Molecular detection, risk factors, and phylogenetic analysis of tick-borne pathogens in dogs from northern Vietnam

@#In tropical regions, numerous tick-borne pathogens (TBPs) play a crucial role as causative agents of infectious diseases in humans and animals. Recently, the population of companion and pet dogs has significantly increased in Vietnam; however, information on the occurrence of TBPs is still limited. The objectives of this investigation were to determine the occurrence rate, risk factors, and phylogenetic characteristics of TBPs in dogs from northern Vietnam. Of 341 blood samples tested by PCR, the total infection of TBPs was 73.9% (252/341). Babesia vogeli (18SrRNA gene – 30.5%) was detected most frequently in studied dogs followed by Rickettsia spp. (OmpA gene – 27%), Anaplasma platys (groEL gene – 22%), Bartonella spp. (16SrRNA – 18.8%), Mycoplasma haemocanis (16SrRNA – 9.4%) and Hepatozoon canis (18SrRNA gene – 1.2%), respectively. All samples were negative for Ehrlichia canis and Anaplasma phagocytophylum. Co-infection was detected in 31.4% of the samples (107/341) of which, A. platys/Bartonella spp. (34/94,10%), Rickettsia spp./B. vogeli (19/94, 5.6%), and M. haemocanis/B. vogeli (19/94, 5.6%) were recorded as the three most frequent two species of co-infection types. Statistical analysis revealed a significant correlation between TBP infection and several host variables regarding age, breed, and living area in the current study. The recent findings reported herein, for the first time in Vietnam, are essential for local veterinarians when considering the appropriate approaches for diagnosing these diseases. Furthermore, this data can be used to establish control measures for future surveillance and prevention strategies against canine TBPs in Vietnam.

Circulation of human respiratory syncytial virus and new ON1 genotype in northern Viet Nam, 2017–2020

@#Objective: Human respiratory syncytial virus (RSV) is a primary cause of paediatric severe acute respiratory infection (SARI) worldwide, especially in developing countries. We investigated the genetic characteristics of RSV in northern Viet Nam to determine the prevalence and distribution of subtypes as well as the diversity and transmission patterns of genotypes. Methods: In two facilities, from January 2017 to December 2020, 1563 clinical specimens were collected from paediatric patients hospitalized with SARI and tested for RSV. Selected positive samples underwent sequencing analysis targeting the second hypervariable region of the G gene using next-generation sequencing. Results: The RSV positivity rate was 28.02% (438/1563 samples), and prevalence was highest in children aged <1 year (43.84%; 192/438). Subtype RSV-A accounted for 53.42% (234/438) of cases, RSV-B for 45.89% (201/438), and there was coinfection in 0.68% (3/438). Both subtypes cocirculated and peaked during August–September in each year of the study. Phylogenetic analysis showed that RSV-A samples belonged to the ON1 genotype, which has three subgenotypes: ON1.1, ON1.2 and ON1.3. However, we did not find the 72-nucleotide duplication in the second hypervariable region of the G gene, a characteristic of genotype ON1, in any RSV-A samples. RSV-B samples belonged to genotype BA9. Discussion: Our results provide additional molecular characterization of RSV infections in Viet Nam. Specially, our study is the first to report the absence of the 72-nucleotide duplication in the G gene of RSV-A genotype ON1 in Viet Nam, which may help in understanding the genetic evolution of RSV and be useful for vaccine development in the future.

How Ho Chi Minh City adapted its care pathway to manage the first large-scale community transmission of COVID-19

@#Ho Chi Minh City, Viet Nam undertook a series of measures in response to the fourth and largest wave of COVID-19. The care pathway was continuously reconfigured through leadership from all levels of government and engagement of the community. This resulted in a shift towards integrated severity-based care consisting of multiple levels of health-care facilities and home care. This flexible approach based on the rapidly changing local context enabled Ho Chi Minh City to limit the extent to which health-care capacity was overwhelmed.

