Economic assessment of an intervention strategy to reduce antimicrobial usage in small-scale chicken farms in Vietnam.

Antimicrobials are a core aspect of most livestock production systems, especially in low-and middle-income countries. They underpin the efficient use of scarce feed resources and stabilize returns on capital and labor inputs. Antimicrobial use (AMU) contributes to the production of healthy animals, yet AMU in livestock is linked to antimicrobial resistance (AMR) in animals, humans and the environment. The Vietnamese Platform for Antimicrobial Reduction in Chicken Production was implemented during 2016-2019 and was one of Southeast Asia's first interventions focused on AMU reductions in livestock production. The project targeted small-scale commercial poultry farms in the Mekong Delta region of Vietnam using a "randomized before-and-after controlled" study design. It provided farmers with a locally adapted support service (farmer training plan, advisory visits, biosecurity, and antimicrobial replacement products) to help them reduce their reliance on antimicrobials. A partial budget analysis was performed comparing the control group (status-quo) and intervention group (alternative). The median net farm-level benefit of the intervention strategies with the project's support was VND 6.78 million (interquartile range (IR) VND -71.9-89 million) per farm. Without project support the benefit was reduced to VND 5.1 million (IR VND -69.1-87.2 million) to VND 5.3 million (IR -VND 68.9-87.5 million) depending on the antimicrobial alternative product used. At the project level with a focus on AMU and its reduction, subsequently influence on the resistance reduction, our results showed that achieving resistance reduction benefits with the current knowledge and technologies required investment of at least VND 9.1 million (US$ 395.10) per farm during the project's lifetime. The results highlight the positive net profit for the majority of enrolled farms and a reasonable investments from the project. The recommendation focuses on the implementation of policies on financial support, legislation, and information as potential solutions to facilitate the application of intervention strategies to reduce AMU in poultry production.

Genetic analysis of ORF5 porcine reproductive and respiratory syndrome virus isolated in Vietnam.

Porcine reproductive and respiratory syndrome virus (PRRSV) is one of the most economically important swine pathogens because it is highly infectious and causes economic losses due to decreased pig productivity. In this study, the 603 bp complete major envelope protein encoding gene (ORF5) of 32 field PRRSV isolates from Vietnam collected during 2008-2012 were sequenced and analyzed. Multiple nucleotide (nt) and deduced amino acid (aa) alignments of ORF5 were performed on the 32 isolates: the representative strains (European and North American genotypes), Chinese strains available in GenBank and vaccine strains licensed for use in Vietnam. The results showed 94.8-100.0% nt identity and 94.0-100% aa similarity among the 32 isolates. These isolates shared similarities with the prototype of the North American PRRSV strain (VR-2332; nt 87.8-89.3%, aa 87.5-90.0%), and Lelystat virus, the prototype of the European PRRSV strain (LV; nt 61.1-61.9%, aa 55.1-57.0%). There was greater similarity with QN07 (nt 96.5-98.5%, aa 96.0-99.0%) from the 2007 PRRS outbreak in QuangNam Province, CH-1a (nt 93.2-95.1%, 91.5-93.5%) isolated in China in 1995 and JXA1 (nt 96.5-98.6%, aa 95.0-98.0%), the highly pathogenic strain from China isolated in 2006. The Vietnamese isolates were more similar to JXA1-R (nt 96.5-98.6%, aa 95.0-98.0%), the strain used in Chinese vaccines, than to Ingelvac MLV/BSL-PS (nt 87.2-89.0%, aa 86.0-89.0%). Phylogenetic analysis showed that the 32 isolates were of the North American genotype and classified into sub-lineage 8.7. This sub-lineage contains highly pathogenic Chinese PRRSV strains. This study documents genetic variation in circulating PRRSV strains and could assist more effective use of PRRS vaccines in Vietnam.

Characterisation of chicken farms in Vietnam: A typology of antimicrobial use among different production systems.

The usage of antimicrobials in livestock production is a driver for antimicrobial resistance worldwide. Reducing the use of antibiotics in the animal sector is a priority and requires a change in practices. Vietnam has diverse husbandry and antimicrobial use practices. The objective of this study was to determine the socio-economic and technical factors associated with antibiotic usage patterns on chicken farms in the north and south of Vietnam. Semi-structured interviews (n = 34) and on-farm questionnaires (n = 125) were conducted to collect socio-economic, technical, biosecurity, health management, and antibiotic usage data. Using Multivariate Corresponding Analysis, we identified three production systems (A, B, C) and three patterns of antibiotic usage (1, 2, 3). Group A raised indoor exotic chickens in an intensive setting and was associated with group 1, which used antibiotics according to company recommendations for both treatment and prevention. Group C raised free-range chickens for their own consumption and was associated with group 2, which used antibiotics according to drugstore advice for treatment. Finally, group B was a market-oriented, semi-confined system associated with group 3, which practiced experience-based antibiotic use and overuse. Farms in the south of Vietnam were associated with group 3 and those in the north with group 2. The prediction of antibiotic usage patterns based on farming practices could lead to the identification of a group of farms to be targeted in order to foster the more prudent use of antibiotics in Vietnam.

The Association of Family Support and Health Education with the Status of Overweight and Obesity in Patients with Type 2 Diabetes Receiving Outpatient Treatment: Evidence from a Hospital in Vietnam.

