Burden and causes of anemia in Vietnam: insights from the global burden of disease data.

BACKGROUND: Anemia is a significant global health issue, impacting 1.92 billion people and ranking as a leading cause of disability. It is marked by low hemoglobin levels, which hinder oxygen delivery to vital organs and result from causes such as nutritional deficiencies and chronic diseases. Despite some progress, anemia remains a major concern in Southeast Asia, including Vietnam. Although the country has reduced its anemia rates, the progress is insufficient to achieve the WHO's 2030 targets for anemia reduction among women of reproductive age. This study explores anemia trends and socio-economic determinants in Vietnam, with a focus on age and gender differences, to inform targeted interventions and policy development. METHODS: This study used the Global Burden of Diseases, Injuries, and Risk Factors (GBD) dataset to explore the burden of anemia and its causes in Vietnam from 1990 to 2021. The GBD study provides data on anemia prevalence and years lived with disability (YLD) by age, sex, and 37 causes across 204 countries and territories. Further, this study employed a regression model to examine how the anemia burden (i.e., prevalence rate and YLD rate) relates to socio-economic factors such as the Human Development Index (HDI), gender disparities in human development achievement, and gender-based inequalities in reproductive health, empowerment, and economic status in Vietnam over this period. RESULTS: In 1990, there were 16.30 million anemia cases in Vietnam, decreasing slightly to 16.05 million by 2021. Male prevalence dropped from 34.90 to 26.58%, while female prevalence increased from 65.10 to 73.42%. Iron deficiency was the main cause, affecting 68.35% of cases in 1990 and 68.84% in 2021, with 24.96% in males and 75.04% in females in 2021. While anemia has decreased among infants, young children, and adolescents due to improved healthcare, it has increased among middle-aged and older adults, especially females. Regression analysis shows that higher human development and gender equality reduce anemia prevalence and disability, whereas gender inequality worsens the issue. CONCLUSIONS: The study underscores that anemia remains a major health concern in Vietnam, marked by significant gender and age disparities. Despite a decrease in overall anemia rates and the effectiveness of specific interventions like iron-folic acid supplementation, females, particularly those of reproductive age and older adults, continue to face higher rates. Socio-economic improvements, including higher income and better human development, are linked to lower anemia rates, though the impact differs by gender. The persistent gender disparity and the shift in burden to older adults highlight the need for more comprehensive, gender-sensitive interventions. Future efforts should integrate nutritional support with broader socio-economic enhancements to effectively address anemia and improve public health in Vietnam.

Age-specific testosterone thresholds: reconsidering diagnostic criteria for hypogonadism across generations of Vietnamese men.

The definition and diagnosis of functional hypogonadism (FH) remains challenging due to the nonspecific nature of symptoms and the inconsistency in normal testosterone thresholds. We conducted this single-center cross-sectional study on medical records of men aged 18 and above undergoing annual health check-ups to evaluate the correlation of age and metabolic components with testosterone. A total of 5,374 healthy men were included in the analysis. Total testosterone levels peaked at 18 years and gradually declined to age 40, followed by a mild increase. Based on the American Urology Association guideline, age-specific cutoffs for low testosterone were 14.61 nmol/l, 12.74 nmol/l, 12.70 nmol/l, and 13.98 nmol/l for those under 30, 30-40, 40-50, and over 50 years old respectively. Triglyceride - Glucose index showed a consistent negative correlation with testosterone across all age groups. In conclusion, testosterone levels demonstrated an age-related decline in early adulthood but a potential increase thereafter among healthy Vietnamese men. Metabolic components, rather than aging, had a consistent negative correlation with testosterone. Age-specific cutoffs for low testosterone may improve the detection of functional hypogonadism.

Clinical profile and short-term outcomes of acute severe ulcerative colitis in Vietnam: insights from a resource-limited setting.

