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Mondon C, Tan PY, Chan CL, Tran TN, Gong YY. Prevalence, determinants, intervention strategies and current gaps in addressing childhood malnutrition in Vietnam: a systematic review. BMC Public Health 2024; 24:960. [PMID: 38575928 PMCID: PMC10996139 DOI: 10.1186/s12889-024-18419-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 03/22/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Childhood malnutrition in all forms is a major public health issue worldwide. This review systematically examined the prevalence and determinants and identify the potential interventions and current gap in addressing malnutrition including undernutrition, overnutrition and micronutrient deficiencies (MNDs) in Vietnamese children aged 0-18 years old. METHODS Embase, Scopus, PubMed, and Web of Science were systematically searched through June 2022 to identify relevant articles published within the past 25 years. Study selection and data extraction were performed by one reviewer and checked for accuracy by the other two reviewers in accordance with PRISMA guideline. Risk of publication bias was assessed using American Dietetic Association Quality Criteria Checklist. RESULTS Seventy-two studies that met the inclusion criteria were included. Undernutrition has decreased over time but still 22.4%, 5.2% and 12.2% of children under 5 were stunted, wasted and underweight, respectively. Anaemia, iron, zinc, and vitamin D deficiencies were the more common forms of MNDs, the prevalence varied by age, region, and socioeconomic group. Population-based surveys reported that 11% and 48% of children aged 0-11 years old were iron and vitamin D deficient, respectively. Zinc deficiency affected almost one-quarter of the children and adolescents. Retinol deficiency was of less concern (< 20%). However, more evidence on MNDs prevalence is needed. Overweight and obesity is now on the rise, affecting one-third of school-aged children. The key determinants of undernutrition included living in rural areas, children with low birth weight, and poor socio-economic status, whereas living in urban and affluent areas, having an inactive lifestyle and being a boy were associated with increased risk of overweight and obesity. Nutrition specific intervention studies including supplementation and food fortification consistently showed improvements in anthropometric indices and micronutrient biomarkers. National nutrition-sensitive programmes also provided nutritional benefits for children's growth and eating behaviours, but there is a lack of data on childhood obesity. CONCLUSION This finding highlights the need for effective double duty actions to simultaneously address different forms of childhood malnutrition in Vietnam. However, evidence on the potential intervention strategies, especially on MNDs and overnutrition are still limited to inform policy decision, thus future research is warranted.
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Affiliation(s)
- Charlotte Mondon
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, LS2 9JT, UK
| | - Pui Yee Tan
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, LS2 9JT, UK.
| | - Chong Ling Chan
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, LS2 9JT, UK
| | - Thuy Nga Tran
- Department of Micronutrient, National Institution of Nutrition, 48B Tang Ba Ho, Hai Ba Trung District, Ha Noi, Vietnam
| | - Yun Yun Gong
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, LS2 9JT, UK.
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Hasan MM, Kader A, Asif CAA, Talukder A. Seasonal variation in the association between household food insecurity and child undernutrition in Bangladesh: Mediating role of child dietary diversity. MATERNAL & CHILD NUTRITION 2023; 19:e13465. [PMID: 36478358 PMCID: PMC10019058 DOI: 10.1111/mcn.13465] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 11/04/2022] [Accepted: 11/07/2022] [Indexed: 12/12/2022]
Abstract
Household food insecurity (HFI) and child dietary diversity (CDD) are variable across seasons. We examined seasonal variation in HFI and child undernutrition association and tested how CDD mediates this association. We analyzed data for 26,353 children aged 6-59 months drawn from nationally representative cross-sectional Food Security and Nutrition Surveillance Project data collected during 2012-2014 in Bangladesh across three seasons annually: Post-Aman harvest (January-April); Monsoon (May-August); and Post-Aus harvest (September-December). Multivariable logistic regression analysis adjusted for individual, maternal, household and geographical characteristics reveals that children of food-insecure households were more likely than food-secure households to be stunted (adjusted odds ratio, AOR: 1.12; 95% confidence interval, CI: 1.02-1.23; p < 0.05), wasted (AOR: 1.21; 95% CI: 1.05-1.39; p < 0.01) and underweight (AOR: 1.16; 95% CI: 1.04-1.3; p < 0.01). CDD mediated 6.1% of the total effect of HFI on underweight. These findings varied across seasons. HFI was associated with greater odds of underweight during Monsoon (AOR: 1.32; 95% CI: 1.08-1.62; p < 0.01) and Post-Aus (AOR: 1.21; 95% CI: 1.06-1.37; p < 0.01) while wasting during Post-Aus (AOR: 1.65; 95% CI: 1.35-2.01; p < 0.001). CDD largely mediated the total effect of HFI on underweight during the Post-Aman in 2012-2014 (23.2%). CDD largely mediated the total effect of HFI on wasting (39.7%) during Post-Aman season in 2014 and on underweight (13.7%) during the same season in 2012. These findings demonstrate that HFI is seasonally associated with child undernutrition and mediated by CDD as well in Bangladesh and seasonality and diversity should be considered while designing appropriate population-level food-based interventions to resolve child undernutrition.
