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Nguyen CT, Nguyen HT, Boyer L, Auquier P, Fond G, Do KN, Dang AK, Do HP, Latkin CA, Ho RCM, Ho CSH. Prevalence and impacts of self-medication in a disadvantaged setting: the importance of multi-dimensional health interventions. Front Public Health 2023; 11:1176730. [PMID: 37575118 PMCID: PMC10412933 DOI: 10.3389/fpubh.2023.1176730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/11/2023] [Indexed: 08/15/2023] Open
Abstract
Background Self-medication is recognized as an effective form of treatment and is increasingly encouraged to treat minor illnesses. However, misuse of self-medication leaves devastating impacts on human health and causes antimicrobial resistance. Using medication without a prescription among farmers could cause more severe effects on their health than non-farm workers since they suffer from several occupational hazards such as excessive exposure to pesticides. Methods A cross-sectional study was conducted in 197 residents living in Moc Chau from August to September. A structured questionnaire and face-to-face were used to collecting data. The multivariate logistic model was applied to indicate associated factors with the self-medication. Results The prevalence of self-medication among farmers was 67%. Pain relievers (66.7%) and antibiotics (32.5%) were the types of medicines that were the most commonly purchased and used without a medical prescription. Ethnics and health status also significantly affected the self-medication practice as well as the purchase and use of antibiotics. The distance to travel to a medical center and the dangerous or difficult travel, participants with arthritis or inpatient treatment had significantly associated with buying and using the medicine and antibiotics without the medical prescription of farmers. Conclusion Our research highlights a considerably high prevalence of self-medication among farmers residing in the mountainous area of Vietnam. Individual factors such as ethnics, health status, distance to health centers, and dangerous or difficult travel were found to be related to the SM practice as well as the purchase and use of antibiotics. From that, the current study suggests interventions. For instance, official guidelines are needed to raise awareness and minimize the disadvantages of self-medication; and digital health technologies should be applied to reduce the gap in healthcare service between mountainous and other areas of Vietnam.
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Affiliation(s)
- Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Hien Thu Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Laurent Boyer
- EA 3279, CEReSS, Research Centre on Health Services and Quality of Life, Aix Marseille University, Marseille, France
| | - Pascal Auquier
- EA 3279, CEReSS, Research Centre on Health Services and Quality of Life, Aix Marseille University, Marseille, France
| | - Guillaume Fond
- EA 3279, CEReSS, Research Centre on Health Services and Quality of Life, Aix Marseille University, Marseille, France
| | - Khanh Nam Do
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Anh Kim Dang
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Huyen Phuc Do
- Institute of Health Economics and Technology, Hanoi, Vietnam
| | - Carl A. Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Roger C. M. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
| | - Cyrus S. H. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Alqarni AS, Pasay-An E, Saguban R, Cabansag D, Gonzales F, Alkubati S, Villareal S, Lagura GAL, Alshammari SA, Aljarboa BE, Mostoles R. Relationship between the Health Literacy and Self-Medication Behavior of Primary Health Care Clientele in the Hail Region, Saudi Arabia: Implications for Public Health. Eur J Investig Health Psychol Educ 2023; 13:1043-1057. [PMID: 37366784 DOI: 10.3390/ejihpe13060080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 06/12/2023] [Accepted: 06/16/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND AND AIM Because they are unaware of the potential adverse effects of medications, people frequently self-medicate as a form of self-care. This study aimed to investigate the factors associated with health literacy and the propensity to self-medicate among the primary healthcare clientele of the city of Hail, Saudi Arabia. METHODS This research employed a cross-sectional approach with the participation of 383 primary health center clientele of the Hail Region of Saudi Arabia. Participation was enacted via convenience sampling from December 2022 to February 2023. The data were collected using a self-administered questionnaire. The investigation utilized descriptive statistics as well as multiple linear regression and correlation for the data analysis. RESULTS Participants who were aged 30 years and above, single, had a college degree, were non-Saudi, had a white-collar occupation and received information from the internet/Google/YouTube had a significant relationship (p < 0.05) with health literacy. On the self-medication scale (SMS), there were significant relationships with age, marital status, educational level and occupation (p < 0.05). The nationality and source of information factors related to health had a positively significant effect on health literacy (p < 0.01), while middle age (24-29 years) had a positive effect on the self-medication scores (p < 0.01). There was a significant positive correlation between the health literacy screening scale (BRIEF) and the self-medication scale (SMS) scores (r = 421, p < 0.001). CONCLUSION Age of 30 years old or above, single status, a college degree, non-Saudi status, white-collar occupation and receiving information from the internet/Google/YouTube were all significant for health literacy. There were also significant relationships with the SMS scores for age, marital status, educational level and occupation. The factors affecting health literacy were older participant age, nationality and the source of information regarding health. Conversely, among the participants, being in the middle-aged group (24-29 years) was a factor that affected their self-medication scores. There was a significant positive correlation between the health literacy screening scale (BRIEF) and the self-medication scale (SMS).