OBJECTIVE: Acute severe ulcerative colitis (ASUC) is a significant complication of ulcerative colitis, affecting roughly 25% of patients and increasing the risk of colectomy and hospital mortality. While intravenous steroids are a primary treatment, only 67% of patients respond, necessitating rescue therapy for non-responders. Data on ASUC in the Vietnamese population are scarce. This study aims to provide insights into the clinical characteristics and short-term outcomes of Vietnamese patients with ASUC. PATIENTS AND METHODS: We conducted a prospective case series on ASUC patients admitted to the University Medical Center in Ho Chi Minh City from January 2021 to June 2023. Steroid response was assessed using the Travis Oxford criteria. We evaluated clinical features, in-hospital steroid response rates, endoscopic remission, and colectomy rates 12 months post-hospitalization. RESULTS: Seventeen patients with a median age of 42 years (70.6% male) were included. The median time from symptom onset to diagnosis was six weeks, and 47.1% had a history of ulcerative colitis. Median CRP value was 75.8 mg/L, and 76.5% had fecal calprotectin concentrations above 800 µg/g. All patients had a Mayo endoscopic subscore of ≥2, with 12.5% showing deep ulcers. Eleven patients (64.7%) responded to in-hospital steroid treatment, while 6 (35.3%) required rescue therapy with infliximab or tofacitinib. After one year, 10 of 11 (90.1%) achieved mucosal healing, and no patients underwent colectomy. CONCLUSIONS: Corticosteroids remain the cornerstone for initial ASUC therapy, though many patients do not respond. Anti-TNF agents and tofacitinib show potential benefits for those unresponsive to steroids. This study highlights the effectiveness of corticosteroids and biologics in managing ASUC in Vietnam.

Human infection with Hymenolepis diminuta: case report of a child in rural Vietnam.

INTRODUCTION: Cases of human infection with Hymenolepis diminuta are very rare, and only a few hundred cases have been described. We report a rare case of H. diminuta infection in a 16-month-old boy living in a rural area of Bac Giang province, Vietnam. CASE PRESENTATION: The patient was admitted to the hospital with mild diarrhea, abdominal pain, and several tapeworm segments in his stool, and no other symptoms. The worm was identified as H. diminuta by morphological examination of eggs in a concentrated stool specimen and genetic sequencing of the 18S rRNA gene of the worm. The patient was successfully treated with single oral dose of praziquantel, and he fully recovered. CONCLUSIONS: This report presents a rare case of human infection with H. diminuta in Vietnam; and contributes to enhancing our understanding of the epidemiology, clinical manifestation, and treatment protocols of human hymenolepiasis.

Evaluation navigation controlled gate of aging spillway on cavitation damage.

BACKGROUND: High-speed flow of clean water or water with sediment released from aging spillways may cause abrasion and cavitation on the concrete surface gradually. The occurrence of irregularities on the concrete surface can exacerbate the erosion problem. Which might jeopardize the safety of dams constantly, hence the rehabilitation efforts become urgent tasks in dam safety projects. METHODS: This study employs a 3D Computational Fluid Dynamics (CFD) model to quantitatively analyze the cavitation risk on the aging concrete surface of the Chay 5 spillway in Ha Giang, Vietnam, under various operation scenarios. There are two standards used to measure cavitation: the cavitation index (σ) which indicates the danger due to the drop of pressure in rapid flow, and the new gasification index (ß) which takes into consideration the formation and collapse of bubbles behind asperities. RESULTS: Three extreme flood cases may not result in potential cavitation because both σ and ß exceed critical thresholds. Regarding the six controlled gate scenarios with normal water level, the σ profiles are approximated 1,0 showing a low likelihood of cavitation damage while the ß values are smaller than 0.8, indicating a considerable risk of cavitation. Besides, the opening height of 100 cm poses the greatest risk of creating severe cavitation erosion in the concave area and slope portion. The flip bucket experienced the most vulnerable cavitation when the opening height is 400 cm. In addition, an approach to spillway surface rehabilitation involving specialized mortars has been presented. CONCLUSION: For aging conveyance structure, gasification index (ß) takes into account irregularities surface, providing a more comprehensive assessment of the likelihood of cavitation damage than cavitation index (σ). After rehabilitation with anti-shrinkage high abrasion resistance mortar, the entire spillway surface is smooth. This allows for reducing the cavitation risk and improvement of life service thereof.

Methanotrophic Communities and Cultivation of Methanotrophs from Rice Paddy Fields Fertilized with Pig-livestock Biogas Digestive Effluent and Synthetic Fertilizer in the Vietnamese Mekong Delta.

