The evaluation of anti-diphtheria toxoid antibodies in healthy population in Kon Tum, Vietnam: a population-based study.

Background: Despite diphtheria immunization are to apply an effective primary immunization in childhood and to maintain immunity throughout life. Cases of diphtheria have been reported in Viet Nam in recent years. The aim of this study was to evaluate the seroprevalence of IgG antibodies to diphtheria toxoid among healthy person population in Kon Tum, Viet Nam. Methods: Blood samples were obtained from 2225 healthy persons aged 2-98 years collected in 2019 and 2020. Samples were tested for diphtheria toxoid antibodies by commercial Anti-Diphtheria Toxoid IgG Enzyme-Linked Immunosorbent Assay (ELISA). Results: An antibody level of <0.01 IU/mL (susceptibility) was found in 802 (36.0%) of the 2225 subjects, 136 (6.1%) had antibody levels of 0.01-0.099 IU/mL (basic protection), and 1287 (57.8%) had antibody levels ≥0.1 IU/mL (full protection). The full protection level increased significantly in persons aged above 60 years with antibody levels of 70.6%. No significant difference in seroprotection prevalence was found according to gender, ethnicity, residence, education and occupation. The results also demonstrated that people with vaccination against diphtheria during past 10 years were found to have a high immunity (83.8%) compared to 54.8% (OR: 4.7; 95%CI: 3.8-6.5) and 60.7% (OR: 3.8; 95%CI: 2.6-5.7) in persons with no and unknown vaccination (p <0.0001). Conclusions: The level of anti-diphtheria toxoid antibodies among children and adults in Kon Tum was low. The high risk of diphtheria outbreaks may occur among individuals lacking basic immunity against diphtheria.

Patient Health Questionnaire (PHQ-9): A depression screening tool for people with epilepsy in Vietnam.

BACKGROUND: Depression is a common mental disorder in people with epilepsy. Depression has a negative impact on medical and surgical treatment of epilepsy thus affecting the quality of life. Despite its high prevalence, depression has been under-recognized and treated improperly. It may also lead to missed work, increased healthcare system utilization, and higher direct medical costs. OBJECTIVES: This study aimed to evaluate the accuracy of the Vietnamese Patient Health Questionnaire (PHQ-9) as a screening tool for depression in people with epilepsy. METHODS: This cross-sectional study was conducted prospectively at epilepsy clinic at Nguyen Tri Phuong hospital, Ho Chi Minh City, Viet Nam from December 2019 to March 2020. A total of 91 adult people with epilepsy were recruited. After completing the Vietnamese PHQ-9 questionnaires, each participant was interviewed in a structured clinical interview for DSM-5 (SCID-5) to establish a diagnosis of major depressive disorder. The diagnostic accuracy of the PHQ-9 was assessed using diagnostic efficiency statistics compared with the gold standard structured interview. RESULTS: The prevalence of major depression in this sample was 25.3%. The areas under receiver operating characteristic (ROC) curve index of PHQ-9 had an estimated value of 0.91. The PHQ-9 at a cutoff point of 8 had the great overall balance of sensitivity (87.0%) and specificity (82.4%). At the cutoff point of 10, PHQ-9 had a higher specificity of 94.1%, but a lower sensitivity of 78.0%. CONCLUSIONS: The Vietnamese version PHQ-9 is an efficient and valid screening tool for depression in people with epilepsy in clinic settings.

Exfiltration and infiltration effect on sewage flow and quality: a case study of Hue, Vietnam.

Sewage generated in Southeast Asia is typically characterized by small per-capita flow and low concentration. This study investigated the impacts of exfiltration (leaking-out) and infiltration (leaking-in) on sewage flow and quality in Hue, Vietnam. Sewage flow and quality were continuously monitored at the sewer outlet of a residential drainage area for 68 and 82 days during dry and rainy seasons, respectively. Infiltration was estimated based on the least sewage flow before morning. Lithium tracer tests were conducted to estimate the exfiltration ratio. The results indicated that sewage of the target sewer was weaker than the typical weak-strength sewage even on no-rain days of the dry season. Monitoring of electrical conductivity indicated that rainfall persistently decreased the sewage concentration for a maximum duration of 228 h. The estimated infiltration accounted for 11% and 62% of the total sewage inflow to the sewer during dry and rainy seasons, respectively. The tracer test indicated that exfiltration ratios during the dry and rainy seasons were 65.6% and 24.0%, respectively. As a result of developing the water balance, only 23% of the water supplied to the area reached the sewer outlet in the dry season, while 123% flowed in the rainy season. These results demonstrate that exfiltration decreased the sewage flow in the dry season, while infiltration significantly increased the sewage flow and decreased the sewage concentration in the rainy season. To the best of our knowledge, this is the first study to quantify the impacts of infiltration and exfiltration on sewage in Southeast Asia.