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Affiliation(s)
- Aidah Sanad Alqarni
- Department of Medical-Surgical Nursing, College of Nursing, King Khalid University, Abha 62521, Saudi Arabia
| | - Eddieson Pasay-An
- Maternal and Child Nursing Department, College of Nursing, University of Hail, Hail 2440, Saudi Arabia
| | - Reynita Saguban
- College of Nursing, University of Hail, Hail 81491, Saudi Arabia
| | - Dolores Cabansag
- College of Nursing, University of Hail, Hail 81491, Saudi Arabia
| | - Ferdinand Gonzales
- Department of Medical-Surgical Nursing, College of Nursing, King Khalid University, Abha 62521, Saudi Arabia
| | - Sameer Alkubati
- Medical Surgical Nursing Department, College of Nursing, University of Hail, Hail 2440, Saudi Arabia
| | - Sandro Villareal
- College of Nursing, University of Hail, Hail 81491, Saudi Arabia
| | - Grace Ann Lim Lagura
- Maternal and Child Nursing Department, College of Nursing, University of Hail, Hail 2440, Saudi Arabia
| | | | | | - Romeo Mostoles
- College of Nursing, University of Hail, Hail 81491, Saudi Arabia
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Duong MC, Pham OKN, Thai TT, Lee R, Nguyen TP, Nguyen VVC, Nguyen HP. Magnitude and patterns of severe Plasmodium vivax monoinfection in Vietnam: a 4-year single-center retrospective study. Front Med (Lausanne) 2023; 10:1128981. [PMID: 37324161 PMCID: PMC10265633 DOI: 10.3389/fmed.2023.1128981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 05/10/2023] [Indexed: 06/17/2023] Open
Abstract
Introduction Infection with Plasmodium vivax is a recognized cause of severe malaria including deaths. The exact burden and patterns of severe P. vivax monoinfections is however still not well quantified, especially in P. vivax endemic regions. We examined the magnitude and patterns of severe malaria caused by monoinfections of P. vivax and associated predictors among patients admitted to a tertiary care center for malaria in Vietnam. Methods A retrospective cohort study was conducted based on the patients' medical records at the Hospital for Tropical Diseases from January 2015 to December 2018. Extracted information included demographic, epidemiologic, clinical, laboratory and treatment characteristics. Results Monoinfections with P. vivax were found in 153 (34.5, 95% CI 30.3-39.1%) patients of whom, uncomplicated and severe malaria were documented in 89.5% (137/153, 95% CI 83.7-93.5%) and 10.5% (16/153, 95% CI 6.5-16.3%), respectively. Patterns of severe malaria included jaundice (8 cases), hypoglycemia (3 cases), shock (2 cases), anemia (2 cases), and cerebral malaria (1 case). Among 153 patients, 73 (47.7%) had classic malaria paroxysm, 57 (37.3%) had >7 days of illness at the time of admission, and 40 (26.1%) were referred from other hospitals. A misdiagnosis as having other diseases from malaria cases coming from other hospitals was up to 32.5% (13/40). Being admitted to hospital after day 7th of illness (AOR = 6.33, 95% CI 1.14-35.30, p = 0.035) was a predictor of severe malaria. Severe malaria was statistically associated with longer hospital length of stay (p = 0.035). Early and late treatment failures and recrudescence were not recorded. All patients recovered completely. Discussion This study confirms the emergence of severe vivax malaria in Vietnam which is associated with delayed hospital admission and increased hospital length of stay. Clinical manifestations of P. vivax infection can be misdiagnosed which results in delayed treatment. To meet the goal of malaria elimination by 2030, it is crucial that the non-tertiary hospitals have the capacity to quickly and correctly diagnose malaria and then provide treatment for malaria including P. vivax infections. More robust studies need to be conducted to fully elucidate the magnitude of severe P. vivax in Vietnam.
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Affiliation(s)
- Minh Cuong Duong
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | | | - Thanh Truc Thai
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Rogan Lee
- Centre for Infectious Diseases and Microbiology, Pathology West-ICPMR and Marie Bashir Institute, University of Sydney, Westmead Hospital, Westmead, NSW, Australia
| | | | - Van Vinh Chau Nguyen
- Department of Health, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Hoan Phu Nguyen
- Medical School, Vietnam National University of Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
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Vasile V, Bunduchi E, Stefan D, Comes CA, Vasile R, Stefan AB. Are We Facing a Radical Change in the Migration Behavior of Medical Graduates from Less Developed Countries? Demographic Profile vs. Social Push Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4894. [PMID: 36981802 PMCID: PMC10049695 DOI: 10.3390/ijerph20064894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/05/2023] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
The phenomenon of migration among medical personnel from less developed countries is a large one, with negative effects on the origin country, but more worrying is graduates' propensity to migrate during or immediately after university studies. The analysis of the labor market in the health sector from the last two decades shows us greater attractiveness of employment in (more) economically developed states compared to the demand from the health sector in graduates' origin countries. This research's purpose is to identify the determinants of the propensity to study and work abroad of medical students as a defined factor for better employment, and to identify the push factors in the origin country. As a result of the dichotomous nature of the dependent variables, logistic regression was applied. The independent variables (gender, residence, medical specialization, grades and perceived economic status) were used to identify the odds of the intention to migrate for studies. The results highlighted a higher propensity to migrate for studies among medical students, with opportunities offered by universities differing across countries and geographical areas. Moreover, students with a lower level of household income have openness to migrate, the tuition fees being managed through part-time/temporary employment during studies.
