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Background: Investment to meet the man power requirements are recognized as urgent; especially to efficiently implement the National Strategy of Preventive Medicine. To strengthen the capability of provincial preventive medicine centers, the Ministry of Health has approved Decision No 05/2006QD-BYT for functions, tasks, authorization and organizational structure of Provincial Preventive Medicine Centers (PPMCs). Objectives: The study was conducted to evaluate the manpower and organization structure of northern PPMCs and provide recommendations for policy makers. Subjects and method: Using the cross-sectional descriptive method, the study covered the preventive medicine centers of 29 northern provinces between Jan to Jun 2007. The information was collected by interviews and self-reported questionnaires. Results:23/29 PPMCs have not met the criteria of man power stated in the Circular 08/2007/TTLB-BYT-BNV. Only 9/29 PPMCs were well organized in accordance with Decision 05/2006/QD-BYT of the Ministry of Health. The average number of staffs in PPMCs was 50+15. Medical staffs accounted for 53%, out of which 21.1% had postgraduate degrees; 32.2% had graduate degrees and 23.3% had been trained in preventive care. Conclusion: To meet the requirements provided by the Decision No05/2006QD-BYT, the man power and training for staffs in PPMCs should be improved and strengthened.
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Medicina PreventivaRESUMEN
Background: Cervical cancer is one of the leading cancers in women worldwide.\r\n', u'Objectives: To evaluate the knowledge, attitude and practice towards cervical cancer and its preventive measures among the parents of young adolescent girls. \r\n', u'Subjects and methods: The cross-sectional survey was conducted in Tuliem District, Hanoi and Cu Chi District, Ho Chi Minh city. By employing a structured interview there have been 218 fathers/mothers of young adolescent girls at secondary school age (11to14 years old) participated in the survey. \r\n', u"Results: There was a limitation in the respondents' understanding about cervical cancer. Although 83% parents have been aware of cervical cancer and 89% considered it as a fatal disease, nearly a half of them does not know any symptoms of the disease. Similarly, inadequate knowledge on causes and risk factors of the disease has been common among respondents. Only 25% of parents are aware of HPV and few knew about the transmission route of this virus. HPV vaccines are still very new for parents. Only 29.8% of interviewees have heard about HPV vaccines. However, 74.3% parents have expressed a wish to have their daughters vaccinated, once HPV vaccines are introduced in Vietnam. \r\n", u'Conclusions: Knowledge, attitude and practice towards cervical cancer among parents of young adolescent girls in these district were quite limited\r\n', u'\r\n', u'
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Neoplasias del Cuello Uterino , Conocimiento , ActitudRESUMEN
Background: Like other countries in the world, Vietnam has seen the appearance of many infectious diseases such as SARS, influenza A/H1N1. Therefore, monitoring and quick response to infectious diseases, increasingly require enhancing the capacity of test systems. \r\n', u'Objectives: To determine the capacity for microbiological diagnosis and etiology of communicable diseases at the provincial centers for preventive medicine.\r\n', u'Subjects and methods: With the application of the cross-sectional approach, the study was conducted on microbiology diagnostic capacity for communicable diseases surveillance and response system in 55 Provincial Preventive Medicine Centers (PPMCs)\r\n', u'Results: Laboratory testing and confirmation (isolation and bio-chemical tests, gram stain) are only available for common nitrobacteria such as Escherichia coli, Vibrio cholera, Shigella, Salmonella, and some of the respiratory bacteria as streptococcus, meningococcus, etc... in most PPMCs. ELISA/MACELISA technique for detecting virus pathogen such as Arbo viruses (Dengue, Japanese B encephalitis) and Hepatitis B, HIV is also a focus of these PPMCs. However, for diseases caused by other viruses like Polio, Rota, measles, influenza, PPMCs have only the ability to collect specimens. \r\n', u'Conclusions: Most of the cases reported in the surveillance reports are based on clinical signs, only. Case confirmation was done by hospital/regional or national laboratory. \r\n', u'\r\n', u'
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Background: Child health care practices in the context of households and community is an important factor to improving the health of children. Some indexes were proposed by the World Health Organization to evaluate these practices. Objectives: To describe the knowledge and practice of pregnant women, under-5-year-old children\u2019s health care and assess the application of the survey toolkit in evaluating various indexes of healthcare practice at family and community levels. Subjects and method: By employing a structured interview, this cross-sectional survey has been conducted in Tu Liem district - Hanoi city and Tien Hai district \u2013 Thai Binh province. 120 mothers of under-5-year-old children participated in the survey. Results:98% of mothers had at least 3 antenatal visits during pregnancy. The rate of complete tetanus vaccination reached 43.3% in Tu Liem and 65% in Tien Hai. Prevalence of infant with low birth weight for age accounted for 8.3% in both districts. The percentage of children given complementary feeding at age of 6 to 9 months as the National Nutrition Program recommendations was only 30%. 65.7% and 68.5% of under-2-year-old children in Tu Liem and Tien Hai were breastfed within the first 30 minutes after delivery. There were a small proportion of mothers who gave complementary food either too early or too late, 8.3% and 8.4% in Tu Liem, 6.7% and 6.6% in Tien Hai, respectively. More than 90% of children were given normal feeding as usual during last their illness, but only 50% of children were given more fluid than usual. 98.2% of mothers knew 2 signs to immediately bring the child to health facilities. The most common injuries in under-5-year-old children were animal bites (62.5%) and falling (31.3%), however only 62.5% of mothers knew at least two measures of injury prevention. Conclusion: The toolkit for collecting data of practical index assessment can be applied at communes.
