Risk Factors for Non-communicable Diseases in Vietnam: A Focus on Pesticides

Agent Orange, which was sprayed in southern Vietnam by the American government, was the main source of dioxin exposure in Vietnam. From the early 1990s, agriculture of Vietnam has attained advances under intensive cultivation. Both production and yields per crop has raised significantly at the farm level, but, on the other hand, the quantity of pesticides used in agriculture has been increased in the absence of regulations and good practices. Illegal business of pesticides with false labels, as well as marketing of expired or poor quality products in stores without license are so popular in Vietnam. Misuse and improper use in agriculture in Vietnam has led to a variety of problems, such as environment pollution (including food producing animals) and adverse health impact on animals and humans. Open dumpsites worsen the general scenario. Similar to the environmental exposure, human exposure to DDT in Vietnam was ranked among the highest worldwide, with recognized effects. Exposed communities have to face birth defects, health disorders and non-communicable diseases (NCDs), from metabolic syndrome, asthma, infertility and other reproductive disorders through to diabetes, obesity, cardiovascular and neurodegenerative diseases, and cancer. A common feature of many chronic disorders and NCDs is metabolic disruption: environmental chemical factors disturb cellular homeostasis, thus affecting the ability of the body to restore a functional internal environment. Among these, endocrine disrupting pesticides can interfere with the action of hormones including metabolic hormones, and are likely to represent the main concern for developmentally-induced NCDs. Since pesticides are often persistent and bio-accumulate in the food chain through the living environment of food-producing organisms, this paper discusses relevant aspects of risk assessment, risk communication and risk management

Antibiotics in the aquatic environment of Vietnam: Sources, concentrations, risk and control strategy

The presence of antibiotics in the aquatic environment is a serious concern because it may lead to the emergence of antibiotic resistance, thus lowering the therapeutic effect of antibiotics. In Vietnam, the problem is aggravated by the irrational use of antibiotics in different sectors of agriculture and human health service. Moreover, the residues of antibiotics in the aquatic environment can be spread widely due to the lack of proper wastewater treatment systems. In this paper, we aim to comprehensively review all relevant sources that discharge antibiotics to the aquatic environment in Vietnam. Apart from the common source of antibiotics from aquaculture, other activities that release considerable amounts of antibiotics into water environment are also included. Environmental concentrations of antibiotics related to those sources are studied to demonstrate their contributions to the presence of antibiotics in the aquatic environment in Vietnam. As antibiotic-contained water may be used as water supply for irrigation and even human consumption in rural areas, the essence of wastewater treatment is highlighted. Finally, we also discuss the new National Action plan from the Ministry of Health for controlling the issue of antibiotic resistance in Vietnam

Rapid assessment of Hib disease burden in Vietnam

<p>Abstract</p> <p>Background</p> <p>Several countries have applied the <it>Haemophilus influenzae </it>type b (Hib) rapid assessment tool (RAT) to estimate the burden of Hib disease where resources for hospital- or population-based surveillance are limited. In Vietnam, we used the Hib RAT to estimate the burden of Hib pneumonia and meningitis prior to Hib vaccine introduction.</p> <p>Methods</p> <p>Laboratory, hospitalization and mortality data were collected for the period January 2004 through December 2005 from five representative hospitals. Based on the WHO Hib RAT protocol, standardized MS Excel spreadsheets were completed to generate meningitis and pneumonia case and death figures.</p> <p>Results</p> <p>We found 35 to 77 Hib meningitis deaths and 441 to 957 Hib pneumonia deaths among children < 5 years of age annually in Vietnam. Overall, the incidence of Hib meningitis was estimated at 18/100,000 (95% confidence interval, CI, 15.1-21.6). The estimated Hib meningitis incidence in children < 5 years age was higher in Ho Chi Minh City (22.5/100,000 [95% CI, 18.4-27.5]) compared to Hanoi (9.8/100,000 [95% CI, 6.5-14.8]). The Hib RAT suggests that there are a total of 883 to 1,915 cases of Hib meningitis and 4,414 to 9,574 cases of Hib pneumonia per year in Vietnam.</p> <p>Conclusions</p> <p>In Hanoi, the estimated incidence of Hib meningitis for children < 5 years of age was similar to that described in previous population-based studies of Hib meningitis conducted from 1999 through 2002. Results from the Hib RAT suggest that there is a substantial, yet unmeasured, disease burden associated with Hib pneumonia in Vietnamese children.</p

