Antibiotic Resistance, Biofilm Formation, and Persistent Phenotype of Klebsiella pneumoniae in a Vietnamese Tertiary Hospital: A Focus on Amikacin.

Klebsiella pneumoniae stands out as a major opportunistic pathogen responsible for both hospital- and community-acquired bacterial infections. This study comprehensively assesses the antibiotic resistance, amikacin persistent patterns, and biofilm-forming ability of 247 isolates of K. pneumoniae obtained from an intensive care unit of a tertiary hospital in Vietnam. Microdilution assays, conducted on a 96-well plate, determined the minimum inhibitory concentrations (MICs) of amikacin. Susceptibility data for other antibiotics were gathered from the antibiogram profile. Stationary-phase bacteria were exposed to 50 × MIC, and viable bacteria counts were measured to determine amikacin persistence. Biofilm forming capacity on 96-well polystyrene surfaces was assessed by biomass and viable bacteria. The prevalence of resistance was notably high across most antibiotics, with 64.8% classified as carbapenem-resistant K. pneumoniae and 81.4% as multidrug resistant. Amikacin, however, exhibited a relatively low rate of resistance. Of the isolates, 58.2% demonstrated a moderate to strong biofilm formation capacity, and these were found to be poorly responsive to amikacin. K. pneumoniae reveals a significant inclination for amikacin persistence, with ∼45% of isolates displaying an antibiotic antibiotic-survival ratio exceeding 10%. The study sheds light on challenges in treating of K. pneumoniae infection in Vietnam, encompassing a high prevalence of antibiotic resistance, a substantial ability to form biofilm, and a notable rate of antibiotic persistence.

Health staff perceptions of patient safety and associated factors in hospitals in Vietnam.

Introduction: Patient safety is a global challenge of preventing and mitigating medical errors which might harm patients during their course of treatment and care. This study was employed to contribute to the existing literature aimed to assess patient safety culture among health staff and to determine predictors of health staff perceptions of patient safety in hospitals in Vietnam. Methods: A cross-sectional study was conducted in three hospitals of Vietnam with a total of 763 participants. This study used the Hospital Patient Safety Scale developed by the American Health and Quality Research Organization. Results: In general, 8 of 12 patient safety dimensions in two hospital; and 10 of 12 dimensions in a third hospital had average scores of 60% and above positive responses. The communication openness and organizational learning dimensions were found to be significant different when comparing hospitals. Regarding sample characteristics, department (subclinical department) and health staff positions (nurses/technicians, pharmacists) were significant predictors in the total model including three hospitals (R2 = 0.07). Conclusion: This study reported that communication openness and organization learning are two aspects that need to be improved they are strongly related to patient safety culture and to knowledge exchange among health staff. It has been suggested that hospitals should deliver patient safety training courses and establish a supportive learning environment to improve these challenges.

Development of gelatin/agarose active coatings functionalized with Ocimum gratissimum L. essential oil for enhancing storability of 'Booth 7' avocado.

Novel active coating from gelatin/agarose (GA) functionalized with Ocimum gratissimum L. essential oil (OGO) had been developed as a medium to evaluate their properties before being applied for avocado preservation. The resultant coating films showed enhanced mechanical, water-barrier, bactericidal, antioxidant, and UV-shielding properties by adding OGO. The best tensile strength (2.91 MPa) and flexibility (45.82 %) was found in the GA film containing 5 % (w/w) of OGO (GA-OGO-5). Furthermore, this coating formulation presented moderate antibacterial activities against Listeria, Pseudomonas, Salmonella, and Escherichia. The GA-OGO-5 coating film also divulged the highest hydrophobicity and adequate antioxidant function (30.75 µg/mL) and thus, was chosen to coat on 'Booth 7' avocados by dipping method. The GA-OGO-5 coating layers were to be efficient to decline the respiration rate of avocado during 6-day storage at 25 °C and 64 %RH. Peel color, weight loss (5.22 %), total soluble solids (8.14 %), and solution pH (6.79) at the end of storage also indicated that the GA-OGO-5 coating presented the best effectiveness for enhancing the storability of avocado as compared to uncoated and GA-treated fruit. Therefore, the GA-OGO coating has been considered as an alternative post-harvest technique to enhance the avocado storability and could be further commercialized for industry application.

Machine learning approach to monitor inkjet jetting status based on the piezo self-sensing.