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Affiliation(s)
| | - Abdul Kader
- Helen Keller IntlCountry OfficeDhakaBangladesh
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Pacillo G, Bao-Nam NV, Burra DD, Trinh HT, Le TD, Truong MT, Nguyen SD, Tran DT, Läderach P. Disruptive Innovations for Well-Functioning Food Systems: The Data-Driven “Food and Nutrition Security Under Climate Evolution” Framework. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2022. [DOI: 10.3389/fsufs.2021.726779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The current climate crisis poses new uncertainties, risks, and vulnerabilities, and is leading to losses for millions of people depending on fragile food systems. Food systems are, however, vastly different across landscapes and communities, and their capacities to respond to climate impacts evolves and changes through time. Humanitarian and development organizations are struggling to keep pace with these changes. Monitoring a large number of diverse food systems during an evolving climate crisis can be expensive and time-consuming. This paper introduces a monitoring approach that uses a combination of open-source earth observations along with national data sources to produce highly contextualized metrics for monitoring Food And Nutrition Security under Climate Evolution (FANSCE). Entirely data-driven, the FANSCE approach has been designed to produce policy recommendations to help monitor, assess, and mitigate climatic impacts on food systems. We developed and tested this approach in Vietnam, where climate variability has become a growing threat to food systems. Our results show that predictors of food and nutrition security differ drastically with the intensity of climate variability. More specifically, our analyses suggest that in areas of high climate variability, levels of food and nutrition security can be significantly predicted based on economic activities, ethnicity, education, health of mothers, and the level of readiness and preparedness to climate impacts of villages and communities. On the other hand, in areas of low climate variability, food and nutrition security are mostly predictable based on the ability of households to access essential services (such as education, health) and communal resources (water, storage, etc.). To support the resilience of food systems, policymakers must regularly monitor how these dimensions react to the changing climate. Addition critical actions to increase food system sustainability in Vietnam include 1) enhanced coordination of institutional responses and capacities across governmental and non-governmental agencies, and 2) better integration of scientific knowledge into national and sub-national decision-making processes.
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Truong DTT, Tran THT, Nguyen TTT, Tran VHT. Double burden of malnutrition in ethnic minority school-aged children living in mountainous areas of Vietnam and its association with nutritional behavior. Nutr Res Pract 2022; 16:658-672. [PMID: 36238380 PMCID: PMC9523200 DOI: 10.4162/nrp.2022.16.5.658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/26/2021] [Accepted: 12/20/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND/OBJECTIVES Although children of ethnic minority groups are experiencing a transition from a predominance of undernutrition to overnutrition, there is little evidence of a dual-malnutrition burden. Therefore, this study examined the double burden of malnutrition among school-aged ethnic minority children living in mountainous areas and its association with their diets. SUBJECTS/METHODS A cross-sectional study was conducted from September 2019 to March 2020 in 3 mountainous areas of Northern Vietnam among 1,556 ethnic minority school-aged children. The prevalence of under-nutrition (stunting and thinness) and over-nutrition (overweight and obesity) were measured using the WHO 2006 child growth standards (height-for-age and BMI-for-age Z-score). Nutritional practices were evaluated by the frequency of food consumption based on a 4-level scale. RESULTS The percentage of children with stunting and thinness were 14.0% and 5.4%, respectively, while the figure for overweight/obesity was 9.4%. The factors positively associated with stunting were living in a family with more than 2 children or being Muong/other ethnicities compared to the Tay ethnicity. Children who consumed fish/shrimps/crabs or milk weekly/daily were less likely to be undernourished compared to those who never consumed these foods. By contrast, children who never consumed foods rich in vitamin A precursors and vitamin A and fruit or consumed daily snacks/junk food were more likely to be overweight/obese. CONCLUSIONS Undernutrition remains a common issue among school-aged children and adolescents of ethnic minority groups, while over-nutrition exists simultaneously. Public health nutrition programs promoting adequate diets and positive lifestyle changes related to nutrition are essential to tackle the double burden of malnutrition among ethnic minority children.