Using lake sediments to assess the long-term impacts of anthropogenic activity in tropical river deltas

Tropical river deltas, and the social-ecological systems they sustain, are changing rapidly due to anthropogenic activity and climatic change. Baseline data to inform sustainable management options for resilient deltas is urgently needed and palaeolimnology (reconstructing past conditions from lake or wetland deposits) can provide crucial long-term perspectives needed to identify drivers and rates of change. We review how palaeolimnology can be a valuable tool for resource managers using three current issues facing tropical delta regions: hydrology and sediment supply, salinisation and nutrient pollution. The unique ability of palaeolimnological methods to untangle multiple stressors is also discussed. We demonstrate how palaeolimnology has been used to understand each of these issues, in other aquatic environments, to be incorporated into policy. Palaeolimnology is a key tool to understanding how anthropogenic influences interact with other environmental stressors, providing policymakers and resource managers with a ‘big picture’ view and possible holistic solutions that can be implemented

Evaluation of microscopic observation drug susceptibility assay for diagnosis of multidrug-resistant Tuberculosis in Viet Nam

<p>Abstract</p> <p>Background</p> <p>Early diagnosis of tuberculosis (TB) and multidrug resistant tuberculosis (MDR TB) is important for the elimination of TB. We evaluated the microscopic observation drug susceptibility (MODS) assay as a direct rapid drug susceptibility testing (DST) method for MDR-TB screening in sputum samples</p> <p>Methods</p> <p>All adult TB suspects, who were newly presenting to Pham Ngoc Thach Hospital from August to November 2008 were enrolled into the study. Processed sputum samples were used for DST by MODS (DST-MODS) (Rifampicin (RIF) 1 μg/ml and Isoniazid (INH) 0.4 μg/ml), MGIT culture (Mycobacterial Growth Indicator Tube) and Lowenstein Jensen (LJ) culture. Cultures positive by either MGIT or LJ were used for proportional DST (DST-LJ) (RIF 40 μg/ml and INH 0.2 μg/ml). DST profiles on MODS and LJ were compared. Discrepant results were resolved by multiplex allele specific PCR (MAS-PCR).</p> <p>Results</p> <p>Seven hundred and nine TB suspects/samples were enrolled into the study, of which 300 samples with DST profiles available from both MODS and DST-LJ were analyzed. Cording in MODS was unable to correctly identify 3 Mycobacteria Other Than Tuberculosis (MOTT) isolates, resulting in 3 false positive TB diagnoses. None of these isolates were identified as MDR-TB by MODS. The sensitivity and specificity of MODS were 72.6% (95%CI: 59.8, 83.1) and 97.9% (95%CI: 95.2, 99.3), respectively for detection of INH resistant isolates, 72.7% (95%CI: 30.9, 93.7) and 99.7% (95%CI: 98.1, 99.9), respectively for detecting RIF resistant isolates and 77.8% (95%CI: 39.9, 97.1) and 99.7% (95%CI: 98.1, 99.9), respectively for detecting MDR isolates. The positive and negative predictive values (PPV and NPV) of DST-MODS were 87.5% (95%CI: 47.3, 99.6) and 99.3% (95%CI: 97.5, 99.9) for detection of MDR isolates; and the agreement between MODS and DST-LJ was 99.0% (kappa: 0.8, <it>P </it>< 0.001) for MDR diagnosis. The low sensitivity of MODS for drug resistance detection was probably due to low bacterial load samples and the high INH concentration (0.4 μg/ml). The low PPV of DST-MODS may be due to the low MDR-TB rate in the study population (3.8%). The turnaround time of DST-MODS was 9 days and 53 days for DST-LJ.</p> <p>Conclusion</p> <p>The DST-MODS technique is rapid with low contamination rates. However, the sensitivity of DST-MODS for detection of INH and RIF resistance in this study was lower than reported from other settings.</p

