Outbreak of Sexually Transmitted Nongroupable Neisseria meningitidis-Associated Urethritis, Vietnam.

We report on an outbreak of nongroupable Neisseria meningitidis-associated urethritis, primarily among men who have sex with men in southern Vietnam. Nearly 50% of N. meningitidis isolates were resistant to ciprofloxacin. This emerging pathogen should be considered in the differential diagnosis and management of urethritis.

Ecological and human health risk assessments of cyanotoxins and heavy metals in a drinking water supply reservoir.

Human beings are frequently exposed to a mixture of chemical pollutants through the ingestion of contaminated drinking water. The present study aimed to assess the ecological and human health risks associated with the contamination of cyanotoxins and heavy metals in a drinking water supply reservoir, the Tri An Reservoir (TAR), in Vietnam. Results demonstrated that the concentrations of individual heavy metals varied in the following order: iron (Fe) > lead (Pb) > arsenic (As) > zinc (Zn). Although the ecological potential risk of heavy metals was low during the study period, the concentration of Fe sometimes exceeded the Vietnamese standard for drinking water. Toxic cyanobacteria and microcystins (MCs) frequently occurred in the TAR with the highest density of 198.7 × 103 cells/mL and 7.8 µg/L, respectively, indicating a high risk of health impacts to humans. The results of the study indicate that exposure to heavy metals does not pose any non-carcinogenic health risks for both adults and children. However, the contamination of MCs in the surface water posed a serious disease enhancement to both adults and children through direct ingestion and dermal absorption.

Information needs of informal caregivers in caring and rehabilitation for dioxin victims in Vietnam.

BACKGROUND: Health outcomes among Agent Orange/dioxin (dioxin) victims are significant due to many individuals requiring daily assistance, informal care, and rehabilitation support. This study aimed to identify the information needs of informal caregivers of dioxin victims in Vietnam. METHODS: A cross-sectional study was conducted in Quynh Phu district, Thai Binh province - an area with a large number of dioxin victims, from June 2019 to June 2020. Quantitative data were collected from 124 caregivers of victims via structured interviews. Qualitative data were collected using semi-structured interview guides with in-depth interviews (IDI) (n = 36) and two focus group discussions (FGD) (n = 12). RESULTS: The results demonstrated that all caregivers of dioxin victims were family members, predominantly older (71.8%), 61.5 years old on average, living on low incomes (87.9%), and were farmers (80.7%). Almost all participants (96.8%) reported having information needs, particularly concerning dioxin's harms, nutrition, dioxin-related policies and rehabilitation, and psychological support for patients. Caregivers reported that they would like to receive information via health staff counselling (85.0%), television (75.0%), and community loudspeaker (65.8%). Notably, the majority of caregivers reported the need for information regarding psychological support (70.0%). These findings are consistent with qualitative data, which identify an urgent need to provide information, especially through health staff and digital resources. CONCLUSION: Many families with dioxin victims lived with little support and information, highlighting their high demand for information about care and rehabilitation. Thus, the healthcare system should promote information support, policy, and psychological support for caregivers and victims. An online support system for caregivers and victims is also recommended.

Bandgap tuning of TiO2 by Cu nanoparticles applied in photocatalytic antifouling-coated PES membranes through PAA-plasma grafted adhesive layer.

This study developed an antifouling coating for polyethersulfone (PES) membranes by tuning the bandgap of TiO2 with Cu nanoparticles (NPs) via a polyacrylic acid (PAA)-plasma-grafted intermediate layer. Cu NPs were synthesized at different molar ratios and precipitated onto TiO2 using the sol-gel method. The resulting Cu@TiO2 photocatalysts were characterized using various techniques, showing reduced bandgap, particle size range of 100-200 nm, and generation of reactive free radicals under light irradiation. The 25% Cu@TiO2 photocatalyst displayed the highest catalytic efficiency for Acid Blue 260 (AB260) degradation, achieving 73% and 96% with and without H2O2, respectively. Photocatalytic membranes based on this catalyst achieved an AB260 degradation efficiency of 91% and remained stable over five cycles. Additionally, sodium alginate-fouled photocatalytic membranes fully recovered water permeability after undergoing photocatalytic degradation of foulants. The modified membrane displayed a higher surface roughness due to the presence of photocatalyst particles. This study demonstrates the potential application of Cu@TiO2/PAA/PES photocatalytic membranes for mitigating membrane fouling in practice.