Pre-operative Factors Predicting Mortality in Six Months and Functional Recovery in Elderly Patients with Hip Fractures

@#Introduction: This study aimed to determine on-admission and perioperative factors predicting six-month mortality and functional recovery in Vietnamese patients with hip fracture. Materials and methods: Between April 2020 and July 2021, 118 patients participated in this prospective study. Patients’ data were collected from medical records. Harris hip score (HHS) was used to evaluate the functional recovery six months after fractures. The obtained data were analysed using a univariate and multivariate model. Results: The mean age of the participants was 79.5±9.4 years and 68.6% of the patients were female. The six-month mortality rate was 5.9% and independently associated with age (odds ratio (OR): 3.512, 95% confidence interval (CI) 1.538 – 8.019; P<0.001, patients aged >80 years vs those aged ≤80 years) and hypoproteinemia (OR: 2.859, 95% CI: 1.001 – 8.166, P=0.049). Among 111 survivors there were 66 (59.5%) of patients with a good functional recovery. Patients aged >80 years had a higher risk of poor functional outcome (OR: 3.167, 95% CI: 1.386 – 7.235, P: 0.006) compared to those aged ≤ 80 years. No significant correlations between other clinical (gender, body mass index, comorbidities, type of fractures or surgery, time until surgery) or laboratory parameters (anaemia, hyperglycemia, marked elevation of C reactive protein level, electrolyte abnormalities, elevated urea) and mortality or functional outcome were found. Conclusion: Advanced age is the most important factor affecting both mortality and functional outcome while hypoproteinemia is associated with a higher risk of mortality in elderly patients with hip fractures.

Report on the Implementation of an Interactive Online Hands-on Seminar for Making Rehabilitation Orthosis with Vietnam in the Period of Travel Restriction / 国際保健医療

Background and Objective  The Projects of Global Growth of Medical Technologies, implemented by NCGM since 2015, have contributed to human resource development through on-site training in partner countries and training in Japan. However, since 2020, online training has become mainstream due to the travel restrictions by COVID-19 impact. As one of the projects, the NCGM and Bach Mai Hospital rehabilitation departments in Vietnam held an interactive online hands-on seminar in FY2022 for Vietnamese occupational therapists and others to provide technical guidance for making splint orthoses to rehabilitate patients with hand dysfunction. This paper aims to report on the preparation and implementation process of the seminar and its results.Preparation and Implementation of the Seminar  NCGM (the instructor) and Bach Mai Hospital (the site of the hands-on training) prepared the seminar through regular online meetings, fostering ownership and collaborative planning on the Vietnamese side, and discussed the program development, necessary materials, participant selection, and obtaining authorization from the Vietnamese Ministry of Health. To ensure the quality of the technical instruction, the seminar was connected via Zoom to both NCGM and Bach Mai Hospital, where the live video of the splinting technique was conducted, along with explanations and Q&A sessions. The post-training evaluation was carried out through a questionnaire with self-assessment of the participants about the knowledge and skills they obtained. Outcome and Discussion  As a result, 96% (27/28) of the participants answered that the seminar was “useful for clinical practice,” suggesting that the interactive online hands-on seminar regarding technical instruction in making splint orthosis was as good as or better than the face-to-face training. We found that the Vietnamese side took ownership from the preparatory stage by establishing a regular online meeting system; the quality of the training was assured by live video by both sides, which enabled detailed technical instruction; the training provider’s skills were improved by more detailed preparation; training was cost-effective compared to on-site training or training in Japan; and the materials used and the training videos can be used as teaching materials, which is expected local benefits and sustainability. These findings can be applied to face-to-face training to make the training more effective and extended as a useful method when similar activities are developed in other countries.

Mathematical models to describe the growth curves of Vietnamese Ri chicken / Modelos matemáticos para descrever as curvas de crescimento do frango Ri vietnamita

Abstract Ri chicken is the most popular backyard chicken breed in Vietnam, but little is known about the growth curve of this breed. This study compared the performances of models with three parameters (Gompertz, Brody, and Logistic) and models containing four parameters (Richards, Bridges, and Janoschek) for describing the growth of Ri chicken. The bodyweight of Ri chicken was recorded weekly from week 1 to week 19. Growth models were fitted using minpack.lm package in R software and Akaike's information criterion (AIC), Bayesian information criterion (BIC), and root mean square error (RMSE) were used for model comparison. Based on these criteria, the models having four parameters showed better performance than the ones with three parameters, and the Richards model was the best one for males and females. The lowest and highest value of asymmetric weights (α) were obtained by Bridges and Brody models for each of sexes, respectively. Age and weight estimated by the Richard model were 8.46 and 7.51 weeks and 696.88 and 487.58 g for males and for females, respectively. Differences in the growth curves were observed between males and female chicken. Overall, the results suggested using the Richards model for describing the growth curve of Ri chickens. Further studies on the genetics and genomics of the obtained growth parameters are required before using them for the genetic improvement of Ri chickens.

