Investigation of Urinary Metabolites of Organophosphate Esters in Hanoi, Vietnam: Assessment Exposure and Estimated Daily Intake.

In recent years, organophosphate esters (OPEs) have become one of the most common additives in various consumer products worldwide, therefore the exposure and impact of OPEs on human health are drawing a lot of attention. In this study, three metabolites of OPEs including bis(1,3-dichloro-2-propyl) phosphate (BDCIPP), diphenyl phosphate (DPhP) and diethyl phosphate (DEP) were investigated in first-morning void urine samples taken from a population (age range: 3-76 years old) in Hanoi, Vietnam. The most dominant urinary OPE metabolite was DEP with the geometric mean of specific gravity adjust (SG-adjusted) concentration were 1960 ng mL-1 and detected frequency (DF) of 98%. Followed by DPhP (8.01 ng mL-1, DF: 100%) and BDCIPP (2.18 ng mL-1, DF: 51%). The results indicated that gender and age might have associations with the OPE metabolites variation in urine samples. The levels of OPE metabolites in urine samples from females were slightly higher than in males. An increase in age seems to have an association with a decrease in DPhP levels in urine. Exposure doses of parent OPEs were evaluated from the unadjusted urinary concentration of corresponding OPE metabolite. The estimated exposure doses of triethyl phosphate (TEP) (mean: 534,000 ng kg-1 d-1) were significantly higher than its corresponding reference dose, suggesting the high potential risk from the current exposure doses of TEP to human health. The results of this work provided the initial information on the occurrence of three OPE metabolites in urine from Hanoi, Vietnam and estimated exposure dose of corresponding parent OPEs.

Occurrence and ecological risk assessment of organophosphate esters in surface water from rivers and lakes in urban Hanoi, Vietnam.

In this study, an investigation on the pollution status, distribution, and ecological risk to the aquatic organisms of six organophosphate tri-esters (tri-OPEs) and two organophosphate tri-esters (di-OPEs) in surface water in urban Hanoi, Vietnam were conducted. In 37 surveyed water samples (6 rivers and 17 lakes), all eight targeted OPEs were discovered with a detection frequency (DF) of 41-100% and the concentration varied largely from below the method detection limit (

A comparative impact evaluation of two human resource models for community-based active tuberculosis case finding in Ho Chi Minh City, Viet Nam.

BACKGROUND: To achieve the WHO End TB Strategy targets, it is necessary to detect and treat more people with active TB early. Scale-up of active case finding (ACF) may be one strategy to achieve that goal. Given human resource constraints in the health systems of most high TB burden countries, volunteer community health workers (CHW) have been widely used to economically scale up TB ACF. However, more evidence is needed on the most cost-effective compensation models for these CHWs and their potential impact on case finding to inform optimal scale-up policies. METHODS: We conducted a two-year, controlled intervention study in 12 districts of Ho Chi Minh City, Viet Nam. We engaged CHWs as salaried employees (3 districts) or incentivized volunteers (3 districts) to conduct ACF among contacts of people with TB and urban priority groups. Eligible persons were asked to attend health services for radiographic screening and rapid molecular diagnosis or smear microscopy. Individuals diagnosed with TB were linked to appropriate care. Six districts providing routine NTP care served as control area. We evaluated additional cases notified and conducted comparative interrupted time series (ITS) analyses to assess the impact of ACF by human resource model on TB case notifications. RESULTS: We verbally screened 321,020 persons in the community, of whom 70,439 were eligible for testing and 1138 of them started TB treatment. ACF activities resulted in a + 15.9% [95% CI: + 15.0%, + 16.7%] rise in All Forms TB notifications in the intervention areas compared to control areas. The ITS analyses detected significant positive post-intervention trend differences in All Forms TB notification rates between the intervention and control areas (p = 0.001), as well as between the employee and volunteer human resource models (p = 0.021). CONCLUSIONS: Both salaried and volunteer CHW human resource models demonstrated additionality in case notifications compared to routine case finding by the government TB program. The salaried employee CHW model achieved a greater impact on notifications and should be prioritized for scale-up, given sufficient resources.

Tuberculosis among economic migrants: a cross-sectional study of the risk of poor treatment outcomes and impact of a treatment adherence intervention among temporary residents in an urban district in Ho Chi Minh City, Viet Nam.