Child Melioidosis Deaths Caused by Burkholderia pseudomallei-Contaminated Borehole Water, Vietnam, 2019.

Within 8 months, 3 children from 1 family in northern Vietnam died from melioidosis. Burkholderia pseudomallei of the same sequence type, 541, was isolated from clinical samples, borehole water, and garden and rice field soil. Boreholes should be properly constructed and maintained to avoid B. pseudomallei contamination.

Impoverishing effect of tobacco use in Vietnam.

BACKGROUND: Tobacco consumption places a significant economic burden on households, which is particularly severe in developing countries like Vietnam. In a country where the social insurance system is weak and healthcare is often expensive, tobacco-consuming households may face a higher risk of living in poverty. Some evidence on the social consequences of tobacco consumption suggests that it might aggravate poverty and inequality in Vietnam; however, to the best of our knowledge, no research provides a reliable estimate of the impoverishing effect of tobacco use in the country thus far. OBJECTIVES: This study quantifies the direct impact of tobacco use on poverty, measured by a poverty head count and the total size of the poverty gap in Vietnam in 2018. METHODS: By deducting tobacco-related expenditure from the total household income, the authors recalculate the actual household disposable income and examine whether the households suffer from the state of secondary poverty. Data from the 2018 Vietnam Household Living Standards Survey were used for calculation. RESULTS: (1) Total tobacco-related expenditure increased the number of poor people by 305 090 (0.31% of the country's population) in 2018. More than one-third of those impoverished people are children, who should be considered victims of adults' tobacco use. (2) Tobacco use increased the poverty gap by 0.08 percentage points from 2.20% to 2.28%. (3) The impoverishment effects of tobacco consumption vary across groups in society and appear to be more intense in rural areas, among ethnic minorities and in the two lowest quintiles of consumption. CONCLUSION: This study confirms the impoverishing effect of tobacco use in Vietnam (305 090 people) and that the effects are heterogeneous across population groups. Therefore, controlling tobacco use should be a part of the broader poverty reduction strategy in Vietnam and should be wisely targeted so as to reduce poverty effectively.

Patient Safety Culture in 2 Public Hospitals in Vietnam: A Mixed Method Study.

BACKGROUND: Patient safety culture is an important measure in assessing the quality of care. There is a growing need to establish a patient safety culture in hospitals. This study explored the perception of health professionals on patient safety culture in 2 public hospitals in Hanoi, Vietnam. METHOD: A mixed-methods study with an online Hospital Survey on Patient Safety Culture (HSOPSC) and qualitative data collection was conducted in Hanoi. The HSOPSC was validated in Vietnam before using it. RESULTS: A total of 626 health professionals, including physicians and nurses, were involved in the survey, and 49 of them participated in in-depth interviews and focus group discussions. The average positive response of patient safety culture composites was high at 85.2% and varied from 49.4% to 97.9%. The strongest areas were teamwork within units (91.3%) and organizational learning/continuous improvement (88.4%), and the areas that needed improvement were staffing (49.4%) and nonpunitive response to error (53.1%). CONCLUSION: The centralized incident reporting, management with peer involvement on event reporting, and continuous quality improvement should be routinely embedded by hospital leaders down to unit managers and all staff.

Life cycle assessment of paper mill wastewater: a case study in Viet Nam.