One of the advantages of inkjet printing in digital manufacturing is the ability to use multiple nozzles simultaneously to improve the productivity of the processes. However, the use of multiple nozzles makes inkjet status monitoring more difficult. The jetting nozzles must be carefully selected to ensure the quality of printed products, which is challenging for most inkjet processes that use multi-nozzles. In this article, we improved inkjet print head monitoring based on self-sensing signals by using machine learning algorithms. Specifically, supervised machine learning models were used to classify nozzle jetting conditions. For this purpose, the self-sensing signals were acquired, and the feature information was extracted for training. A vision algorithm was developed to label the nozzle status for classification. The trained models showed that the classification accuracy is higher than 99.6% when self-sensing signals are used for monitoring. We also proposed a so-called hybrid monitoring method using trained machine learning models, which divides the feature space into three regions based on predicted jetting probability: certain jetting, certain non-jetting, and doubt regions. Then, the nozzles with uncertain status in the doubt region can be verified by jet visualization to improve the accuracy and efficiency of the monitoring process.

Mobilization of Heavy Metals in a Saline Confined Aquifer as a Consequence of Rainwater Injection: A Case Study in Southern Vietnam.

An artificial recharge test was performed in Ho Chi Minh City, Vietnam to see the geochemical response of a saline coastal plain aquifer to the injected rainwater. The results show that the rainwater injection can cause mobilization of heavy metals due to pyrite oxidation and this phenomenon can persist even after the full recovery of the injected water. In this study, a 30-m-deep well was installed in a confined aquifer. Pyrite framboids were observed in the sediment samples collected during the well drilling. A total of 400 L rainwater was injected into the well for 70 min. After waiting 63 h, the well was extracted at a pump speed of 2.7 L/min and the chemistry of the pumped groundwater was monitored for 10 h. The groundwater showed geochemical features close to rainwater at the early stage of pumping and gradually changed to those of the background waters, especially, in electrical conductivity and Cl- concentration, as the pumping proceeded. However, the groundwater pumped in the later stage showed much increased concentrations in SO42-, total iron (FeT), AsT, Ni, Mn and Zn relative to the calculated mixing concentrations due to pyrite oxidation even though NO3-, the pyrite oxidant, already had disappeared. It was revealed from the geochemical modeling that the persistent pyrite oxidation was the result of the reaction with ferrihydrite, which precipitated in pores of the sediment by the injection of aerated water. We believe our study is a good example showing the importance of careful design of the artificial recharge systems to avoid or minimize the geochemical disturbance of aquifer.

Hybrid Device Fabrication Using Roll-to-Roll Printing for Personal Environmental Monitoring.

Roll-to-roll (R2R) printing methods are well known as additive, cost-effective, and ecologically friendly mass-production methods for processing functional materials and fabricating devices. However, implementing R2R printing to fabricate sophisticated devices is challenging because of the efficiency of material processing, the alignment, and the vulnerability of the polymeric substrate during printing. Therefore, this study proposes the fabrication process of a hybrid device to solve the problems. The device was created so that four layers, composed of polymer insulating layers and conductive circuit layers, are entirely screen-printed layer by layer onto a roll of polyethylene terephthalate (PET) film to produce the circuit. Registration control methods were presented to deal with the PET substrate during printing, and then solid-state components and sensors were assembled and soldered to the printed circuits of the completed devices. In this way, the quality of the devices could be ensured, and the devices could be massively used for specific purposes. Specifically, a hybrid device for personal environmental monitoring was fabricated in this study. The importance of environmental challenges to human welfare and sustainable development is growing. As a result, environmental monitoring is essential to protect public health and serve as a basis for policymaking. In addition to the fabrication of the monitoring devices, a whole monitoring system was also developed to collect and process the data. Here, the monitored data from the fabricated device were personally collected via a mobile phone and uploaded to a cloud server for additional processing. The information could then be utilized for local or global monitoring purposes, moving one step toward creating tools for big data analysis and forecasting. The successful deployment of this system could be a foundation for creating and developing systems for other prospective uses.

Associations between four polymorphisms of the SLCO1B1 and effectiveness of the statins: a meta-analysis.

