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Chau NVV, Thuong TC, Hung NT, Hong NTT, Quy DT, Thien TB, Hiep CM, Minh NNQ, Khanh TH, Han DDK, Truc THC, Ny NTH, Thanh LK, Nguyet LA, Thuy CT, Nhu LNT, Van Quang P, Nguyen PNT, Qui PT, Rogier van Doorn H, Thwaites CL, Thanh TT, Dung NT, Thwaites G, Anh NT, Nhan LNT, Van Tan L. Emerging Enterovirus A71 Subgenogroup B5 Causing Severe Hand, Foot, and Mouth Disease, Vietnam, 2023. Emerg Infect Dis 2024; 30:363-367. [PMID: 38270132 PMCID: PMC10826755 DOI: 10.3201/eid3002.231024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024] Open
Abstract
We report on a 2023 outbreak of severe hand, foot, and mouth disease in southern Vietnam caused by an emerging lineage of enterovirus A71 subgenogroup B5. Affected children were significantly older than those reported during previous outbreaks. The virus should be closely monitored to assess its potential for global dispersal.
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Chau NVV, Trung TN, Khanh PNQK, Nhat PTH, Van HMT, Hai HB, Thuy DB, Tung NLN, Khoa DB, Vien TTD, Hao NV, Oanh PKN, Khoa TD, Phong NT, Nguyen NT, Huynh J, Walker TM, Van Nuil J, An LP, McKnight J, Toan LM, Tan LV, Dung NT, Truong NT, Thwaites CL. Wearable devices for remote monitoring of hospitalized patients with COVID-19 in Vietnam. Wellcome Open Res 2023; 7:257. [PMID: 38601327 PMCID: PMC11004598 DOI: 10.12688/wellcomeopenres.18026.2] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 04/12/2024] Open
Abstract
Patients with severe COVID-19 disease require monitoring with pulse oximetry as a minimal requirement. In many low- and middle- income countries, this has been challenging due to lack of staff and equipment. Wearable pulse oximeters potentially offer an attractive means to address this need, due to their low cost, battery operability and capacity for remote monitoring. Between July and October 2021, Ho Chi Minh City experienced its first major wave of SARS-CoV-2 infection, leading to an unprecedented demand for monitoring in hospitalized patients. We assess the feasibility of a continuous remote monitoring system for patients with COVID-19 under these circumstances as we implemented 2 different systems using wearable pulse oximeter devices in a stepwise manner across 4 departments.
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Affiliation(s)
| | | | | | - Phung Tran Huy Nhat
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Kings College, London, UK
| | | | - Ho Bich Hai
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | | | - Dao Bach Khoa
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | - Nguyen Van Hao
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
- University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | | | - Tran Dang Khoa
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | | | - Julie Huynh
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Timothy M Walker
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Jennifer Van Nuil
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Luu Phuoc An
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Jacob McKnight
- Health Systems Collaborative, University of Oxford, Oxford, UK
| | - Le Mau Toan
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Le Van Tan
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | | | - C Louise Thwaites
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - OUCRU COVID Research Group
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Kings College, London, UK
- University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Health Systems Collaborative, University of Oxford, Oxford, UK
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Tam NT, Anh NT, Tung TS, Thach PN, Dung NT, Trang VD, Hung LM, Dien TC, Ngoc NM, Van Duyet L, Cuong PM, Phuong HVM, Thai PQ, Tung NLN, Man DNH, Phong NT, Quang VM, Thoa PTN, Truong NT, Thao TNP, Linh DP, Tai NT, Bao HT, Vuong VT, Nhung HTK, Hong PND, Hanh LTP, Chung LT, Nhan NTT, Thanh TT, Hung DT, Mai HK, Long TH, Trang NT, Thuong NTH, Hong NTT, Nhu LNT, Ny NTH, Thuy CT, Thanh LK, Nguyet LA, Mai LTQ, Thuong TC, Nga LH, Thanh TT, Thwaites G, Rogier van Doorn H, Chau NVV, Kesteman T, Van Tan L. Spatiotemporal Evolution of SARS-CoV-2 Alpha and Delta Variants during Large Nationwide Outbreak of COVID-19, Vietnam, 2021. Emerg Infect Dis 2023; 29:1002-1006. [PMID: 37015283 PMCID: PMC10124647 DOI: 10.3201/eid2905.221787] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023] Open
Abstract
We analyzed 1,303 SARS-CoV-2 whole-genome sequences from Vietnam, and found the Alpha and Delta variants were responsible for a large nationwide outbreak of COVID-19 in 2021. The Delta variant was confined to the AY.57 lineage and caused >1.7 million infections and >32,000 deaths. Viral transmission was strongly affected by nonpharmaceutical interventions.
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Dung NT, Hung LM, Hoa HTT, Nga LH, Hong NTT, Thuong TC, Ngoc NM, Ny NTH, Quy VT, Thoa VTK, Thanh NT, Tho PV, Toan LM, Quang VM, Man DNH, Phat NT, Phuong TTL, Tam TTT, Thoa PTN, Tam NH, Lan TTT, Thanh TT, Maurer-Stroh S, Khanh LTT, Yen LM, Hung NH, Thwaites G, Tung NLN, Thwaites L, Chau NVV, Anh NT, Van Tan L. Monkeypox Virus Infection in 2 Female Travelers Returning to Vietnam from Dubai, United Arab Emirates, 2022. Emerg Infect Dis 2023; 29:778-781. [PMID: 36696624 PMCID: PMC10045713 DOI: 10.3201/eid2904.221835] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Mpox was diagnosed in 2 women returning to Vietnam from the United Arab Emirates. The monkeypox viruses belonged to an emerging sublineage, A.2.1, distinct from B.1, which is responsible for the ongoing multicountry outbreak. Women could contribute to mpox transmission, and enhanced genomic surveillance is needed to clarify pathogen evolution.
