Unveiling the applicability of the Brussels Infant and Toddler Stool Scale for hard stool in young children: A South Asian perspective.

BACKGROUND AND AIM: The Rome IV criteria, the standard for diagnosing functional constipation (FC), deem the Bristol Stool Scale (BSS) unsuitable for assessing stool consistency in young children. Hence, the Brussels Infant and Toddler Stool Scale (BITSS) was developed. We aimed to validate and test the reliability of BITSS for hard stools and FC among infants and toddlers, where there is limited evidence in Asian populations. METHODS: The research evaluated FC in children aged 0-48 months who came for medical examination using Rome IV criteria. Stool properties provided by caregivers were assessed sequentially through three methods: the BSS, the BITSS, and caregiver reports. RESULTS: A total of 370 responses were received, with an average age of 26.2 months. Substantial agreement was observed between the BITSS and caregiver reports for hard stools (concordance rate: 91.9%, κ = 0.75), while near-perfect agreement was found between BITSS and BSS (concordance rate: 93.5%, κ = 0.81). The BITSS exhibited higher sensitivity than the BSS in assessing hard stools (95.3% vs 87.5%, P < 0.001). And the BITSS (23.5%) identified the highest prevalence of FC than the BSS (20.5%) and caregiver report (18.7%), with near-perfect agreement. Moderate agreement was reported when evaluating the test-retest reliability between BITSS and caregiver reports (concordance rate: 86.2%, κ = 0.44). CONCLUSIONS: The BITSS, more sensitive than the BSS in identifying abnormal, especially hard stools, aids in early FC detection in young children. These findings support using BITSS over BSS for evaluating hard stools in infants and toddlers, both in Vietnam and globally.

Hand washing behavior and associated factors in Vietnam based on the Multiple Indicator Cluster Survey, 2010-2011.

BACKGROUND: Handwashing is a cost-effective way of preventing communicable diseases such as respiratory and food-borne illnesses. However, handwashing rates are low in developing countries. Target 7C of the seventh Millennium Development Goals was to increase by half the proportion of people with sustainable access to safe drinking water and basic sanitation by 2015. Studies have found that better access to improved water sources and sanitation is associated with higher rates of handwashing. OBJECTIVE: Our goal was to describe handwashing behaviour and identify the associated factors in Vietnamese households. DESIGN: Data from 12,000 households participating in the Vietnam Multiple Indicator Cluster Survey 2011 were used. The survey used a multistage sampling method to randomly select 100 clusters and 20 households per cluster. Self-administered questionnaires were used to collect data from a household representative. Demographic variables, the presence of a specific place for handwashing, soap and water, access to improved sanitation, and access to improved water sources were tested for association with handwashing behaviour in logistic regression. RESULTS: Almost 98% of households had a specific place for handwashing, and 85% had cleansing materials and water at such a place. The prevalence of handwashing in the sample was almost 85%. Educational level, ethnicity of the household head, and household wealth were factors associated with handwashing practice (p<0.05). Those having access to an improved sanitation facility were more likely to practise handwashing [odds ratio (OR)=1.69, 95% confidence interval (CI): 1.37-2.09, p<0.001], as were those with access to improved water sources (OR=1.74, 95% CI: 1.37-2.21, p<0.001). CONCLUSIONS: Households with low education, low wealth, belonging to ethnic minorities, and with low access to improved sanitation facilities and water sources should be targeted for interventions implementing handwashing practice. In addition, the availability of soap and water at handwashing sites should be increased and practical teaching programs should be deployed in order to increase handwashing rates.

Trends and determinants of infant and under-five childhood mortality in Vietnam, 1986-2011.

BACKGROUND: Although Vietnam has taken great efforts to reduce child mortality in recent years, a large number of children still die at early age. Only a few studies have been conducted to identify at-risk groups in order to provide baseline information for effective interventions. OBJECTIVE: The study estimated the overall trends in infant mortality rate (IMR) and under-five mortality rate (U5MR) during 1986-2011 and identified demographic and socioeconomic determinants of child mortality. DESIGN: Data from the Vietnam Multiple Indicator Cluster Surveys (MICSs) in 2000 (MICS2), 2006 (MICS3) and 2011 (MICS4) were analysed. The IMR and U5MR were calculated using the indirect method developed by William Brass. Unadjusted and adjusted odds ratios were estimated to assess the association between child death and demographic and socioeconomic variables. Region-stratified stepwise logistic regression was conducted to test the sensitivity of the results. RESULTS: The IMR and U5MR significantly decreased for both male and female children between 1986 and 2010. Male children had higher IMR and U5MR compared with females in all 3 years. Women who were living in the Northern Midlands and Mountain areas were more likely to experience child deaths compared with women who were living in the Red River Delta. Women who were from minor ethnic groups, had low education, living in urban areas, and had multiple children were more likely to have experienced child deaths. CONCLUSION: Baby boys require more healthcare attention during the first year of their life. Comprehensive strategies are necessary for tackling child mortality problems in Vietnam. This study shows that child mortality is not just a problem of poverty but involves many other factors. Further studies are needed to investigate pathways underlying associations between demographic and socioeconomic conditions and childhood mortality.

Changes and socioeconomic factors associated with attitudes towards domestic violence among Vietnamese women aged 15-49: findings from the Multiple Indicator Cluster Surveys, 2006-2011.

BACKGROUND: Understanding factors associated with domestic violence-supportive attitudes among Vietnamese women is important for designing effective policies to prevent this behavior. Previous studies have largely overlooked risk factors associated with domestic violence-supportive attitudes by women in Vietnam. OBJECTIVE: This paper explores and identifies socioeconomic factors that contribute to domestic violence-supportive attitudes among Vietnamese women using data from the Multiple Indicator Cluster Surveys (MICS). DESIGN: Secondary data from two cross-sectional studies (MICS 3, 2006, and MICS 4, 2011) with representative samples (9,471 and 11,663 women, respectively) in Vietnam were analyzed. The prevalence of supportive attitudes toward domestic violence and associations with age, residence region, area, education level, household wealth index, ethnicity, and marital status were estimated using descriptive statistics and multivariate Poisson models, giving estimates of relative risk. RESULTS: Overall, the prevalence of acceptance of domestic violence declined between 2006 and 2011 in Vietnam (65.1% vs. 36.1%). Socioeconomic factors associated with women's condoning of domestic violence were age, wealth, education level, and living area. In particular, younger age and low educational attainment were key factors associated with violence-supportive attitudes, and these associations have become stronger over time. CONCLUSION: Higher educational attainment in women is an important predictor of women's attitudes toward domestic violence. To date, Doi Moi and the Vietnamese government's commitment to the Millennium Development Goals may have positively contributed to lowering the acceptance of domestic violence. Tailored interventions that focus on education will be important in further changing attitudes toward domestic violence.