Although in a critical position in the economy, the paper industry releases a lot of wastewater that requires adequate treatment for sustainable development. This study presents an application of Life cycle assessment (LCA) with the ReCiPe tool on the wastewater treatment plant (WWTP) of a paper factory in Vietnam to evaluate the environmental effect of the individual techniques in WWTP, especially the internal circulation (IC) reactor, a pioneer and practical anaerobic technology. Both Midpoint and Endpoint categories results demonstrated that chemical use and electricity consumption mainly contributed to the environmental impact in the WWTP. The Dissolved air flotation (DAF) and Moving bed biofilm reactor (MBBR) are classified as effective techniques to reduce the impacts on the environment. Moreover, the comparison of LCA between IC and up-flow anaerobic sludge bed (UASB) shows that IC is the better practically green technique for the environment.

Removal of total nitrogen from wastewater by a combination of Chlorella sp. and audible sound.

In developing countries, nitrogen in the traditional market wastewater is a critical environmental problem. In this study, the microalga Chlorella sp., which was isolated from wastewater, was used to remove the total nitrogen (TN) from conventional market wastewater in combination with audible sound (Vietnamese classical music). In addition, effects of sound exposure on removal efficiency at different initial cell densities were analyzed. Results revealed that music sound control demonstrates potential to improve the removal efficiency. TN removal efficiencies of 96%, 69.5%, and 4.3% were observed for treatments with Chlorella sp./audible sound, Chlorella sp., and without Chlorella sp., respectively. The significance of probability value (p-value) (<0.05) on the paired sample t-test confirmed the critical role of audible sound and Chlorella sp. density on the TN removal in screening experiments. The predicted optimal conditions for TN removal were as follows: a Chlorella sp. density of 4%, an audible sound of 52.5 dB, and a cultivation time of 4.6 days. Results based on statistical analysis revealed that the quadratic models for TN removal are significant at a low p-value (<0.05) and a high predicted coefficient of determination (R2 = 0.9452) value. The obtained statistical results also indicated that most of the variables are significant for the abatement of TN from market wastewater using Chlorella sp.

Pesticide production wastewater treatment by Electro-Fenton using Taguchi experimental design.

In this study, the electro-Fenton (EF) method was applied to remove total organic carbon (TOC) from the pesticide production wastewater containing tricyclazole (TC). Statistical Taguchi method was used to optimize the treatment performance. Analysis of variance (ANOVA) indicated that the polynomial regression model fitted experimental data with R2 of 0.969. The optimal conditions for eliminating 75.4% TOC and 93.7% TC were 0.2 mM of Fe2+, 990 mg/L of Na2SO4, 180 min of reaction time at pH 3 with 2.22 mA/cm2 of current density. The removal of TC present in the wastewater followed the first-order reaction kinetic model (R2 = 0.993); while that was the second-order kinetic model in the case of the TOC removal (R2 = 0.903). In addition, the experimental results and theory approaches (density functional theory and natural bond orbital calculations) also showed the C-N bond breaking and nitrate ions cleavage to ammonia. Acute toxicity of the pesticide wastewater after treatment (PWAT) on microcrustaceans showed that the treated wastewater still exhibited high toxicity against D. magna, with LC50 values of 3.84%, 2.68%, 2.05%, and 1.78% at 24 h, 48 h, 72 h, and 96 h, respectively.

High performance electron blocking layer-free InGaN/GaN nanowire white-light-emitting diodes.

We investigated the effect of coupled quantum wells to reduce electron overflow in InGaN/GaN dot-in-a-wire phosphor-free white color light-emitting diodes (white LEDs) and to improve the device performance. The light output power and external quantum efficiency (EQE) of the white LEDs with coupled quantum wells were increased and indicated that the efficiency droop was reduced. The improved output power and EQE of LEDs with the coupled quantum wells were attributed to the significant reduction of electron overflow primarily responsible for efficiency degradation through the near-surface GaN region. Compared to the commonly used AlGaN electron blocking layer between the device active region and p-GaN, the incorporation of a suitable InGaN quantum well between the n-GaN and the active region does not adversely affect the hole injection process. Moreover, the electron transport to the device active region can be further controlled by optimizing the thickness and bandgap energy of this InGaN quantum well. In addition, a blue-emitting InGaN quantum well is incorporated between the quantum dot active region and the p-GaN, wherein electrons escaping from the device active region can recombine with holes and contribute to white-light emission. The resulting device exhibits high internal quantum efficiency of 58.5% with highly stable emission characteristics and virtually no efficiency droop.