Resumo O frango Ri é a raça de frango de quintal mais popular do Vietnã, mas pouco se sabe sobre a curva de crescimento dessa raça. Este estudo comparou o desempenho de modelos com três parâmetros (Gompertz, Brody e Logistic) e modelos contendo quatro parâmetros (Richards, Bridges e Janoschek) para descrever o crescimento do frango Ri. O peso corporal do frango Ri foi registrado semanalmente da semana 1 à semana 19. Os modelos de crescimento foram ajustados usando o pacote minpack.lm no software R e o critério de informação de Akaike (AIC); critério de informação bayesiano (BIC) e erro quadrático médio (RMSE) foram usados ​​para comparação de modelos. Com base nesses critérios, os modelos com quatro parâmetros apresentaram melhor desempenho do que os com três parâmetros, sendo o modelo de Richards o melhor para homens e mulheres. O menor e o maior valor dos pesos assimétricos (α) foram obtidos pelos modelos Bridges e Brody para cada um dos sexos, respectivamente. A idade e o peso estimados pelo modelo de Richard foram de 8,46 e 7,51 semanas e 696,88 e 487,58 g para homens e mulheres, respectivamente. Diferenças nas curvas de crescimento foram observadas entre frangos machos e fêmeas. No geral, os resultados sugeriram o uso do modelo de Richards para descrever a curva de crescimento de frangos Ri. Mais estudos sobre a genética e genômica dos parâmetros de crescimento obtidos são necessários antes de usá-los para o melhoramento genético de frangos Ri.

Mathematical models to describe the growth curves of Vietnamese Ri chicken / Modelos matemáticos para descrever as curvas de crescimento do frango Ri vietnamita

Ri chicken is the most popular backyard chicken breed in Vietnam, but little is known about the growth curve of this breed. This study compared the performances of models with three parameters (Gompertz, Brody, and Logistic) and models containing four parameters (Richards, Bridges, and Janoschek) for describing the growth of Ri chicken. The bodyweight of Ri chicken was recorded weekly from week 1 to week 19. Growth models were fitted using minpack.lm package in R software and Akaike’s information criterion (AIC), Bayesian information criterion (BIC), and root mean square error (RMSE) were used for model comparison. Based on these criteria, the models having four parameters showed better performance than the ones with three parameters, and the Richards model was the best one for males and females. The lowest and highest value of asymmetric weights (α) were obtained by Bridges and Brody models for each of sexes, respectively. Age and weight estimated by the Richard model were 8.46 and 7.51 weeks and 696.88 and 487.58 g for males and for females, respectively. Differences in the growth curves were observed between males and female chicken. Overall, the results suggested using the Richards model for describing the growth curve of Ri chickens. Further studies on the genetics and genomics of the obtained growth parameters are required before using them for the genetic improvement of Ri chickens.

O frango Ri é a raça de frango de quintal mais popular do Vietnã, mas pouco se sabe sobre a curva de crescimento dessa raça. Este estudo comparou o desempenho de modelos com três parâmetros (Gompertz, Brody e Logistic) e modelos contendo quatro parâmetros (Richards, Bridges e Janoschek) para descrever o crescimento do frango Ri. O peso corporal do frango Ri foi registrado semanalmente da semana 1 à semana 19. Os modelos de crescimento foram ajustados usando o pacote minpack.lm no software R e o critério de informação de Akaike (AIC); critério de informação bayesiano (BIC) e erro quadrático médio (RMSE) foram usados para comparação de modelos. Com base nesses critérios, os modelos com quatro parâmetros apresentaram melhor desempenho do que os com três parâmetros, sendo o modelo de Richards o melhor para homens e mulheres. O menor e o maior valor dos pesos assimétricos (α) foram obtidos pelos modelos Bridges e Brody para cada um dos sexos, respectivamente. A idade e o peso estimados pelo modelo de Richard foram de 8,46 e 7,51 semanas e 696,88 e 487,58 g para homens e mulheres, respectivamente. Diferenças nas curvas de crescimento foram observadas entre frangos machos e fêmeas. No geral, os resultados sugeriram o uso do modelo de Richards para descrever a curva de crescimento de frangos Ri. Mais estudos sobre a genética e genômica dos parâmetros de crescimento obtidos são necessários antes de usá-los para o melhoramento genético de frangos Ri.