Biogas digestive effluent (BDE) has been applied to rice fields in the Vietnamese Mekong Delta (VMD). However, limited information is available on the community composition and isolation of methanotrophs in these fields. Therefore, the present study aimed (i) to clarify the responses of the methanotrophic community in paddy fields fertilized with BDE or synthetic fertilizer (SF) and (ii) to isolate methanotrophs from these fields. Methanotrophic communities were detected in rhizospheric soil at the rice ripening stage throughout 2 cropping seasons, winter-spring (dry) and summer-autumn (wet). Methanotrophs were isolated from dry-season soil samples. Although the continued application of BDE markedly reduced net methane oxidation potential and the copy number of pmoA genes, a dissimilarity ordination ana-lysis revealed no significant difference in the methanotrophic community between BDE and SF fields (P=0.167). Eleven methanotrophic genera were identified in the methanotrophic community, and Methylosinus and Methylomicrobium were the most abundant, accounting for 32.3-36.7 and 45.7-47.3%, respectively. Type-I methanotrophs (69.4-73.7%) were more abundant than type-II methanotrophs (26.3-30.6%). Six methanotrophic strains belonging to 3 genera were successfully isolated, which included type I (Methylococcus sp. strain BE1 and Methylococcus sp. strain SF3) and type II (Methylocystis sp. strain BE2, Methylosinus sp. strain SF1, Methylosinus sp. strain SF2, and Methylosinus sp. strain SF4). This is the first study to examine the methanotrophic community structure in and isolate several methanotrophic strains from BDE-fertilized fields in VMD.

Vietnam Association of Gastroenterology consensus for the diagnosis and treatment of functional dyspepsia.

Abstract: Functional dyspepsia (FD) is a common disorder in clinical practice. It is necessary to rule out physical causes to diagnose this condition. However, the diagnosis is challenging particularly in resource-limited areas. The aim of this consensus is to update international and regional guidelines on the management of FD. The consensus panel included 32 experts from major Vietnamese universities and institutes. This consensus study was conducted using the Delphi method. The grade of recommendation and level of evidence were assessed using the Grading of Recommendations, Assessment, Development, and Evalua-tion system. The consensus level was defined as ≥80% for agreement on the proposed statements. The expert panel approved 14 statements after two rounds of voting, which were related to two sections: (1) diagnostic tests for FD and (2) treatment of FD. This consensus is expected to help physicians in identifying and managing FD appropriately in daily clinical practice and to contribute FD data to Asian regions.

Vietnamese people's behavior and future intention to purchase medicines and functional foods on the internet: a cross-sectional study.

This study investigated Vietnamese people's behavior and future intention to purchase medicines and functional foods online and their associated factors. From March to May 2023, a Google Form questionnaire was distributed via social networks and online platforms. Convenience and snowballing sampling methods were employed to recruit 1,305 Vietnamese people. In the past year, 50.3% of participants purchased at least one kind of medicine and/or functional foods online (medicines: 27.6%, functional foods: 45.1%). Among 656 buyers, nearly a third bought these products more than three times and only 5.9% felt dissatisfied with their previous experiences. This purchasing behavior was more prevalent among females, those married, having higher education levels, usually shopping online, having longer time of Internet use per day, and seeking health information on the Internet (p < 0.001). In addition, 77.5% of participants intended to purchase these products online in the future and 61.2% would introduce this kind of online purchase to other people. The purchase intention was significantly associated with the participants' previous experiences, area, contracting chronic diseases, and using the Internet for self-medication, while factors associated with the introducing intention included their education level, occupation, and previous experiences in online purchases (p < 0.001).

Health-related quality of life of people with depression: pre-post intervention compared with age-matched general population in Vietnam.