Intrinsic and extrinsic effects on the electrotoroidic switching in a ferroelectric notched nanodot by a homogeneous electric field.

The control of topological defects in ferroelectrics, in particular by a homogeneous electric field, has emerged as an active research direction. A polarization vortex, which is a fundamental topological defect formed in ferroelectric nanodots, has recently been demonstrated to be switchable by a homogeneous electric field through the control of the built-in electrical distribution using low-symmetry nanodots. Such electrotoroidic switching is investigated for nearly ideal systems, e.g., free-standing nanodots. However, the electrotoroidic switching may be impacted by several factors, for instance, the nanoscale effect of flexoelectricity (intrinsic effect), epitaxial strain and the frequency of the applied field (extrinsic effects). In the present study, the switching of the polarization vortex in a notched nanodot under a homogeneous electric field is investigated. The emphasis is put on a comparison between intrinsic and extrinsic effects on the vortex switching. The results show that the vortex switching takes place through alternate vortex-to-polar and polar-to-vortex transformations due to the appearance of the notch. Although the flexoelectricity breaks the symmetry of the polarization field in the notched nanodot during the polarization transformation and gives rise to an unusual behavior of the vortex core, which departs from the symmetry axis of the notched nanodot, this intrinsic effect plays a relatively insignificant role in the switching behavior of the polarization vortex. In comparison to the intrinsic effect, interestingly, the extrinsic effects strongly influence the vortex switching behavior. Specifically, the frequency of the applied electric field can alter both the shape of the toroidal hysteresis loop and the domain transformation process of the vortex switching. In addition, under substrate constraints, the magnitude of the coercive electric fields at which the vortex-to-polar and polar-to-vortex transformations occur linearly decreases with the increase of strain. The present study provides instructive information on the efficient control of a polarization vortex, which is dominated by extrinsic factors rather than intrinsic ones.

Molecular epidemiology analysis of enterovirus 71 strains isolated in Dak Lak, Vietnam, 2011-2016.

Human enterovirus 71 (EV71) is the major etiologic agent of hand, foot, and mouth disease (HFMD). EV71 outbreaks have been reported in Dak Lak in recent years, however, the genotypes/subgenotypes information and phylogeny of circulating EV71 strains are limited. The objectives of this study were to determine the genotypes/subgenotypes and investigate the phylogeny of EV71 isolates in Dak Lak over a 6-year period. Viruses were isolated from clinical samples from patients with HFMD. In total, 43 EV71 isolates circulated in Dak Lak during 2011-2016 were used for the phylogenetic analysis using complete VP1 gene. The phylogenetic analysis of the VP1 gene revealed that two major genotypes, B and C, were found. Among the 43 EV71 strains, 29 belonged to subgenotype C4, 2 belonged to subgenotype C5, and 12 belonged to subgenotype B5. Of these, the subgenotype C4 was predominant in 2011-2013 and this was later replaced by the subgenotype B5 in 2014. The subgenotype B5 was dominant between 2014 and 2015, and then C4 recirculated in 2016. Our study also indicated that the subgenotypes C4 and B5 emerged into Dak Lak were closely related to variants causing epidemics of HFMD in the southern and central region of Vietnam and Thailand. Sequence analysis showed that nine amino acid mutations were detected in the VP1 region. Our results identified two significant amino acid substitutions (D31N and E145G/Q) associated with enhancing EV71 virulence.

Fatal avian influenza A(H5N1) infection in a 36-week pregnant woman survived by her newborn in Sóc Trang Province, Vietnam, 2012.