Mathematical models to describe the growth curves of Vietnamese Ri chicken

Abstract Ri chicken is the most popular backyard chicken breed in Vietnam, but little is known about the growth curve of this breed. This study compared the performances of models with three parameters (Gompertz, Brody, and Logistic) and models containing four parameters (Richards, Bridges, and Janoschek) for describing the growth of Ri chicken. The bodyweight of Ri chicken was recorded weekly from week 1 to week 19. Growth models were fitted using minpack.lm package in R software and Akaikes information criterion (AIC), Bayesian information criterion (BIC), and root mean square error (RMSE) were used for model comparison. Based on these criteria, the models having four parameters showed better performance than the ones with three parameters, and the Richards model was the best one for males and females. The lowest and highest value of asymmetric weights () were obtained by Bridges and Brody models for each of sexes, respectively. Age and weight estimated by the Richard model were 8.46 and 7.51 weeks and 696.88 and 487.58 g for males and for females, respectively. Differences in the growth curves were observed between males and female chicken. Overall, the results suggested using the Richards model for describing the growth curve of Ri chickens. Further studies on the genetics and genomics of the obtained growth parameters are required before using them for the genetic improvement of Ri chickens.

Resumo O frango Ri é a raça de frango de quintal mais popular do Vietnã, mas pouco se sabe sobre a curva de crescimento dessa raça. Este estudo comparou o desempenho de modelos com três parâmetros (Gompertz, Brody e Logistic) e modelos contendo quatro parâmetros (Richards, Bridges e Janoschek) para descrever o crescimento do frango Ri. O peso corporal do frango Ri foi registrado semanalmente da semana 1 à semana 19. Os modelos de crescimento foram ajustados usando o pacote minpack.lm no software R e o critério de informação de Akaike (AIC); critério de informação bayesiano (BIC) e erro quadrático médio (RMSE) foram usados para comparação de modelos. Com base nesses critérios, os modelos com quatro parâmetros apresentaram melhor desempenho do que os com três parâmetros, sendo o modelo de Richards o melhor para homens e mulheres. O menor e o maior valor dos pesos assimétricos () foram obtidos pelos modelos Bridges e Brody para cada um dos sexos, respectivamente. A idade e o peso estimados pelo modelo de Richard foram de 8,46 e 7,51 semanas e 696,88 e 487,58 g para homens e mulheres, respectivamente. Diferenças nas curvas de crescimento foram observadas entre frangos machos e fêmeas. No geral, os resultados sugeriram o uso do modelo de Richards para descrever a curva de crescimento de frangos Ri. Mais estudos sobre a genética e genômica dos parâmetros de crescimento obtidos são necessários antes de usá-los para o melhoramento genético de frangos Ri.

Systematic sequencing of imported cases leads to detection of SARS-CoV-2 B.1.1.529 (Omicron) variant in central Viet Nam

@#As authorities braced for the arrival of the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), infrastructure investments and government directives prompted action in central Viet Nam to establish capacity for genomic surveillance sequencing. From 17 November 2021 to 7 January 2022, the Pasteur Institute in Nha Trang sequenced 162 specimens from 98 150 confirmed SARS-CoV-2 cases in the region collected from 8 November to 31 December 2021. Of these, all 127 domestic cases were identified as the B.1.617.2 (Delta) variant, whereas 92% (32/35) of imported cases were identified as the B.1.1.529 (Omicron) variant, all among international flight passengers. Patients were successfully isolated, enabling health-care workers to prepare for additional cases. Most (78%) of the 32 Omicron cases were fully vaccinated, suggesting continued importance of public health and social measures to control the spread of new variants.