BACKGROUND: In Vietnam, there is a paucity of health-related quality of life (HRQoL) research on people with depression as well as a lack of evidence on supported self-management (SSM) intervention for depression on HRQoL. This study aimed to compare the HRQoL of people with depression and age-matched people in the Vietnamese population, evaluate the effects of Tele-SSM intervention on HRQoL, and examine the association between the changes in HRQoL score and mental health well-being (depression, anxiety, and stress). METHODS: This study was a pre- and post-study involving Vietnamese adults aged 18-64 who had depression symptoms (score ≥ 5 points in the PHQ-9). Participants (N = 58) completed Tele-SSM-a supported self-management intervention incorporating cognitive behavioral therapy and non-violent communication and using a task-shifting approach. To compare with the general population, we conducted a 1-to-1 matching by age with an EQ-5D-5L valuation study with a nationally representative sample of the Vietnamese general population. RESULTS: HRQoL was significantly impaired in people with depression compared to the age-matched general population. Regarding health profile, participants reported the most difficulties in usual activities, pain/discomfort, and anxiety/depression dimensions. Significant improvements were observed in HRQoL scores post-intervention compared to pre-intervention in both EQ-VAS scores (from 59.84 to 79.48) and utility scores (from 0.79 to 0.90). These results remained lower than the age-matched general population (EQ-VAS score = 83.28, utility score = 0.96). Depression was associated with lower HRQoL while controlling for stress, anxiety symptoms and sociodemographic characteristics. CONCLUSIONS: These results indicate that HRQoL is significantly impaired in people with depression and contribute to providing empirical evidence of Tele-SSM intervention in improving HRQoL. Further randomized controlled trials should be conducted to evaluate the effectiveness and cost-effectiveness of the Tele-SSM intervention.

Microplastic pollution in coastal surface seawater of Southern Vietnam.

Microplastics have recently emerged as a significant environmental concern due to their direct impacts on marine ecosystems. Vietnam, with its 3260-km coastline, faces an elevated risk of microplastic pollution due to various coastal anthropogenic activities. This study explored microplastic distribution in coastal surface seawater in the Southern Vietnam regions of Tien Giang, Can Gio, and Vung Tau. A total of 45 samples were collected in April, 2019, and the results showed that microplastics present at all sampling sites, with the abundance varying from 0.074 ± 0.109 pieces/m3 in Can Gio to 0.56 ± 0.35 pieces/m3 in Tien Giang. Estuarial sites showed higher abundances for all regions. Most microplastics were under 2.8 mm, fragmented, and primarily white or transparent. Polypropylene, polyethylene, and ethylene-vinyl acetate were the dominant polymers. This research indicates the urgency of further investigations to comprehensively understand the influence of wind patterns and other environmental factors on microplastic distribution.

Invasive Fungal Rhinosinusitis: The First Histopathological Study in Vietnam.

BACKGROUND: Invasive fungal rhinosinusitis (IRFS) is a rare but highly fatal disease. The two primary groups of pathogens, Mucorales and Aspergillus, require different treatments and have distinct prognoses. PURPOSE: This study aimed to analyze the histopathological features of IFRS. METHODS: We conducted a retrospective study involving 57 IFRS cases. Demographic and comorbid characteristics were obtained from clinical records. Two pathologists independently examined the histopathological features using H&E, PAS, and GMS-stained slides. Fungal groups were identified with PCR under the guidance of histopathology. RESULTS: The mean age of IFRS was 58.9 ± 13.4. The male-to-female ratio was 1.4:1. 100% of cases had diabetes comorbidity. Mucorales, Aspergillus, and other fungi were found in 61.4%, 33.3%, and 5.3% of cases, respectively. No Aspergillus and Mucorales co-infections were detected. Histopathology and PCR results were strongly concordant in classifying pathogens (Cohen's kappa = 84.2%, 95% CI 60.1% - 100%, p < 0.001). Mucormycosis exhibited higher rates of extensive necrosis and vascular invasion, and lower rates of pigment and spore presence than the non-Mucormycosis group (p < 0.001, p = 0.01, p = 0.02, p = 0.03, respectively). Extensive necrosis and vascular invasion were statistically significantly correlative (OR = 13.03, 95% CI 2.62-64.75, p = 0.002). CONCLUSIONS: IFRS predominantly affects older adults and males. Histopathology is a reliable method for differentiating between Mucorales and Aspergillus. When extensive necrosis is detected, it is critical to investigate for vascular invasion carefully. The vascular invasion, degree of necrosis, pigments, and spores are valuable factors for distinguishing fungal agents of IFRS.

