Spatial and temporal-trend assessment of desertification-sensitive land using the desertification sensitivity index in the provincial Ninh Thuan, Vietnam.

Desertification is a specific land-degrading process, reducing soil productivity and potentially threatening global food security. Therefore, spatially and temporally identifying and mapping desertification-sensitive areas is essential for better management. The current study aimed to (1) assess spatial areas sensitive to desertification and (2) examine the changing tendency of the desertification-sensitive areas over the past 25 years in the provincial Ninh Thuan. The desertification sensitivity index (DSI) was computed based on the Medalus model using 10 quantitative parameters, grouped into the soil, climate, and vegetation quality indexes, computed for the years 1996, 2005, 2010, and 2016. GIS was used to map desertification-sensitive areas associated with five DSI classes. Results showed that classes II and III had the highest area percentage, followed by classes IV and V, and class I. The classes most sensitive to desertification (classes IV and V) covered around 13 to 17%, and classes II and III were 25 to 32% of the total study area, respectively. The coastal areas located in the southeastern parts were more sensitive to desertification than the other parts. Over the four examined periods, the areas of classes IV and V increased while those of classes II and I decreased. These indicated that the study province tended to increase in its desertification sensitivity with a severe increase in the coastal areas over the past 25 years. The key factors involved in these changes could be related the human activities and climate variation, which could be more serious in southeastern areas than in the other areas.

Care needs assessment of older adults with dementia in a semi-rural district in Vietnam: A community-based cross-sectional study.

BACKGROUND: The increasing needs of people living with dementia (PLWD) in Vietnam present an enormous public health challenge. Vietnam is an understudied country, and little is known regarding the overall unmet needs of caregivers or the demographic risk factors associated with unmet caregiving needs. This study aimed to determine the burden of unmet care needs of community-dwelling PLWD and identify sociodemographic risks associated with unmet care needs. METHODS: A cross-sectional study in a rural area facing urbanisation in Hanoi, Vietnam recruited PWLD-caregiver dyads with multistage sampling. We utilised the Camberwell Assessment of Need for the Elderly (CANE) instrument to evaluate care needs across four domains. Caregivers rated PLWD needs, with higher scores indicating greater unmet needs. The Mann-Whitney test was employed for comparing two groups, while the Kruskal-Wallis test was used for comparisons involving more than two groups in the analysis, and a P-value of less than 0.05 was considered statistically significant. RESULTS: Among 90 PLWD participating in the study, the overall mean care needs score was 11.6 ± 4.3, with only 16.2% of PLWD having their care needs met. Environmental and physical needs were more frequently met than psychological or social needs. Only 48.0% and 43.9% of environmental and physical needs were met respectively, and a meagre 20.9% and 23.6% for psychological and social needs. Unmet care needs were more frequent for PWLD who were female, single or divorced, had lower monthly household income, or who were in more advanced stages of dementia, as indicated by Clinical Dementia Rating scores ≥1. CONCLUSIONS: Unmet needs for PWLD are common. Increased caregiver education, resources, and services in Vietnam are urgently required to improve the quality of life for this population.

Heavy metal pollution in surface water bodies in provincial Khanh Hoa, Vietnam: Pollution and human health risk assessment, source quantification, and implications for sustainable management and development.

The global issue of heavy metal pollution in surface water poses a significant concern, with the potential to harm public health through various pathways. Given that pollution levels are dependent on water bodies and seasons and their potential impacts on human health vary with children and adults, it is crucial to identify and quantify pollution sources for the development of sustainable management strategies. The current study aimed to evaluate pollution levels and associated health risks of heavy metals and to quantify their pollution sources in various surface water bodies in Khanh Hoa, Vietnam. Water samples were taken from three water bodies (reservoirs, rivers, and narrow waterways) during two seasons (dry and rainy) from 2016 to 2020 and analyzed for seven heavy metals. The results showed that iron had the highest concentration of 392.4 (µg L-1), followed by zinc (25.7 µg L-1), arsenic (3.93 µg L-1), copper (3.77 µg L-1), lead (2.77 µg L-1), chromium (2.71 µg L-1), and cadmium (0.57 µg L-1). Narrow waterways were more polluted with heavy metals (heavy metal pollution index, HPI = 29.5) than other water bodies, such as rivers (23.3) and reservoirs (21.7), and the dry season had a higher HPI (26.5) than the rainy season (24.0). The hazard index for children varied from 1.2 to 1.48, while that for adults was less than 1, suggesting that surface water may have adverse impacts on children's health. The factor analysis identified three primary sources of contamination, namely combustion emissions/street dust, agricultural run-off, and other sources. Cadmium is the most critical metal in determining HPI, while arsenic and chromium are the two key elements potentially influencing children's health. Managing pollution sources, reducing the metal concentration, and controlling the pathways through which metals enter the human body should be implemented for a healthier environment and long-term development.

