Passive Smoking Exposure and Perceived Health Status in Children Seeking Pediatric Care Services at a Vietnamese Tertiary Hospital

Indoor Aeroallergen Sensitization and Associated Factors in Hospitalized Children with Asthma Exacerbations

Background

Allergic asthma represents the most popular phenotype of childhood asthma and is characterized by eosinophilic airway inflammation associated with specific immunoglobulin E (IgE) antibodies sensitization to various allergens, as evidenced by serology or skin prick test.2 Sensitization to indoor aeroallergens is associated with severe asthma and severe asthma exacerbations.

Objective

This study aimed to identify the prevalence of aeroallergen sensitization and its associated factors in children with an asthma exacerbation in Vietnam.

Methods

A cross-sectional study was conducted at Children's Hospital 1, Ho Chi Minh City (HCMC). Children who were aged 3 to 15 and admitted to the hospital with moderate or severe asthma exacerbation were recruited to the study. Data was collected from interviews and medical records. SPT was used to identify aeroallergen sensitization. The association between school-age, living area, and passive smoking with the odds of aeroallergen sensitization was assessed using a multivariable logistic regression.

Results

The prevalence of aeroallergen sensitization was 82.6% and this figure in school-age children was higher than that in preschool-age ones (93.8% vs 72.1%, p=0.001). School-age, living in HCMC, and passive smoking significantly increased the odds of aeroallergen sensitization in asthmatic children with adjusted OR [95%CI] as 6.9 [2.1-23.3], 4.1 [1.5-11.5], and 2.9 [1.0-8.4], respectively. Asthmatic children with aeroallergen sensitization required more hours to resolve an asthma exacerbation than those without (22.4 vs 15.2, p=0.006).

Conclusion

Aeroallergen sensitization was common in hospitalized children with moderate or severe asthma exacerbation. It is necessary to establish environmental policy and screening practices of aeroallergen sensitization to improve the quality of asthma management for Vietnamese children.

Tobacco smoking and nicotine dependence among patients with respiratory diseases in Vietnam: Status and correlated factors

INTRODUCTION

Understanding nicotine dependence can support clinicians in enhancing the effectiveness of treatments for respiratory patients. Our research aimed to assess the severity of nicotine dependence among patients with respiratory diseases in Vietnam and accordingly suggest potential interventions for tobacco cessation.

METHODS

A cross-sectional study was conducted at the Respiratory center of Bach Mai Hospital, Hanoi, for two months of 2016 (October and November). A total of 508 respondents participated in the study Data on socio-economic characteristics and smoking patterns were collected. The Euroqol-5 dimensions-5 levels (EQ-5D-5L) and Fagerström test for nicotine dependence (FTND) were used to evaluate patient's quality of life and the nicotine dependence level, respectively. Kruskal-Wallis and Chi-square tests were used to assess the differences between variables. We applied the multivariate logistic regression and Tobit regression to categorize the association between nicotine dependence level and other factors.

RESULTS

A total of 508 patients enrolled in our study. Former smokers and current smokers accounted for 8.1% and 38.6% of the sample, respectively. Current smokers were more likely to be male, work as free lancers, and report anxiety/depression. Higher level of nicotine dependence among current smokers was associated with the employment status of the patient. The mean number of cigarettes per day was 15.7 (SD = 11.1). The mean score of the FTND was 5.1 (SD = 2.0). Freelancers were more likely to be a current smoker (OR = 2.65, 95% CI = 2.21; 5.79). People who experienced anxiety/depression had a higher likelihood of smoking (OR = 2.21, 95% CI = 1.04; 4.72).

CONCLUSIONS

Current smokers demonstrated a moderate level of nicotine dependence, which predict a difficult quitting and suggest the development of specialized programs to support smoking cessation counseling. Furthermore, the capabilities of physicians in supporting and counseling patients in quitting smoking should be strengthened.

Change in Compliance of Staff at 4 Vietnam Universities after the Enactment of Smoke-free Environment Decree

BACKGROUND

The Tobacco Control Law in Vietnam was adopted in 2012 and came into force from May 2013, followed by a number of guiding sub-law legal documents. Smoke-free campus policy in university is considered an important measure to protect people from secondhand smoking as well as staffs and students will be in favour of the policy. Furthermore, there has been evidence suggested that smoke-free policy had positive impact on active smoking as well as anti-smoking attitude.

METHODS

A cross-sectional self-administered study of staff at 4 universities were conducted in 2 phases, Phase 1 as early introduction of the Law (n = 900) and Phase 2 as 1-year post (n = 885). Demographics, tobacco consumption, compliance status and compliance with awareness towards the campus smoking regulations were assessed in both phases.

RESULTS

Daily smoking prevalence decreased significantly (P < .05) 1 year after implementing the smoke-free policy, while a significant increase in occasional smoking (P < .01). Compliance of staff to the regulation the campus should be indoor smoke-free was significantly increase at Phase 2 compared to Phase 1, however participants reported there would be places on campus that smokers frequently violated the smoke-free regulations.

CONCLUSIONS

The study indicated a significant positive change in compliance of staff at the 4 universities after the implementation of the Tobacco Control Law, included the smoke-free policy. Although the prevalence of tobacco smoking in this study was low, the proportion of respondents who reported to reduce infringement the smoke-free policy suggests support for staff smokers would be beneficial. Raising awareness and enforcement is likely to enhance the long-term outcomes of the implementation of smoke-free environment.