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Pham NT, Bui QT, Tran DM, Larsson M, Pham MP, Olson L. Pertussis seasonal variation in Northern Vietnam: the evidence from a tertiary hospital. BMC Public Health 2024; 24:286. [PMID: 38267959 PMCID: PMC10809638 DOI: 10.1186/s12889-024-17705-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 01/08/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Pertussis is a highly contagious and dangerous respiratory disease that threatens children's health in many countries, including Vietnam, despite vaccine coverage. From 2015 to 2018, Vietnam experienced an increasing number of pertussis patients. Therefore, this study aimed to investigate the trend and examine the seasonal variations of pertussis in North Vietnam. METHODS Data were collected from medical records of all under-5-year-old inpatients admitted to the National Children's Hospital in Hanoi, Vietnam (VNCH) 2015-2018. A descriptive analysis was performed to describe the distribution of incident cases by year and season. Linear multivariable regression was conducted to investigate the association between the incidence of cases and seasonality adjusted by age and vaccination status. RESULTS We identified 1063 laboratory-confirmed patients during 2015-2018, including 247 (23.2%) severe patients. The number of pertussis patients admitted to VNCH per 1000 hospitalizations was 3.2 in 2015, compared to 1.9, 3.1, and 2.1 in 2016, 2017, and 2018, respectively. Outbreaks occurred biennially; however, there was no significant difference in the number of severe patients over this period. Most cases occurred in the hot season (509 patients, or nearly half of the study population). With the adjustment of the vaccination rate and average age, the risk of pertussis-associated hospitalization in the mild season and the hot season was 21% (95% CI [0.12; 0.3]) and 15% (95% CI [0.05; 0.25]) higher than that in the warm season, respectively. The rate of hospitalizations was high in the mild season (28.9%) and the warm season (30.8%), nearly twice as much as that in the hot season; nevertheless, the death rate was only striking high in the mild season, about 5-6 times as much as those in the other seasons. CONCLUSION The pertussis incidence in Northern Vietnam varied between seasons, peaking in the hot season (April-July). However, severe patients and deaths increased in the mild season (December-March). Interventions, for example, communication activities on pertussis and vaccination, are of immense importance in lowering the prevalence of pertussis. In addition, early diagnoses and early warnings performed by health professionals should be encouraged.
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Affiliation(s)
- Nhung Th Pham
- Infection Prevention and Control Department, Vietnam National Children's Hospital, Hanoi, Vietnam
- Field Epidemiology Training Program - Ministry of Health, Hanoi, Vietnam
| | - Quyen Tt Bui
- Faculty of Fundamental Sciences, Hanoi University of Public Health, No. 1A Duc Thang Ward, North Tu Liem, Ha Noi, Vietnam.
| | - Dien M Tran
- Vietnam National Children's Hospital, Hanoi, Vietnam
- Pediatric Department, School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Mattias Larsson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Training and Research Academic Collaboration, Sweden-Vietnam, Stockholm, Sweden
| | - Mai P Pham
- School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Linus Olson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
- Training and Research Academic Collaboration, Sweden-Vietnam, Stockholm, Sweden.
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
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Tran QTL, Phan PH, Bui LNH, Bui HTV, Hoang NTB, Tran DM, Trinh TT. Child Melioidosis Deaths Caused by Burkholderia pseudomallei-Contaminated Borehole Water, Vietnam, 2019. Emerg Infect Dis 2022; 28:1689-1693. [PMID: 35697339 PMCID: PMC9328891 DOI: 10.3201/eid2808.220113] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Within 8 months, 3 children from 1 family in northern Vietnam died from melioidosis. Burkholderia pseudomallei of the same sequence type, 541, was isolated from clinical samples, borehole water, and garden and rice field soil. Boreholes should be properly constructed and maintained to avoid B. pseudomallei contamination.