Assessment of HIV viral load monitoring in remote settings in Vietnam - comparing people who inject drugs to the other patients.

INTRODUCTION: Increasing access to viral load (VL) monitoring is essential to fight HIV epidemics. In remote settings in Vietnam, using dried blood spot (DBS) sampling for specimen collection could improve the situation. Here, people who inject drugs (PWID) represent many newly antiretroviral therapy (ART)-initiated patients. The goals of this evaluation were to evaluate if access to VL monitoring and the rate of virological failure differed between PWID and non-PWID. METHODS: Prospective cohort study of patients newly initiated on ART in remote settings in Vietnam. DBS coverage at 6, 12 and 24 months of ART was investigated. Factors associated with DBS coverage were identified through logistic regression, as were factors associated with virological failure (VL ≥1,000 copies/mL) at 6, 12 and 24 months of ART. RESULTS: Overall 578 patients were enrolled in the cohort, of whom 261 (45%) were PWID. DBS coverage improved from 74.7% to 82.9% between 6 and 24 months of ART (p = 0.001). PWID status was not associated with DBS coverage (p = 0.74), but DBS coverage was lower in patients who were late to clinical visits and in those in WHO stage 4 (p = 0.023 and p = 0.001, respectively). The virological failure rate decreased from 15.8% to 6.6% between 6 and 24 months of ART (p<0.001). In multivariate analysis, PWID were more at risk of failure (p = 0.001), as were patients who were late to clinical visits (p<0.001) and not fully adherent (p<0.001). CONCLUSIONS: Despite training and simple procedures, DBS coverage was not perfect. DBS coverage was not associated with PWID status. Close management is required for effective routine HIV VL monitoring. PWID were more at risk of failure, as were patients who were not fully adherent and patients who were late to clinical visits. Specific interventions targeting these patients are needed to improve their outcomes. Overall, efforts in coordination and communication are essential to improve global HIV care. TRIAL REGISTRATION: Clinical Trial Number: NCT03249493.

Assessment of groundwater quality based on principal component analysis and pollution source-based examination: a case study in Ho Chi Minh City, Vietnam.

The current study aimed to assess the quality of apportion pollution sources and examine the impacts of anthropogenic activities on groundwater. The study was implemented in two sequential steps of (1) bulk examination of groundwater quality followed by principal component analysis/factor analysis (PCA/FA) to apportion pollution sources and (2) pollution source-based examination to assess the effects of anthropogenic activities. Well-water samples were taken in Ho Chi Minh City, Vietnam, in 2015 (233 samples) and 2019 (20 samples) and analyzed for 8 and 15 water quality parameters, respectively. The results showed that 99% of studied wells had pH value lower than the permissible limit, and 29, 20, 15, and 14% of studied wells had concentrations of Fe, NH4+, COD (chemical oxygen demand), and coliform, respectively, higher than the maximum permissible limit. PCA/FA revealed that three pollution sources, ranked in the order of importance: agricultural, urban, and industrial activities, could mainly contribute to enriching the pollutant concentrations of groundwater. While agricultural activities may contaminate groundwater with organic substances, the urban area may enrich bacterial-pathogen density such as E. coli and coliform, and the industrial area may contribute to contaminating groundwater with some inorganic parameters. Groundwater quality index and ANOVA showed that groundwater of the studied area was poor to very poor in quality and that in the agricultural area was the worst of the three land-use types. In brief, the groundwater quality in the studied area was degraded and agricultural activities were the most important factor causing the degradation followed by urban and industrial activities.