BACKGROUND: Tuberculosis (TB) remains a major cause of avoidable deaths. Economic migrants represent a vulnerable population due to their exposure to medical and social risk factors. These factors expose them to higher risks for TB incidence and poor treatment outcomes. METHODS: This cross-sectional study evaluated WHO-defined TB treatment outcomes among economic migrants in an urban district of Ho Chi Minh City, Viet Nam. We measured the association of a patient's government-defined residency status with treatment success and loss to follow-up categories at baseline and performed a comparative interrupted time series (ITS) analysis to assess the impact of community-based adherence support on treatment outcomes. Key measures of interest of the ITS were the differences in step change (ß6) and post-intervention trend (ß7). RESULTS: Short-term, inter-province migrants experienced lower treatment success (aRR = 0.95 [95% CI: 0.92-0.99], p = 0.010) and higher loss to follow-up (aOR = 1.98 [95% CI: 1.44-2.72], p < 0.001) than permanent residents. Intra-province migrants were similarly more likely to be lost to follow-up (aOR = 1.86 [95% CI: 1.03-3.36], p = 0.041). There was evidence that patients > 55 years of age (aRR = 0.93 [95% CI: 0.89-0.96], p < 0.001), relapse patients (aRR = 0.89 [95% CI: 0.84-0.94], p < 0.001), and retreatment patients (aRR = 0.62 [95% CI: 0.52-0.75], p < 0.001) had lower treatment success rates. TB/HIV co-infection was also associated with lower treatment success (aRR = 0.77 [95% CI: 0.73-0.82], p < 0.001) and higher loss to follow-up (aOR = 2.18 [95% CI: 1.55-3.06], p < 0.001). The provision of treatment adherence support increased treatment success (IRR(ß6) = 1.07 [95% CI: 1.00, 1.15], p = 0.041) and reduced loss to follow-up (IRR(ß6) = 0.17 [95% CI: 0.04, 0.69], p = 0.013) in the intervention districts. Loss to follow-up continued to decline throughout the post-implementation period (IRR(ß7) = 0.90 [95% CI: 0.83, 0.98], p = 0.019). CONCLUSIONS: Economic migrants, particularly those crossing provincial borders, have higher risk of poor treatment outcomes and should be prioritized for tailored adherence support. In light of accelerating urbanization in many regions of Asia, implementation trials are needed to inform evidence-based design of strategies for this vulnerable population.

Target screening analysis of 970 semi-volatile organic compounds adsorbed on atmospheric particulate matter in Hanoi, Vietnam.

Vietnam's rapid economic development has resulted in dramatic increases in construction and the number of transportation vehicles. There is now growing public concern regarding increasing air pollution, especially in big cities; however, little information is available on air quality, particularly regarding semi-volatile organic compounds (SVOCs) adsorbed on atmospheric particulate matter. Here, we determined the frequency and concentrations of 970 SVOCs in 48 air particle samples collected by means of high-volume air sampling in Hanoi, Vietnam, by using a target screening method and a gas chromatography-mass spectrometry database. A total of 118 compounds (12.2% of the target compounds) were detected at least once in the samples, and the number of chemicals detected in each sample ranged from 85 to 103 (median, 92). For samples collected near a heavily trafficked road, the concentrations of target compounds in the samples were higher in samples collected during the day than in those collected at night, whereas the opposite was true for samples collected in a highly populated residential area with industrial activities related to the production of fresh noodles. Sixteen PAHs were detected at high concentrations in nearly 100% of the samples. Eighteen pesticides were detected, with permethrin being detected the most frequently (>70% samples), which can be explained by the use of permethrin-based Permecide 50 EC for dengue fever control during the sampling period. Endocrine-disrupting chemicals (i.e., bisphenol A, 4-nitrophenol) and pharmaceuticals and personal care products (diethyltoluamide, caffeine) were detected in over 90% of the samples. Seven sterols, five phthalate compounds and five organophosphorus flame retardants were detected in the samples. This is the first comprehensive survey of SVOCs adsorbed on atmospheric particulate matter in Vietnam, and as such, this study provides important new information about the frequency and concentrations of atmospheric SVOC contamination. The variety of chemicals detected in this study implies an abundance of pollution sources; further investigations to determine these pollution sources and the risks posed by the detected SVOCs to human health are warranted.