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Affiliation(s)
- Valentina Vasile
- Institute of National Economy, Romanian Academy, 13 Calea 13 Septembrie, 050711 Bucharest, Romania; (V.V.); (D.S.); (C.-A.C.)
| | - Elena Bunduchi
- Institute of National Economy, Romanian Academy, 13 Calea 13 Septembrie, 050711 Bucharest, Romania; (V.V.); (D.S.); (C.-A.C.)
- Faculty of Economics and Law, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania;
| | - Daniel Stefan
- Institute of National Economy, Romanian Academy, 13 Calea 13 Septembrie, 050711 Bucharest, Romania; (V.V.); (D.S.); (C.-A.C.)
- Faculty of Economics and Law, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania;
| | - Calin-Adrian Comes
- Institute of National Economy, Romanian Academy, 13 Calea 13 Septembrie, 050711 Bucharest, Romania; (V.V.); (D.S.); (C.-A.C.)
- Faculty of Economics and Law, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania;
| | - Razvan Vasile
- “Costin C. Kirițescu” National Institute of Economic Research, Romanian Academy, 13 Calea 13 Septembrie, 050711 Bucharest, Romania;
| | - Anamari-Beatrice Stefan
- Faculty of Economics and Law, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania;
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Nguyen TTP, Do TX, Nguyen HA, Nguyen CTT, Meyer JC, Godman B, Skosana P, Nguyen BT. A National Survey of Dispensing Practice and Customer Knowledge on Antibiotic Use in Vietnam and the Implications. Antibiotics (Basel) 2022; 11:antibiotics11081091. [PMID: 36009960 PMCID: PMC9405246 DOI: 10.3390/antibiotics11081091] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 07/26/2022] [Accepted: 08/04/2022] [Indexed: 11/28/2022] Open
Abstract
Misconceptions and pressures have increased the sales of antibiotics without a prescription across countries. There are concerns with such practices in Vietnam given rising antimicrobial resistance rates. A national survey was conducted among 360 private drugstores located in nine provinces in Vietnam. Anonymous interviews were conducted with participants selected by convenience sampling. Subsequently, multivariable logistic regression analyses were undertaken evaluating the relationship between customer characteristics and antibiotic purchases. A total of 480 out of 1626 surveyed participants purchased antibiotics, 81.7% of which did not have a prescription, involving 29 different antibiotics. In 86.4% of these, participants were prescribed antibiotics by drug sellers. Most antibiotics were sold to treat respiratory tract infections (61.4%), with the ‘Access’ antibiotics (amoxicillin and cephalexin) being the most frequently sold. Only one-fifth of participants understood that they were breaking the law by purchasing antibiotics without a prescription. Participants purchasing antibiotics without a prescription had lower awareness concerning antibiotic laws and treatment duration (p < 0.05). Under 50% agreed to having a doctors’ prescription in the future when purchasing antibiotics. Freelancer occupation (OR = 0.52, 95% CI = 0.83−0.96) and a lower educational level (OR = 0.49, 95% CI = 0.25−0.96) were factors related to purchasing antibiotics without a prescription. Overall, we recommend increasing fines and monitoring of drugs stores, greater promotion of the family doctor system as well as increasing media and educational campaigns to limit self-purchasing of antibiotics in Vietnam and reduce resistance.
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Affiliation(s)
- Thuy Thi Phuong Nguyen
- Department of Pharmaceutical Management and Economics, Hanoi University of Pharmacy, Hanoi City 10000, Vietnam
| | - Thang Xuan Do
- Department of Pharmaceutical Management and Economics, Hanoi University of Pharmacy, Hanoi City 10000, Vietnam
| | - Hoang Anh Nguyen
- The National Center of Drug Information & Adverse Drug Reaction Monitoring, Hanoi University of Pharmacy, Hanoi City, 10000, Vietnam
- Bach Mai Hospital, Hanoi City 10000, Vietnam
| | - Cuc Thi Thu Nguyen
- Department of Pharmaceutical Management and Economics, Hanoi University of Pharmacy, Hanoi City 10000, Vietnam
- Correspondence: (C.T.T.N.); (B.G.)
| | - Johanna Catharina Meyer
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa
| | - Brian Godman
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK
- Centre of Medical and Bio allied Health Sciences Research, Ajman University, Ajman P.O. Box 346, United Arab Emirates
- Correspondence: (C.T.T.N.); (B.G.)