Normal Values and Associated Factors in Highresolution Anorectal Manometry in Healthy Vietnamese Adults / Valores normais e fatores associados na manometria anorretal de alta resolução em adultos vietnamitas saudáveis

Abstract Introduction The present study aims to identify normal high-resolution anorectal manometry (HRAM) values and related factors in healthy Vietnamese adults. Methods The present cross-sectional study was conducted at the Viet Duc hospital, Hanoi, Vietnam, during April and May 2019. Healthy volunteers were recruited to participate in the study. Anorectal measurement values from the digestive tract, including pressure, were recorded. Results A total of 76 healthy volunteers were recruited. The mean functional anal canal length was 4.2 ± 0.5 cm, while the mean anal high-pressure zone length was 3.4 ± 0.5 cm. Themean defecation index was 1.4 ± 0.8, with values ranging from 0.3 to 5.0. The mean threshold volume to elicit the rectoanal inhibitory reflex (RAIR) was 18.1 mL. The mean rectal sensation values were 32.4mL, 81.6mL, and 159 mL for first sensation, desire to defecate, and urge to defecate, respectively. Dyssynergic patterns occurred in ~ 50% of the study participants and included mainly types I (27.6%) and III (14.6%). There were significant differences between male and female patients in terms of maximum anal squeeze pressure, maximum anal cough pressure, maximum anal strain pressure, maximum rectal cough pressure, and maximum rectal strain pressure (all p<0.01). Conclusions The present study establishes normal HRAM values in healthy Vietnamese adults, particularly regarding normal values of anorectal pressure and rectal sensation. Further studies that include larger sample sizes should be conducted to further confirm the constants and their relationships.

Resumo Introdução O presente estudo tem como objetivo identificar valores normais de manometria anorretal de alta resolução e fatores relacionados em adultos vietnamitas saudáveis. Métodos O presente estudo transversal foi conduzido no hospital Viet Duc, Hanói, Vietnã, durante abril e maio de 2019. Voluntários saudáveis foram recrutados para participar do estudo. Valores de medição anorretal, incluindo pressão do trato digestivo, foram registrados. Resultados Um total de 76 voluntários saudáveis foram recrutados. O comprimento funcional médio do canal anal foi de 4,2 ± 0,5 cm, enquanto o comprimento médio da zona anal de alta pressão foi de 3,4 ± 0,5 cm. O índice médio de defecação foi de 1,4 ± 0,8, com valores variando de 0,3 a 5,0. O volume limite médio para eliciar o reflexo inibitório retoanal (RAIR, sigla em inglês) foi de 18,1 mL. Os valores médios da sensação retal foram 32,4mL, 81,6mL e 159 mL para a primeira sensação, o desejo de defecar e a urgência de defecar, respectivamente. Os padrões dissinérgicos ocorreram em aproximadamente 50% dos participantes do estudo e incluíram principalmente os tipos I (27,6%) e III (14,6%). Houve diferenças significativas entre homens e mulheres na pressão de compressão anal máxima, pressão de tosse anal máxima, pressão de distensão anal máxima, pressão de tosse retal máxima e pressão de distensão retal máxima (todos p<0,01). Conclusões O presente estudo estabelece valores normais de HRAM em adultos vietnamitas saudáveis, particularmente no que diz respeito aos valores normais de pressão anorretal e sensação retal. Mais estudos que incluam tamanhos de amostra maiores devemser realizados a fim de confirmar melhor as constantes e suas relações.

Characteristics of severe malaria in hospitalized children in Ho Chi Minh City from 2012 to 2019

@#In Vietnam, severe malaria is currently rare but is a life-threatening disease. It may be misdiagnosed with other common diseases. This descriptive study aimed to characterize severe malaria and its clinical aspects, as well as outcomes of infected pediatric patients to improve case management. The case-series study was carried out based on medical records of children aged between one month and 15 years with malaria diagnosed by blood smear or rapid diagnostic test. Chi-squared test with the p values less than 0.05 were considered statistically significant. There were 47 cases enrolled in the study. The prevalence of severe malaria was 29.8% (57.1% in children under five). The morbidity was 71.4% in male and 28.6% in female. Common clinical signs of severe malaria were fever (100%), severe anemia (21.4%), hepatomegaly (85.7%), and splenomegaly (71.4%). Common biological abnormalities in severe malaria were anemia, thrombocytopenia, increased liver enzymes, and high CRP level. The severe malaria was mainly caused by P. falciparum (100%). The age range for those infected with P. falciparum was 6.5 ± 4.5 years (min 0.3; max 14.9). The successful rate of treatment was 92.9% with artesunate. Antimalarial treatment time was 9.0 (6 – 12) days for severe malaria, which was twice as many as that for non-severe malaria (p = 0.067). The current clinical and biological findings of severe malaria are different from those in previous times, which make it easy to be overlooked. Therefore, it’s important to perform malaria diagnostic tests when there’re clinical suggestions of severe malaria, including fever, hepatomegaly or splenomegaly.