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3
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Phan PH, Nguyen DT, Dao NH, Nguyen HTT, Vu AV, Hoang ST, Nguyen LV, Cao TV, Tran DM. Case Report: Successful Treatment of a Child With COVID-19 Reinfection-Induced Fulminant Myocarditis by Cytokine-Adsorbing oXiris® Hemofilter Continuous Veno-Venous Hemofiltration and Extracorporeal Membrane Oxygenation. Front Pediatr 2022; 10:946547. [PMID: 35903158 PMCID: PMC9315247 DOI: 10.3389/fped.2022.946547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Indirect cardiomyocyte damage-related hyperinflammatory response is one of the key mechanisms in COVID-19-induced fulminant myocarditis. In addition to the clinical benefit of using cytokines absorption hemofiltration, the effectiveness of instituting veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support for cardiac compromise has been reported. However, current literature enunciates a paucity of available data on the effectiveness of these novel modalities. CASE PRESENTATION We reported a 9-year-old boy with recurrent COVID-19 infection-causing fulminant myocarditis, who was treated successfully by using novel modalities of oXiris ® hemofilter continuous venovenous hemofiltration (CVVH) and VA-ECMO. The patient made a full recovery without any sequelae. CONCLUSION We conclude that the novel highly-absorptive hemofilter CVVH and VA-ECMO may be effective treatment modalities in managing SARS-CoV-2-induced fulminant myocarditis. Our report highlights the need for further well-designed investigations to confirm this extrapolation.
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Affiliation(s)
- Phuc H Phan
- Pediatric COVID-19 Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Dung T Nguyen
- Pediatric COVID-19 Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Nam H Dao
- Pediatric COVID-19 Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Ha T T Nguyen
- Pediatric COVID-19 Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - An V Vu
- Pediatric COVID-19 Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Son T Hoang
- Cardiovascular Center, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Lam V Nguyen
- Pediatric COVID-19 Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Tung V Cao
- Pediatric COVID-19 Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Dien M Tran
- Pediatric COVID-19 Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam
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4
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Garpvall K, Duong V, Linnros S, Quốc TN, Mucchiano D, Modeen S, Lagercrantz L, Edman A, Le NK, Huong T, Hoang NTB, Le HT, Khu DT, Tran DM, Phuc PH, Hanberger H, Olson L, Larsson M. Admission screening and cohort care decrease carbapenem resistant enterobacteriaceae in Vietnamese pediatric ICU's. Antimicrob Resist Infect Control 2021; 10:128. [PMID: 34462014 PMCID: PMC8404250 DOI: 10.1186/s13756-021-00994-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 08/15/2021] [Indexed: 02/07/2023] Open
Abstract
Objectives To assess if admission screening for Carbapenem Resistant Enterobacteriaceae (CRE) and cohort care can reduce CRE acquisition (CRE colonization during hospital stay), Hospital Acquired Infections (HAI), hospital-stay, mortality, and costs in three Intensive Care Units (ICU’s) at the Vietnamese National Children’s Hospital. Method CRE screening using rectal swabs and ChromIDCarbas elective culture at admission and if CRE negative, once weekly. Patients were treated in cohorts based on CRE colonization status. Results CRE colonization at baseline point-prevalence screening was 76.9% (103/134). Of 941 CRE screened at admission, 337 (35.8%) were CREpos. 694 patients met inclusion criteria. The 244 patients CRE negative at admission and screened > 2 times were stratified in 8 similar size groups (periods), based on time of admission. CRE acquisition decreased significant (OR − 3.2, p < 0.005) from 90% in period 2 (highest) to 48% in period 8 (last period). Patients with CRE acquisition compared to no CRE acquisition had a significantly higher rate of culture confirmed HAI, n = 20 (14%) vs. n = 2 (2%), longer hospital stays, 3.26 vs. 2.37 weeks, and higher total treatment costs, 2852 vs. 2295 USD. Conclusion Admission CRE screening and cohort care in pediatric ICU’s significantly decreased CRE acquisition, cases of HAI and duration of hospital-stay.