Molecular phylogeny and cryptic morphology: A combined approach to taxonomic novelties in Polycarpaea (Caryophyllaceae) from Vietnam.

Three new species of Polycarpaea from Vietnam, Polycarpaea vanphongensis V.T. Tran, H.T. Truong & N.V. Binh, Polycarpaea chungana V.T. Tran, H.T. Truong & N.V. Binh, Polycarpaea phuquocensis V.T. Tran, H.T. Truong & N.V. Binh are described and illustrated based on evidence of molecular sequence data from two markers (ITS1-5.8S-ITS2 and rps16) and combined morphological characteristics. Polycarpaea vanphongensis is closely related to Polycarpaea gaudichaudi Gagnep., Polycarpaea arenaria (Lour.) Gagnep., Polycarpaea phuquocensis V.T. Tran, H.T. Truong & N.V. Binh but differs by its stem glabrous, leaf ovate to elliptic, glabrous, ovary oblong ovoid, base obtuse, apex attenuate, capsule oblong void, 3.8 mm long. Polycarpaea phuquocensis V.T. Tran, H.T. Truong & N.V. Binh differs from the three species mentioned above by its stem being densely villous, leaf spathulate, ciliate, ovary ovoid, base acute, apex obtuse, capsule ovoid, 1.2 mm long. Polycarpaea chungana V.T. Tran, H.T. Truong & N.V. Binh is most similar to Polycarpaea lignosa Gagnep., but differs in having leaf oblong or linear, sparse ciliate, sepal and petal apex deeply concaved or slightly bifid, ovary ovoid, ovoid, 0.8-1.0 mm long. Furthermore, the achievements of analysis using molecular data on the systematic positions of 7 other species are results that have not been in previous molecular analyses.

Determination of nutritional sufficiency ranges for pomelo (Citrus grandis Osbeck) grown on alluvial soils using DRIS.

Pomelo is an important tropical fruit with a high nutrient content and economic value in the Vietnamese Mekong Delta (VMD). The Diagnosis and Recommendation Integrated System (DRIS) helps determine the leaf nutrient status of various plants worldwide. However, the DRIS-based nutritional balance in pomelo leaves remains to be established. Therefore, in this study, we aimed to (i) construct the DRIS norms and indices for nutrients, including macronutrients (N, P, K, Ca, and Mg) and trace elements (Cu, Fe, Zn, and Mn) in pomelo leaves, and (ii) establish nutrient sufficiency value ranges for sustainable pomelo cultivation in the VMD. We collected 270 leaf samples at three stages of pomelo growth, i.e., flowering, fruit development, and postharvest, and calculated DRIS indices for various nutrients. The DRIS indices established for various nutrients in pomelo leaves were accurate and reliable, as indicated by the high coefficient of determination (R2 = 0.43-0.93, p < 0.05) between nutrient concentrations and their DRIS indices. We observed that pomelo leaves were deficient in N (IN = -6.82), P (IP = -24.0), and Fe (IFe = -0.40) at the flowering stage and most deficient in P (IP = -15.6), K (IK = -11.7), Fe (IFe = -0.50), and Mn (IMn = -2.31) at the fruit development stage. However, only N (IN = -2.64) and P (IP = -13.4) shortages were observed at the postharvest stage. Thus, in this study, we evaluated nutrient value ranges (deficient, balanced, and excess) in pomelo leaves at their different growth stages and established DRIS indices for various nutrients. The results contribute to our understanding of the nutritional status of pomelo leaves, which can help growers improve plant health for sustainable pomelo production.

The Role of Complementary Feeding Practices in Addressing the Double Burden of Malnutrition among Children Aged 6-23 Months: Insight from the Vietnamese General Nutrition Survey 2020.