| | - Phumzile Skosana
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa
| | - Binh Thanh Nguyen
- Department of Pharmaceutical Management and Economics, Hanoi University of Pharmacy, Hanoi City 10000, Vietnam
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Abdelwahed RNK, Jassem M, Alyousbashi A. Self-Medication Practices, Prevalence, and Associated Factors among Syrian Adult Patients: A Cross-Sectional Study. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:9274610. [PMID: 35800339 PMCID: PMC9256391 DOI: 10.1155/2022/9274610] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/04/2022] [Accepted: 06/04/2022] [Indexed: 11/18/2022]
Abstract
Objectives Self-medication (SM) means using drugs to treat self-diagnosed diseases or symptoms. Despite its important role in reducing the load on medical services, it may bear many risks. This study aims to determine the prevalence of SM and its determinants among adult inpatients of Damascus Hospital, Syria. Study design. Cross-sectional study. Methods 453 adult inpatients were asked to complete a questionnaire through face-to-face interviews. Data were analysed using statistical package for the social sciences (SPSS). A chi-square test was used to detect correlation between variables. Results Out of 453 respondents, 67.3% practiced self-medication. Most used drugs were analgesics, antipyretics, and antibiotics. The main indications for SM included headache, cough/flu, and body aches. Pharmacists were the main source of knowledge about the drugs used in SM. The leading reason for practicing SM was the mildness of the complaint. Approximately half of the participants declared they read leaflets of drugs they used in SM. In this study, SM was significantly associated with monthly income, age, and living place. Conclusions The prevalence of SM in Damascus Hospital is high. Larger, nationwide studies are needed to identify the prevalence and determining factors of SM in Syria and to suggest the appropriate measures to control this phenomenon.
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Affiliation(s)
- Rawan N. K. Abdelwahed
- Dermatology and Venereology University Hospital, Ministry of Higher Education, Damascus, Syria
| | - Manaf Jassem
- Department of Internal Medicine, Damascus Hospital, Ministry of Health, Damascus, Syria
| | - Ayham Alyousbashi
- Department of Pediatrics, Damascus Hospital, Ministry of Health, Damascus, Syria
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Saha A, Marma KKS, Rashid A, Tarannum N, Das S, Chowdhury T, Afrin N, Chakraborty P, Emran M, Mehedi HMH, Hussain MI, Barua A, Mistry SK. Risk factors associated with self-medication among the indigenous communities of Chittagong Hill Tracts, Bangladesh. PLoS One 2022; 17:e0269622. [PMID: 35696405 PMCID: PMC9191716 DOI: 10.1371/journal.pone.0269622] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 05/24/2022] [Indexed: 11/23/2022] Open
Abstract
Background In developing countries like Bangladesh, self-medication has become a predicament associated with health risks and clinical complications. To date, no studies have been conducted on the practice of self-medication among the indigenous population living in Chittagong Hill Tract (CHT). Objectives This study was aimed to determine the prevalence of self-medication and analyzing the factors associated with it among the indigenous population in CHT. Methods This cross-sectional study was conducted from late October to early December 2020; among different indigenous group populations residing in the three districts of CHT aged 18 or more. A pre-tested and semi-structured questionnaire was developed to collect data on socio-demographic characteristics, health status, frequency of self-medication, reasons for self-medication in last one year, as well as other variables. Multivariate logistic regression was performed to assess associated factors with self-medication. Results A total of 1350 people from different indigenous populations were interviewed, among whom 49.9% practiced self-medication. The rate of self-prescribed antibiotics usage (80.9%) was significantly higher compared to other drugs. Self-prescribed medications were mostly used for diarrhea and food poisoning (60.6%), cough, cold and fever (51.4%), and headache (51.4%). A common source of self-prescribed medicines was community or retail pharmacy and the most reported reason for self-prescribed medication was the long-distance of healthcare facilities from home. Conclusion The prevalence of self-medication is substantially high among indigenous people and the effect is alarming. Particular concern is the misuse of antibiotics and analgesic drugs. Increasing awareness among the population of the negative effect of self-medication and implementation of proper policies and actions are urgently needed to prevent self-medication among indigenous population in Bangladesh.
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Affiliation(s)
- Ayan Saha
- Department of Genetic Engineering and Biotechnology, East West University, Dhaka, Bangladesh
- * E-mail: ,
| | | | - Afrah Rashid
- Department of Public Health and Bioinformatics, Asian University for Women, Chattogram, Bangladesh
| | - Nowshin Tarannum
- Department of Microbiology, University of Chittagong, Chattogram, Bangladesh
| | - Srabanty Das
- Department of Biochemistry and Molecular Biology, University of Chittagong, Chattogram, Bangladesh
| | | | - Nusrat Afrin
- Department of Pharmacy, University of Chittagong, Chattogram, Bangladesh
| | - Prashanta Chakraborty
- Department of Genetic Engineering and Biotechnology, University of Chittagong, Chattogram, Bangladesh
| | - Md. Emran
- Department of Biochemistry & Biotechnology, University of Science & Technology Chittagong, Chattogram, Bangladesh
| | | | | | - Ashim Barua
- Upazila Health Complex, Alikadam, Bandarban, Bangladesh
| | - Sabuj Kanti Mistry
- ARCED Foundation, Mirpur, Dhaka, Bangladesh
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