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Thwaites CL, Thanh TT, Ny NTH, Nguyet LA, Nhat NTD, Thuy CT, Thanh NTL, Dung NT, Campbell J, Thai PQ, Tan LV, Choisy M, Boni MF. Seroprotection against tetanus in southern Vietnam. Vaccine 2023; 41:2208-2213. [PMID: 36849339 PMCID: PMC10580288 DOI: 10.1016/j.vaccine.2023.02.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/17/2023] [Accepted: 02/10/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND Ongoing tetanus cases and sporadic outbreaks of vaccine-preventable diseases associated with routine vaccination programmes remain problems in many low and middle-income countries, including Vietnam. With no human-to-human transmission or natural immunity, tetanus antibody levels indicate both individual risk of tetanus and gaps in vaccination programmes. METHODS To investigate gaps in immunity to tetanus in Vietnam, a country with a historically high level of tetanus vaccination coverage, tetanus antibodies were measure by ELISA from samples selected from a long-term serum bank, established for the purposes of general-population seroepidemiological investigations in southern Vietnam. Samples were selected from 10 provinces, focussing on age-groups targeted by national vaccination programmes for infants and pregnant women (Expanded Programme on Immunization, EPI, and Maternal and Neonatal Tetanus, MNT). RESULTS Antibodies were measured from a total of 3864 samples. Highest tetanus antibody concentrations occurred in children under 4 years old, over 90 % of whom had protective levels. Approximately 70 % of children aged 7-12 years had protective antibody concentrations although there was variation among provinces. For infants and children, there were no significant differences in tetanus protection between males and females, but for adults aged 20-35 years, in five of the ten provinces surveyed, protection against tetanus was higher in females (p < 0.05) who are eligible for booster doses under the MNT programme. In seven of ten provinces, antibody concentrations were inversely related to age (p < 0.01) and protection of older individuals was generally low. CONCLUSION Widespread immunity to tetanus toxoid is seen in infants and young children consistent with the high coverage rates reported for diptheria tetanus toxoid and pertussis (DTP) in Vietnam. However, the lower antibody concentrations seen in older children and men suggest reduced immunity to tetanus in populations not targeted by EPI and MNT programmes.
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Affiliation(s)
- C Louise Thwaites
- Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam; Centre for Global Health and Tropical Medicine, University of Oxford, UK
| | - Tran Tan Thanh
- Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam
| | - Nguyen Thi Han Ny
- Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam
| | - Lam Anh Nguyet
- Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam
| | | | - Cao Thu Thuy
- Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam
| | | | | | - James Campbell
- Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam; Centre for Global Health and Tropical Medicine, University of Oxford, UK.
| | - Pham Quang Thai
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam; School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
| | - Le Van Tan
- Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam
| | - Marc Choisy
- Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam; Centre for Global Health and Tropical Medicine, University of Oxford, UK
| | - Maciej F Boni
- Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam; Centre for Global Health and Tropical Medicine, University of Oxford, UK; Center for Infectious Disease Dynamics, Department of Biology, Pennsylvania State University, University Park, PA 16802, United States
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Chau NVV, Nguyet LA, Dung NT, Quang VM, Truong NT, Toan LM, Hung LM, Man DNH, Khoa DB, Phong NT, Ngoc NM, Thao HP, Ty DTB, Thanh PB, Ny NTH, Thanh LK, Thuy CT, Anh NT, Hong NTT, Nhu LNT, Yen LM, Thwaites G, Thanh TT, Tan LV. Kinetics of Neutralizing Antibodies against Omicron Variant in Vietnamese Healthcare Workers after Primary Immunization with ChAdOx1-S and Booster Immunization with BNT162b2. Am J Trop Med Hyg 2023; 108:137-144. [PMID: 36450229 PMCID: PMC9833090 DOI: 10.4269/ajtmh.22-0434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/14/2022] [Indexed: 12/02/2022] Open
Abstract
We studied the development and persistence of neutralizing antibodies against SARS-CoV-2 ancestral strain, and Delta and Omicron (BA.1 and BA.2) variants in Vietnamese healthcare workers (HCWs) up to 15 weeks after booster vaccination. We included 47 HCWs, including group 1 (G1, N = 21) and group 2 (G2; N = 26) without and with breakthrough Delta variant infection before booster immunization, respectively). The study participants had completed primary immunization with ChAdOx1-S and booster vaccination with BNT162b2. Neutralizing antibodies were measured using a surrogate virus neutralization assay. Of the 21 study participants in G1, neutralizing antibodies against ancestral strain, Delta variant, BA.1, and BA.2 were (almost) abolished at month 8 after the second dose, but all had detectable neutralizing antibodies to the study viruses at week 2 post booster dose. Of the 26 study participants in G2, neutralizing antibody levels to BA.1 and BA.2 were significantly higher than those to the corresponding viruses measured at week 2 post breakthrough infection and before the booster dose. At week 15 post booster vaccination, neutralizing antibodies to BA.1 and BA.2 dropped significantly, with more profound changes observed in those without breakthrough Delta variant infection. Booster vaccination enhanced neutralizing activities against ancestral strain and Delta variant compared with those induced by primary vaccination. These responses were maintained at high levels for at least 15 weeks. Our findings emphasize the importance of the first booster dose in producing cross-neutralizing antibodies against Omicron variant. A second booster to maintain long-term vaccine effectiveness against the currently circulating variants merits further research.
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Affiliation(s)
- Nguyen Van Vinh Chau
- 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
| | - Lam Anh Nguyet
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | - Vo Minh Quang
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | - Le Mau Toan
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Le Manh Hung
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | - Dao Bach Khoa
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | - Nghiem My Ngoc
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | | | - Pham Ba Thanh
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | - Le Kim Thanh
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Cao Thu Thuy
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Nguyen To Anh
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | | | - Lam Minh Yen
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Guy Thwaites
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Tran Tan Thanh
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Le Van Tan
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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Nguyen Le Thao M, Nguyen Thi Hong Y, Dang Trong T, Dung NT, Day J, Phuong LT, Kestelyn E, Chau NVV, Le Manh H, Van Nuil JI. Balancing uncertainty and proactivity in care seeking for hepatitis C: qualitative research with participants enrolled in a treatment trial in Ho Chi Minh City, Vietnam. Int J Qual Stud Health Well-being 2022; 17:2126602. [PMID: 36154660 PMCID: PMC9542774 DOI: 10.1080/17482631.2022.2126602] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Purpose Direct acting antiviral treatment to cure hepatitis C virus (HCV) is becoming more accessible yet the experiences of those accessing care and treatment and the contexts under which care seeking takes place are largely unknown in low- and middle-income countries. These experiences are important for insight into the challenges people encounter and the support/structures they utilize. The study objective was to explore the experiences of care seeking and treatment for participants enrolled in a clinical trial in Ho Chi Minh City, Vietnam. Methods We used in-depth interviews, home visits, mobile interviews, at both the clinic and in the home as we explored how participants experienced health and illness within their social worlds over time. Results We enrolled 20 participants, of whom 20 completed the first interview, 16 the second, and 18 completed the last interview. Findings explore four themes: (1) navigating uncertainty, (2) proactivity in the face of challenges, (3) living in fear with faith, and (4) dynamic support systems. Conclusions Understanding how participants envision and act upon their lived experiences can help to develop public health programmes that effectively address barriers and promote access to care and treatment for people with HCV in Vietnam.