Магнитные характеристики твердых растворов Ni1–xMxMnSb (M = Ti, V, Cr)

The results of an experiment on the study of the crystal and magnetic structures of substitutional solid solutions of the Ni0.90M0.10MnSb (M = Ti, V, Cr) systems using thermal neutron diffraction in the temperature range ~ 3–300 K are presented. It is found that all the studied compositions have ferromagnetic ordering along the c axis. In the spectra of Ni0.90V0.10MnSb and Ni0.90Cr0.10MnSb solid solutions, a reflection appears in the region 2Θ = 28.6°, which indicates the formation of antiferromagnetic ordering. It has been found that this reflection disappears at a temperature T = 75 K in Ni0.90V0.10MnSb, while it is observed in the spectrum of Ni0.90Cr0.10MnSb over the entire temperature range under study. Within the framework of density functional theory (DFT), an ab initio calculation of the crystal structure and magnetic moments for Ni1–xMxMnSb (M = Ti, V, Cr; x = 0; 0.125; 0.250) was carried out. It has been established that titanium, vanadium, and chromium ions participate in electron transfer only with Mn and Sb ions. The DFT results predict the existence of magnetic moments for Ti, V, and Cr ions. It was found that the spins of Ti, V, and Cr ions are antiferromagnetically coupled with the spins of Mn and Ni ions. The results obtained are of interest for the development of new concepts and models of structural design, which makes it possible to synthesize fundamentally new functional materials with already specified physical properties.Представлены результаты эксперимента по изучению кристаллической и магнитной структур твердых растворов замещения систем Ni0,90M0,10MnSb (M = Ti, V, Cr) с помощью дифракции тепловых нейтронов в интервале температур ~ 3–300 К. Обнаружено, что все исследуемые составы обладают ферромагнитным упорядочением вдоль оси с. На спектрах твердых растворов Ni0,90V0,10MnSb и Ni0,90Сr0,10MnSb в области 2Θ = 28,6° отмечено появление рефлекса, который указывает на формирование антиферромагнитного упорядочения. Установлено, что данный рефлекс исчезает при температуре T = 75 К в Ni0,90V0,10MnSb, а на спектре Ni0,90Cr0,10MnSb он наблюдается во всем исследуемом диапазоне температур. В рамках теории функционала плотности (DFT) проведен ab initio расчет кристаллической структуры и магнитных моментов для Ni1–xMxMnSb (M = Ti, V, Cr; x = 0; 0,125; 0,250). Установлено, что ионы титана, ванадия и хрома участвуют в переносе электрона только с ионами Mn и Sb. Результаты DFT предсказывают существование магнитных моментов у ионов Ti, V и Cr. Обнаружено, что спины ионов Ti, V и Cr антиферромагнитно связаны со спинами ионов Mn и Ni. Полученные результаты представляют интерес для разработки новых концепции и моделей структурного дизайна, при котором возможен синтез принципиально новых функциональных материалов с уже заданными физическими свойствами

Bacterial Load of Pneumococcal Serotypes Correlates with Their Prevalence and Multiple Serotypes Is Associated with Acute Respiratory Infections among Children Less Than 5 Years of Age