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Affiliation(s)
- Duong Thuy Thi Truong
- Department of Nutrition and Food Safety, University of Medicine and Pharmacy - Thai Nguyen University, Thai Nguyen 24000, Vietnam
| | - Trang Huyen Thi Tran
- Department of Nutrition and Food Safety, University of Medicine and Pharmacy - Thai Nguyen University, Thai Nguyen 24000, Vietnam
| | - Tam Thanh Thi Nguyen
- Department of Nutrition and Food Safety, University of Medicine and Pharmacy - Thai Nguyen University, Thai Nguyen 24000, Vietnam
| | - Van Hong Thi Tran
- Department of Nutrition and Food Safety, University of Medicine and Pharmacy - Thai Nguyen University, Thai Nguyen 24000, Vietnam
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Abidi SHR, Almas A, Ghani A, Sabir S, Iqbal R. Assessment of macronutrients consumption in the diet of adolescent school children in four seasons: a longitudinal study from an urban city in Pakistan. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2021; 40:43. [PMID: 34656183 PMCID: PMC8520200 DOI: 10.1186/s41043-021-00268-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 10/01/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND A healthy diet in the adolescence period is essential for physical, mental, and immunological development. We aimed to assess macronutrient consumption in the diet of adolescent school children using 24 h recalls in four seasons of the year. METHOD This was a longitudinal study conducted from February 2014 to June 2015. The study population included 155 school children aged 7-14 years from an urban school in Karachi. 24HR recall was conducted on 4 random days of the 4 main seasons. A food composition table was developed where the weight, calories, carbohydrate, fat, and protein content of the food items were listed. Macronutrients quantification was calculated by using proportional weight from the food composition table. Food groups were also assigned to each food item including vegetables, fruits, grains, protein foods, dairy products, and oils. RESULTS A total of 155 adolescent children aged between 7 and 14 years were approached. Out of the 155 preadolescents and adolescents, 150 (96.7%) agreed to participate. The mean (SD) age of the children was 11.31 (1.6) years, and 59% of all the children were males. Overall mean (SD) daily intake for all seasons was 195.31 (86.87) grams of carbohydrates, 94.77 (71.87) grams of proteins, and 55.87 (30.79) grams of fats. Carbohydrates formed 48.16%, protein 21.92%, and fat 29.93% of the total caloric intake. The mean (SD) daily caloric intake was 1517 (644) grams. Overall, the highest source of calories was from carbohydrate 781 (347) Kilocalories (Kcal), followed by fat 502 (277) Kcal and protein 379 (287). The Carbohydrate intake in 24 h was highest in the autumn; 212.81 (85.37), and there was a significant difference in carbohydrate intake in all seasons (p value 0.003). Consumption of discretionary food group was high (31.3%), and consumption of fruits and vegetables was low (29%). CONCLUSION The study reports a suboptimal caloric intake of fewer than 2000 cal/day among the adolescents from school. The highest source of calories was from carbohydrates.The highest consumption of food was in autumn and the least in summer. Fruits and vegetable intake was low, and discretionary food intake was high.
