Bronchial hyperresponsiveness is common in Hanoi, Vietnam: Asthma probably underdiagnosed.

BACKGROUND: Bronchial hyperresponsiveness (BHR) is a key pathophysiological feature of asthma. Methacholine challenge test (MCT) is a common bronchoprovocation test useful for confirming a diagnosis of asthma. Studies of BHR in the general population of Asian countries are rare. AIM: To estimate prevalence and determinants of BHR in Hanoi, Vietnam, and to study the association between BHR and symptoms common in asthma and previously diagnosed asthma. METHODS: 1500 out of 5872 randomly selected adults in urban and rural Hanoi, who had participated in a questionnaire survey (83% participated), were randomly selected and invited to clinical examinations. Totally 684 subjects (46%) participated. MCT was performed in 366 subjects. BHR was defined as a FEV1-decrease of ≥20% from baseline following methacholine inhalations (PC20). Cut offs used in the analyses were PC20 ≤ 1 mg/ml, ≤2 mg/ml and ≤8 mg/ml. RESULTS: The prevalence of BHR was 16.4% at doses ≤8 mg/ml, while 9.6% reacted on doses ≤2 mg/ml. PC20 ≤ 2 mg/ml was associated with FEV1 <80% of predicted. PC20 ≤ 2 mg/ml, but not PC20 ≤ 8 mg/ml, was associated with multi-sensitization to airborne allergens. BHR defined as PC20 ≤ 8 mg/ml was associated with age >45y. The combination of asthmatic wheeze (wheezing with breathlessness apart from colds) and BHR, irrespectively of magnitude of BHR, was more common than the combination of BHR with previously diagnosed asthma. CONCLUSIONS: The results indicate BHR to be more common in Hanoi than previously found in south-east Asia. Although the prevalence of physician diagnosed asthma has increased in Vietnam, our results indicate that asthma still may be underdiagnosed in Vietnam.

Attempted suicide in Hanoi, Vietnam.

BACKGROUND: Attempted suicide is a key predictor of suicide, which is among the dominant causes of young people's deaths worldwide. Very little is known about the characteristics of suicide attempters in Asia, especially in Vietnam. METHODS: Medical records of 509 patients (515 attempted-suicide events) admitted to Bach Mai General Hospital in Hanoi, Vietnam from 1 January 1999 to 30 April 2001 were analysed according to the criteria of the WHO Multicentre Study of Attempted Suicide. RESULTS: The suicide attempters' mean age was 28.3+/-12.9 years. Nearly half (48.7%) were aged 15-24. The female-to-male ratio of patients living in urban areas (2.1:1) was higher than in rural areas (1.2:1). In urban areas, students (32 %) and homeworkers (28%) and, in rural areas, farmers (56 %) and students (17%) were the salient occupational categories. Acute life stressors were the main causes (73.8%) of suicide attempts. Only in some 6% of cases had a psychiatric illness been diagnosed before the suicide attempts. As a means of attempting suicide, intoxication with analgesics and antipyretics (e. g. paracetamol) with low medical lethality scores was a frequent method among the urban patients, the majority of whom (81%) consequently stayed in hospital less than 24 h. Pesticide and rat poison, more commonly (57.2%) used by attempters in rural areas, had higher medical lethality scores and also necessitated more prolonged hospital treatment. CONCLUSIONS: Some suicide-preventive strategies used in the West for young people may be applicable in Vietnam. Reducing access to pesticides and rat poison is comparable to western efforts to make paracetamol or firearms less freely available. Skills in resolving family and other conflicts can be taught in schools according to WHO's suicide-prevention resources for teachers.