Background: Among pneumococcal serotypes, some serotypes are more prevalent in the nasopharynx than others; determining factors for higher prevalence remain to be fully explored. As non-vaccine serotypes have emerged after the introduction of 7-valent conjugate vaccines, study of serotype specific epidemiology is in need. When two or more serotypes co-colonize, they evolve rapidly to defend host\u27s immune responses; however, a clear association of cocolonization with a clinical outcome is lacking. Methods: Children less than 5 years old who were admitted to hospital due to acute respiratory infections (ARI) (n = 595) and healthy children (n = 350) were recruited. Carriage of pneumococcus was determined by culture and lytA PCR in the nasopharyngeal samples. Serotype/serogroup detection and its quantification were done by the nanofluidic real time PCR system. Spearman\u27s correlation and logistic regression were used to examine a correlation of serotype/serogroup specific bacterial load with its prevalence and an association of co-colonization with ARI respectively. Results: Serotype/serogroup specific bacterial load was correlated with its prevalence, both in ARI cases (Spearman\u27s rho = 0.44, n = 186; P<0.0001) and healthy children (Spearman\u27s rho = 0.41, n = 115; P<0.0001). The prevalence of multiple serotypes was more common in ARI cases than in healthy children (18.5% vs 7.1%; aOR 2.92, 95% CI: 1.27-6.71; P = 0.01). The dominant serotype in the co-colonization had a 2 log10 higher bacterial load than the subdominant serotype, both in ARI cases (P<0.001) and healthy children (P<0.05). Conclusions: High bacterial load in the nasopharynx may help transmit pneumococci among hosts, and increase the chance of successful acquisition and colonization. Co-colonization of multiple serotypes of pneumococci is linked with ARI, which infers the interactions of multiple serotypes may increase their pathogenicity; however, they may compete for growth in number

Global, regional, and national burden of Alzheimer's disease and other dementias, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.

BACKGROUND: The number of individuals living with dementia is increasing, negatively affecting families, communities, and health-care systems around the world. A successful response to these challenges requires an accurate understanding of the dementia disease burden. We aimed to present the first detailed analysis of the global prevalence, mortality, and overall burden of dementia as captured by the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016, and highlight the most important messages for clinicians and neurologists. METHODS: GBD 2016 obtained data on dementia from vital registration systems, published scientific literature and surveys, and data from health-service encounters on deaths, excess mortality, prevalence, and incidence from 195 countries and territories from 1990 to 2016, through systematic review and additional data-seeking efforts. To correct for differences in cause of death coding across time and locations, we modelled mortality due to dementia using prevalence data and estimates of excess mortality derived from countries that were most likely to code deaths to dementia relative to prevalence. Data were analysed by standardised methods to estimate deaths, prevalence, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs; computed as the sum of YLLs and YLDs), and the fractions of these metrics that were attributable to four risk factors that met GBD criteria for assessment (high body-mass index [BMI], high fasting plasma glucose, smoking, and a diet high in sugar-sweetened beverages). FINDINGS: In 2016, the global number of individuals who lived with dementia was 43·8 million (95% uncertainty interval [UI] 37·8-51·0), increased from 20.2 million (17·4-23·5) in 1990. This increase of 117% (95% UI 114-121) contrasted with a minor increase in age-standardised prevalence of 1·7% (1·0-2·4), from 701 cases (95% UI 602-815) per 100 000 population in 1990 to 712 cases (614-828) per 100 000 population in 2016. More women than men had dementia in 2016 (27·0 million, 95% UI 23·3-31·4, vs 16.8 million, 14.4-19.6), and dementia was the fifth leading cause of death globally, accounting for 2·4 million (95% UI 2·1-2·8) deaths. Overall, 28·8 million (95% UI 24·5-34·0) DALYs were attributed to dementia; 6·4 million (95% UI 3·4-10·5) of these could be attributed to the modifiable GBD risk factors of high BMI, high fasting plasma glucose, smoking, and a high intake of sugar-sweetened beverages. INTERPRETATION: The global number of people living with dementia more than doubled from 1990 to 2016, mainly due to increases in population ageing and growth. Although differences in coding for causes of death and the heterogeneity in case-ascertainment methods constitute major challenges to the estimation of the burden of dementia, future analyses should improve on the methods for the correction of these biases. Until breakthroughs are made in prevention or curative treatment, dementia will constitute an increasing challenge to health-care systems worldwide