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ConocimientoRESUMEN
Background: The strategy of Integrated Management of Childhood Illness (IMCI) was developed as an approach/tool for reducing the childhood mortality in developing countries. IMCI was approved by the Ministry of Health of Viet Nam and has been implemented in more than 3500 communal health centers nationwide. Aims: 1) To discover the quality of health care services for children under-5 and the situation of IMCI in health facilities. 2) To propose solutions to improve the quality of health care services for children. Materials and method: The cross-sectional study using quantitative and qualitative approaches conducted 58 direct observations in health workers, interviewed 58 caretakers, comprehensively interviewed 20 local leaders and technical staffs, facilitated 12 focal group discussions and reviewed 120 records of 12 commune health centers. Results: IMCI was considered by all of the participants as a comprehensive approach to improving the quality of childhood health care at first-level health facilities. IMCI contributed towards improved case management skills of health workers, improved the supply of essential drugs and supplies for child health care. As a result, the quality of health services for children under-5 has been promoted (93% of illness children were correctly assessed and classified, 84.6% of them were correctly treated and counseled). Health workers in Ly Nhan district, Ha Nam province adhered to 8.4+/-1.5 out of 10 essential steps of comprehensive child health care. Contrarily, this indicator was low in the districts of Bac Giang province (4.8+/-1.5), not much different to untrained IMCI health workers. Conclusion: IMCI is a useful strategy to improving the quality of child health care. But there were some difficulties that affected the implementation of this strategy in first-level health facilities.
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Atención Integrada a las Enfermedades Prevalentes de la InfanciaRESUMEN
Background: In recent years, due to the outbreak of new infectious diseases, re-emerging diseases and bio-terrorist threats, the biological safety for laboratories is essential\r\n', u'Objectives: to evaluate knowledge and practices related to biosafety of researchers in microbiological laboratories\r\n', u'Subjects and method: The study was carried out in the period 2006-2007. Questionnaires and checklists were used for the direct interview the knowledge and observe the practices related to biological safety of 97 laboratory technicians from microbiology laboratories of 22 provincial centers for preventive medicine, which represent for all areas in Vietnam.\r\n', u'Results: The percentage of technicians defines correctly the hazardous groups of some common pathogens are 8.2-33%. The percentage of technicians define correctly the transmission routes of Bacillus anthracis, Staphylococus, Streptococcus are 1%, 15% and 19.6%, respectively. The opinion that thay can wear the laboratory blouse out of laboratories, bring personal belongings into the laboratory and pipeting by mouth are 21.6%, 50.5% and 23.7%, respectively. Regarding laboratory practices: The percentage of technicians does not use gloves is 37.8%; pipeting by mouth: 22.6%. Over 40% technicians do not disinfect working area or washing hands with alcohol after experiments\r\n', u'Conclusion: The results of this study are a basis for planning programs to train, supervise and improve the operational quality of the microbiological laboratory of the provincial preventive health care centers.\r\n', u'\r\n', u'\r\n', u'
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Actitud , Biotecnología , SeguridadRESUMEN
Background: The male infertility accounts for approximately 40%-50%, in which the cases without sperms in semen occupy nearly 5% for Obstructive Azoospermia (OA). Percutaneous Epididymal Sperm Aspiration (PESA) in combination with serum FSH (Follicle Stimulating Hormone) test was effective in the diagnosis and treatment of this disease. Objectives: To evaluate preliminarily the results of the technique of PESA in the diagnosis of OA and in combination with intracytoplasmic sperm injection (ICSI) for treating male infertility. Subjects and method: A longitudinal, interventional study was carried out on 110 cases of male infertility treated at the Assisted Reproductive Technology Center of National Hospital of Obstetrics and Gynecology from August 7th 2005 to July 30th 2006. All patients underwent PESA and then testicular fine needle aspiration (TEFNA) if necessary. Results: The mean age of patients was 34.75+/-6.68 years. Among 110 patients, 54 cases (49.1%) had post-operative diagnoses of OA, 56 cases (50.9%) were diagnosed with complete azoospermia after PESA and TEFNA procedures. There were correlations between the volume of left and right testis and the probability of sperms in testing samples (p= 0.03 and =0.05, respectively). Also, serum FSH concentration related to the positive result of sperm test (p< 0.0001). Conclusion: PESA is less-invasive and exact method to the diagnosis of azoospermia. It should be done PESA for patients with testis volume >=10ml and serum FSH concentration <20mIU/mL.