyl accident and deposited in sandy topsoil in Ivankiv district of Kyiv Region (Ukraine), in radioactive trench waste materials from the Red forest, and in bottom sediments from the Cooling pond has been assessed. The efficiency of the models describing the dissolution/weathering rates of U fuel particles developed 15-20 years ago was tested, and their predictions for the dynamics of remobilization, mobility and plants uptake of 90Sr were confirmed. It was found that at present in the topsoil and in radioactive trench waste material, total dissolution of fuel particles of low chemical stability (UO2+x) has occurred and about half of the non-oxidized chemically stable fuel particles (UO2) has also dissolved, indicating radiological stabilization of the environment and that the mobile fraction of radionuclides would be reduced in the future. The biological availability of 90Sr in topsoil due to fuel particles dissolution has reached maximum values and further decrease is expected. The presence of chemically extra-stable fuel particles (U-Zry-Ox) in environments should be taken into account when the total radionuclides activity concentrations are assessed during radioactive materials management. It was shown that nearly half of the 90Sr activity remained as part of the non-dissolved UO2 fuel particles at the time of the study. Taking into consideration that 31 ±â€¯4% of the radionuclide activities were still associated with non-dissolved chemically extra-stable particles (U-Zry-Ox) in radioactive trench waste materials from the Red forest, increased dissolution should not be expected in the near future. The physico-chemical form of radionuclides in air exposed sediments from the Cooling pond were determined, and results showed that about 70-80% of total 90Sr, 241Am and plutonium isotopes activity were associated with U fuel particles. The low dissolution rate of radionuclides from the pond sediments is attributed to prolonged slightly alkaline pH in the medium due to zebra mussel residues. According to new data, the emission value of 238Pu associated with fuel particles released during the Chernobyl accident amounted to 1.8 × 1013Bq (1.2% of the activity in the reactor) and 90Sr amounted to 2.6 × 1015Bq (1.5% of the activity in the reactor).

Analysis of the relationship binding in situ gamma count rates and soil sample activities: Implication on radionuclide inventory and uncertainty estimates due to spatial variability.

The paper strives to identify through geostatistical simulations the parameters which build up a correlation between radionuclide activity concentrations measured on core samples and corresponding in situ total gamma count rates measured into boreholes drilled within the contaminated soil. This numerical exercise demonstrates that a linear relationship should exist between logarithmic values of in situ count rates and logarithmic values of activity concentrations when the contamination is strongly structured through space. A sensitivity analysis to some parameters (geostatistical range of the contamination structure, core sampling method, soil water content, multiple gamma-emitter contamination, etc.) is undertaken to identify which situations may impede the use of such a correlation. Then this approach is applied on Chernobyl measurements undertaken in 2015 and compared to the co-kriging method which considers the localization of the measurements and the additional measurements. It appears that co-kriging is a better estimator than linear regression, but the latter remains an acceptable way of estimating activity from gamma emitters and presents better results than lognormal regression. Therefore, total gamma logging measurements performed into boreholes of porous media contaminated by gamma-emitting radionuclides can be used for characterizing contamination and dealing with its spatial variability with the use of co-kriging.

The effects of socioecological factors on variation of communicable diseases: A multiple-disease study at the national scale of Vietnam.

OBJECTIVE: To examine the effects of socioecological factors on multiple communicable diseases across Vietnam. METHODS: We used the Moran's I tests to evaluate spatial clusters of diseases and applied multilevel negative binomial regression models using the Bayesian framework to analyse the association between socioecological factors and the diseases queried by oral, airborne, vector-borne, and animal transmission diseases. RESULTS AND SIGNIFICANCE: The study found that oral-transmission diseases were spatially distributed across the country; whereas, the airborne-transmission diseases were more clustered in the Northwest and vector-borne transmission diseases were more clustered in the South. Most of diseases were sensitive with climatic factors. For instance, a 1°C increase in average temperature is significantly associated with 0.4% (95CI, 0.3-0.5), 2.5% (95%CI, 1.4-3.6), 0.9% (95%CI, 0.6-1.4), 1.1% (95%CI), 5% (95%CI, 3-.7.4), 0.4% (95%CI, 0.2-0.7), and 2% (95%CI, 1.5-2.8) increase in risk of diarrhoea, shigellosis, mumps, influenza, dengue, malaria, and rabies respectively. The influences of socio-economic factors on risk of communicable diseases are varied by factors with the biggest influence of population density. The research findings reflect an important implication for the climate change adaptation strategies of health sectors. A development of weather-based early warning systems should be considered to strengthen communicable disease prevention in Vietnam.

Spatiotemporal variation of hand-foot-mouth disease in relation to socioecological factors: A multiple-province analysis in Vietnam.

