Seroprevalence of Tissue and Luminal Helminths among Patients in Hanoi Medical University Hospital, Vietnam, 2018.

A serological survey was performed using ELISA to estimate the prevalence of tissue and luminal helminthic infections among hospital patients in Hanoi region, Vietnam. An overall seroprevalence of tissue and luminal helminthiases was 64.0% (95% CI 61.2-66.8) among 1,120 patients who visited Hanoi Medical University Hospital, Vietnam in 2018. The highest seroprevalence was observed against Toxocara spp. (59.0%), followed by Strongyloides stercoralis (46.3%), Gnathostoma spp. (25.5%), cysticercus (12.8%), Angiostrongylus cantonensis (10.5%), Fasciola spp. (11.1%), and Clonorchis sinensis (8.7%). Mono-infection by one species (11.1%) was lower than multiple infections (53.0%) (P<0.05). The seroprevalence in males (59.3%) was lower than in females (66.2%) but not statistically significant (P>0.05). Children (<15 years) revealed lower seroprevalence (34.0%) than adults (68.4%), and the age group 51-70 years revealed the highest seroprevalence (76.0%). Among the seropositive patients, eosinophilia (≥8.0%) was noted in 80.2%. The present results suggested active transmission of various tissue and luminal helminths among people in Hanoi, Vietnam.

Two Human Cases of Echinococcus ortleppi Infection in the Lung and Heart in Vietnam.

This is a report of 2 cases of human hydatidosis caused by Echinococcus ortleppi in Vietnam. The patients were a 12-year-old male (case 1) having a cyst of 10.0×9.0 cm size in the lung and a 50-year-old female with a 3.0×3.3 cm-sized cyst in the heart. Eosinophilia was 33.7% in the male and 45.8% in the female patient. C-reactive protein was increased to 16.5 mg/L in the male and 18.2 mg/L in the female. Both patients were positive for ELISA at OD=2.5 and 3.1, respectively. Echinococcus protoscolices were collected from the cysts by amniocentesis and surgery. The protoscolices were identified as E. ortleppi by morphology and analysis of mitochondrial NADH dehydrogenase 1 (nad1) gene sequence. Both patients were cured by surgical resection of the hydatid cyst combined with albendazole medication. The E. ortleppi infection in lung is the second report, and the other in the heart is the first in Vietnam.

Prevalence and pregnancy outcomes of gestational diabetes mellitus by different international diagnostic criteria: a prospective cohort study in Vietnam.

Background: Several diagnostic criteria for gestational diabetes mellitus (GDM) have been developed and used internationally. This study estimated the prevalence of GDM and pregnancy outcomes among Vietnamese women.Methods: A prospective cohort study of 2030 women was undertaken in Vietnam between 2015 and 2016. Baseline interview and a single-step 75-g oral glucose tolerance test (OGTT) were conducted at 24-28 weeks of gestation. GDM was defined by five international diagnostic criteria: America Diabetes Association (ADA), European Association for the Study of Diabetes (EASD), International Association of the Diabetes and Pregnancy study groups (IADPSG), National Institute of Health and Clinical Excellence (NICE), and World Health Organization (WHO). Maternal and neonatal outcomes were assessed using medical records. Besides descriptive statistics and univariate analyses, logistic regressions were performed to ascertain the associations between GDM and maternal and neonatal outcomes.Results: The prevalence of GDM varied considerably by the diagnostic criteria: 6.4% (ADA), 7.9% (EASD), 22.8% (IADPSG/WHO), and 24.2% (NICE). Women with GDM according to EASD were more likely to have macrosomic infants (adjusted odds ratio (OR) 4.35, 95% confidence interval [CI]: 1.49-12.72), despite no apparent increase in risk under other criteria. Babies born to mothers with GDM appeared to be large-for-gestational age (LGA) by ADA criteria (adjusted OR 2.10, 95% CI: 1.10-4.02) or EASD criteria (adjusted OR 2.15, 95% CI: 1.16-3.98), when compared to their counterparts in the normal group. No significant differences in maternal and other neonatal outcomes were found between the normal and GDM groups.Conclusions: A global guideline is needed for the diagnosis, prevention and management of GDM.

Strongyloidiasis in northern Vietnam: epidemiology, clinical characteristics and molecular diagnosis of the causal agent.