Enhancing the light extraction efficiency of AlInN nanowire ultraviolet light-emitting diodes with photonic crystal structures.

In this paper, AlInN nanowire ultraviolet light-emitting diodes (LEDs) with emission at ∼299 nm have been successfully demonstrated. We have further studied the light extraction properties of these nanowire LEDs using photonic crystal structures with square and hexagonal lattices of nanowires. The light extraction efficiency (LEE) of the periodic nanowire LED arrays was found to be significantly increased as compared to random nanowire LEDs. The LEEs reach ∼ 56%, and ∼ 63% for the square and hexagonal photonic crystal-based nanowire structures, respectively. Moreover, highly transverse-magnetic polarized emission was observed with dominant vertical light emission for the AlInN nanowire ultraviolet LEDs.

Improving carrier transport in AlGaN deep-ultraviolet light-emitting diodes using a strip-in-a-barrier structure.

This paper reports the illustration of electron blocking layer (EBL)-free AlGaN light-emitting diodes (LEDs) operating in the deep-ultraviolet (DUV) wavelength at ∼270nm. In this work, we demonstrated that the integration of an optimized thin undoped AlGaN strip layer in the middle of the last quantum barrier (LQB) could generate enough conduction band barrier height for the effectively reduced electron overflow into the p-GaN region. Moreover, the hole injection into the multi-quantum-well active region is significantly increased due to a large hole accumulation at the interface of the AlGaN strip and the LQB. As a result, the internal quantum efficiency and output power of the proposed LED structure has been enhanced tremendously compared to that of the conventional p-type EBL-based LED structure.

High-performance nanowire ultraviolet light-emitting diodes with potassium hydroxide and ammonium sulfide surface passivation.

Potassium hydroxide (KOH) and ammonium sulfide (NH4)2Sx have been used as a surface passivation treatment to improve the electrical and optical performance of AlGaN nanowire ultraviolet (UV) light-emitting diodes (LEDs). Enhancements in photoluminescence at 335 nm (49%), optical output power (65%), and electroluminescence (83%), with respect to the as-grown nanowire LED are recorded for the AlGaN nanowire UV LEDs with surface passivation. These enhancements are attributed to the reduced nonradiative recombination on the nanowire surfaces. This study provides a potential surface passivation approach to produce high-power AlGaN nanowire LEDs operating in the UV spectrum.

Treatment of tapioca processing wastewater in a sequencing batch reactor: Mechanism of granule formation and performance.

The formation of aerobic granular sludge was carried out in a sequencing batch reactor (SBR) for tapioca processing wastewater treatment. The effect of organic loading rates (OLRs) in the range of 2.5-10.0 kg COD m-3 day-1 on the granulation was investigated. The size and settleability of the aerobic granular sludge increased with increasing OLR from 2.5 to 7.5 kg COD m-3 day-1. The mature granules had an average size of 2.5 mm and good settleability with the sludge volume index (SVI) lower than 50 mL g-1. The granules had a layered structure consisting of anoxic sludge core with nematodes and an outer aerobic layer surrounded by stalked ciliates. Removal efficiencies of chemical oxygen demand (COD) and NH4+-N reached 90.0%-93.0% and 86.6%-92.5%, respectively. Simultaneous nitrification and denitrification at the OLR of 7.5 kg COD m-3 day-1 resulted in the improvement of total nitrogen (TN) removal efficiency to 66.1%.

Utilization of Services Provided by Village-Based Ethnic Minority Midwives in Vietnam: Lessons From Implementation Research.