- Department of Public Health, Daffodil International University, Dhaka, Bangladesh
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Zawahir S, Le HTT, Nguyen TA, Beardsley J, Dang AD, Bernays S, Viney K, Cao TH, Drabarek D, Tran HH, Nguyen ST, Pham VTT, Luong TM, Tran HTM, Nguyen NV, Jan S, Marais BJ, Negin J, Marks GB, Fox GJ. Inappropriate supply of antibiotics for common viral infections by community pharmacies in Vietnam: A standardised patient survey. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 23:100447. [PMID: 35465041 PMCID: PMC9019242 DOI: 10.1016/j.lanwpc.2022.100447] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND This study aimed to evaluate the appropriateness of antibiotic dispensing of private pharmacies in Vietnam. METHODS Standardised patient surveys were conducted in randomly selected community pharmacies across 40 districts in Vietnam. Four clinical scenarios were represented by patient actors: (a) an adult requesting treatment for a sibling with a viral upper respiratory tract infection (URTI), (b) a parent requesting treatment for a child with acute diarrhoea, (c) an adult making a direct antibiotic request, and (d) an adult presenting with an antibiotic prescription. We calculated the proportion of interactions that resulted in inappropriate supply of antibiotics and patient advice. Predictors of inappropriate antibiotic supply were assessed. FINDINGS Patient actors attended 949 pharmacies, resulting in 1266 clinical interactions. Antibiotics were inappropriately supplied to 92% (291/316) of adults requesting treatment for URTI symptoms, 43% (135/316) for children with acute diarrhoea symptoms and to 84% (267/317) of direct request for antibiotics. Only 49% of pharmacies advised patients regarding their antibiotic use. Female actors were more likely to be given antibiotics than male actors for URTI (aOR 2·71, 1·12-6·60) but not for diarrhoeal disease. Pharmacies in northern Vietnam were more likely than those in southern Vietnam to supply antibiotics without a prescription: for adult URTI (aOR=5·8, 95% CI: 2·2-14·9) and childhood diarrhoea (aOR=3·5, 95% CI: 2·0-6·0) symptoms, but less likely to dispense for direct antibiotics request. INTERPRETATION Inappropriate antibiotic supply was common in Vietnamese private pharmacies. Multifaceted measures are urgently needed to achieve WHO's global action plan for the optimal use of antimicrobials. FUNDING This study was funded by a grant from the Australian Department of Foreign Affairs and Trade.
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Affiliation(s)
- Shukry Zawahir
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | | | | | - Justin Beardsley
- The University of Sydney Marie Bashir Institute for Infectious Diseases and Biosecurity, Sydney, NSW, Australia
| | - Anh Duc Dang
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | - Sarah Bernays
- School of Public Health, The University of Sydney, Sydney, Australia
| | - Kerri Viney
- Centre of Global Health, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Research School of Population Health, Australian National University, Canberra ACT, Australia
| | - Thai Hung Cao
- Medical Service Administration, Ministry of Health, Viet Nam
| | - Dorothy Drabarek
- School of Public Health, The University of Sydney, Sydney, Australia
| | - Hoang Huy Tran
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | | | | | - Tan Minh Luong
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | | | | | - Stephen Jan
- The George Institute for Global Health Australia, Institute for Global Health, Sydney, Australia
| | - Ben J Marais
- The University of Sydney Marie Bashir Institute for Infectious Diseases and Biosecurity, Sydney, NSW, Australia
| | - Joel Negin
- School of Public Health, The University of Sydney, Sydney, Australia
| | - Guy B Marks
- Woolcock Institute of Medical Research, University of Sydney, Glebe, Australia
- University of New South Wales, Sydney, Australia
| | - Greg J Fox
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
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Over-the-Counter Medicine Attitudes and Knowledge among University and College Students in Brunei Darussalam: Findings from the First National Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052658. [PMID: 35270352 PMCID: PMC8909889 DOI: 10.3390/ijerph19052658] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 01/09/2022] [Accepted: 01/19/2022] [Indexed: 12/04/2022]
Abstract
Over-the-counter (OTC) medicine is defined as safe and effective for the general public to use, without seeking therapy from a health professional. As primary social media and internet users, university and college students are more likely to be exposed to unverified sources of health information. This study aims to assess the knowledge, attitudes, and behaviour of students at institutions of higher learning in Brunei with regard to the safe use of OTC medicines. A cross-sectional study was performed using a self-administered online questionnaire, adapted from the literature with additional information from the United States Food and Drug Administration (FDA) on the educational resources in understanding OTC medicine for consumers. The questionnaire consisted of 4 sections: demographic information, knowledge of OTC medicines, attitudes, and practice. Descriptive and inferential statistics were used for data analysis. A total of 335 students returned a completed questionnaire. The students had a mean knowledge score of 7.1 out of 9, with more than half (53.4%) having good knowledge (knowledge score > 7), and only a small percentage (5.7%) with poor knowledge. Almost all of the students (99.7%) had a positive attitude toward OTC medicine use. Few of the students practiced improper habits in terms of OTC medicine use, such as not reading the instructions or taking more than the recommended dose. Awareness of proper OTC medicine use among students in institutions of higher learning is necessary to prevent the rise of inappropriate user practices.