OBJECTIVE: Statins are the first-choice therapy for dyslipidemia, but their effectiveness can be influenced by genetic polymorphisms. This study was conducted to assess the association of variants of the solute carrier anion transporter family 1B1 (SLCO1B1) gene, which encodes a transporter involving the hepatic clearance of the statins and their therapeutic efficacy. METHOD: A systematic review was performed on four electronic databases to identify relevant studies. The pooled mean difference with 95% confidence interval (CI) in percentage change of concentration of LDL-C, total cholesterol (TC), HDL-C, and triglycerides was calculated. Heterogeneity between studies and publication bias, subgroup analyses, and sensitivity analyses were also carried out using R software. RESULTS: Twenty-one studies on 24 365 participants and four variants [rs4149056 (c.521T>C), rs2306283 (c.388A>G), rs11045819 (c.463C>A), rs4363657 (g.89595T>C)] were analyzed. A statistically significant association was found between the LDL-C-lowering effectiveness and the rs4149056 and rs11045819 in the heterozygote model; and the rs4149056, rs2306283, and rs11045819 in the homozygote model. In the subgroup analyses, non-Asian populations, simvastatin, and pravastatin showed significant associations between LDL-C-lowering efficacy and the rs4149056 or rs2306283. Significant associations between the rs2306283 and HDL-C-increasing effectiveness were found in the homozygote model. Regarding TC-reducing, significant associations were observed in the heterozygote and homozygote models of the rs11045819. There was no heterogeneity and publication bias among most studies. CONCLUSION: SLCO1B1 variants can be used as signals to predict the statins' effectiveness.

Hormone-dependent sexual responses of female mice in response to manual genital stimulation.

Although copulatory behavior is thought to have a strong innate basis in mice, there is also clear evidence that sexual experience shapes its expression. Reinforcement of behavior through rewarding genital tactile stimulation is a primary candidate mechanism for this modification. In rats, manual tactile clitoral stimulation is rewarding only when it is temporally distributed, which is hypothesized to result from an innate preference for species-typical copulatory patterning. Here we test this hypothesis using mice, which have a temporal copulatory pattern which is distinctly less temporally distributed than that of rats. Female mice received manual clitoral stimulation which was either temporally continuous every second, or stimulation which was temporally distributed, occurring every 5 s, This pattern of stimulation was paired with environmental cues in a conditioned place preference apparatus to assess reward. Neural activation in response to this stimulation was evaluated by measuring FOS immunoreactivity. Results indicated that both temporal patterns of clitoral stimulation were rewarding, but that continuous stimulation better reproduced brain activation associated with sexual reward. Furthermore, continuous, but not distributed stimulation elicited a lordosis response in some females, and this response increased within and across days. Sexual reward, neural activation and lordosis resulting from tactile genital stimulation were eliminated by ovariectomy and restored with combined 17ß-estradiol and progesterone treatment but not 17ß-estradiol treatment alone. These observations are consistent with the hypothesis that sexual reward resulting from species-typical genital tactile stimulation has a permissive effect on copulatory behavior of female mice.

Allopurinol-induced Stevens-Johnson syndrome and toxic epidermal necrolysis: Signal detection and preventability from Vietnam National pharmacovigilance database.

WHAT IS KNOWN AND OBJECTIVE: Allopurinol, the first-line medication for hyperuricemia is well-known for its association with severe cutaneous adverse reactions, especially Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). In the current study, we analysed the Vietnamese spontaneous reporting database to identify signals and preventability of allopurinol-induced SJS/TEN in Vietnam from 2010 to 2019. METHODS: Signal generation was assessed using the case/non-case method. Reporting odds ratios (RORs) and 95% confidence intervals (95% CI) were calculated. RESULTS: Among 72,822 spontaneous ADR reports submitted to the Vietnam National Drug Information and Adverse Drug Reaction Monitoring Centre, 392 reports were on SJS/TEN, of which, 65 cases (16.6%) were related to allopurinol. The signals of allopurinol-induced SJS/TEN in Vietnam started in 2014 (ROR of 3.531, 95% CI: 1.830-6.810) and annually increased until 2019 (ROR of 11.923, 95% CI: 8.508-16.710). The preventability assessment showed that no allopurinol-induced SJS/TEN case was definitely unpreventable. 61.6% of the SJS/TEN cases were avoidable because they were associated with inappropriate prescribing such as unapproved indications, too high initial dose and even rechallenging in patients with a history of allopurinol allergy. WHAT IS NEW AND CONCLUSION: The signals of allopurinol-induced SJS/TEN in Vietnam started in 2014 and annually increased until 2019. Our first report specifically focusing on the ADR preventability of allopurinol showed that correction of medical errors relating to prescription could prevent more than 60% of SJS/TEN cases in Vietnamese allopurinol users. This is a feasible and practical solution, provided that there would be a systematic change in both healthcare systems and public awareness.