Assessment and source quantification of heavy metal(loid)s in surface water using multivariate analyses from the Saigon River, Vietnam.

The metal concentration in surface water of a river could be affected by season, position, and oceanic process such as tide. The current study aimed to (1) examine the heavy metal(loid) concentration in surface water from the Saigon River as affected by the combination of season, tide, and position and (2) apportion and quantify pollution sources. Ninety-six surface water samples were collected from 13 sites on the River in four campaigns (rainy season + ebb tide, rainy season + flood tide, dry season + ebb tide, and dry season + flood tide). Eight heavy metal(loid)s (Al, B, Bi, Fe, Mn, Pb, Sr, and Zn) were measured and subjected to multivariate analyses. Three-way ANOVA showed that in the rainy season, the total concentration of the metal(loid)s (TCM) in two tides was not clearly different from each other while in the dry season the TCM was significantly higher during the ebb tide than during the flood tide. Principal component analysis/factor analysis and Pearson correlation matrix showed that the TCM could be derived from three main sources, grouped into anthropogenic activities such as industrial, agricultural, and domestic wastes from inside Ho Chi Minh city, and natural origins from lowland area and acid sulfate soil. Three pollution sources explained 70% and 68% of the total variance of TCM in the rainy and dry seasons, respectively. In brief, the metal(loid) concentration was significantly affected by the season and tide and the pollution sources could be derived from inside Ho Chi Minh City and from lowland areas beyond the river estuary.

Prevalence and Factors Associated with Psychological Distress among Older Adults Admitted to Hospitals After Fall Injuries in Vietnam.

Although psychological distress is one of the major health issues among aging populations, little is known about how this challenge affects older patients after falls. A cross-sectional study was conducted in Thai Binh province, Vietnam, to explore the prevalence of psychological distress and associated factors among 405 older patients after falls. The 6-item Kessler Psychological Distress Scale (K6) was used to measure psychological distress. Socio-demographic and clinical characteristics were collected using a structured questionnaire. Multivariate Tobit and Logistic regressions were used to determine factors associated with psychological distress. The prevalence of psychological distress among participants was 26.2%. Patients who were alone or older had a higher likelihood of psychological distress. Patients with a history of falls in the past 12 months were more likely to suffer from psychological distress (OR = 2.87, 95%CI = 1.74; 4.72). Having two and three comorbidities was significantly associated with greater K6 scores and a higher risk of psychological distress. This study underlined a significantly high prevalence of psychological distress among older patients after falls. Providing frequent mental health monitoring, screening, treatment, and facilitating social engagements are important implications to improve the mental health of this population.

A systematic review of pharmacoeconomic evaluations of erlotinib in the first-line treatment of advanced non-small cell lung cancer.

OBJECTIVE: To review and assess the quality of the available evidence on the cost-effectiveness of erlotinib in the first-line treatment of advanced non-small cell lung cancer (NSCLC). METHODS: A systematic review was conducted to identify full-text original economic evaluations of erlotinib in the first-line treatment of advanced NSCLC written in English and published from the year 2000 onwards. Study characteristics and results were recorded and compared. The quality of the studies was assessed by the Quality of Health Economic Studies (QHES) questionnaire. RESULTS: Eleven out of 130 papers were chosen for this review. Comparative regimens consisted of a best supportive care, reverse strategy, bevacizumab, cisplatin plus pemetrexed, carboplatin plus gemcitabine or gefitinib. The methods most used in these studies were modeling and sensitivity analysis and cost-effectiveness analysis. All of the studies evaluated direct costs and used quality-adjusted life-year (QALY) and life-years gained (LYG) as outcome, with 3% and 3.5% discount rate. The studies assigned ICER that ranged from dominant to I$305,510.31/QALY and from I$31,209.55/LYG to I$66,540.20/LYG. Based on the willingness to pay threshold, seven studies concluded that erlotinib was cost-effective, two studies showed that erlotinib was cost-effective on specific patients with certain conditions, and two studies comparing erlotinib with reverse strategy did not find a difference in cost-effectiveness. The high quality of these studies was confirmed using the QHES tool: the mean score was 75.77 out of 100 (SD 9.38). CONCLUSION: Most of these high-quality studies suggested that erlotinib was cost-effective in the first-line treatment of advanced NSCLC.