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Nguyen TA, Pham YN, Doan NP, Nguyen TH, Do TT, Van Vu G, Marks GB, McKinn S, Negin J, Bernays S, Fox GJ. Factors affecting healthcare pathways for chronic lung disease management in Vietnam: a qualitative study on patients' perspectives. BMC Public Health 2021; 21:1145. [PMID: 34130687 PMCID: PMC8207672 DOI: 10.1186/s12889-021-11219-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) and asthma rank among the leading causes of respiratory morbidity, particularly in low- and middle-income countries. This qualitative study aimed to explore the healthcare pathways of patients with chronic respiratory disease, and factors influencing their ability to access healthcare in Vietnam, where COPD and asthma are prevalent. METHODS We conducted 41 in-depth interviews among patients, including 31 people with COPD, eight with asthma and two with asthma-COPD overlap syndrome. Participants were recruited at provincial- or national-level health facilities in two urban and two rural provinces in Vietnam. The interviews were audio-recorded, transcribed, and analysed using thematic analysis. RESULTS Patients' healthcare pathways were complex and involved visits to multiple health facilities before finally obtaining a definitive diagnosis at a provincial- or national-level hospital. Access to healthcare was affected considerably by participants' limited knowledge of their respiratory conditions, the availability of social support, especially from family members, the costs of healthcare as well as health system factors (including the coverage of public health insurance, the distance to health facilities, and attitude of healthcare providers). CONCLUSION The study demonstrated the need for improved access to timely diagnosis and treatment of chronic lung disease within the lower level of the health system. This can be achieved by enhancing the communication skills and diagnostic capacity of local healthcare workers. Health education programmes for patients and caregivers will contribute to improved control of lung disease.
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Affiliation(s)
- Thu-Anh Nguyen
- Woolcock Institute of Medical Research, 298 Kim Ma, Ba Dinh, Hanoi, Vietnam. .,Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
| | - Yen Ngoc Pham
- Woolcock Institute of Medical Research, 298 Kim Ma, Ba Dinh, Hanoi, Vietnam
| | - Nhung Phuong Doan
- Woolcock Institute of Medical Research, 298 Kim Ma, Ba Dinh, Hanoi, Vietnam
| | - Thao Huong Nguyen
- Woolcock Institute of Medical Research, 298 Kim Ma, Ba Dinh, Hanoi, Vietnam
| | - Toan Thanh Do
- School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | | | - Guy B Marks
- Australia South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
| | - Shannon McKinn
- School of Public Health, University of Sydney, Sydney, Australia
| | - Joel Negin
- School of Public Health, University of Sydney, Sydney, Australia
| | - Sarah Bernays
- School of Public Health, University of Sydney, Sydney, Australia.,London School of Hygiene and Tropical Medicine, London, UK
| | - Greg J Fox
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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11
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Routine Medical Check-Up and Self-Treatment Practices among Community-Dwelling Living in a Mountainous Area of Northern Vietnam. BIOMED RESEARCH INTERNATIONAL 2021; 2021:8734615. [PMID: 33977109 PMCID: PMC8087461 DOI: 10.1155/2021/8734615] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 04/11/2021] [Accepted: 04/17/2021] [Indexed: 11/17/2022]
Abstract
This study was conducted to evaluate the routine medical check-up and self-treatment behaviors of people living in a remote and mountainous setting in Northern Vietnam and identify their associations. A cross-sectional study was conducted on 175 people in August 2018 in Cao Son commune, Da Bac district, Hoa Binh. Information regarding routine medical check-ups and self-treatment behaviors was collected by using a structured questionnaire. Multivariate logistic regression was used to examine the associations. Results show that 24% of the mountainous people had routine medical check-ups in the last 12 months. The rate of self-treatment in the past three months was 33.7%. The number of chronic diseases (OR = 1.5, 95% CI = 1.0-2.3), health information sources from radio/television (OR = 3.3, 95% CI = 1.2-9.5), or social media (OR = 24.8, 95% CI = 1.2-512.4) was related to routine medical check-up. People who did not have routine medical check-up were more likely to have self-treatment practice (OR = 6.3, 95% CI = 1.9-21.1) than those who had a regular health check. Promoting health education and communication through mass media to raise people's awareness about regular health check-ups is a promising way to improve people's self-treatment status.
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12
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Ethnic Variations in Healthcare Service Utilization and Access in Vietnamese Mountainous Setting. ScientificWorldJournal 2021; 2021:6650303. [PMID: 33976587 PMCID: PMC8087479 DOI: 10.1155/2021/6650303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/14/2021] [Accepted: 04/17/2021] [Indexed: 11/17/2022] Open
Abstract
Evidence of health service use and access across different target groups is essential for policy development, health promotion, and promotion of equity in healthcare. This study aims to look at ethnic variations in health service use and access among residents in mountainous areas of Vietnam. A cross-sectional descriptive study was conducted on 321 adults from two mountainous communes in Bac Kan province. Healthcare service use and access were evaluated by using a structured questionnaire. Zero-inflated Poisson regression was used to examine the ethnic variations in the healthcare service use and access. Of 321 mountainous residents, 63.6% used health services in the previous 12 months, of which 24.9% respondents used inpatient services and 47.9% used outpatient services. The number of outpatient medical services used by the Tay participant was higher than that of the Kinh and other ethnic groups (p < 0.05). Multivariate regression results showed that compared to Kinh people, Tay people had a higher number of outpatient service use (Coef. = 0.25, p=0.04), while people in other ethnicities had a lower number of service use (Coef. = -0.64, p=0.01). Meanwhile, no difference was found among groups regarding the number of inpatient service use (p > 0.05). This study showed the ethnic differences in outpatient use of health services among communities living in the northern mountainous setting of Vietnam.