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Affiliation(s)
- K Garpvall
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18B 4fl, 171 77, Stockholm, Sweden
| | - V Duong
- Vietnam National Children's Hospital, 18 ngõ 879 Đường La Thành, Láng Thượng, Đống Đa, Hà Nội, Vietnam
| | - S Linnros
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18B 4fl, 171 77, Stockholm, Sweden
| | - T N Quốc
- Vietnam National Children's Hospital, 18 ngõ 879 Đường La Thành, Láng Thượng, Đống Đa, Hà Nội, Vietnam
| | - D Mucchiano
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18B 4fl, 171 77, Stockholm, Sweden
| | - S Modeen
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18B 4fl, 171 77, Stockholm, Sweden
| | - L Lagercrantz
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18B 4fl, 171 77, Stockholm, Sweden
| | - A Edman
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18B 4fl, 171 77, Stockholm, Sweden
| | - N K Le
- Vietnam National Children's Hospital, 18 ngõ 879 Đường La Thành, Láng Thượng, Đống Đa, Hà Nội, Vietnam.,Training and Research Academic Collaboration (TRAC), Sweden - Vietnam, 18 ngõ 879 Đường La Thành, Láng Thượng, Đống Đa, Hà Nội, Vietnam.,Research Institute for Child Health, 18 ngõ 879 Đường La Thành, Láng Thượng, Đống Đa, Hà Nội, Vietnam
| | - T Huong
- Vietnam National Children's Hospital, 18 ngõ 879 Đường La Thành, Láng Thượng, Đống Đa, Hà Nội, Vietnam
| | - N T B Hoang
- Vietnam National Children's Hospital, 18 ngõ 879 Đường La Thành, Láng Thượng, Đống Đa, Hà Nội, Vietnam
| | - H T Le
- Vietnam National Children's Hospital, 18 ngõ 879 Đường La Thành, Láng Thượng, Đống Đa, Hà Nội, Vietnam
| | - D Tk Khu
- Vietnam National Children's Hospital, 18 ngõ 879 Đường La Thành, Láng Thượng, Đống Đa, Hà Nội, Vietnam.,Training and Research Academic Collaboration (TRAC), Sweden - Vietnam, 18 ngõ 879 Đường La Thành, Láng Thượng, Đống Đa, Hà Nội, Vietnam
| | - D M Tran
- Vietnam National Children's Hospital, 18 ngõ 879 Đường La Thành, Láng Thượng, Đống Đa, Hà Nội, Vietnam.,Research Institute for Child Health, 18 ngõ 879 Đường La Thành, Láng Thượng, Đống Đa, Hà Nội, Vietnam
| | - P H Phuc
- Vietnam National Children's Hospital, 18 ngõ 879 Đường La Thành, Láng Thượng, Đống Đa, Hà Nội, Vietnam.,Training and Research Academic Collaboration (TRAC), Sweden - Vietnam, 18 ngõ 879 Đường La Thành, Láng Thượng, Đống Đa, Hà Nội, Vietnam.,Research Institute for Child Health, 18 ngõ 879 Đường La Thành, Láng Thượng, Đống Đa, Hà Nội, Vietnam
| | - H Hanberger
- Training and Research Academic Collaboration (TRAC), Sweden - Vietnam, 18 ngõ 879 Đường La Thành, Láng Thượng, Đống Đa, Hà Nội, Vietnam.,Department of Clinical Microbiology and Department of Clinical and Experimental Medicine, Linköping University, 581 83, Linköping, Sweden
| | - L Olson
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18B 4fl, 171 77, Stockholm, Sweden. .,Training and Research Academic Collaboration (TRAC), Sweden - Vietnam, 18 ngõ 879 Đường La Thành, Láng Thượng, Đống Đa, Hà Nội, Vietnam. .,Department of Women's and Children's Health, Karolinska Institutet, Tomtebodavägen 18B 8fl, 171 77, Stockholm, Sweden.