BACKGROUND: Reports of pregnant women infected with avian influenza are rare. Studies showed that A/H5N1 virus can penetrate the placental barrier and infect the fetus. Of six documented cases, four died and two survivors had a spontaneous abortion. OBJECTIVES: We report a clinical, outcome and epidemiological characteristics of a 36-week pregnant woman infected with A/H5N1 and her newborn in Soc Trang province of Vietnam in 2012. METHODS: Epidemiological and laboratory investigations were conducted. Clinical manifestations, progress, treatment and outcome of the case-patient and her newborn were collected. Human tracheal aspirate, throat swab and serum specimens were tested for influenza A/H5N1, A/H3N1, A/H1N1pdm09 and B by real-time RT-PCR and genome sequencing. Poultry throat and rectal swabs were tested by PCR and virus isolation. RESULTS: Case-patient hospitalized with high fever and cough, and died after onset 6 days. She continuously slaughtered sick poultry 5 days before illness onset. Clinical manifestation showed rapid progressive severe pneumonia. Her tracheal aspirate sample was positive influenza A/H5N1 virus. Her new-born was delivered by caesarean section with low birth weight and early onset pneumonia, however fully recovered after 16 days treatment. Neonate's throat swabs and paired serum samples tested negative for influenza A/H5N1. Clade 1.1 A/H5N1 virus was detected in poultry samples, was same clade and highly homogenous with the virus was detected in the mother. CONCLUSIONS: This was the first documented a live birth from a pregnant woman infected with influenza A/H5N1 virus. Intensive studies are needed to better understand mother-to-child transmission of influenza A/H5N1 virus.

Synergistic effect of pressurized carbon dioxide and sodium hypochlorite on the inactivation of Enterococcus sp. in seawater.

This study investigated the effect of combined treatments using pressurized carbon dioxide (PCD) and sodium hypochlorite (NaOCl) on the inactivation of Enterococcus sp. in artificial seawater. Bacterial inactivation was conducted in a liquid-film-forming apparatus with various pressure conditions, CO2 supply rates, and chlorine dosages. Combined PCD/chlorine treatments resulted in greater disinfection efficiency than those for the two individual treatments. Synergy values were correlated with pressure and CO2 concentrations (p < 0.001). Combination of 0.9 MPa PCD (various CO2 supply rates: 25% CO2 + 75% N2, 50% CO2 + 50% N2, and 100% CO2) and chlorine (0.20 mg L-1) yielded average synergy values of 4.9, 5.2, and 4.4 log, respectively, within 3 min. Combined treatment with PCD (100% CO2, 0.3 MPa, and 20 °C) and chlorine (0.20-0.22 mg L-1) achieved an average synergy value of 4.6 log and complete inactivation (5.2-5.5 log reductions) of Enterococcus sp. within 4 min. In contrast, when the two individual treatments (PCD and chlorine) were used, only 3.7 and 1.8-2.3 log reductions, respectively, were achieved after 25 min. These findings suggest that the combined PCD/chlorine treatment has synergistic benefits and provides a promising method for the disinfection of ballast water.

Comparison of disinfection effect of pressurized gases of CO2, N2O, and N2 on Escherichia coli.

Based on the production of gas bubbles with the support of a liquid film-forming apparatus, a device inducing contact between gas and water was used to inactivate pathogens for water disinfection. In this study, the inactivation effect of CO2 against Escherichia coli was investigated and compared with the effects of N2O and N2 under the same pressure (0.3-0.9 MPa), initial concentration, and temperature. The optimum conditions were found to be 0.7 MPa and an exposure time of 25 min. Under identical treatment conditions, a greater than 5.0-log reduction in E. coli was achieved by CO2, while 3.3 log and 2.4 log reductions were observed when N2O and N2 were used, respectively. Observation under scanning electron microscopy and measurement of bacterial cell substances by UV-absorbance revealed greater cell rupture of E. coli following treatment with CO2 than when treatment was conducted using N2O, N2 and untreated water. The physical effects of the pump, acidified characteristics and the release of intracellular substances caused by CO2 were bactericidal mechanism of this process. Overall, the results of this study indicate that CO2 has the disinfection potential without undesired by-product forming.