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13
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Mok CZ, Sellappans R, Ee Loo JS. The prevalence and perception of self-medication among adults in the Klang Valley, Malaysia. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2021; 29:29-36. [PMID: 32715568 DOI: 10.1111/ijpp.12660] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/26/2020] [Accepted: 07/02/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Self-medication, while potentially beneficial, also brings certain risks such as inappropriate treatment and adverse effects. In this study, we determine the prevalence and perception towards self-medication among adults living in the Klang Valley, Malaysia. METHODS This study was a cross-sectional study which sampled 562 respondents across the Klang Valley, Malaysia using a stratified quota sampling method and a self-administered questionnaire. The questionnaire consisted of three sections: demographic data, self-medication practices and perception towards self-medication. Perception towards self-medication was measured using 20 statements with a 5-point Likert scale. Descriptive and inferential tests as well as factor analysis were used to analyse the data. KEY FINDINGS The overall prevalence of self-medication for minor ailments was 63.5%. Self-medication was practised to a similar degree regardless of respondent demographics. Respondents most frequently obtained their medicines for self-medication of minor ailments from pharmacies without consulting the pharmacist (68.6%), followed by using leftover medications at home (44.8%) and obtaining medicines from friends and family (16.0%). Factor analysis revealed that self-medication behaviour is driven by good perception towards self-medication in terms of efficacy, safety and convenience, as well as by previous personal or shared experiences. CONCLUSION The prevalence of self-medication is high among adults in the Klang Valley, Malaysia. Adults who self-medicate view the consequences of self-medication in a positive light and may be influenced by previous personal or shared experiences. As certain risks with self-medication may be underestimated, efforts to educate the public while promoting a more proactive approach among healthcare professionals should be encouraged.
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Affiliation(s)
- Chi Zen Mok
- School of Pharmacy, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya Selangor, Malaysia
| | - Renukha Sellappans
- School of Pharmacy, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya Selangor, Malaysia
| | - Jason Siau Ee Loo
- School of Pharmacy, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya Selangor, Malaysia
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14
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Godman B, Haque M, Islam S, Iqbal S, Urmi UL, Kamal ZM, Shuvo SA, Rahman A, Kamal M, Haque M, Jahan I, Islam MZ, Hossain MM, Munzur-E-Murshid, Kumar S, Charan J, Bhatt R, Dutta S, Abhayanand JP, Sharma Y, Saleem Z, Phuong TNT, Kwon HY, Kurdi A, Wale J, Sefah I. Rapid Assessment of Price Instability and Paucity of Medicines and Protection for COVID-19 Across Asia: Findings and Public Health Implications for the Future. Front Public Health 2020; 8:585832. [PMID: 33381485 PMCID: PMC7767884 DOI: 10.3389/fpubh.2020.585832] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 10/15/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Countries have introduced a variety of measures to prevent and treat COVID-19 with medicines and personal protective equipment (PPE), with some countries adopting preventative strategies earlier than others. However, there has been considerable controversy surrounding some treatments. This includes hydroxychloroquine where the initial hype and misinformation lead to shortages, price rises and suicides. Price rises and shortages have also been seen for PPE. Such activities can have catastrophic effects on patients where there are high co-payment levels and issues of affordability. Consequently, there is a need to investigate this further. Objective: Assess changes in the availability, utilization and prices of relevant medicines and PPE during the pandemic among a range of Asian countries. Our approach: Narrative literature review combined with interviews among community pharmacists to assess changes in consumption, prices and shortages of medicines and PPE from the beginning of March 2020 until end of May 2020. In addition, suggestions on ways to reduce misinformation. Results: 308 pharmacists took part from five Asian countries. There was an appreciable increase in the utilization of antimicrobials in Pakistan (in over 88% of pharmacies), with lower increases or no change in Bangladesh, India, Malaysia and Vietnam. Encouragingly, there was increased use of vitamins/immune boosters and PPE across the countries, as well as limited price rises for antimicrobials in India, Malaysia and Vietnam, although greater price rises seen for analgesics and vitamin C/immune boosters. Appreciable price increases were also seen for PPE across some countries. Conclusion: Encouraging to see increases in utilization of vitamins/immune boosters and PPE. However, increases in the utilization and prices of antimicrobials is a concern that needs addressing alongside misinformation and any unintended consequences from the pandemic. Community pharmacists can play a key role in providing evidence-based advice, helping to moderate prices, as well as helping address some of the unintended consequences of the pandemic.