| | - M Larsson
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18B 4fl, 171 77, Stockholm, Sweden.,Training and Research Academic Collaboration (TRAC), Sweden - Vietnam, 18 ngõ 879 Đường La Thành, Láng Thượng, Đống Đa, Hà Nội, Vietnam
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Tran HTT, Le HTT, Tran HTP, Khu DTK, Lagercrantz H, Tran DM, Winbladh B, Hellström‐Westas L, Alfvén T, Olson L. Hypothermic treatment for neonatal asphyxia in low-resource settings using phase-changing material-An easy to use and low-cost method. Acta Paediatr 2021; 110:85-93. [PMID: 32347576 DOI: 10.1111/apa.15331] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 11/28/2022]
Abstract
AIM To evaluate whether phase-changing material can be used for therapeutic hypothermia of asphyxiated newborns in low-resource settings. METHODS Prospective interventional study of asphyxiated term infants fulfilling criteria for hypothermia treatment at Vietnam National Children's Hospital from September 2014 to September 2016. Hypothermia was induced within 6 hours after birth and maintained for 72 hours by a phase-changing material mattress with melting point of 32°C. Rectal temperature was continuously measured, and deviations from target temperature range 33.5-34.5°C were recorded. RESULTS In total 52 infants (mean gestational age 39.3 ± 1.1 weeks) included and cooled, the median temperature at initiation of cooling was 35.3 (IQR 34.5-35.9)°C. The median time to reach target temperature was 2.5 (IQR 2-3) hours. The mean temperature during the cooling phase was 33.95 ± 0.2°C. Throughout the cooling phase, the target temperature range (33.5-34.5°C) was maintained more than 80% of the time. Rate of rewarming was 0.5 ± 0.14°C/hour. CONCLUSION Phase-changing material can be used as an effective cooling method. Though not a servo-controlled system, it is easy to induce hypothermia, maintain target temperature and rewarm infants in a slow and controlled manner without need for frequent changes and minimum risk of skin injury.
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Affiliation(s)
- Hang T. T. Tran
- Neonatal Intensive Care Unit Vietnam National Children’s Hospital (VNCH) Hanoi Vietnam
- Research Institute for Child Health Hanoi Vietnam
- Department of Global Public Health Karolinska Institutet Stockholm Sweden
| | - Ha T. T. Le
- Neonatal Intensive Care Unit Vietnam National Children’s Hospital (VNCH) Hanoi Vietnam
| | - Hanh T. P. Tran
- Neonatal Intensive Care Unit Vietnam National Children’s Hospital (VNCH) Hanoi Vietnam
| | - Dung T. K. Khu
- Neonatal Intensive Care Unit Vietnam National Children’s Hospital (VNCH) Hanoi Vietnam
- Training and Research Academic Collaboration Vietnam‐Sweden
| | - Hugo Lagercrantz
- Department of Women’s and Children’s Health Karolinska Institutet Stockholm Sweden
| | - Dien M. Tran
- Research Institute for Child Health Hanoi Vietnam
| | - Birger Winbladh
- Department of Women’s and Children’s Health Karolinska Institutet Stockholm Sweden
| | | | - Tobias Alfvén
- Department of Global Public Health Karolinska Institutet Stockholm Sweden
- Sachs’ Children and Youth Hospital Stockholm Sweden
| | - Linus Olson
- Neonatal Intensive Care Unit Vietnam National Children’s Hospital (VNCH) Hanoi Vietnam
- Training and Research Academic Collaboration Vietnam‐Sweden
- Department of Women’s and Children’s Health Karolinska Institutet Stockholm Sweden
- Department of Womens and Children’s Health Uppsala University Uppsala Sweden
- Department of Clinical Research and Education Södersjukhuset Karolinska Institutet Stockholm Sweden
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6
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Pham NTH, Le NDT, Le NK, Nguyen KD, Larsson M, Olson L, Tran DM. Pertussis epidemiology and effect of vaccination among diagnosed children at Vietnam, 2015-2018. Acta Paediatr 2020; 109:2685-2691. [PMID: 32181924 DOI: 10.1111/apa.15259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 03/05/2020] [Accepted: 03/13/2020] [Indexed: 11/28/2022]
Abstract
AIM To evaluate effect and costs of pertussis vaccination at Vietnam National Children's Hospital. METHODS Pertussis cases were defined by positive laboratory tests of children under 5 years January 2015-June 2018, and data on patient characteristics, clinical data and hospitalisation costs were collected through patient records. RESULTS Of 909 inpatients, 400 (44%) were <2 months, the age for first DPT vaccination, and mechanical ventilation was more common than in children >2 months (9% vs 4%, OR = 2.3, CI 1.3-3.9), as well as persistent cough (99%), violent cough (87%) and pneumonia (91%). Comparing non-vaccinated (172 cases, 19%) and DPT vaccinated patients >2 months of age hospitalisation was 106-fold higher (149.6 vs 1.39 per 100 000 population), and proportion of severe patients, length of hospital stay and hospitalisation costs were significantly greater (23.9% vs 12.8%; 13 vs 10 days; 826 USD vs 582 USD, CI 23-423, P = .03). CONCLUSION Incidence and proportion of complications among under 2-month infants were higher than in older patients. DPT vaccination protects children from pertussis infection, and in case of pertussis infection decreases severity. Results indicate that the Ministry of Health should consider adding a booster vaccine for pregnant women in an extended vaccination programme.