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Affiliation(s)
| | - Aysha Almas
- Department of Medicine, Aga Khan University, Stadium Road, Karachi, Pakistan.
| | - Abdul Ghani
- Health Department, Government of Baluchistan, Chaghi, Pakistan
| | - Sania Sabir
- Department of Medicine, Aga Khan University, Stadium Road, Karachi, Pakistan
| | - Romania Iqbal
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
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Waswa LM, Jordan I, Krawinkel MB, Keding GB. Seasonal Variations in Dietary Diversity and Nutrient Intakes of Women and Their Children (6-23 Months) in Western Kenya. Front Nutr 2021; 8:636872. [PMID: 33763444 PMCID: PMC7982591 DOI: 10.3389/fnut.2021.636872] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/12/2021] [Indexed: 01/09/2023] Open
Abstract
Seasonal variations in food availability and access contributes to inadequate nutrient intakes, particularly in low income countries. This study assessed the effect of seasonality on dietary diversity (DD) and nutrient intakes of women and children aged 6–23 months in a rural setting in Western Kenya. A longitudinal study was conducted among 426 mother-child pairs during the harvest and post-harvest seasons in 2012. Dietary intakes were assessed using 24-h dietary recalls and dietary diversity scores (DDS) and nutrient intakes calculated for both seasons. Effect of seasonality on women dietary diversity scores (WDDS) and children's dietary diversity scores (CDDS) were assessed using generalised linear mixed models (GLMM). The proportion of women consuming diets with high DDS (>4 out of 9 food groups) increased from 36.4 to 52.4% between the two seasons, with mean WDDS being significantly higher in November compared to July/August (4.62 ± 1.43 vs. 4.16 ± 1.14, P < 0.001). A significantly higher proportion of children consumed foods from ≥4 out of 7 food groups in November compared to July/August (62.4 vs. 52.6%, P = 0.004). Mean CDDS (3.91 vs. 3.61, P = 0.004) was low but significantly higher in November compared to July/August. Estimated marginal mean WDDS increased from 4.17 to 4.38, and decreased for CDDS from 3.73 to 3.60 between the seasons. Seasonality had a small but significant effect on WDDS, P = 0.008 but not on CDDS, P = 0.293. Increase in CDDS in November was due to age and not seasonal effect. Higher women education and household food security were associated with higher WDDS and CDDS. Intakes of iron, calcium and vitamin E were higher among women in November and significantly different between the seasons. Agro-ecological zone, ethnic group and home gardening influenced nutrient intakes of the women. Seasonality had an effect on the DD of women but not of children, thus other factors apart from food availability influence the quality of children's diets during the complementary feeding period. With increasing age and transition to family foods, children's DD is expected to be affected by seasonality. Integrated interventions to alleviate seasonal food insecurity and strengthen rural households' resilience against seasonal deterioration in diet quality are recommended.
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Affiliation(s)
- Lydiah M Waswa
- Department of Human Nutrition, Faculty of Health Sciences, Egerton University, Egerton, Kenya
| | - Irmgard Jordan
- Center for international Development and Environmental Research, Justus Liebig University Giessen, Giessen, Germany
| | - Michael B Krawinkel
- Institute of Nutritional Sciences-International Nutrition, Justus Liebig University Giessen, Giessen, Germany
| | - Gudrun B Keding
- Division of Quality of Plant Products, Department of Crop Sciences, Faculty of Agricultural Sciences, George August University Goettingen, Goettingen, Germany
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Le TT, Le TTD, Do NK, Nadezhda VS, Andrej MG, Nguyen TTT, Nguyen TTM, Vu TT, Le TH, Nguyen TTL, Duong TAD. Ethnic Variations in Nutritional Status among Preschool Children in Northern Vietnam: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214060. [PMID: 31652691 PMCID: PMC6862071 DOI: 10.3390/ijerph16214060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 10/16/2019] [Accepted: 10/21/2019] [Indexed: 11/16/2022]
Abstract
(1) Background: Vietnam is a multiethnic country undergoing rapid economic development, the improvement in nutritional status in preschool children is not equally shared by all ethnic groups; (2) Methods: A cross-sectional study was performed from September-December 2018 on 16,177 children aged 24-60 months representing Kinh (n = 14421), Muong (n = 1307) and Tay (n = 449) ethnic groups. Prevalence of malnutrition, overweight, obesity and anthropometric indices were compared across ethnic groups, using WHO 2006 child growth standards; (3) Results: The prevalence of malnutrition among children of Kinh, Muong and Tay origins was 14.7%, 34.3% and 43.2%, respectively. The corresponding data for overweight was 5.5%, 2.7%, 2.2% and for obesity 2.8%, 0.8% and 0.4%, respectively. The prevalence of stunting remained the highest in three subtypes of malnutrition in all ethnic groups. Kinh children were heavier and taller than the other groups, while Muong children were taller than Tay children (p-value < 0.001); and (4) Conclusions: Malnutrition remains a major public health issue among children of minor ethnicities while overweight and obesity is an emerging challenge for the Kinh ethnic group. The results imply that a community-based intervention should be specific to ethnicity to reduce the gap in nutritional status between ethnic groups in Vietnam.