BACKGROUND: Global progress in reducing maternal mortality requires improving access to maternal and child health services for the most vulnerable groups. This article reports results of implementation research that aimed to increase the acceptability of village-based ethnic minority midwives (EMMs) by local communities in Vietnam through implementing an integrated interventions package. METHODS: The study was carried out in 2 provinces in Vietnam, Dien Bien and Kon Tum. A quasi-experimental survey with pretest/posttest design was adopted, which included 6 months of intervention implementation. The interventions package included introductory "launch" meetings, monthly review meetings at community health centers, and 5-day refresher training for EMMs. A mixed-methods approach was used involving both quantitative and qualitative data. A structured questionnaire was used in the pre- and posttest surveys, complemented by in-depth interviews and focus group discussions with EMMs, relatives of pregnant women, community representatives, and health managers. RESULTS: Introductions of EMMs to their local communities by local authorities and supervision of performance of EMMs contributed to significant increases in utilization of services provided by EMMs, from 58.6% to 87.7%. Key facilitators included information on how to contact EMMs, awareness of services provided by EMMs, and trust in services provided by EMMs. The main barriers to utilization of EMM services, which may affect sustainability of the EMM scheme, were low self-esteem of EMMs and small allowances to EMMs, which also affected the recognition of EMMs in the community. CONCLUSIONS: Providing continuous support and integration of EMMs within frontline service provision and ensuring adequate local budget for monthly allowances are the key factors that should allow sustainability of the EMM scheme and continued improvement of access to maternal and child health care among poor ethnic minority people living in mountainous areas in Vietnam.

The Association Between Gender Inequalities and Women's Utilization of Maternal Health Services: A Cross-Sectional Survey in Eight South Central Coast Provinces, Vietnam.

BACKGROUND: Gender inequalities influence the utilization of maternal health services in Vietnam, but little research has been published. This study, therefore, aimed to explore the association between gender inequalities and women's utilization of maternal health services in Vietnam. METHODS: The study was conducted in 8 provinces in the South Central Coast region of Vietnam during August 2013 to May 2014. A total of 907 women who delivered a year prior to the date of interview participated in the study. A multiple logistic regression model was used to examine the association between gender inequalities (including sociodemographic determinants of health) and utilization of 4 or more antenatal care (ANC4+) services, institutional delivery, and ever used contraceptive methods. RESULTS: The utilization rate of maternal health services was varied, from 53.9% for ANC4+ to 87.7% for ever used a contraceptive method and 97% for institutional delivery. Ethnicity was identified as the most influential variable out of all sociodemographic determinants of health. Regarding gender inequalities, couple communication was the only variable having significant association with women's utilization of maternal health services. CONCLUSION: Women's equal role within context of their daily life and relations with their husbands (discussing maternal care with husband and having equal income to husband) supported their use of maternal health services. Therefore, there should be concerted efforts from all relevant stakeholders including the health system to focus on disadvantaged women in planning and delivery of maternal health services, especially to ethnic minority women. Male involvement strategy should be implemented to promote maternal health care, especially during the prenatal and postpartum period. To provide more culturally sensitive and right-based approaches in delivery of maternal health services to disadvantaged women in Vietnam, interventions are recommended that promote male involvement, that is, to engage men in service delivery to adapt and ensure the most appropriate and effective maternal health care.

Community-Based Screening for Cervical Cancer Using Visual Inspection With Acetic Acid: Results and Lessons Learned From a Pilot Study in Vietnam.