Histone macroH2A1 is a stronger regulator of hippocampal transcription and memory than macroH2A2 in mice.

Histone variants H2A.Z and H3.3 are epigenetic regulators of memory, but roles of other variants are not well characterized. macroH2A (mH2A) is a structurally unique histone that contains a globular macrodomain connected to the histone region by an unstructured linker. Here we assessed if mH2A regulates memory and if this role varies for the two mH2A-encoding genes, H2afy (mH2A1) and H2afy2 (mH2A2). We show that fear memory is impaired in mH2A1, but not in mH2A2-deficient mice, whereas both groups were impaired in a non-aversive spatial memory task. However, impairment was larger for mH2A1- deficient mice, indicating a preferential role for mH2A1 over mH2A2 in memory. Accordingly, mH2A1 depletion in the mouse hippocampus resulted in more extensive transcriptional de-repression compared to mH2A2 depletion. mH2A1-depleted mice failed to induce a normal transcriptional response to fear conditioning, suggesting that mH2A1 depletion impairs memory by altering transcription. Using chromatin immunoprecipitation (ChIP) sequencing, we found that both mH2A proteins are enriched on transcriptionally repressed genes, but only mH2A1 occupancy was dynamically modified during learning, displaying reduced occupancy on upregulated genes after training. These data identify mH2A as a regulator of memory and suggest that mH2A1 supports memory by repressing spurious transcription and promoting learning-induced transcriptional activation.

AI-assisted reliability assessment for gravure offset printing system.

In printed electronics, flawless printing quality is crucial for electronic device fabrication. While printing defects may reduce the performance or even cause a failure in the electronic device, there is a challenge in quality evaluation using conventional computer vision tools for printing defect recognition. This study proposed the computer vision approach based on artificial intelligence (AI) and deep convolutional neural networks. First, the data set with printed line images was collected and labeled. Second, the overall printing quality classification model was trained and evaluated using the Grad-CAM visualization technique. Third and last, the pretrained object detection model YOLOv3 was fine-tuned for local printing defect detection. Before fine-tuning, ground truth bounding boxes were analyzed, and anchor box sizes were chosen using the k-means clustering algorithm. The overall printing quality and local defect detection AI models were integrated with the roll-based gravure offset system. This AI approach is also expected to complement more accurate printing reliability analysis firmly.

Allopurinol-induced severe cutaneous adverse reactions in Vietnamese: the role of HLA alleles and other risk factors.

Aim: To reveal the association of three class I HLA alleles, including HLA-A*33:03, HLA-B*58:01 and HLA-C*03:02, and allopurinol-induced severe cutaneous adverse reactions (SCARs) in Vietnamese patients. Methods: A case-control study on 100 allopurinol-induced SCARs patients, 183 tolerant controls and 810 population controls was performed. The HLA-A*33:03 and HLA-C*03:02 alleles were detected with the nested allele-specific PCR method; the HLA-B*58:01 allele was detected with the sequence-specific primer PCR method. Results: There were strong associations between HLA-B*58:01 and HLA-C*03:02 and allopurinol-induced SCARs. Specific associations were found between HLA-B*58:01 and Stevens-Johnson syndrome/toxic epidermal necrolysis and between HLA-C*03:02 and drug reaction with eosinophilia and systemic symptoms, with a gene dosage effect. The multivariate regression analysis indicated two significant independent risk factors: HLA-B*58:01/HLA-C*03:02 and estimated glomerular filtration rate <60 ml/min/1.73 m2. The specificity, positive predictive value and negative predictive value of HLA-B*58:01 testing were higher than the HLA-C*03:02 or the multiplex testing, especially in patients with impaired renal function. Conclusion: The results supported pre-treatment HLA-B*58:01 testing in Vietnamese patients with declined renal function to prevent SCARs.

The association between HLA-B*15:02 and phenytoin-induced severe cutaneous adverse reactions: a meta-analysis.

