RESUMO
Tobacco smoking is a leading cause of premature death. Smoking prevalence in Vietnam ranks among the highest in Southeast Asia. Given the important role of health care workers (HCWs) in promoting and supporting smoking cessation, this project aimed to characterize the prevalence of smoking among HCWs in Vietnam, and their attitudes toward smoking cessation interventions. A cross-sectional survey was conducted among care workers in four levels of the health system, within four provinces of Vietnam. Descriptive statistics evaluated participant attitudes, perception, behaviors, and knowledge about smoking. Multivariable logistic regression models evaluated risk factors for smoking. Among 3343 HCWs, 7.5% identified as current smokers, comprising 22.2% males and 0.5% of females. Males had substantially greater odds (adjusted odds ratio = 55.3; 95% confidence interval [29.0, 105.6] of identifying as current smokers compared with females. HCWs in urban settings had higher odds of identifying as smokers compared with rural workers (adjusted odds ratio = 1.72; 95% confidence interval [1.23, 2.24]. Strong support for smoking cessation policies and interventions were identified, even among staff who smoked. HCWs play an integral role in identifying smokers and supporting smoking cessation interventions for their patients. Efforts to support affordable smoking cessation interventions within health facilities are likely to contribute to a reduction in smoking prevalence in Vietnam.
Assuntos
Fumar , Fumar Tabaco , Estudos Transversais , Feminino , Instalações de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Humanos , Masculino , Fumar/epidemiologia , Inquéritos e Questionários , Vietnã/epidemiologiaRESUMO
OBJECTIVE: The aim of the study was to report the results of the International Nosocomial Infection Control Consortium (INICC) study conducted from May 2008 to March 2015. METHODS: A device-associated healthcare-acquired infection surveillance study in three adult intensive care units (ICUs) and 1 neonatal ICU from 4 hospitals in Vietnam using U.S. the Centers for Disease Control and Prevention's National Healthcare Safety Network (CDC/NHSN) definitions and criteria as well as INICC methods. RESULTS: We followed 1592 adult ICU patients for 12,580 bed-days and 845 neonatal ICU patients for 4907 bed-days. Central line-associated bloodstream infection (CLABSI) per 1000 central line-days rate was 9.8 in medical/surgical UCIs and 1.5 in the medical ICU. Ventilator-associated pneumonia (VAP) rate per 1000 mechanical ventilator-days was 13.4 in medical/surgical ICUs and 23.7 in the medical ICU. Catheter-associated urinary tract infection (CAUTI) rate per 1000 urinary catheter-days was 0.0 in medical/surgical ICUs and 5.3 in the medical ICU. While most device-associated healthcare-acquired infection rates were similar to INICC international rates (4.9 [CLABSI]; 16.5 [VAP]; 5.3 [CAUTI]), they were higher than CDC/NHSN rates (0.8 [CLABSI], 1.1 [VAP], and 1.3 [CAUTI]) for medical/surgical ICUs, with the exception of CAUTI rate for medical/surgical ICU and CLABSI rate for the medical ICU. Because of limited resources of our Vietnamese ICUs, cultures could not be taken as required by the CDC/NHSN criteria, and therefore, there was underreporting of CLABSI and CAUTI, influencing their rates. Most device utilization ratios and bacterial resistance percentages were higher than INICC and CDC/NHSN rates. CONCLUSIONS: Device-associated healthcare-acquired infection rates found in the ICUs of our study were higher than CDC/NHSN US rates, but similar to INICC international rates. It is necessary to build more capacity to conduct surveillance and prevention strategies.