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Affiliation(s)
- Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
- Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden
- School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Mainul Haque
- Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, Malaysia
| | - Salequl Islam
- Department of Microbiology, Jahangirnagar University, Dhaka, Bangladesh
| | - Samiul Iqbal
- Department of Orthodontics, Faculty of Dentistry, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Umme Laila Urmi
- Department of Microbiology, Jahangirnagar University, Dhaka, Bangladesh
| | - Zubair Mahmood Kamal
- Integrated Sleep Disorders Center, McGuire VAMC/VCU Health, Richmond, VA, United States
| | | | - Aminur Rahman
- Finance & Account Division, Grameen Euglena, Dhaka, Bangladesh
| | - Mustafa Kamal
- Al-Manar Hospital Ltd., Modern Hospital Cumilla Ltd., Dhaka, Bangladesh
| | - Monami Haque
- Human Resource Department, Square Toiletries Limited, Rupayan Center, Dhaka, Bangladesh
| | - Iffat Jahan
- Department of Physiology, Eastern Medical College, Comilla, Bangladesh
| | - Md. Zakirul Islam
- Department of Pharmacology, Eastern Medical College, Comilla, Bangladesh
| | | | - Munzur-E-Murshid
- WISH2ACTION Project, Handicap International, Kurigram, Bangladesh
| | - Santosh Kumar
- Department of Periodontology and Implantology, Karnavati University, Gandhinagar, India
| | - Jaykaran Charan
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, India
| | - Rohan Bhatt
- Department of Pediatric Dentistry, Karnavati University, Gandhinagar, India
| | - Siddhartha Dutta
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, India
| | | | - Yesh Sharma
- Department of Conservative Dentistry and Endodontics, Rajasthan University of Health Sciences, Jaipur, India
| | - Zikria Saleem
- Department of Pharmacy Practice, Faculty of Pharmacy, The University of Lahore, Lahore, Pakistan
| | - Thuy Nguyen Thi Phuong
- Pharmaceutical Administration & PharmacoEconomics, Hanoi University of Pharmacy, Hanoi, Vietnam
| | - Hye-Young Kwon
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
- College of Pharmacy, Seoul National University, Seoul, South Korea
| | - Amanj Kurdi
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
- Department of Pharmacology, College of Pharmacy, Hawler Medical University, Erbil, Iraq
| | - Janney Wale
- Independent Consumer Advocate, Brunswick, VIC, Australia
| | - Israel Sefah
- Ghana Health Service, Keta Municipal Hospital, Pharmacy Department, Keta, Ghana
- University of Health and Allied Sciences, School of Pharmacy, Pharmacy Practice Department, Volta Region, Ghana
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15
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Hoang MT, Do KN, Pham HQ, Nguyen CT, Ha GH, Vu GT, Tran BX, Latkin C, Ho RCM, Ho CS. Psychological distress among mountainous farmers in Vietnam: a cross-sectional study of prevalence and associated factors. BMJ Open 2020; 10:e038490. [PMID: 32764088 PMCID: PMC7412583 DOI: 10.1136/bmjopen-2020-038490] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Psychological distress has been known as a major health problem among farmers across the world. In Vietnam, approximately 50% of farmers have lived in rural and mountainous areas. Yet, little has been known about how psychological distress impacts mountainous farmers' health. OBJECTIVES This study aimed to examine the prevalence and risk factors related to psychological distress among mountainous farmers in Vietnam. DESIGN AND SETTING A cross-sectional study was performed from August to September 2018 in Moc Chau district, Vietnam. A structured questionnaire and face-to-face interviews were used for data collection. PARTICIPANTS A random sample of 197 farmers aged at least 18 years, spoke Vietnamese, was not suffering from severe diseases and residing in Moc Chau at the time of the survey were recruited. PRIMARY AND SECONDARY OUTCOME MEASURES The Kessler Psychological Distress Scale (K6) was employed to measure psychological distress. The tobit and logistic regressions were applied to indicate associated factors. RESULTS The prevalence of psychological distress was 38.2% (95% CI 31.3% to 45.5%). Having a greater comorbidities (OR=6.17; 95% CI 1.44 to 26.43), drinking alcohol (OR=3.86; 95% CI 1.02 to 14.59) and obtaining health information from health workers (OR=3.77; 95% CI 1.22 to 11.66) were positively associated with the prevalence of psychological distress. By contrast, being overweight (OR=0.29; 95% CI 0.09 to 0.93), adopting books as the primary source of health information (OR=0.11; 95% CI 0.01 to 0.8), and receiving a higher number of home visits by community health workers (CHWs) (OR=0.38; 95% CI 0.14 to 0.99) were negatively associated with the prevalence of psychological distress. CONCLUSION This study highlighted a high prevalence of psychological distress among mountainous farmers. Providing routine psychological and physical health screening, developing CHWs to provide clinical support and raising health awareness are critical implications for reducing psychological distress in this population.
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Affiliation(s)
- Men Thi Hoang
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Viet Nam
- Faculty of Pharmacy, Duy Tan University, Da Nang, Viet Nam
| | - Khanh Nam Do
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
| | - Hai Quang Pham
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Viet Nam
- Faculty of Medicine, Duy Tan University, Da Nang, Viet Nam
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Viet Nam
- Faculty of Medicine, Duy Tan University, Da Nang, Viet Nam
| | - Giang Hai Ha
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Viet Nam
- Faculty of Pharmacy, Duy Tan University, Da Nang, Viet Nam
| | - Giang Thu Vu
- Center of Excellence in Evidence-Based Medicine, Nguyen Tat Thanh University, Ho Chi Minh, Viet Nam
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States
| | - Carl Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore
| | - Cyrus Sh Ho
- Department of Psychological Medicine, National University Hospital, Singapore
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