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Affiliation(s)
| | | | - Thuan Dang Trong
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | - Jeremy Day
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Evelyne Kestelyn
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Hung Le Manh
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Jennifer Ilo Van Nuil
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
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Chau NVV, Trung TN, Khanh PNQK, Nhat PTH, Van HMT, Hai HB, Thuy DB, Tung NLN, Khoa DB, Vien TTD, Hao NV, Oanh PKN, Khoa TD, Phong NT, Nguyen NT, Huynh J, Walker TM, Van Nuil J, An LP, McKnight J, Toan LM, Tan LV, Dung NT, Truong NT, Thwaites CL. Wearable devices for remote monitoring of hospitalized patients with COVID-19 in Vietnam. Wellcome Open Res 2022. [DOI: 10.12688/wellcomeopenres.18026.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Patients with severe COVID-19 disease require monitoring with pulse oximetry as a minimal requirement. In many low- and middle- income countries, this has been challenging due to lack of staff and equipment. Wearable pulse oximeters potentially offer an attractive means to address this need, due to their low cost, battery operability and capacity for remote monitoring. Between July and October 2021, Ho Chi Minh City experienced its first major wave of SARS-CoV-2 infection, leading to an unprecedented demand for monitoring in hospitalized patients. We assess the feasibility of a continuous remote monitoring system for patients with COVID-19 under these circumstances as we implemented 2 different systems using wearable pulse oximeter devices in a stepwise manner across 4 departments.
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Chau NVV, Nguyet LA, Truong NT, Toan LM, Dung NT, Hung LM, Nhan MT, Man DNH, Ngoc NM, Thao HP, Tu TNH, Mai HK, Hung DT, Ny NTH, Thanh LK, Anh NT, Hong NTT, Nhu LNT, Yen LM, Choisy M, Thanh TT, Thwaites G, Tan LV. Immunogenicity of Oxford-AstraZeneca COVID-19 Vaccine in Vietnamese Health-Care Workers. Am J Trop Med Hyg 2022; 106:556-561. [PMID: 34996048 PMCID: PMC8832887 DOI: 10.4269/ajtmh.21-0849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 11/29/2021] [Indexed: 11/07/2022] Open
Abstract
We studied the immunogenicity of the Oxford-AstraZeneca vaccine in health-care workers of a major infectious diseases hospital in Vietnam. We measured neutralizing antibodies before and 14 days after each dose, and at day 28 and month 3 after dose 1. A total of 554 workers (136 men and 418 women; age range, 22-71 years; median age, 36 years) participated with the study. Of the 144 participants selected for follow-up after dose 1, 104 and 94 gave blood for antibody measurement at weeks 6 and 8, and at month 3 after dose 1, respectively. The window time between the two doses was 6 weeks. At baseline, none had detectable neutralizing antibodies. After dose 1, the proportion of participants with detectable neutralizing antibodies increased from 27.3% (151 of 554) at day 14 to 78.0% (432 of 554) at day 28. Age correlated negatively with the development and the levels of neutralizing antibodies. However, at day 28, these differences were less profound, and women had a greater seroconversion rate and greater levels of neutralizing antibodies than men. After dose 2, these age and gender associations were not observable. In addition, the proportion of study participants with detectable neutralizing antibodies increased from 70.2% (73 of 104) before dose 2 (week 6, after dose 1) to 98.1% (102 of 104) 14 days later. At month 3, neutralizing antibodies decreased and 94.7% (89 of 94) of the study participants remained seropositive. The Oxford-AstraZeneca COVID-19 vaccine is immunogenic in Vietnamese health-care workers. These data are critical to informing the deployment of the COVID-19 vaccine in Vietnam and in Southeast Asia, where vaccination coverage remains inadequate.
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Affiliation(s)
| | - Lam Anh Nguyet
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | - Le Mau Toan
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | - Le Manh Hung
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Mai Thanh Nhan
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | - Nghiem My Ngoc
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | | | | | | | | | - Le Kim Thanh
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Nguyen To Anh
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | | | - Lam Minh Yen
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Marc Choisy
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Tran Tan Thanh
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Guy Thwaites
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Institute of Pasteur, Nha Trang City, Vietnam
| | - Le Van Tan
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
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Chau NVV, Ngoc NM, Nguyet LA, Quang VM, Ny NTH, Khoa DB, Phong NT, Toan LM, Hong NTT, Tuyen NTK, Phat VV, Nhu LNT, Truc NHT, That BTT, Thao HP, Thao TNP, Vuong VT, Tam TTT, Tai NT, Bao HT, Nhung HTK, Minh NTN, Tien NTM, Huy NC, Choisy M, Man DNH, Ty DTB, Anh NT, Uyen LTT, Tu TNH, Yen LM, Dung NT, Hung LM, Truong NT, Thanh TT, Thwaites G, Tan LV. An observational study of breakthrough SARS-CoV-2 Delta variant infections among vaccinated healthcare workers in Vietnam. EClinicalMedicine 2021; 41:101143. [PMID: 34608454 PMCID: PMC8481205 DOI: 10.1016/j.eclinm.2021.101143] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Data on breakthrough SARS-CoV-2 Delta variant infections in vaccinated individuals are limited. METHODS We studied breakthrough infections among Oxford-AstraZeneca vaccinated healthcare workers in an infectious diseases hospital in Vietnam. We collected demographic and clinical data alongside serial PCR testing, measurement of SARS-CoV-2 antibodies, and viral whole-genome sequencing. FINDINGS Between 11th-25th June 2021 (7-8 weeks after the second dose), 69 staff tested positive for SARS-CoV-2. 62 participated in the study. Most were asymptomatic or mildly symptomatic and all recovered. Twenty-two complete-genome sequences were obtained; all were Delta variant and were phylogenetically distinct from contemporary viruses obtained from the community or from hospital patients admitted prior to the outbreak. Viral loads inferred from Ct values were 251 times higher than in cases infected with the original strain in March/April 2020. Median time from diagnosis to negative PCR was 21 days (range 8-33). Neutralizing antibodies (expressed as percentage of inhibition) measured after the second vaccine dose, or at diagnosis, were lower in cases than in uninfected, fully vaccinated controls (median (IQR): 69.4 (50.7-89.1) vs. 91.3 (79.6-94.9), p=0.005 and 59.4 (32.5-73.1) vs. 91.1 (77.3-94.2), p=0.002). There was no correlation between vaccine-induced neutralizing antibody levels and peak viral loads or the development of symptoms. INTERPRETATION Breakthrough Delta variant infections following Oxford-AstraZeneca vaccination may cause asymptomatic or mild disease, but are associated with high viral loads, prolonged PCR positivity and low levels of vaccine-induced neutralizing antibodies. Epidemiological and sequence data suggested ongoing transmission had occurred between fully vaccinated individuals. FUNDING Wellcome and NIH/NIAID.