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Affiliation(s)
- Nhung T. H. Pham
- Vietnam National Children’s Hospital Ha Noi Vietnam
- Field Epidemiology Training Program ‐ Ministry of Health Ha Noi Vietnam
| | - Nhan D. T. Le
- Field Epidemiology Training Program ‐ Ministry of Health Ha Noi Vietnam
- Institute of Public Health Ho Chi Minh City Vietnam
| | - Ngai K. Le
- Vietnam National Children’s Hospital Ha Noi Vietnam
| | - Khoa D. Nguyen
- General Department of Preventive Medicine ‐ Ministry of Health Ha Noi Vietnam
| | - Mattias Larsson
- Department of Global Public Health Karolinska Institutet Stockholm Sweden
- Training and Research Academic Collaboration Stockholm Sweden
- Training and Research Academic Collaboration Hanoi Vietnam
| | - Linus Olson
- Department of Global Public Health Karolinska Institutet Stockholm Sweden
- Training and Research Academic Collaboration Stockholm Sweden
- Training and Research Academic Collaboration Hanoi Vietnam
- Department of Women’s and Children’s Health Karolinska Institutet Stockholm Sweden
| | - Dien M. Tran
- Vietnam National Children’s Hospital Ha Noi Vietnam
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7
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Le HT, Nguyen LV, Tran DM, Do HT, Tran HT, Le YT, Phan PH. The first infant case of COVID-19 acquired from a secondary transmission in Vietnam. Lancet Child Adolesc Health 2020; 4:405-406. [PMID: 32213326 PMCID: PMC7118689 DOI: 10.1016/s2352-4642(20)30091-2] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 01/25/2023]
Affiliation(s)
- Hai T Le
- Emergency Department, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Lam V Nguyen
- Center for Pediatric Tropical Diseases, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Dien M Tran
- Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Hai T Do
- Center for Pediatric Tropical Diseases, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Huong T Tran
- Center for Pediatric Tropical Diseases, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Yen T Le
- Center for Pediatric Tropical Diseases, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Phuc H Phan
- Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam.
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Tran DM, Larsson M, Olson L, TB Hoang N, Kien Ngai L, TK Khu D, Nguyen HD, Vu TV, Trinh TH, Le TQ, TT Phan P, Nguyen BG, Pham NH, Mai BH, Nguyen TV, Nguyen PTK, Le ND, Huynh TM, Anh Thu Le T, Chi Thanh T, Berglund B, Nilsson LE, Bornefall E, Huu SL, Stig-Inge. Hanberger H. 492. High Prevalence of Colonization with Carbapenem-Resistant Enterobacteriaceae Among Patients Admitted to Vietnamese Hospitals: Risk Factors and Burden of Disease. Open Forum Infect Dis 2019. [PMCID: PMC6811223 DOI: 10.1093/ofid/ofz360.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Carbapenem-resistant Enterobacteriaceae (CRE) is an increasing problem worldwide, but particularly problematic in low- and middle-income countries (LMIC) due to limitations of resources for surveillance of CRE and infection prevention and control (IPC). Methods A point prevalence survey (PPS) with screening for colonization with CRE was conducted on 2233 patients admitted to neonatal, pediatric and adult care at 12 Vietnamese hospitals located in northern, central and southern Vietnam during 2017 and 2018. CRE colonisation was determined by culturing of fecal specimens on selective agar for CRE. Risk factors for CRE colonisation were evaluated. A CRE admission and discharge screening sub-study was conducted among one of the most vulnerable patient groups; infants treated at an 80-bed Neonatal ICU from March throughout June 2017 to assess CRE acquisition, hospital-acquired infection (HAI) and treatment outcome. Results A total of 1165 (52%) patients were colonized with CRE, most commonly Klebsiella pneumoniae (n = 805), Escherichia coli (n = 682) and Enterobacter spp. (n = 61). Duration of hospital stay, HAI, intubation, peripheral venous catheter and treatment with a carbapenem were independent risk factors for CRE colonization. The PPS showed that the prevalence of CRE colonization increased on average 4.2% per day and mean CRE colonisation rates increased from 13% on the day of admission to 89% at day 15 of hospital stay. At the NICU CRE colonisation increased from 32% at admission to 87% at discharge, mortality was significantly associated (OR 5·5, P < 0·01) with CRE colonisation and HAI on admission. Conclusion These data indicate that there is an epidemic spread of CRE in Vietnamese hospitals with rapid transmission to hospitalized patients. CRE colonization places a major burden on the healthcare system due to the increased risk of HAI caused by CRE and associated increased mortality. This study shows that large-scale epidemiological surveillance of CRE using affordable methods is possible in low- and middle-income countries. Disclosures All authors: No reported disclosures.