Background/Objectives: Optimal infant and young child feeding (IYCF) practices are crucial to addressing the double burden of malnutrition (DBM), encompassing undernutrition (including micronutrient deficiencies) and overnutrition. This study examined the demographic and socioeconomic determinants of IYCF practices, and their impacts on the DBM among 2039 Vietnamese children aged 6-23 months from the General Nutrition Survey 2020. Methods: Thirteen IYCF indicators recommended by the WHO/UNICEF were evaluated. Associations between IYCF indicators and outcome variables were assessed using logistic regressions. Results: The prevalence of stunting, underweight, and overweight subjects was 10.9%, 5.6%, and 3.1%, respectively. Low serum zinc affected 56.7% of children, while 14.3% had low serum retinol, 31.2% had anemia, and 34.6% had iron deficiency (ID). Only 36.7% of children achieved minimum dietary diversity (MDD), and 29.0% achieved the minimum acceptable diet (MAD). Children from the younger age group (6-11 months), ethnic minorities, those living in rural/mountainous regions, and poorer wealth quintiles had reduced odds of meeting IYCF criteria, including MDD and MAD. Infants meeting MDD had reduced odds of stunting [adjusted odds ratio (95% confidence intervals): 0.61 (0.41, 0.92)], and ID [0.69 (0.54, 0.88)]. Children meeting MAD had reduced odds of anemia [0.72 (0.57, 0.91)], ID [0.66 (0.52, 0.84)], and low serum retinol [0.63 (0.41, 0.99)]. Continued breastfeeding (12-23 months) reduced the odds of being underweight [0.50 (0.27, 0.92)] and of having low serum zinc [0.70 (0.52, 0.96)]. Adequate minimum milk feeding frequency had increased odds of being overweight [3.33 (1.01, 11.09)]. Conclusions: Suboptimal IYCF practices were significant predictors of the DBM among Vietnamese children, with evident age-specific, geographical, and socioeconomic disparities.

Influence of Peanut Consumption on the Gut Microbiome: A Randomized Clinical Trial.

Background: Peanut consumption could impact cardiometabolic health through gut microbiota, a hypothesis that remains to be investigated. A randomized clinical trial in Vietnam evaluated whether peanut consumption alters gut microbiome communities. Methods: One hundred individuals were included and randomly assigned to the peanut intervention and control groups. A total of 51 participants were provided with and asked to consume 50 g of peanuts daily, while 49 controls maintained their usual dietary intake for 16 weeks. Stool samples were collected before and on the last day of the trial. After excluding 22 non-compliant participants and those who received antibiotic treatment, 35 participants from the intervention and 43 from the control were included in the analysis. Gut microbiota composition was measured by shotgun metagenomic sequencing. Associations of changes in gut microbial diversity with peanut intervention were evaluated via linear regression analysis. Linear mixed-effects models were used to analyze associations of composition, sub-community structure, and microbial metabolic pathways with peanut intervention. We also performed beta regression analysis to examine the impact of peanut intervention on the overall and individual stability of microbial taxa and metabolic pathways. All associations with false discovery rate (FDR)-corrected p-values of <0.1 were considered statistically significant. Results: No significant changes were found in α- and ß-diversities and overall gut microbial stability after peanut intervention. However, the peanut intervention led to lower enrichment of five phyla, five classes, two orders, twenty-four metabolic pathways, and six species-level sub-communities, with a dominant representation of Bifidobacterium pseudocatenulatum, Escherichia coli D, Holdemanella biformis, Ruminococcus D bicirculans, Roseburia inulinivorans, and MGYG-HGUT-00200 (p < 0.05 and FDR < 0.1). The peanut intervention led to the short-term stability of several species, such as Faecalibacterium prausnitzii F and H, and a metabolic pathway involved in nitrate reduction V (p < 0.05; FDR < 0.1), known for their potential roles in human health, especially cardiovascular health. Conclusions: In summary, a 16-week peanut intervention led to significant changes in gut microbial composition, species-level sub-communities, and the short-term stability of several bacteria, but not overall gut microbial diversity and stability. Further research with a larger sample size and a longer intervention period is needed to confirm these findings and investigate the direct impact of gut-microbiome-mediated health effects of peanut consumption. Trial registration: The International Traditional Medicine Clinical Trial Registry (ITMCTR). Registration number: ITMCTR2024000050. Retrospectively Registered 24 April 2024.

Active case finding to detect symptomatic and subclinical pulmonary tuberculosis disease: implementation of computer-aided detection for chest radiography in Viet Nam.