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Affiliation(s)
| | - Nghiem My Ngoc
- Hospital for Tropical Diseaes, Ho Chi Minh City, Vietnam
| | - Lam Anh Nguyet
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Vo Minh Quang
- Hospital for Tropical Diseaes, Ho Chi Minh City, Vietnam
| | | | - Dao Bach Khoa
- Hospital for Tropical Diseaes, Ho Chi Minh City, Vietnam
| | | | - Le Mau Toan
- Hospital for Tropical Diseaes, Ho Chi Minh City, Vietnam
| | | | | | - Voong Vinh Phat
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | | | | | | | | | - Vo Trong Vuong
- Hospital for Tropical Diseaes, Ho Chi Minh City, Vietnam
| | | | - Ngo Tan Tai
- Hospital for Tropical Diseaes, Ho Chi Minh City, Vietnam
| | - Ho The Bao
- Hospital for Tropical Diseaes, Ho Chi Minh City, Vietnam
| | | | | | | | - Nguy Cam Huy
- Hospital for Tropical Diseaes, Ho Chi Minh City, Vietnam
| | - Marc Choisy
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | | | - Nguyen To Anh
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | | | - Lam Minh Yen
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | - Le Manh Hung
- Hospital for Tropical Diseaes, Ho Chi Minh City, Vietnam
| | | | - Tran Tan Thanh
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Guy Thwaites
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Le Van Tan
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
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11
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Chau NVV, Hong NTT, Ngoc NM, Anh NT, Trieu HT, Nhu LNT, Yen LM, Minh NNQ, Phong NT, Truong NT, Huong LTT, Tu TNH, Hung LM, Thanh TT, Dung NT, Dung NT, Thwaites G, Van Tan L. Rapid whole-genome sequencing to inform COVID-19 outbreak response in Vietnam. J Infect 2021; 82:276-316. [PMID: 33774018 PMCID: PMC7992298 DOI: 10.1016/j.jinf.2021.03.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 03/20/2021] [Indexed: 12/02/2022]
Affiliation(s)
| | | | - Nghiem My Ngoc
- Hospital for Tropical Disease, Ho Chi Minh City, Vietnam
| | - Nguyen To Anh
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | | | - Lam Minh Yen
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | | | | | | | | | - Le Manh Hung
- Hospital for Tropical Disease, Ho Chi Minh City, Vietnam
| | - Tran Tan Thanh
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | | | - Guy Thwaites
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Le Van Tan
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.
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12
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Van Vinh Chau N, Lam VT, Dung NT, Yen LM, Minh NNQ, Hung LM, Ngoc NM, Dung NT, Man DNH, Nguyet LA, Nhat LTH, Nhu LNT, Ny NTH, Hong NTT, Kestelyn E, Dung NTP, Xuan TC, Hien TT, Phong NT, Tu TNH, Geskus RB, Thanh TT, Truong NT, Binh NT, Thuong TC, Thwaites G, Van Tan L. The Natural History and Transmission Potential of Asymptomatic Severe Acute Respiratory Syndrome Coronavirus 2 Infection. Clin Infect Dis 2020; 71:2679-2687. [PMID: 32497212 PMCID: PMC7314145 DOI: 10.1093/cid/ciaa711] [Citation(s) in RCA: 196] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 06/02/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Little is known about the natural history of asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS We conducted a prospective study at a quarantine center for coronavirus disease 2019 in Ho Chi Minh City, Vietnam. We enrolled quarantined people with reverse-transcription polymerase chain reaction (RT-PCR)-confirmed SARS-CoV-2 infection, collecting clinical data, travel and contact history, and saliva at enrollment and daily nasopharyngeal/throat swabs (NTSs) for RT-PCR testing. We compared the natural history and transmission potential of asymptomatic and symptomatic individuals. RESULTS Between 10 March and 4 April 2020, 14 000 quarantined people were tested for SARS-CoV-2; 49 were positive. Of these, 30 participated in the study: 13 (43%) never had symptoms and 17 (57%) were symptomatic. Seventeen (57%) participants imported cases. Compared with symptomatic individuals, asymptomatic people were less likely to have detectable SARS-CoV-2 in NTS collected at enrollment (8/13 [62%] vs 17/17 [100%]; P = .02). SARS-CoV-2 RNA was detected in 20 of 27 (74%) available saliva samples (7 of 11 [64%] in the asymptomatic group and 13 of 16 [81%] in the symptomatic group; P = .56). Analysis of RT-PCR positivity probability showed that asymptomatic participants had faster viral clearance than symptomatic participants (P < .001 for difference over the first 19 days). This difference was most pronounced during the first week of follow-up. Two of the asymptomatic individuals appeared to transmit SARS-CoV-2 to 4 contacts. CONCLUSIONS Asymptomatic SARS-CoV-2 infection is common and can be detected by analysis of saliva or NTSs. The NTS viral loads fall faster in asymptomatic individuals, but these individuals appear able to transmit the virus to others.
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Affiliation(s)
| | - Vo Thanh Lam
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | - Lam Minh Yen
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | - Le Manh Hung
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Nghiem My Ngoc
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Nguyen Tri Dung
- Center for Disease Control and Prevention, Ho Chi Minh City, Vietnam
| | | | - Lam Anh Nguyet
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | | | | | | | - Evelyne Kestelyn
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | | | | | - Tran Tinh Hien
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | | | | | - Ronald B Geskus
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Tran Tan Thanh
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | | | | | - Guy Thwaites
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Le Van Tan
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
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13
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Chau NVV, Toan LM, Man DNH, Thao HP, Lan NPH, Ty DTB, Hieu DK, Tien NTM, Ngoc NM, Hung LM, Dung NT, Thanh TT, Truong NT, Thwaites G, Tan LV. Absence of SARS-CoV-2 antibodies in health care workers of a tertiary referral hospital for COVID-19 in southern Vietnam. J Infect 2020; 82:e36-e37. [PMID: 33221367 PMCID: PMC7674964 DOI: 10.1016/j.jinf.2020.11.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 11/17/2020] [Indexed: 12/21/2022]
Affiliation(s)
| | - Le Mau Toan
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | | | | | | | - Dinh Khac Hieu
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | - Nghiem My Ngoc
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Le Manh Hung
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | - Tran Tan Thanh
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | - Guy Thwaites
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Le Van Tan
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.
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14
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Chau NVV, Hong NTT, Ngoc NM, Thanh TT, Khanh PNQ, Nguyet LA, Nhu LNT, Ny NTH, Man DNH, Hang VTT, Phong NT, Que NTH, Tuyen PT, Tu TNH, Hien TT, Minh NNQ, Hung LM, Truong NT, Yen LM, Rogier van Doorn H, Dung NT, Thwaites G, Dung NT, Van Tan L. Superspreading Event of SARS-CoV-2 Infection at a Bar, Ho Chi Minh City, Vietnam. Emerg Infect Dis 2020; 27. [PMID: 33063657 PMCID: PMC7774544 DOI: 10.3201/eid2701.203480] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
We report a superspreading event of severe acute respiratory syndrome coronavirus 2 infection initiated at a bar in Vietnam with evidence of symptomatic and asymptomatic transmission, based on ministry of health reports, patient interviews, and whole-genome sequence analysis. Crowds in enclosed indoor settings with poor ventilation may be considered at high risk for transmission.
