RESUMEN
We studied a community cluster of 25 mpox cases in Vietnam caused by emerging monkeypox virus sublineage C.1 and imported into Vietnam through 2 independent events; 1 major cluster carried a novel APOBEC3-like mutation. Three patients died; all had advanced HIV co-infection. Viral evolution and its potential consequences should be closely monitored.
Asunto(s)
Monkeypox virus , Mpox , Filogenia , Vietnam/epidemiología , Humanos , Mpox/epidemiología , Mpox/virología , Mpox/transmisión , Monkeypox virus/genética , Monkeypox virus/clasificación , Masculino , Femenino , Adulto , Persona de Mediana Edad , Enfermedades Transmisibles Emergentes/virología , Enfermedades Transmisibles Emergentes/transmisión , Enfermedades Transmisibles Emergentes/epidemiología , Infecciones por VIH/transmisión , Infecciones por VIH/virología , Infecciones por VIH/epidemiología , Historia del Siglo XXI , Mutación , Coinfección/virologíaRESUMEN
Most of people who inject drugs in Vietnam live in their family homes and these living have formed the burden on caring. This study aimed at exploring the characteristic of depression of caregivers of HIV - positive injection drug users and relative factors. Cross - sectional assessment data were gathered from 138 caregivers recruited from Hanoi city. About 20% of the study sample had a depressed condition from mild to extremely severe. Caregiver burden and family function were significantly associated with depression of caregivers. This study addressed the needs of intervention to improve family function and to decrease caregiver burden aimed at raising mental health of caregivers of HIV - positive injection drug users.
RESUMEN
BACKGROUND: As a dual response to the HIV epidemic and the high level of injecting drug use in Vietnam, the Ministry of Health (MOH) initiated a pilot methadone maintenance therapy (MMT) program in Hai Phong and Ho Chi Minh City (HCMC) in early 2009. The objectives of the pilot were to provide evidence on whether MMT could be successfully implemented in Vietnam and scaled up to other localities. METHODS: A prospective study was conducted among 965 opiate drug users admitted to the pilot. Data on demographic characteristics, sexual behaviors, substance use behaviors (including heroin use), and blood-borne virus infection (HIV, hepatitis B, and hepatitis C) were collected at treatment initiation and then again at 3-, 6-, 9-, 12-, 18-, and 24-month intervals thereafter. RESULTS: Twenty-four months after treatment initiation, heroin use as measured by urine test or self-report had reduced from 100 % of participants at both sites to 14.6 % in Hai Phong and 22.9 % in HCMC. When adjusted for multiple factors in Generalized Estimating Equations (GEE) logistic regression modeling, independent predictors of continued heroin use after 24 months of MMT in HCMC were the following: poor methadone adherence (adjusted odds ratio (AOR) = 3.7, 95 % confidence interval (CI) 1.8-7.8); currently on antiretroviral treatment (ART) (AOR = 1.8, 95 % CI 1.4-2.4); currently on TB treatment (AOR = 2.2, 95 % CI 1.4-3.4); currently experiencing family conflict (AOR = 1.6, 95 % CI 1.1-2.4); and currently employed (AOR = 0.8, 95 % CI 0.6-1.0). For Hai Phong participants, predictors were the following: currently on ART (AOR = 2.0, 95 % CI = 1.4-3.0); currently experiencing family conflict (AOR = 2.0, 95 % CI = 1.0-3.9); and moderate adherence to methadone (AOR = 2.1, 95 % CI = 1.2-1.9). In Hai Phong, the percentage of participants who were employed had also increased by end of study from 35.0 to 52.8 %, while in HCMC the level remained relatively unchanged, between 52.2 and 55.1 %. DISCUSSION: Study findings were used in multiple fora to convince policymakers and the public on the significant and vital role MMT can play in reducing heroin use and improving quality of life for individuals and families. Four years after this study was completed, Vietnam had expanded MMT to 162 clinics in 44 provinces serving 32,000 patients.