Aim: Phenytoin (PHT) is a common anticonvulsant agent known for inducing severe cutaneous adverse reactions (SCARs). HLA-B*15:02 as a risk factor of PHT-induced SCARs was reported in numerous studies with inconsistent results. This meta-analysis aimed to establish pooling evidence of this association. Materials & methods: Pooled odds ratios (ORs) with 95% CIs were estimated using a random-effects model. Results: A total of 11 studies on 1389 patients, were included for the analyses. There was a significant association between HLA-B*15:02 and PHT-induced SCAR (pooled OR = 2.29, 95% CI: 1.25-4.19, p = 0.008). Furthermore, there was a significant association regarding Stevens-Johnson syndrome/toxic epidermal necrolysis (OR = 3.63, 95% CI: 2.15-6.13, p < 0.001) but no association regarding drug reaction with eosinophilia and systemic symptom. Conclusion: The results supported the recommendations of HLA-B*15:02 screening before treatment with PHT.

IoT device fabrication using roll-to-roll printing process.

With the development of technology, wireless and IoT devices are increasingly used from daily life to industry, placing demands on rapid and efficient manufacturing processes. This study demonstrates the fabrication of an IoT device using a roll-to-roll printing process, which could shorten the device fabrication time and reduce the cost of mass production. Here, the fabricated IoT device is designed to acquire data through the sensor, process the data, and communicate with end-user devices via Bluetooth communication. For fabrication, a four-layer circuit platform consisting of two conductive layers, an insulating layer including through holes, and a solder resist layer is directly printed using a roll-to-roll screen printing method. After the printing of the circuit platform, an additional layer of solder paste is printed to assemble the electrical components into the device, inspiring the fully roll-to-roll process for device fabrication. Successful IoT device deployment opens the chance to broaden the roll-to-roll fabrication process to other flexible and multilayer electronic applications.

High-Efficiency Electrospray Deposition Method for Nonconductive Substrates: Applications of Superhydrophobic Coatings.

When highly insulating materials are used as substrates for electronic devices, manufacturing yields become worse, and electronic components are often damaged due to undissipated electrostatic charges on such substrates. In the case of electrospray deposition, the problem of undissipated charges is particularly vexing. If charges accumulated on the substrate are not properly compensated, a repulsive force is generated against the incoming charged droplets, which negatively affects the uniformity and deposition rate of the coating layer. In order to overcome this limitation, we demonstrated a new electrospray method, which can significantly increase the deposition efficiency even in the presence of accumulated charges on nonconductive substrates. A highly reliable superhydrophobic layer was uniformly deposited on highly insulating substrates, including printed circuit board (PCB), polyester (PET), and polyimide (PI) substrates.

A novel nested allele-specific PCR protocol for the detection of the HLA-A*33:03, a SCAR-associated allele, in Vietnamese people.

BACKGROUND: Severe cutaneous adverse drug reactions (SCARs) are rare but deadly drug reactions with severe damages to patients. One of the most well-known SCARs risk factors is the human leukocyte antigen (HLA) genes polymorphism. Among the HLA polymorphic alleles, the HLA-A*33:03 allele has been found in association with SCARs induced by various drugs, especially in Asian people. There has not been any report on the specific detection protocol of the HLA-A*33:03 allele. OBJECTIVE: This study aimed to design a nested AS-PCR protocol for detecting and distinguishing diplotype genotype of the HLA-A*33:03 allele. METHODS: A nested allele-specific (AS)-PCR protocol with four primer sets was designed. The method was compared with the Sanger sequencing method on 100 samples of unknown genotypes of unrelated Vietnamese people. RESULTS: The nested AS-PCR method could identify the HLA-A*33:03 allele and the HLA-A*33:03 diplotype genotypes. Comparison with the Sanger sequencing method showed an absolute agreement (κ = 1.00, p < 0.001). The nested ASPCR protocol had a sensitivity of 100% (95%CI: 92.13-100%) and a specificity of 100% (95%CI: 93.51-100%). The protocol was used for the determination of HLA-A*33:03 allele distribution in 810 unrelated Vietnamese Kinh people, showing a frequency of HLA-A*33:03 carriers of 19.6% and an allele frequency of 10.55%. CONCLUSIONS: A novel nested AS-PCR method with a hundred-percent sensitivity and a specificity for the HLA-A*33:03 allele detection was reported. The protocol can be applied for the stratification of patients at SCAR risks with various drugs.

Photocatalytic degradation of methyl orange dye by Ti3C2-TiO2 heterojunction under solar light.