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15
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Nguyen HA, Cooke GS, Day JN, Flower B, Phuong LT, Hung TM, Dung NT, Khoa DB, Hung LM, Kestelyn E, Thwaites GE, Chau NVV, Turner HC. The direct-medical costs associated with interferon-based treatment for Hepatitis C in Vietnam. Wellcome Open Res 2020; 4:129. [PMID: 32734002 PMCID: PMC7372532 DOI: 10.12688/wellcomeopenres.15408.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2020] [Indexed: 02/02/2023] Open
Abstract
Background: Injectable interferon-based therapies have been used to treat hepatitis C virus (HCV) infection since 1991. International guidelines have now moved away from interferon-based therapy towards direct-acting antiviral (DAA) tablet regimens, because of their superior efficacy, excellent side-effect profiles, and ease of administration. Initially DAA drugs were prohibitively expensive for most healthcare systems. Access is now improving through the procurement of low-cost, generic DAAs acquired through voluntary licenses. However, HCV treatment costs vary widely, and many countries are struggling with DAA treatment scale-up. This is not helped by the limited cost data and economic evaluations from low- and middle-income countries to support HCV policy decisions. We conducted a detailed analysis of the costs of treating chronic HCV infection with interferon-based therapy in Vietnam. Understanding these costs is important for performing necessary economic evaluations of novel treatment strategies. Methods: We conducted an analysis of the direct medical costs of treating HCV infection with interferon alpha (IFN) and pegylated-interferon alpha (Peg-IFN), in combination with ribavirin, from the health sector perspective at the Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam, in 2017. Results: The total cost of the IFN treatment regimen was estimated to range between US$1,120 and US$1,962. The total cost of the Peg-IFN treatment regimen was between US$2,156 and US$5,887. Drug expenses were the biggest contributor to the total treatment cost (54-89%) and were much higher for the Peg-IFN regimen. Conclusions: We found that treating HCV with IFN or Peg-IFN resulted in significant direct medical costs. Of concern, we found that all patients incurred substantial out-of-pocket costs, including those receiving the maximum level of support from the national health insurance programme. This cost data highlights the potential savings and importance of increased access to generic DAAs in low- and middle-income countries and will be useful within future economic evaluations.
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Affiliation(s)
| | - Graham S. Cooke
- Division of Infectious Diseases, Imperial College London, London, UK
| | - Jeremy N. Day
- Oxford University Clinical Research Unit, Ho Chi Minh, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Barnaby Flower
- Oxford University Clinical Research Unit, Ho Chi Minh, Vietnam
| | | | - Trinh Manh Hung
- Oxford University Clinical Research Unit, Ho Chi Minh, Vietnam
| | | | - Dao Bach Khoa
- Hospital for Tropical Diseases, Ho Chi Minh, Vietnam
| | - Le Manh Hung
- Hospital for Tropical Diseases, Ho Chi Minh, Vietnam
| | - Evelyne Kestelyn
- Oxford University Clinical Research Unit, Ho Chi Minh, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Guy E. Thwaites
- Oxford University Clinical Research Unit, Ho Chi Minh, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - SEARCH Investigators
- Oxford University Clinical Research Unit, Ho Chi Minh, Vietnam
- Division of Infectious Diseases, Imperial College London, London, UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Hospital for Tropical Diseases, Ho Chi Minh, Vietnam
| | - Hugo C. Turner
- Oxford University Clinical Research Unit, Ho Chi Minh, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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16
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Van Tan L, Thi Thu Hong N, My Ngoc N, Tan Thanh T, Thanh Lam V, Anh Nguyet L, Nguyen Truc Nhu L, Thi Ha Ny N, Ngoc Quang Minh N, Nguyen Huy Man D, Thi Ty Hang V, Nguyen Quoc Khanh P, Chanh Xuan T, Thanh Phong N, Nguyen Hoang Tu T, Tinh Hien T, Manh Hung L, Thanh Truong N, Min Yen L, Thanh Dung N, Thwaites G, Van Vinh Chau N. SARS-CoV-2 and co-infections detection in nasopharyngeal throat swabs of COVID-19 patients by metagenomics. J Infect 2020; 81:e175-e177. [PMID: 32562797 PMCID: PMC7403860 DOI: 10.1016/j.jinf.2020.06.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 06/14/2020] [Indexed: 01/17/2023]
Affiliation(s)
- Le Van Tan
- Oxford University Clinical Research Unit, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam.
| | - Nguyen Thi Thu Hong
- Oxford University Clinical Research Unit, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam
| | - Nghiem My Ngoc
- Hospital for Tropical Diseases, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam
| | - Tran Tan Thanh
- Oxford University Clinical Research Unit, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam
| | - Vo Thanh Lam
- Hospital for Tropical Diseases, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam
| | - Lam Anh Nguyet
- Oxford University Clinical Research Unit, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam
| | - Le Nguyen Truc Nhu
- Oxford University Clinical Research Unit, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam
| | - Nguyenn Thi Ha Ny
- Oxford University Clinical Research Unit, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam
| | - Ngo Ngoc Quang Minh
- Children's Hospital 1, 341 Su Van Hanh, District 10, Ho Chi Minh City, Vietnam
| | - Dinh Nguyen Huy Man
- Hospital for Tropical Diseases, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam
| | - Vu Thi Ty Hang
- Oxford University Clinical Research Unit, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam
| | - Phan Nguyen Quoc Khanh
- Oxford University Clinical Research Unit, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam
| | | | - Nguyen Thanh Phong
- Hospital for Tropical Diseases, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam
| | - Tran Nguyen Hoang Tu
- Hospital for Tropical Diseases, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam
| | - Tran Tinh Hien
- Oxford University Clinical Research Unit, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam; Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
| | - Le Manh Hung
- Hospital for Tropical Diseases, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam
| | - Nguyen Thanh Truong
- Hospital for Tropical Diseases, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam
| | - Lamh Min Yen
- Oxford University Clinical Research Unit, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam
| | - Nguyen Thanh Dung
- Hospital for Tropical Diseases, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam
| | - Guy Thwaites
- Oxford University Clinical Research Unit, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam; Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
| | - Nguyen Van Vinh Chau
- Hospital for Tropical Diseases, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam
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17
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Kestelyn E, Dung NTP, Lam Minh Y, Hung LM, Quan NM, Dung NT, Minh NNQ, Xuan TC, Phong NT, Ninh Thi Thanh V, Donovan J, Tu TNH, Nhat LTH, Truong NT, Man DNH, Thao HP, Ngoc NM, Lam VT, Phat HH, Phuong PM, Geskus RB, Ha VTN, Quang NN, Tran Tinh H, Tan LV, Thwaites GE, Day JN, Chau NVV. A multi centre randomized open label trial of chloroquine for the treatment of adults with SARS-CoV-2 infection in Vietnam. Wellcome Open Res 2020; 5:141. [PMID: 33110944 PMCID: PMC7573712 DOI: 10.12688/wellcomeopenres.15936.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2020] [Indexed: 12/02/2022] Open
Abstract
Background: COVID-19 is a respiratory disease caused by a novel coronavirus (SARS-CoV-2) and causes substantial morbidity and mortality. There is currently no vaccine to prevent COVID-19 or therapeutic agent to treat COVID-19. This clinical trial is designed to evaluate chloroquine as a potential therapeutic for the treatment of hospitalised people with COVID-19. We hypothesise that chloroquine slows viral replication in patients with COVID-19, attenuating the infection, and resulting in more rapid decline of viral load in throat/nose swabs. This viral attenuation should be associated with improved patient outcomes. Method: The study will start with a 10-patient prospective observational pilot study following the same entry and exclusion criteria as for the randomized trial and undergoing the same procedures. The main study is an open label, randomised, controlled trial with two parallel arms of standard of care (control arm) versus standard of care with 10 days of chloroquine (intervention arm) with a loading dose over the first 24 hours, followed by 300mg base orally once daily for nine days. The study will recruit patients in three sites in Ho Chi Minh City, Vietnam: the Hospital for Tropical Diseases, the Cu Chi Field Hospital, and the Can Gio COVID hospital. The primary endpoint is the time to viral clearance from throat/nose swab, defined as the time following randomization until the midpoint between the last positive and the first of the negative throat/nose swabs. Viral presence will be determined using RT-PCR to detect SARS-CoV-2 RNA. Discussion: The results of the study will add to the evidence-based guidelines for management of COVID-19. Given the enormous experience of its use in malaria chemoprophylaxis, excellent safety and tolerability profile, and its very low cost, if proved effective then chloroquine would be a readily deployable and affordable treatment for patients with COVID-19. Trial registration: Clinicaltrials.gov NCT04328493 31/03/2020.