Objective: In Viet Nam, tuberculosis (TB) prevalence surveys revealed that approximately 98% of individuals with pulmonary TB have TB-presumptive abnormalities on chest radiographs, while 32% have no TB symptoms. This prompted the adoption of the "Double X" strategy, which combines chest radiographs and computer-aided detection with GeneXpert testing to screen for and diagnose TB among vulnerable populations. The aim of this study was to describe demographic, clinical and radiographic characteristics of symptomatic and asymptomatic Double X participants and to assess multilabel radiographic abnormalities on chest radiographs, interpreted by computer-aided detection software, as a possible tool for detecting TB-presumptive abnormalities, particularly for subclinical TB. Methods: Double X participants with TB-presumptive chest radiographs and/or TB symptoms and known risks were referred for confirmatory GeneXpert testing. The demographic and clinical characteristics of all Double X participants and the subset with confirmed TB were summarized. Univariate and multivariable logistic regression modelling was used to evaluate associations between participant characteristics and subclinical TB and between computer-aided detection multilabel radiographic abnormalities and TB. Results: From 2020 to 2022, 96 631 participants received chest radiographs, with 67 881 (70.2%) reporting no TB symptoms. Among 1144 individuals with Xpert-confirmed TB, 51.0% were subclinical. Subclinical TB prevalence was higher in older age groups, non-smokers, those previously treated for TB and the northern region. Among 11 computer-aided detection multilabel radiographic abnormalities, fibrosis was associated with higher odds of subclinical TB. Discussion: In Viet Nam, Double X community case finding detected pulmonary TB, including subclinical TB. Computer-aided detection software may have the potential to identify subclinical TB on chest radiographs by classifying multilabel radiographic abnormalities, but further research is needed.

Economic inequalities in adolescents' internalising symptoms: longitudinal evidence from eight countries.

BACKGROUND: Research, mainly conducted in Europe and North America, has shown an inequitable burden of internalising mental health problems among adolescents from poorer households. We investigated whether these mental health inequalities differ across a diverse range of countries and multiple measures of economic circumstances. METHODS: In this longitudinal observational cohort study, we analysed data from studies conducted in eight countries (Australia, Ethiopia, India, Mexico, Peru, South Africa, the UK, and Viet Nam) across five global regions. All studies had self-reported measures of internalising symptoms using a validated scale at two timepoints in adolescence; a measure of household income, household consumption expenditure, or subjective wealth; and data collected between 2000 and 2019. Household income (measured in four countries), consumption expenditure (six countries), and adolescents' subjective assessment of household wealth (five countries) were measured in mid-adolescence (14-17 years). The primary outcome (internalising symptoms, characterised by negative mood, affect, and anxiety) was measured later in adolescence between age 17 and 19 years. Analyses were linear regression models with adjustment. Effect estimates were added to random-effects meta-analyses to aid understanding of cross-country differences. FINDINGS: The overall pooled sample of eight studies featured 18 910 adolescents (9568 [50·6%] female and 9342 [49·4%] male). Household income had a small or null association with adolescents' internalising symptoms. Heterogeneity (I2 statistic) was 71·04%, falling to 39·71% after adjusting for baseline symptoms. Household consumption expenditure had a stronger association with internalising symptoms (decreases of 0·075 SD in Peru [95% CI -0·136 to -0·013], 0·034 SD in South Africa [-0·061 to -0·006], and 0·141 SD in Viet Nam [-0·202 to -0·081] as household consumption expenditure doubled). The I2 statistic was 74·24%, remaining similar at 74·83% after adjusting for baseline symptoms. Adolescents' subjective wealth was associated with internalising symptoms in four of the five countries where it was measured. The I2 statistic was 57·09% and remained similar after adjusting for baseline symptoms (53·25%). We found evidence for cross-country differences in economic inequalities in adolescents' internalising symptoms, most prominently for inequalities according to household consumption expenditure. Subjective wealth explained greater variance in symptoms compared with the objective measures. INTERPRETATION: Our study suggests that economic inequalities in adolescents' mental health are prevalent in many but not all countries and vary by the economic measure considered. Variation in the magnitude of inequalities suggests that the wider context within countries plays an important role in the development of these inequalities. FUNDING: Wellcome Trust.

The calls of Vietnamese bats: a major step toward the acoustic characterization of Asian bats.