CONTEXT: Vietnam still applies the opportunistic cytology-based screening model, which failed to have an impact on the increasing burden of cervical cancer in Vietnam. OBJECTIVES: To pilot a community-based screening model for cervical cancer using visual inspection with acetic acid (VIA) in Vietnam by training midwife and assistant physician working at grassroots level of health care system. DESIGN: The study employed a pre-experimental design. SETTING: Cases from 2 provinces of Vietnam. PARTICIPANTS: The study trained 36 assistant physicians/midwives working at commune health centers to do VIA screening for cervical cancer and provided screening services for 1945 women 30 to 65 years of age. INTERVENTION: The pilot intervention had 2 aims: train health care workers to do VIA screening and assess the quality of screening services provided by the trained staffs by examining the diagnostics value of VIA. RESULTS: All selected health care workers were able to perform VIA screening method after training. Their VIA services had high diagnostic value: positive predicted value of 11.5% and negative predicted value of 99%; for the detection of cervical intraepithelial neoplasia (CIN) 2, the sensitivity of VIA is 100%, specificity of 67.0%, positive predicted value of 5.7%, and negative predicted value of 100%; for the detection of CIN 3, the sensitivity of VIA is 100%, specificity of 66.5%, positive predicted value of 3.8%, and negative predicted value of 100%. The diagnostic value of VIA is comparable with Papanicolaou test but requires far fewer resources and suitable with community-based setting. CONCLUSION: Local midwives and assistant physicians who currently work at commune health centers and district health centers can be trained to do VIA efficiently. Regarding to implications for policy and practice, VIA can offer significant advantages over Papanicolaou test in low-resource settings like Vietnam, particularly in terms of increased screening coverage, improved follow-up care, and overall program quality.

Reproductive tract infection and related factors among female migrants working in industrial zones in Vietnam 2013-2014.

We conducted this study to analyze factors related to reproductive tract infections (RTIs) among female migrant workers (FMWs) in four industrial zones across four regions in Vietnam. A analytical cross-sectional study was implemented with FMWs aged between 18 and 49 year old in four industrial zones in Hanoi, Da Nang, Ho Chi Minh (HCM) city and Binh Duong, Vietnam. Stratified sampling was used to select about 6400 married and unmarried FMWs. Cases were identified through self-reporting of female migrants concerning RTIs symtoms experienced in the 1 year prior to the study. Based on multivariate logistic regression results, we suggested that about 32% of FMWs reported having RTIs problems (27.6% in Hanoi, 30.3% in Danang, 36% in HCMC and 32.9% in Binhduong). We also identified different factors related to RTIs among different study sites. Marital status, level of education, social-economic status and numbers of migration were important related factors of RTIs.

Exploring the influence of context in a community-based facilitation intervention focusing on neonatal health and survival in Vietnam: a qualitative study.

BACKGROUND: In the Neonatal health - Knowledge into Practice (NeoKIP) trial in Vietnam, local stakeholder groups, supported by trained laywomen acting as facilitators, promoted knowledge translation (KT) resulting in decreased neonatal mortality. In general, as well as in the community-based NeoKIP trial, there is a need to further understand how context influences KT interventions in low- and middle-income countries (LMICs). Thus, the objective of this study was to explore the influence of context on the facilitation process in the NeoKIP intervention. METHODS: A secondary content analysis was performed on 16 Focus Group Discussions with facilitators and participants of the stakeholder groups, applying an inductive approach to the content on context through naïve understanding and structured analysis. RESULTS: The three main-categories of context found to influence the facilitation process in the NeoKIP intervention were: (1) Support and collaboration of local authorities and other communal stakeholders; (2) Incentives to, and motivation of, participants; and (3) Low health care coverage and utilization. In particular, the role of local authorities in a KT intervention was recognized as important. Also, while project participants expected financial incentives, non-financial benefits such as individual learning were considered to balance the lack of reimbursement in the NeoKIP intervention. Further, project participants recognized the need to acknowledge the needs of disadvantaged groups. CONCLUSIONS: This study provides insight for further understanding of the influence of contextual aspects to improve effects of a KT intervention in Vietnam. We suggest that future KT interventions should apply strategies to improve local authorities' engagement, to identify and communicate non-financial incentives, and to make disadvantaged groups a priority. Further studies to evaluate the contextual aspects in KT interventions in LMICs are also needed.