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Affiliation(s)
- Evelyne Kestelyn
- Oxford University Clinical Research Unit, University of Oxford, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Nguyen Thi Phuong Dung
- Oxford University Clinical Research Unit, University of Oxford, Ho Chi Minh City, Vietnam
| | - Yen Lam Minh
- Oxford University Clinical Research Unit, University of Oxford, Ho Chi Minh City, Vietnam
| | - Le Manh Hung
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | | | | | | | | | - Van Ninh Thi Thanh
- Oxford University Clinical Research Unit, University of Oxford, Ho Chi Minh City, Vietnam
| | - Joseph Donovan
- Oxford University Clinical Research Unit, University of Oxford, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | | | - Le Thanh Hoang Nhat
- Oxford University Clinical Research Unit, University of Oxford, Ho Chi Minh City, Vietnam
| | | | | | | | - Nghiêm My Ngoc
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Vo Thanh Lam
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | | | - Ronald B. Geskus
- Oxford University Clinical Research Unit, University of Oxford, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Vo Thi Nhi Ha
- Administration of Science, Technology and Training (ASTT), Ministry of Health, Hanoi, Vietnam
| | - Nguyen Ngo Quang
- Administration of Science, Technology and Training (ASTT), Ministry of Health, Hanoi, Vietnam
| | - Hien Tran Tinh
- Oxford University Clinical Research Unit, University of Oxford, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Le Van Tan
- Oxford University Clinical Research Unit, University of Oxford, Ho Chi Minh City, Vietnam
| | - Guy E. Thwaites
- Oxford University Clinical Research Unit, University of Oxford, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Jeremy N. Day
- Oxford University Clinical Research Unit, University of Oxford, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | | | - OUCRU COVID-19 Research Group
- Oxford University Clinical Research Unit, University of Oxford, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
- Thu Duc Hospital, Ho Chi Minh City, Vietnam
- Children’s Hospital 1, Ho Chi Minh City, Vietnam
- Cu Chi field hospital, Cu Chi, Vietnam
- Administration of Science, Technology and Training (ASTT), Ministry of Health, Hanoi, Vietnam
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18
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Nguyen HA, Cooke GS, Day JN, Flower B, Phuong LT, Hung TM, Dung NT, Khoa DB, Hung LM, Kestelyn E, Thwaites GE, Chau NVV, Turner HC. The direct-medical costs associated with interferon-based treatment for Hepatitis C in Vietnam. Wellcome Open Res 2019; 4:129. [PMID: 32734002 PMCID: PMC7372532 DOI: 10.12688/wellcomeopenres.15408.1] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2019] [Indexed: 02/02/2023] Open
Abstract
Background: Injectable interferon-based therapies have been used to treat hepatitis C virus (HCV) infection since 1991. International guidelines have now moved away from interferon-based therapy towards direct-acting antiviral (DAA) tablet regimens, because of their superior efficacy, excellent side-effect profiles, and ease of administration. Initially DAA drugs were prohibitively expensive for most healthcare systems. Access is now improving through the procurement of low-cost, generic DAAs acquired through voluntary licenses. However, HCV treatment costs vary widely, and many countries are struggling with DAA treatment scale-up. This is not helped by the limited cost data and economic evaluations from low- and middle-income countries to support HCV policy decisions. We conducted a detailed analysis of the costs of treating chronic HCV infection with interferon-based therapy in Vietnam. Understanding these costs is important for performing necessary economic evaluations of novel treatment strategies. Methods: We conducted an analysis of the direct medical costs of treating HCV infection with interferon alpha (IFN) and pegylated-interferon alpha (Peg-IFN), in combination with ribavirin, from the health sector perspective at the Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam, in 2017. Results: The total cost of the IFN treatment regimen was estimated to range between US$1,120 and US$1,962. The total cost of the Peg-IFN treatment regimen was between US$2,156 and US$5,887. Drug expenses were the biggest contributor to the total treatment cost (54-89%) and were much higher for the Peg-IFN regimen. Conclusions: We found that treating HCV with IFN or Peg-IFN resulted in significant direct medical costs. Of concern, we found that all patients incurred substantial out-of-pocket costs, including those receiving the maximum level of support from the national health insurance programme. This cost data highlights the potential savings and importance of increased access to generic DAAs in low- and middle-income countries and will be useful within future economic evaluations.