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Affiliation(s)
- Dien M Tran
- Vietnam National Children’s Hospital, Hanoi, Ha Noi, Vietnam
| | | | - Linus Olson
- Karolinska Institutet, Stockholms Lan, Sweden
| | - Ngoc TB Hoang
- Vietnam National Children’s Hospital, Hanoi, Ha Noi, Vietnam
| | - Le Kien Ngai
- Vietnam National Children’s Hospital, Hanoi, Ha Noi, Vietnam
| | - Dung TK Khu
- Vietnam National Children’s Hospital, Hanoi, Ha Noi, Vietnam
| | | | - Tam V Vu
- Uong Bi Hospital, Quang Ninh, Vietnam, Uong Bi, Quang Ninh, Vietnam
| | | | - Thinh Q Le
- Children’s Hospital 1, Ho Chi Minh, Ho Chi Minh, Vietnam
| | | | | | | | - Bang H Mai
- Central Military Hospital 108, Hanoi, Ha Noi, Vietnam
| | - Tuan V Nguyen
- Central Military Hospital 108, Hanoi, Ha Noi, Vietnam
| | | | - Nhan D Le
- Da Nang General Hospital, Da Nang, Vietnam
| | - Tuan M Huynh
- University Medical Clinic, HCMC, Ho Chi Minh, Vietnam
| | | | - Tran Chi Thanh
- Training and Research Academic Collaboration Sweden-Vietnam, Hanoi, Ha Noi, Vietnam
| | - Björn Berglund
- Faculty of Medicine, Linköping University, Linkoping, Ostergotlands Lan, Sweden
| | - Lennart E Nilsson
- Clinical Microbiology, Faculty of Medicine, Linköping University, Linkoping, Ostergotlands Lan, Sweden
| | - Elin Bornefall
- Infectious Diseases, Faculty of Medicine, Linköping University, Linkoping, Ostergotlands Lan, Sweden
| | - Song L Huu
- Central Military Hospital 108, Hanoi, Ha Noi, Vietnam
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9
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Peters L, Olson L, Khu DTK, Linnros S, Le NK, Hanberger H, Hoang NTB, Tran DM, Larsson M. Multiple antibiotic resistance as a risk factor for mortality and prolonged hospital stay: A cohort study among neonatal intensive care patients with hospital-acquired infections caused by gram-negative bacteria in Vietnam. PLoS One 2019; 14:e0215666. [PMID: 31067232 PMCID: PMC6505890 DOI: 10.1371/journal.pone.0215666] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 04/05/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Antibiotic resistance (ABR) is an increasing burden for global health. The prevalence of ABR in Southeast Asia is among the highest worldwide, especially in relation to hospital-acquired infections (HAI) in intensive care units (ICU). However, little is known about morbidity and mortality attributable to ABR in neonates. AIM This study aimed to assess mortality and the length of hospitalization attributable to ABR in gram-negative bacteria (GNB) causing HAI in a Vietnamese neonatal ICU (NICU). METHODS We conducted a prospective cohort study (n = 296) in a NICU in Hanoi, Vietnam, from March 2016 to October 2017. Patients isolated with HAI caused by GNB were included. The exposure was resistance to multiple antibiotic classes, the two outcomes were mortality and length of hospital stay (LOS). Data were analysed using two regression models, controlling for confounders and effect modifiers such as co-morbidities, time at risk, severity of illness, sex, age, and birthweight. RESULTS The overall case fatality rate was 44.3% and the 30 days mortality rate after infection was 31.8%. For every additional resistance to an antibiotic class, the odds of a fatal outcome increased by 27% and LOS increased by 2.1 days. These results were statistically significant (p < 0.05). CONCLUSION ABR was identified as a significant risk factor for adverse outcomes in neonates with HAI. These findings are generally in line with previous research in children and adults. However, heterogeneous study designs, the neglect of important confounders and varying definitions of ABR impair the validity, reliability, and comparability of results.