BACKGROUND: Strongyloidiasis is a health problem in Vietnam, but appropriate information is still limited. The aim of this study was to determine the prevalence, geographical distribution, epidemiological aspects, symptoms and other health indicators of Strongyloides stercoralis infections in patients from 27 provinces of northern Vietnam attending the Hanoi Medical University Hospital during 2016 and 2017. METHODS: Blood samples of 2000 patients were analyzed for S. stercoralis infection with an IgG ELISA test. Seroprevalence was analyzed by gender, age group, locality of origin (rural or urban areas) and symptoms. Stools from the seropositive patients were examined for the detection of worms which were subsequently used for species identification by morphology and rDNA ITS1 sequencing. RESULTS: A seroprevalence of 20% was detected, showing an increasing prevalence from young to older age groups but without significant gender difference. Seroprevalence was higher in rural areas than in urban areas, both in general and individually in all provinces without exception, and lower in the mountainous areas than in the large valley lowlands. The follow-up of the 400 patients showed eosinophilia in 100% of cases, diarrhoea in 64.5%, digestion difficulties in 58.0%, stomachache in 45.5%, stomach and duodenal ulcers in 44.5%, itching in 28.0% and fever in 9.5%. The prevalence of symptoms and signs were also higher in older age groups than in younger age groups. Worms were detected in stools of 10.5% of the patients. Sequencing of a 501-bp nuclear ribosomal DNA ITS1 fragment allowed for the verification of infection by Strongyloides stercoralis. CONCLUSIONS: To our knowledge, this study is the largest survey of human strongyloidiasis in Vietnam so far and the first molecular identification of this nematode species in this country. Long-term chronicity may probably be usual in infected subjects, mainly in the older age groups.

Detection of four patients who were infected by Schistosoma haematobium in Vietnam.

INTRODUCTION: Schistosoma lives as a parasite in the portal vein causing intestinal lesions. It also lives in the liver, spleen, and the vein of the urinary bladder causing lesions in the urinary system. Angola is an endemic area of Schistosoma haematobium, which causes lesions in the urinary system, including the urinary bladder. In this study, we aimed to identify and classify the parasites that were collected from four patients from Angola, who currently live in Vietnam, by morphological and molecular methods. PATIENTS AND METHODS: The main clinical symptoms of the patients were collected, and Schistosoma eggs were taken from urine by a centrifugal method from the four patients in 2016. Identification of the species by morphological method was taken using a microscope. The DNA of the Schistosoma was also isolated and was identified by cytochrome C oxidase subunit 1 (Cox1) sequence. RESULTS: The four Vietnamese patients infected with S. haematobium in Angola returned to Vietnam. All the patients felt strange and had cystalgia and hematuria (blood urine), and one of them was diagnosed with urinary bladder cancer, where surgery was necessary for that patient. Schistosoma eggs, which were collected from the urine of the four patients, were identified as S. haematobium by morphological and molecular methods. These patients were the first reports of Schistosoma in Vietnam. CONCLUSION: Four Vietnamese schistosomiasis patients returned from Angola: three were diagnosed with schistosomiasis and one was diagnosed with urinary bladder cancer. They had similar symptoms including a strange feeling, cystalgia, hematuria, and eosinophilia and were detected with Schistosoma eggs in urine.

Comparison of direct effects of clinically available vasodilators; nitroglycerin, nifedipine, cilnidipine and diltiazem, on human skeletonized internal mammary harvested with ultrasonic scalpel.

Direct vasodilator effects of nitroglycerin, nifedipine, cilnidipine and diltiazem on human skeletonized internal mammary artery graft harvested with ultrasonic scalpel were assessed in the presence of 0.1 or 0.2 µM of noradrenaline. Ring preparations were made of distal end section of the bypass grafts, and those dilated by acetylcholine were used for assessment. Each drug dilated the artery in a concentration-related manner (0.01-10 µM, n = 6 for each drug) with a potency of nitroglycerin > nifedipine = cilnidipine > diltiazem. These results indicate that nitroglycerin can be useful for treating internal mammary artery spasm, that clinical utility of diltiazem may not depend on its vasodilator effect on the bypass graft, and that cilnidipine as well as nifedipine will have anti-spastic action which is in the middle between those of nitroglycerine and diltiazem.