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Affiliation(s)
| | - Graham S. Cooke
- Division of Infectious Diseases, Imperial College London, London, UK
| | - Jeremy N. Day
- Oxford University Clinical Research Unit, Ho Chi Minh, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Barnaby Flower
- Oxford University Clinical Research Unit, Ho Chi Minh, Vietnam
| | | | - Trinh Manh Hung
- Oxford University Clinical Research Unit, Ho Chi Minh, Vietnam
| | | | - Dao Bach Khoa
- Hospital for Tropical Diseases, Ho Chi Minh, Vietnam
| | - Le Manh Hung
- Hospital for Tropical Diseases, Ho Chi Minh, Vietnam
| | - Evelyne Kestelyn
- Oxford University Clinical Research Unit, Ho Chi Minh, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Guy E. Thwaites
- Oxford University Clinical Research Unit, Ho Chi Minh, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - SEARCH Investigators
- Oxford University Clinical Research Unit, Ho Chi Minh, Vietnam
- Division of Infectious Diseases, Imperial College London, London, UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Hospital for Tropical Diseases, Ho Chi Minh, Vietnam
| | - Hugo C. Turner
- Oxford University Clinical Research Unit, Ho Chi Minh, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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19
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Ho NT, Thompson C, Nhan LNT, Van HMT, Dung NT, Tran My P, Quang VM, Minh NNQ, Tuan TA, Hung NT, Tuan HM, Vinh Chau NV, Wolbers M, Thwaites GE, Choisy M, Baker S. Retrospective analysis assessing the spatial and temporal distribution of paediatric acute respiratory tract infections in Ho Chi Minh City, Vietnam. BMJ Open 2018; 8:e016349. [PMID: 29358416 PMCID: PMC5780701 DOI: 10.1136/bmjopen-2017-016349] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Acute respiratory tract infections (ARIs) are the leading cause of morbidity and mortality in young children in low/middle-income countries. Using routine hospital data, we aimed to examine the spatial distribution, temporal trends and climatic risk factors of paediatric ARIs in Vietnam. METHODS Data from hospitalised paediatric (<16 years) patients with ARIs residing in Ho Chi Minh City (HCMC) between 2005 and 2010 were retrieved from the two main Children's Hospitals and the Hospital for Tropical Diseases in HCMC. Spatial mapping and time series analysis were performed after disaggregating data into upper respiratory tract infections (URIs) and lower respiratory tract infections (LRIs). RESULTS Over the study period, there were 155 999 paediatric patients admitted with ARIs (33% of all hospital admissions). There were 68 120 URIs (14%) and 87 879 LRIs (19%). The most common diagnoses were acute pharyngitis (28% of all ARI), pneumonia (21%), bronchitis (18%) and bronchiolitis (16%). A significant increasing trend over time was found for both URIs (mean weekly incidence per 1000 population, I=3.12), incidence rate ratio for 1-week increase in time (RR 1.0, 95% CI 1.02 to 1.17) for URI and (I=4.02, RR 1.08 (95% CI 1.006 to 1.16)) for LRI. The weekly URI incidence peaked in May-June and was significantly associated with lags in weekly URI incidence and the average humidity, rainfall and water level. The weekly LRI incidence exhibited significant seasonality (P<0.0001), with an annual peak in September-October and was significantly associated with lags in weekly LRI incidence and lags in weekly average temperature, rainfall and water level. CONCLUSIONS ARIs are a leading cause of childhood hospitalisation in HCMC, Vietnam. The incidence of ARIs was higher in the wet season and in specific HCMC districts. These results may guide health authorities in where and when to effectively allocate resources for the prevention and control of ARIs.
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Affiliation(s)
- Nhan Thi Ho
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Program, Ho Chi Minh City, Vietnam
- Pediatrics, Columbia UniversityMedical Center, New York, New York, United States
| | - Corinne Thompson
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Program, Ho Chi Minh City, Vietnam
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Infection Biology, The London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Nguyen Thanh Dung
- General planning, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Phuc Tran My
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Program, Ho Chi Minh City, Vietnam
| | - Vo Minh Quang
- General planning, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | - Tran Anh Tuan
- General medicine, Children’s Hospital 1, Ho Chi Minh City, Vietnam
| | | | - Ha Manh Tuan
- General medicine, Children’s Hospital 2, Ho Chi Minh City, Vietnam
| | | | - Marcel Wolbers
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Program, Ho Chi Minh City, Vietnam
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Guy E Thwaites
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Program, Ho Chi Minh City, Vietnam
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Marc Choisy
- Institute of Research and Development, Ho Chi Minh City, Vietnam
| | - Stephen Baker
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Program, Ho Chi Minh City, Vietnam
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Department of Medicine, University of Cambridge, Cambridge, UK
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20
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Merson L, Phong TV, Nhan LNT, Dung NT, Ngan TTD, Kinh NV, Parker M, Bull S. Trust, Respect, and Reciprocity: Informing Culturally Appropriate Data-Sharing Practice in Vietnam. J Empir Res Hum Res Ethics 2015; 10:251-63. [PMID: 26297747 PMCID: PMC4692260 DOI: 10.1177/1556264615592387] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
International science funders and publishers are driving a growing trend in data sharing. There is mounting pressure on researchers in low- and middle-income settings to conform to new sharing policies, despite minimal empirically grounded accounts of the ethical challenges of implementing the policies in these settings. This study used in-depth interviews and focus group discussions with 48 stakeholders in Vietnam to explore the experiences, attitudes, and expectations that inform ethical and effective approaches to sharing clinical research data. Distinct views on the role of trust, respect, and reciprocity were among those that emerged to inform culturally appropriate best practices. We conclude by discussing the challenges that authors of data-sharing policies should consider in this unique context.
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Affiliation(s)
- Laura Merson
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Tran Viet Phong
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
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21
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Bajpai VK, Rahman A, Dung NT, Huh MK, Kang SC. In vitro inhibition of food spoilage and foodborne pathogenic bacteria by essential oil and leaf extracts of Magnolia liliflora Desr. J Food Sci 2009; 73:M314-20. [PMID: 19241564 DOI: 10.1111/j.1750-3841.2008.00841.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of this study was to examine the chemical composition of the essential oil isolated from the floral parts of Magnolia liliflora Desr. by hydrodistillation, and to test the efficacy of essential oil and various leaf extracts against a diverse range of microorganisms comprising food spoilage and foodborne pathogenic bacteria. The chemical composition of essential oil was analyzed by GC-MS. It was determined that 52 compounds, which represented 78.07% of total oil, were present in the oil. The oil contained mainly levoxine (15.59%), methylcyclopropane (24.26%), 2-beta-pinene (5.3%), caryophyllene oxide (4.01%), and beta-caryophyllene (1.7%). The oil (1000 ppm/disc) and leaf extracts (1500 ppm/disc) exhibited promising antibacterial effects against the tested pathogens as a diameter of zones of inhibition (9 to 18 and 7 to 12 mm) and MIC values (125 to 1000 and 500 to 3000 microg/mL), respectively. Also, the oil had a potent detrimental effect on the viable count of the tested bacteria. The results obtained in this study support the role of essential oil and the leaf extracts derived from M. liliflora as a remarkable approach to inhibit the growth of food spoilage and foodborne pathogens.