Development and validation of the Vi-Med® tool for medication review

Clinical pharmacy practice in Vietnam is unregulated by standard procedures, thus motivating this study, whichdeveloped and validated a tool called Vi-Med® for use in supporting medication review (MR) in Vietnamese hospitals.Six clinical pharmacists from six hospitals used the tool, which comprises three forms: Form 1 for the collectionof patient information, Form 2 for the implementation of MR, and Form 3 for the documentation of pharmacistinterventions (PIs). The tool also comes with eight pre-identified drug-related problems (DRPs) and seven PIs.The pharmacists were asked to categorize 30 PI-associated scenarios under appropriate DRPs and correspondinginterventions. Concordance among the pharmacists was assessed on the basis of agreement level (%) and Cohen’skappa (κ). We also evaluated the user-friendliness of the tool using a four-point Likert scale. Concordance in thepanel with respect to DRPs and PIs was substantial (κ = 0.76 and 80.4% agreement) and almost perfect (κ = 0.83 and87.6% agreement), respectively. All the experts were satisfied with the structure and content of Vi-Med®. Five of themevaluated the tool as very suitable, very useful, and definitely fitting for everyday use. Vi-Med® satisfactorily achievedconsistency and user-friendliness, enabling its use in daily clinical pharmacy practice.

The potential efficacy of the E2-subunit vaccine to protect pigs against different genotypes of classical swine fever virus circulating in Vietnam

Sexual awareness and cognitive social capital among high school students: a cross-sectional study in rural Vietnam / Journal of Rural Medicine

Objective: Since the late 1980s, Vietnam has seen numerous social changes, likely leading to changes in adolescent sexual awareness. Adolescents are currently exposed to a plethora of sexual information without adequate sex education and knowledge. Globally, researchers have identified sexual knowledge and self-esteem as determinants of adolescent sexual awareness and behavior, but little is known about the role of social capital, especially in rural areas. This study aimed to clarify the relationship between sexual awareness and cognitive social capital among high school students in rural Vietnam.Materials and Methods: We conducted a questionnaire-based survey assessing sexual knowledge, sexual awareness, perceptions of peers’ sexual experience, structural and cognitive social capital, and self-esteem (Rosenberg Self-Esteem Scale) in March 2017 among 1,583 11th graders at four public high schools in Hai Duong Province, Vietnam.Results: The final sample comprised 1,517 students (95.8% of total responses): 609 boys (40.1%) and 908 girls (59.9%). Multiple logistic regression analysis was performed with intolerance toward premarital sex as the dependent variable. In the first model, the independent variables were self-esteem, knowledge of proper timing for condom use, and perception that many peers are sexually experienced. The second model added an indicator of cognitive social capital. In the first model, self-esteem, knowledge of proper timing for condom use, and perception that many peers are sexually experienced were all significantly associated with intolerance toward premarital sex for both boys and girls. In the second model, for both boys and girls, only cognitive social capital was significantly associated with intolerance toward premarital sex.Conclusion: The results of this study regarding the effect of social capital in rural Vietnam are consistent with previous findings in urban areas. Social capital should be emphasized in efforts to improve sexual awareness and, in turn, sexual and reproductive health among adolescents in rural areas.

Patterns of hepatitis B virus exposure and associated predictors in Vietnam: A crosssectional study

Objective: To examine the magnitude of isolated anti-HBc and other HBV serological patterns and associated predictors among adults seeking general health check-up at a large health center in Vietnam. Methods: All 564 outpatients seeking general health checkup between January 2016 and December 2016 were asked to undertake HBV surface antigen, surface antibody, IgG and IgM core antibody (anti-HBc total), platelet counts, and liver function testing. An administered questionnaire was used to collect information regarding demography, in-house sources of infection, lifestyle, health condition and treatment, and HBV vaccination. Results: Male gender (P=0.043), age (P=0.000), living in urban areas (P=0.040), HBV vaccination status (P=0.033), and ALT (P=0.040) were associated with isolated anti-HBc. HBV infection was associated with HBV vaccination status (P=0.001), ALT levels (P=0.010), AST levels (P=0.020), and platelet counts (P=0.007). Past/resolved HBV infection was associated with AST levels (P=0.005), ALT levels (P=0.014), and age (P=0.000). Conclusions: Isolated anti-HBc is quite prevalent. Predictors of isolated anti-HBc include male gender, living in rural areas, and HBV non-vaccination. The prevalence of isolated anti-HBc also increases with age. To timely detect occult HBV infection and prevent transmission, anti-HBc testing should be included in the health check-up for high risk individuals and screening program where HBV nucleic acid test is not available. To prevent transmission, clinicians need to pay more attention on those who are at risk of having isolated anti-HBc and closely follow-up patients with isolated anti-HBc and educate them about the prevention of HBV infection.