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Affiliation(s)
- Lynn Peters
- Global Health program, Karolinska Institutet, Stockholm, Sweden
| | - Linus Olson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Training and Research Academic Collaboration Sweden-Vietnam, Karolinska Institutet, Stockholm, Sweden
| | - Dung T. K. Khu
- Training and Research Academic Collaboration Sweden-Vietnam, Karolinska Institutet, Stockholm, Sweden
- Department of Neonatology, Vietnam National Children’s Hospital, Hanoi, Vietnam
| | - Sofia Linnros
- Global Health program, Karolinska Institutet, Stockholm, Sweden
| | - Ngai K. Le
- Training and Research Academic Collaboration Sweden-Vietnam, Karolinska Institutet, Stockholm, Sweden
- Department of Microbiology, Vietnam National Children’s Hospital, Hanoi, Vietnam
| | - Håkan Hanberger
- Department of Clinical and Experimental Medicine, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Ngoc T. B. Hoang
- Department of Microbiology, Vietnam National Children’s Hospital, Hanoi, Vietnam
| | - Dien M. Tran
- Research Institute for Child Health, Hanoi, Vietnam
- Department of Surgery, Vietnam National Children’s Hospital, Hanoi, Vietnam
| | - Mattias Larsson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Training and Research Academic Collaboration Sweden-Vietnam, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
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10
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Bui QT, Vu LT, Tran DM. Trajectories of depression in adolescents and young adults in Vietnam during rapid urbanisation: evidence from a longitudinal study. J Child Adolesc Ment Health 2018; 30:51-59. [PMID: 29911958 DOI: 10.2989/17280583.2018.1478299] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES This paper investigates the trajectories of depression symptoms in adolescents and young adults, and explores factors associated with their depression. METHOD For each respondent, three waves of data were collected in 2006, 2009 and 2013 from adolescents and young adults aged 10 to 24 years. The modified Center for Epidemiological Studies Depression Scale was used to interview participants, while the generalised estimating equation (GEE) model was used to identify whether certain factors were associated with depression. RESULTS The mean depression scores in 2006, 2009 and 2013 were 29.76, 30.80 and 30.51 respectively. Compared to boys, girls reported higher initial levels of depressive symptoms. The depression score was found to be highest among adolescents aged 15 to 17 years. Depression among young people was associated with age, gender, marital status, education levels, general health and living location. CONCLUSION Using longitudinal design, this research demonstrated the different trajectories of depression scores between boys and girls over time and provided evidence for interventions improving adolescent mental health in a semi-urban area of Vietnam.
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Affiliation(s)
- Quyen Tt Bui
- a Department of Biostatistics , Hanoi University of Public Health , Ha Noi , Vietnam
| | - Lan Th Vu
- b Department of Epidemiology , Hanoi University of Public Health , Ha Noi , Vietnam
| | - Dien M Tran
- c Vietnam National Children's Hospital , Ha Noi , Vietnam
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11
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Bacey J, Spurlock F, Starner K, Feng H, Hsu J, White J, Tran DM. Residues and toxicity of esfenvalerate and permethrin in water and sediment, in tributaries of the Sacramento and San Joaquin rivers, California, USA. Bull Environ Contam Toxicol 2005; 74:864-71. [PMID: 16097319 DOI: 10.1007/s00128-005-0661-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Affiliation(s)
- J Bacey
- California Environmental Protection Agency, California Department of Pesticide Regulation, 1001 I Street, Sacramento, CA 95812, USA
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