Southeast Asia includes several global biodiversity hotspots and bats account for nearly one-third of mammal species currently known in the region. While acoustic methods have become widespread in bat research, basic information is often lacking on the echolocation calls produced by Asian bat species. Since such information can aid a wide variety of research and conservation initiatives, descriptions of the calls emitted by Asian bats are fundamental. The aim of our study was to provide a standardized analysis and description of the Vietnamese bat echolocation calls. We analyzed call recordings of 87 species arranged in eight families. This constitutes 74% of the echolocating bats presently known in Vietnam and includes the first call descriptions for five taxa. Our use of an open-source software and the deposition of recordings in the ChiroVox repository will facilitate comparative studies in Asia and the information we provide represents one of the most comprehensive bioacoustic databases for Asian bats to date.

Association between dietary factors and breast cancer risk: a matched case-control study in Vietnam.

BACKGROUND: The role of diet in breast cancer prevention is controversial and limited in low-middle-income countries (LMICs). This study aimed to investigate the association between different dietary factors and breast cancer risk in Vietnamese women. METHODS: Three hundred seventy newly histologically confirmed breast cancer cases and 370 controls matched by 5-year age from September 2019 to March 2020 in Ho Chi Minh City were recorded dietary intake using a validated food frequency questionnaire. Odds ratios (OR) and 95% confidence intervals (95% CI) were evaluated using conditional logistic regression and adjusted with potential confounders. RESULTS: Compared to the lowest quartile of intake, we found that the highest intake of vegetables, fruit, soybean products, coffee, and egg significantly decreased breast cancer risk, including dark green vegetables (OR 0.46, 95% CI 0.27-0.78, ptrend=0.022), legumes (OR 0.19, 95% CI 0.08-0.44, ptrend <0.001), starchy vegetables (OR 0.37, 95% CI 0.21-0.66, ptrend=0.003), other vegetables (OR 0.46, 95% CI 0.28-0.77, ptrend=0.106), fruits (OR 0.44, 95% CI 0.26-0.74, ptrend <0.001), soybean product (OR 0.45, 95% CI 0.24-0.86, ptrend=0.311), coffee (OR 0.47, 95% CI 0.23-0.95, ptrend 0.004), and egg (OR 0.4, 95% CI 0.23-0.71, ptrend=0.002). CONCLUSION: Greater consumption of vegetables, fruit, soybean products, coffee, and eggs is associated with a lower risk of breast cancer. This study provides evidence of breast cancer prevention by increasing the intake of these dietary groups, especially in LMICs.

Determinants of antibiotic prescribing in primary care in Vietnam: a qualitative study using the Theoretical Domains Framework.

BACKGROUND: To formulate effective strategies for antimicrobial stewardship (AMS) in primary care, it is crucial to gain a thorough understanding of factors influencing prescribers' behavior within the context. This qualitative study utilizes the Theoretical Domains Framework (TDF) to uncover these influential factors. METHODS: We conducted a qualitative study using in-depth interviews and focus group discussions with primary care workers in two provinces in rural Vietnam. Data analysis employed a combined inductive and deductive approach, with the deductive aspect grounded in the TDF. RESULTS: Thirty-eight doctors, doctor associates, and pharmacists participated in twenty-two interviews and two focus group discussions. We identified sixteen themes, directly mapping onto seven TDF domains: knowledge, skills, behavioral regulation, environmental context and resources, social influences, social/professional role and identity, and optimism. Factors driving unnecessary prescription of antibiotics include low awareness of antimicrobial resistance (AMR), diagnostic uncertainty, prescription-based reimbursement policy, inadequate medication supplies, insufficient financing, patients' perception of health insurance medication as an entitlement, and maintaining doctor-patient relationships. Potential factors facilitating AMS activities include time availability for in-person patient consultation, experience in health communication, and willingness to take action against AMR. CONCLUSION: Utilizing the TDF to systematically analyze and present behavioral determinants offers a structured foundation for designing impactful AMS interventions in primary care. The findings underscore the importance of not only enhancing knowledge and skills but also implementing environmental restructuring, regulation, and enablement measures to effectively tackle unnecessary antibiotic prescribing in this context.