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Affiliation(s)
- V K Bajpai
- Dept. of Biotechnology, Daegu Univ., Kyoungsan, Kyoungbook 712-714, Republic of Korea
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22
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Holland WG, Do TT, Huong NT, Dung NT, Thanh NG, Vercruysse J, Goddeeris BM. The effect of Trypanosoma evansi infection on pig performance and vaccination against classical swine fever. Vet Parasitol 2003; 111:115-23. [PMID: 12531288 DOI: 10.1016/s0304-4017(02)00363-1] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Although Trypanosoma evansi is not considered as an important pathogen in pigs, it may interfere with other pathogens or vaccinations by its immunosuppressive nature. In order to determine whether T. evansi alters pig performance and induces immunosuppression in pigs, induction of immune responses by vaccination against classical swine fever (CSF) and by immunization with a control antigen, human serum albumin (HSA), was assessed in T. evansi-infected and non-infected animals. Although T. evansi infection did not have a significant influence on growth performance, feed conversion or PCV, antibody responses against both the test antigen HSA and the CSF vaccine were significantly reduced in T. evansi-infected animals as compared to uninfected animals. Moreover, the reduced response against the CSF vaccine appears to be accompanied by a less well-developed protection against CSF with higher fever responses and leukopenia. This immunosuppression might explain the accounts of poor protection of CSF-vaccinated pigs reported in T. evansi-endemic areas of Vietnam, and suggests that prior treatments with trypanocidal drugs to improve the efficacy of CSF vaccination, may be justified.
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Affiliation(s)
- W G Holland
- Ghent University, Faculty of Veterinary Medicine, Department Virology-Parasitology-Immunology, Salisburylaan 133, B-9820 Merelbeke, Belgium
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23
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Hien TV, Loc PP, Hoa NT, Duong NM, Quang VM, McNeil MM, Dung NT, Ashford DA. First cases of disseminated penicilliosis marneffei infection among patients with acquired immunodeficiency syndrome in Vietnam. Clin Infect Dis 2001; 32:e78-80. [PMID: 11181140 DOI: 10.1086/318703] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2000] [Revised: 06/06/2000] [Indexed: 11/03/2022] Open
Abstract
To our knowledge, this is the first report of penicilliosis marneffei among patients with acquired immunodeficiency syndrome (AIDS) in Vietnam. The 4 patients we studied were from Ho Chi Minh City and the provinces of Tay Ninh, Dong Nai, and Kon Tum. In 2 patients, the infections were fatal.
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Affiliation(s)
- T V Hien
- Center for Tropical Diseases, Cho Quan Hospital, Ho Chi Minh City, Vietnam.
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24
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Hien TT, VinhChau NV, Vinh NN, Hung NT, Phung MQ, Toan LM, Mai PP, Dung NT, HoaiTam DT, Arnold K. Management of multiple drug-resistant malaria in Viet Nam. Ann Acad Med Singap 1997; 26:659-63. [PMID: 9494675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Malaria is still the most common infectious cause of mortality and morbidity in Viet Nam as it is in many developing countries in the tropics. The presence of resistance to available antimalarials and compliance in the target population are factors that influence the choice of drugs and regimens. In order to develop an ideal treatment for malaria, we conducted several clinical trials in patients with the disease in different settings. The results of these trials suggest that a combination of single dose artemisinin (or its derivatives) and mefloquine is the most effective, safe and practical treatment for acute non-complicated malaria due to multidrug-resistant Plasmodium falciparum. Concerning severe and complicated malaria, parenteral or rectal multi-doses of artemisinin or analogues are recommended due to their rapid parasite clearance time and other possible anti-cytoadherence effects. With its rapid parasite clearance, very early treatment of uncomplicated cases with artemisinin (and derivatives), especially at a health post level may help to prevent the development of complications, consequently reducing the number of severe cases and the malaria mortality rate.
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Affiliation(s)
- T T Hien
- Malaria Research Unit, Centre for Tropical Diseases, Ho Chi Minh City, Viet Nam
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25
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Dung NT, Wellby ML. Effect of high room temperature on urinary iodine assay. Clin Chem 1997; 43:1084-5. [PMID: 9191568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- N T Dung
- Dept. of Biochem., Hosp. of Endocrinol., Hanoi, Vietnam
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26
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Hien TT, Phu NH, Mai NT, Chau TT, Trang TT, Loc PP, Cuong BM, Dung NT, Vinh H, Waller DJ. An open randomized comparison of intravenous and intramuscular artesunate in severe falciparum malaria. Trans R Soc Trop Med Hyg 1992; 86:584-5. [PMID: 1287905 DOI: 10.1016/0035-9203(92)90138-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
An open paired randomized comparison of intramuscular and intravenous artesunate was conducted in 28 adult patients with severe falciparum malaria. The dose regimen in both groups was 2 mg/kg given immediately followed by 1 mg/kg at 12 and 24 h, and then daily until the patient could swallow. Both routes of administration were well tolerated and there was no evidence of toxicity. One patient in each treatment group died. Clinical and parasitological measures of recovery in survivors were similar in the 2 groups with mean fever clearance times of 37.3 h (standard deviation [SD] = 26.1 h) and 31.5 h (SD = 24.2 h) and mean parasite clearance times of 33.4 h (SD = 13.9 h) and 29.4 h (SD = 12.7 h) in the intravenous and intramuscular groups respectively. Artesunate is equally effective and well tolerated when given by the intravenous or intramuscular routes.
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Affiliation(s)
- T T Hien
- Wellcome Trust Clinical Research Unit, Cho Quan Hospital, Ho Chi Minh City, Vietnam
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27
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Nauman J, Dung NT, Porta S, Sadjak A. Effects of adrenaline pretreatment on in vitro binding of 125I-triiodothyronine to nuclear receptor, intracellular distribution of endogenous triiodothyronine and activities of alfa-glycerophosphate dehydrogenase and malic enzyme in rat liver. Horm Metab Res 1984; 16:521-4. [PMID: 6094322 DOI: 10.1055/s-2007-1014839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Especially coated adrenaline tablets (A) or placebo tablets (P) which release linearly the hormone were implanted in male Wistar rats. Six hours later animals were sacrificed and kinetic parameters of T3-125I binding to nuclear receptor, intracellular distribution of endogenous T3 and activities of alfa-GPD and ME were investigated. The association constant values (Ka) of nuclear receptor were increased after pretreatment with 7.5, 15 and 45 mg A tablets and were 1.07, 1.35 and 1.48 X 10(9) M-1 vs 0.85 X 10(8) M-1 value seen after P. The maximal binding capacity (MBC) values decreased after pretreatment with the same doses of A and were 0.044, 0.036 and 0.025 pmol T3/100 micrograms DNA vs. 0.065 pmol T3/100 micrograms DNA in P pretreated. Adrenaline pretreatment significantly increased the amount of endogenous T3 present in liver nuclei while the amount of T3 present in cytosol decreased. Activity of mitochondrial alfa-GPD was increased after 15 and 45 mg of A. Significant rise of activity of cytosol ME was seen only after pretreatment with 45 mg of A.
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