This study aims to establish the association of family support and nutrition and health education by health workers with the status of overweight and obesity among patients with type 2 diabetes mellitus (T2DM) receiving outpatient treatment at a hospital. This descriptive cross-sectional study was conducted on 280 outpatients with type 2 diabetes at Bach Mai hospital from December 2019 to September 2020 by using assessments of anthropometric parameters and examining dietary habits and family support, as well as nutrition and health education and counseling by health workers. The prevalence of overweight and obesity in patients with T2DM was 35.4% (51.2% in men and 22.2% in women; P < .05). Patients never or rarely supported by their families or counseled by health workers were more vulnerable to overweight and obesity than those who frequently received support and counseling (OR = 1.41 vs 2.06; P < .05). Family support and counseling from health workers play a crucial role in promoting and sustaining healthy dietary habits and proper physical exercise in diabetic patients, contributing to their lowered risk of overweight and obesity.

How dietary intake of type 2 diabetes mellitus outpatients affects their fasting blood glucose levels?

OBJECTIVE: The study aims to explore the association between the adherence to dietary recommendations among type 2 diabetes mellitus (T2DM) patients with their fasting blood glucose levels. METHOD: This is a cross-sectional anthropometric and dietary study conducted on 169 T2DM patients receiving outpatient treatment at the Central Nursing and Rehabilitation Hospital in Thanh Hoa provincial hospital in Vietnam in 2018. RESULTS: The rate of patients who had good fasting glycemic control was still low (30.8%). Their diets were poor in energy and unbalanced; the contribution of carbohydrates to the total dietary intake was high (68.2%), and only 24.9% of patients consumed 4-6 meals/day. There was a statistically significant association between the dietary intake with carbohydrate dietary intake containing ≥60% carbohydrate and the number of meals per day (<4 meals) with their fasting blood glucose levels (OR = 4.964, p < 0.05 and OR = 16.508; p < 0.01, respectively). CONCLUSIONS AND RECOMMENDATIONS: Hospital staff are advised to combine treatment with dietary counseling to help patients controlling their weights and glycemic levels more efficient, thereby contributing to improving their treatment outcomes.

Is obesity associated with decreased health-related quality of life in school-age children?-Results from a survey in Vietnam.

BACKGROUND: Overweight and obesity have short-term and long-term effects on children's physical and mental health. These conditions currently have a tendency to increase among Vietnamese school children. AIMS: This study aimed to assess the quality of life among 8-10 year-old children in Vietnam. METHODS: This cross-sectional study was conducted with a sample of 264 children aged 8-10 years (including 88 obese children and 176 normal-weight ones) at two primary schools in Hanoi, Vietnam, in 2018 and their mothers or fathers participated in this study. The Vietnamese version of the Pediatric Quality of Life Inventory (PedsQL) 4.0 generic score scales were used to collect information from children and their parents about the children's quality-of-life. Mean and standard deviation of PedsQL scores were calculated. Independent t-test was used to compare mean scores between normal-weight and obese children. RESULTS: Both child self reports and parent-proxy reports revealed that obese children had significantly lower scores for the total scales compared to normal weight children (80.7 versus 84.0; p < 0.05 for proxy reports and 77.6 vs 84.6; p < 0.001 for self reports). Total scale and subscale scores reported by parents were lower compared to those reported by children. Besides, 79% of normal weight children reported having PedsQL total scores in the highest quartile (≥75%), compared to 56.8 % of obese children (p = 0.01). Similarly, these proportions for parent-proxy reports were 79.5% and 65.9%, respectively (p < 0.05). Emotional scores were both found the lowest among the four subscales (71.6 for child self reports and 73.1 for parent-proxy reports). RECOMMENDATIONS: Interventions aimed to improve quality of life of overweight and obese children in Vietnam should not focus only on diet adjustment and physical exercise but need to address all dimensions of health-related quality of life, especially emotional, social and school functioning.

Knowledge, Attitude, Frequency and Level of Consumption Regarding Non-alcoholic Carbonated Soft Drinks among Students from Two High Schools in Hanoi, Vietnam in 2015.

OBJECTIVE: This article aims to describe the knowledge, attitude, frequency and level of consumption regarding non-alcoholic carbonated soft drinks (NCSD) among students from two high schools in Hanoi. MATERIALS AND METHODS: A cross-sectional survey including a semi-quantitative food frequency were conducted with 620 students from two high schools, one in the urban area and the other in the rural area of Hanoi city. RESULTS: Data on knowledge of health risk associated with the consumption of NCSD showed neagtive results (only 11.9% of the students were able to identify all the contents of NCSD correctly, and 2.7% knew all eight health risks due to consumption of NCSD). Besides, 31.4% of all students did not have the intention to quit NCSD despite being aware of health risks associated with the consumption of NCSD. Students who reported consuming NCSD within one month prior to the study constituted 83.1%, and those who consumed NCSD 1-2 times/week accounted for the highest proportion, being 21.3%. On average, each student consumed 2,094 ml NCSD within one month prior to the study. Suburban students and male students consumed more than urban and female ones, respectively (p < 0.01). RECOMMENDATIONS: Students should be equipped with information about NCSD related health risks and encouraged to consume less NCSD.