Clinical outcomes of patients with chronic hepatitis C after generic direct-acting antiviral treatments in Vietnam: A retrospective analysis

Objective: To evaluate the outcomes of generic direct-acting antiviral treatments for chronic hepatitis C in Vietnam. Methods: The medical records of 522 patients (median 45 years; Female, 25.3%) with chronic hepatitis C treated at a tertiary hospital in northern Vietnam in 2016 were retrospectively reviewed. Results: Female patients were significantly older than male patients (median 52, IQR 41-59 vs. 43 years, IQR: 39-55; P<0.001). Among 522 patients, 49.4% were infected with hepatitis C virus (HCV) genotype 6, followed by 1a (19.0%), 1b (13.0%), and 3 (5.9%). Coinfection with hepatitis B virus or human immunodeficiency virus was noted in 5.8% and 3.1% of patients, respectively. Patients were treated with ledipasvir/sofosbuvir with or without ribavirin (70.9%), sofosbuvir/pegylated-interferon + ribavirin (13.2%), daclatasvir/ sofosbuvir with or without ribavirin (12.5%), or sofosbuvir/ribavirin (3.4%), and 96.4% (n=503) completed the direct-acting antiviral treatment. No patient discontinued treatment due to adverse event(s). A sustained virologic response 12 weeks after the end of the treatment (SVR12) was evaluated in 62.6% of patients. Overall sustained virologic response 12 weeks after the end of the treatment was 98.7% regardless of HCV genotypes or direct-acting antiviral regimens. The severity of liver stiffness was significantly decreased from 10.2 to 6.3 kilopascals measured by transient elastography by the treatment (P<0.001). Among patients who completed the directacting antiviral treatment, 17.7% returned for further follow-ups after SVR12. Conclusions: In Vietnam, the current generic direct-acting antiviral treatment for chronic hepatitis C was effective regardless of HCV genotypes and direct-acting antiviral regimens with the attenuation of liver stiffness. It is feasible to implement direct-acting antiviral treatment to cure chronic hepatitis C patients at any liver fibrosis stages in Vietnam.

Treatment for COVID-19 patients in Vietnam: Analysis of time-to-recovery

To describe the recovery time and related factors among COVID-19 patients in Vietnam. Methods: We used the secondary data obtained from the official database of the Ministry of Health of Vietnam and other public data sources that were available by April 9th, 2020. Cox proportional hazards model was carried out to identify factors related to recovery time among COVID-19 patients. Results: By April 9th, 2020, the cumulative number of COVID-19 cases detected in Vietnam was 255, of which 129 (50.6%) patients had fully recovered. The median recovery time of patients was 17 (95% CI=16-19) days. Older patients had a lower likelihood of recovery (HR=0.98, 95% CI=0.97-0.99, P0.001), whereas patients with a history of international incoming travel had a higher likelihood of recovery (HR=1.57, 95% CI=1.03-2.40, P=0.036). There was no statistically significant difference in the recovery time of patients treated in different hospital settings. Conclusions: More attention is needed for older patients and who did not have international travel history. Patients confirmed with COVID-19 could be treated at local health facilities to avoid unnecessary referrals and burdens to specialized hospitals at the central level.