Photocatalytic activity is a feasible solution to tackle environmental pollution caused by industrial pollutants. In this research, Ti3C2-TiO2 composite with a unique structure was fabricated successfully via a hydrothermal method. Especially, the in-situ transformation of TiO2 from Ti3C2 MXene creates an intimate heterostructure, which leads to prolonging separation and migration of charged carriers. Thus, this Ti3C2-TiO2 composite enhances effectively methyl orange (MO) degradation efficiency (around 99%) after 40 light-exposed minutes. Besides, the optimal concentration of MO solution was estimated at 40 mg/L and Ti3C2-TiO2 photocatalyst also exhibited good stability after five runs. Moreover, the radical trapping test and the MO photodegradation mechanism over Ti3C2-TiO2 system were also demonstrated. This research illustrates the potential of MXenes as effective co-catalysts for photocatalysis and extends the applications of two-dimensional materials.

A Novel Allele-Specific PCR Protocol for the Detection of the HLA-C*03:02 Allele, a Pharmacogenetic Marker, in Vietnamese Kinh People.

BACKGROUND: Allopurinol, a common anti-hyperuricemia drug, is well known as an inducer of severe cutaneous adverse drug reactions (SCARs). One of the most well-defined risk factors of allopurinol-induced SCARs is the presence of polymorphic alleles of human leukocyte antigen (HLA) genes, such as HLA-B*58:01 and HLA-C*03:02 alleles. There is no commercial test or published in-house protocol for the specific detection of the HLA-C*03:02 allele. In this article, we established for the first time a simple allele-specific (AS) PCR method to identify HLA-C*03:02 allele carriers, and at the same time, determine their zygosities. METHODS: A two-step AS-PCR protocol, using four primer sets, was designed to specifically amplify and differentiate the HLA-C*03:02 allele from 17 other HLA-C alleles found in Vietnamese people. The protocol was validated with PCR-sequencing-based typing (SBT) of 100 samples of unknown genotypes. RESULTS: The PCR protocol can detect the HLA-C*03:02 allele and determine the zygosity. The results of this protocol were highly consistent with those of the SBT (ĸ = 0.98, p < 0.001). Regarding the specific detection of the HLA-C*03:02 allele, the PCR protocol had a sensitivity of 100% (95% CI: 91.61-100%) and specificity of 98.3% (95% CI: 90.9-99.7%). The protocol was used to determine the distribution of the HLA-C*03:02 allele in 810 unrelated Vietnamese Kinh people, 14.2% of which were HLA-C*03:02 carriers, the allele frequency was 7.5%. CONCLUSION: A novel AS-PCR protocol with a sensitivity of 100% for the detection of the HLA-C*03:02 allele was established. The protocol can be used for personalized treatment with allopurinol in order to minimize the risk of SCARs in Vietnamese people as well as in other Asian populations with similar genetic characteristics.

The Utilization of Maternal Healthcare Services Among Ethnic Minority Populations in Vietnam.

BACKGROUND: Previous studies have observed lower utilization of maternal healthcare services by ethnic minority groups in Vietnam compared with the majority Kinh community. This study sought to assess the utilization of maternal healthcare service-associated factors within 12 ethnic minority groups. METHOD: The cross-sectional study enrolled 996 women from 12 ethnic minority groups in Vietnam in 2019. Women had pregnancy outcomes in the last 5 years. The two variables for maternal healthcare utilization were [1] a minimum of four antenatal contacts and [2] health facility-based delivery. We examined the association of individual characteristics of maternal healthcare services using multilevel modeling. Odds ratios (ORs) and 95% confidence intervals (CIs) were reported. RESULTS: This nationally representative study found that 34.1% of women from ethnic minority backgrounds had four or more antenatal contacts during pregnancy, ranging from 8.3% in Mong community to 80.2% in Cham An Giang. Most of the women (94.4%) delivered at health facilities. Factors independently correlated with having fewer than four antenatal contacts included being illiterate, early marriage, unemployment, religious affiliation, household economy, and distance to the nearest health facility. Factors significantly associated with home delivery were living in the most disadvantaged areas and having fewer than four antenatal contacts. CONCLUSION: Substantial inequity exists in antenatal coverage both within ethnic minority groups and between socio-economic groups. The low coverage of having at least four antenatal contacts and its' correlates with facility-based delivery suggests that the government should focus efforts on increasing the number of antenatal contacts for ethnic minority women.