BACKGROUND: Hand-foot-and-mouth disease (HFMD) is a significant public health issue in Asia-pacific countries. Numerous studies have examined the relationship between socio-ecological factors and HFMD however the research findings were inconsistent. This study examined the association between socio-ecologic factors and HFMD in multiple provinces across Vietnam. METHODS: We applied a spatial autoregressive model using a Bayesian framework to examine the relationship between HFMD and socio-demographic factors. We used a Generalized Linear Model (GLD) with Poisson family to examine the province-specific association between monthly HFMD and climatic factors while controlling for spatial lag, seasonality and long-term trend of HFMD. Then, we used a random-effect meta-analysis to generate pooled effect size of climate-HFMD association for regional and country scale. RESULTS: One percent increase in newborn breastfed within 1h of birth, households with permanent houses, and households accessed to safe water resulted in 1.57% (95% CI: -2.25, -0.93), 0.96% (-1.66, -0.23), and 1.13% (-2.16, -0.18) reduction in HFMD incidence, respectively. At the country-level, HFMD increased 7% (RR: 1.07; 95%CI: 1.052-1.088) and 3.1% (RR: 1.031, 95%CI: 1.024-1.039) for 1°C increase in monthly temperature above 26°C and 1% increase in monthly humidity above 76%. Whereas, HFMD decreased 3.1% associated with 1mm increase in monthly cumulative rainfalls. The climate-HFMD relationship was varied by regions and provinces across the country. CONCLUSIONS: The findings reflect an important implication for the climate change adaptation strategies and public-health decision, of which development of weather-based early warning systems should be considered to strengthen communicable disease prevention system.

Temporal and spatial analysis of hand, foot, and mouth disease in relation to climate factors: A study in the Mekong Delta region, Vietnam.

This study examined the temporal and spatial patterns of hand, foot, and mouth disease (HFMD) in the Mekong Delta region in Vietnam. A time-series analysis was used to examine the temporal patterns of HFMD in relation to climate factors while a retrospective space-time scan was used to detect the high-risk space-time clusters of this disease. A 1°C increase in average temperature was associated with 5.6% increase in HFMD rate at lag 5days (95% CI 0.3-10.9). A 1% increase in humidity had equal influence of 1.7% increases on HFMD rate at both lag 3days and 6days (95% CI 0.7-2.7 and 95% CI 0.8-2.6, respectively). An increase in 1 unit of rainfall was associated with a 0.5% increase of HFMD rate on the lag 1 and 6days (95% CI 0.2-0.9 and 95% CI 0.1-0.8, respectively). The predictive model indicated that the peak of HFMD was from October to December - the rainy season in the Mekong Delta region. Most high-risk clusters were located in areas with high population density and close to transport routes. The findings suggest that HFMD is influenced by climate factors and is likely to increase in the future due to climate change related weather events.

Heatwave and risk of hospitalization: A multi-province study in Vietnam.

The effects of heatwaves on morbidity in developing and tropical countries have not been well explored. The purpose of this study was to examine the relationship between heatwaves and hospitalization and the potential influence of socio-economic factors on this relationship in Vietnam. Generalized Linear Models (GLM) with Poisson family and Distributed Lag Models (DLM) were applied to evaluate the effect of heatwaves for each province (province-level effect). A random-effects meta-analysis was applied to calculate the pooled estimates (country-level effects) for 'all causes', infectious, cardiovascular, and respiratory admissions queried by lag days, regions, sex, and ages. We used random-effects meta-regression to explore the potential influence of socio-economic factors on the relationship between heatwaves and hospitalization. The size of province-level effects varied across provinces. The pooled estimates show that heatwaves were significantly associated with a 2.5% (95%CI: 0.8-4.3) and 3.8% (95%CI, 1.5-6.2) increase in all causes and infectious admissions at lag 0. Cardiovascular and respiratory admissions (0.8%, 95%CI: -1.6-3.3; 2.2%, 95%CI: -0.7-5.2) were not significantly increased after a heatwave event. The risk of hospitalization due to heatwaves was higher in the North than in the South for all causes (5.4%, 95%CI: -0.1-11.5 versus 1.3%, 95%CI: 0.1-2.6), infectious (11.2%, 95%CI: 3.1-19.9 versus 3.2%, 95%CI: 0.7-5.7), cardiovascular (7.5%, 95%CI: 1.1-14.4 versus -1.2%, 95%CI: -2.6-2.3), and respiratory diseases (2.7%, 95%CI: -5.4-11.5 versus 2.1%, 95%CI: -0.8-1.2). A non-significant influence of socio-economic factors on the relationship between heatwave and hospitalization was observed. This study provides important evidence and suggests implications for the projected impacts of climate change related extreme weather. Climate change adaptation programs of the health sector should be developed to protect residents from the effects of extreme weather events such as heatwaves in Vietnam.

Heavy rainfall and risk of infectious intestinal diseases in the most populous city in Vietnam.

The association between heavy rainfall and infectious intestinal diseases (IID) has not been well described and little research has been conducted in developing countries. This study examines the association between heavy rainfall and hospital admissions for IID in Ho Chi Minh City, the most populous city in Vietnam. An interrupted time-series method was used to examine the effect of each individual heavy rainfall event (HRE) on IID. The percentage changes in post-HRE level and trends of IID were estimated for 30days following each HRE. Then a random-effect meta-analysis was used to quantify the pooled estimate of effect sizes of all HREs on IID. The pooled estimates were calculated over a 21day lag period. The effects of a HRE on IID varied across individual HREs. The pooled estimates indicate that the levels of IID following a HRE increased from 7.3% to 13.5% for lags from 0 to 21days, however statistically significant increases were only observed for lags from 4 to 6days (13.5%, 95%CI: 1.4-25.4; 13.3%, 95%CI: 1.5-25.0; and 12.9%, 95%CI: 1.6-24.1 respectively). An average decrease of 0.11% (95%CI: -0.55-0.33) per day was observed for the post-HRE trend. This finding has important implications for the projected impacts on residents living in this city which is highly vulnerable to increased heavy rainfall associated with climate change. Adaptation and intervention programs should be developed to prevent this additional burden of disease and to protect residents from the adverse impacts of extreme weather events.