Patterns of hepatitis B virus exposure and associated predictors in Vietnam: A crosssectional study

Objective: To examine the magnitude of isolated anti-HBc and other HBV serological patterns and associated predictors among adults seeking general health check-up at a large health center in Vietnam. Methods: All 564 outpatients seeking general health checkup between January 2016 and December 2016 were asked to undertake HBV surface antigen, surface antibody, IgG and IgM core antibody (anti-HBc total), platelet counts, and liver function testing. An administered questionnaire was used to collect information regarding demography, in-house sources of infection, lifestyle, health condition and treatment, and HBV vaccination. Results: Male gender (P=0.043), age (P=0.000), living in urban areas (P=0.040), HBV vaccination status (P=0.033), and ALT (P=0.040) were associated with isolated anti-HBc. HBV infection was associated with HBV vaccination status (P=0.001), ALT levels (P=0.010), AST levels (P=0.020), and platelet counts (P=0.007). Past/resolved HBV infection was associated with AST levels (P=0.005), ALT levels (P=0.014), and age (P=0.000). Conclusions: Isolated anti-HBc is quite prevalent. Predictors of isolated anti-HBc include male gender, living in rural areas, and HBV non-vaccination. The prevalence of isolated anti-HBc also increases with age. To timely detect occult HBV infection and prevent transmission, anti-HBc testing should be included in the health check-up for high risk individuals and screening program where HBV nucleic acid test is not available. To prevent transmission, clinicians need to pay more attention on those who are at risk of having isolated anti-HBc and closely follow-up patients with isolated anti-HBc and educate them about the prevention of HBV infection.

Clinical outcomes of patients with chronic hepatitis C after generic direct-acting antiviral treatments in Vietnam: A retrospective analysis

Objective: To evaluate the outcomes of generic direct-acting antiviral treatments for chronic hepatitis C in Vietnam. Methods: The medical records of 522 patients (median 45 years; Female, 25.3%) with chronic hepatitis C treated at a tertiary hospital in northern Vietnam in 2016 were retrospectively reviewed. Results: Female patients were significantly older than male patients (median 52, IQR 41-59 vs. 43 years, IQR: 39-55; P<0.001). Among 522 patients, 49.4% were infected with hepatitis C virus (HCV) genotype 6, followed by 1a (19.0%), 1b (13.0%), and 3 (5.9%). Coinfection with hepatitis B virus or human immunodeficiency virus was noted in 5.8% and 3.1% of patients, respectively. Patients were treated with ledipasvir/sofosbuvir with or without ribavirin (70.9%), sofosbuvir/pegylated-interferon + ribavirin (13.2%), daclatasvir/ sofosbuvir with or without ribavirin (12.5%), or sofosbuvir/ribavirin (3.4%), and 96.4% (n=503) completed the direct-acting antiviral treatment. No patient discontinued treatment due to adverse event(s). A sustained virologic response 12 weeks after the end of the treatment (SVR12) was evaluated in 62.6% of patients. Overall sustained virologic response 12 weeks after the end of the treatment was 98.7% regardless of HCV genotypes or direct-acting antiviral regimens. The severity of liver stiffness was significantly decreased from 10.2 to 6.3 kilopascals measured by transient elastography by the treatment (P<0.001). Among patients who completed the directacting antiviral treatment, 17.7% returned for further follow-ups after SVR12. Conclusions: In Vietnam, the current generic direct-acting antiviral treatment for chronic hepatitis C was effective regardless of HCV genotypes and direct-acting antiviral regimens with the attenuation of liver stiffness. It is feasible to implement direct-acting antiviral treatment to cure chronic hepatitis C patients at any liver fibrosis stages in Vietnam.

Treatment for COVID-19 patients in Vietnam: Analysis of time-to-recovery

To describe the recovery time and related factors among COVID-19 patients in Vietnam. Methods: We used the secondary data obtained from the official database of the Ministry of Health of Vietnam and other public data sources that were available by April 9th, 2020. Cox proportional hazards model was carried out to identify factors related to recovery time among COVID-19 patients. Results: By April 9th, 2020, the cumulative number of COVID-19 cases detected in Vietnam was 255, of which 129 (50.6%) patients had fully recovered. The median recovery time of patients was 17 (95% CI=16-19) days. Older patients had a lower likelihood of recovery (HR=0.98, 95% CI=0.97-0.99, P0.001), whereas patients with a history of international incoming travel had a higher likelihood of recovery (HR=1.57, 95% CI=1.03-2.40, P=0.036). There was no statistically significant difference in the recovery time of patients treated in different hospital settings. Conclusions: More attention is needed for older patients and who did not have international travel history. Patients confirmed with COVID-19 could be treated at local health facilities to avoid unnecessary referrals and burdens to specialized hospitals at the central level.