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Affiliation(s)
- Thi Tuyet Le
- Department of Human and Animal Physiology, Faculty of Biology, Hanoi National University of Education, 136 Xuan Thuy Street, Hanoi 100000, Vietnam.
| | - Thi Thuy Dung Le
- Department of Pediatrics, Hanoi Medical University, 1 Ton That Tung street, Dongda district, Hanoi 100000, Vietnam.
- Department of Public Health, Healthcare, General Hygiene and Bioethics, North-Eastern Federal University, 677000 Yakutsk, Russia.
| | - Nam Khanh Do
- Department of Nutrition and Food Safety, Institute of Preventive Medicine and Public Health, Hanoi Medical University, 1 Ton That Tung street, Dongda district, Hanoi 100000, Vietnam.
| | - V Savvina Nadezhda
- Central Scientific Research Laboratory, Northern State Medical University, 163000 Arkhangelsk, Russia.
| | - M Grjibovski Andrej
- Department of Public Health, Healthcare, General Hygiene and Bioethics, North-Eastern Federal University, 677000 Yakutsk, Russia.
- Central Scientific Research Laboratory, Northern State Medical University, 163000 Arkhangelsk, Russia.
- Department of Health Policy and Organization, Al-Farabi Kazakh National University, Almaty 050040, Kazakhstan.
- West Kazakhstan Marat Ospanov Medical University, Aktobe 030019, Kazakhstan.
| | - Thi Trung Thu Nguyen
- Department of Human and Animal Physiology, Faculty of Biology, Hanoi National University of Education, 136 Xuan Thuy Street, Hanoi 100000, Vietnam.
| | - Thi Thanh Mai Nguyen
- Department of Pediatrics, Hanoi Medical University, 1 Ton That Tung street, Dongda district, Hanoi 100000, Vietnam.
| | - Thi Tuyen Vu
- Department of Nutrition and Food Safety, Institute of Preventive Medicine and Public Health, Hanoi Medical University, 1 Ton That Tung street, Dongda district, Hanoi 100000, Vietnam.
| | - Thi Huong Le
- Department of Nutrition and Food Safety, Institute of Preventive Medicine and Public Health, Hanoi Medical University, 1 Ton That Tung street, Dongda district, Hanoi 100000, Vietnam.
| | - Thi Thu Lieu Nguyen
- Department of Nutrition and Food Safety, Institute of Preventive Medicine and Public Health, Hanoi Medical University, 1 Ton That Tung street, Dongda district, Hanoi 100000, Vietnam.
| | - Thi Anh Dao Duong
- Department of Human and Animal Physiology, Faculty of Biology, Hanoi National University of Education, 136 Xuan Thuy Street, Hanoi 100000, Vietnam.
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Frison S, Kerac M, Checchi F, Prudhon C. Anthropometric indices and measures to assess change in the nutritional status of a population: a systematic literature review. BMC Nutr 2016. [DOI: 10.1186/s40795-016-0104-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Rocklöv J, Bao Giang K, Van Minh H, Ebi K, Nilsson M, Sahlen KG, Weinehall L. Local research evidence for public health interventions against climate change in Vietnam. Glob Health Action 2014; 7:26552. [PMID: 25511887 PMCID: PMC4265643 DOI: 10.3402/gha.v7.26552] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Joacim Rocklöv
- Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden;
| | - Kim Bao Giang
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Hoang Van Minh
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Kristie Ebi
- Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; School of Public Health, University of Washington, Seattle, WA, USA
| | - Maria Nilsson
- Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Klas-Göran Sahlen
- Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Lars Weinehall
- Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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