Genome Sequence of a Virulent African Swine Fever Virus Isolated in 2020 from a Domestic Pig in Northern Vietnam

This study reports the genome sequence of an isolated African swine fever (ASF) virus (VNUA-ASFV-05L1/HaNam) obtained at the fourth passage on pulmonary alveolar macrophages. The virus was isolated during a typical acute ASF outbreak in pigs in a northern province of Vietnam in 2020

An Assessment of the Values of French Colonial Townhouses in Hanoi Towards A More Sustainable Conservation

As the capital city of French Indochina, Hanoi was well planned by the French and immensely invested in the construction of public buildings as well as houses. In addition to public buildings and villas designed in French colonial styles that shaped the so-called distinctive architectural heritage in Hanoi throughout the colonial years, a large number of townhouses built during 1920 - 1950 which formed the cityscape of Hanoi in the first half of the 20th century should be noted. After nearly 70 years since the French army withdrew from the city, the number of French townhouses has considerably decreased. The remaining houses have shown that this is a real “treasure” that needs to be conserved because of their important values, not only in terms of urban architecture but also in cultural and historical aspects. However, a fact requiring special attention is that French townhouses in Hanoi - unlike French public buildings and villas - have not yet been recognised as heritage so that they can be kept to avoid the risk of deterioration or demolition under the impact of rapid urbanisation in the market economy. One of the main reasons for this negative urban development is that there has been no concrete or comprehensive rating system to assess the values of those townhouses which will closely correspond to their characteristics and contexts. Therefore, the authors - based on site surveys and by applying some appropriate methods such as expert consultations and case studies - have developed a full set of criteria to help evaluate those remaining townhouses as accurately as possible. This system can be used as a basis for a systematic assessment and classification towards a more effective conservation and even promoting the values of those townhouses with regard to the development of a modern society and in consideration of sustainable heritage conservation as a mainstream in the world.

Effects of ENSO on Autumn Rainfall in Central Vietnam

28 years (1980–2007) of station and gridded reanalysis data were used to investigate the effects of El Niño/Southern Oscillation (ENSO) on autumn rainfall in the Extended Central Vietnam (ECV) region. Results show that, under El Niño conditions, autumn rainfall in Central Vietnam is reduced by about 10 to 30%. This reduction seems to be caused by a weakening of the North East monsoon circulation, which appears to be linked to an anomalous anticyclonic vortex and a positive sea level pressure anomaly over the East Sea. In addition, the disappearance of a secondary moisture source over the southern region of the East Sea also favors the reduction in rainfall over this region. Conversely, during La Niña, the total autumn rainfall in the ECV region increases by about 9 to 19%. The strengthening of the North East monsoon, with a cyclonic wind anomaly over the East Sea, helps to increase the moisture supply to the area by about 10 to 20%, resulting in enhanced rainfall in the ECV. It is also found that the La Niña conditions do not only cause an increase in rainfall, but also change the temporal distribution of the monthly rainfall over the region, with more rainfall in the latter months of the year

Determinants of antibiotic prescribing in primary care in Vietnam: a qualitative study using the Theoretical Domains Framework

Background: To formulate effective strategies for antimicrobial stewardship (AMS) in primary care, it is crucial to gain a thorough understanding of factors influencing prescribers' behavior within the context. This qualitative study utilizes the Theoretical Domains Framework (TDF) to uncover these influential factors. Methods: We conducted a qualitative study using in-depth interviews and focus group discussions with primary care workers in two provinces in rural Vietnam. Data analysis employed a combined inductive and deductive approach, with the deductive aspect grounded in the TDF. Results: Thirty-eight doctors, doctor associates, and pharmacists participated in twenty-two interviews and two focus group discussions. We identified sixteen themes, directly mapping onto seven TDF domains: knowledge, skills, behavioral regulation, environmental context and resources, social influences, social/professional role and identity, and optimism. Factors driving unnecessary prescription of antibiotics include low awareness of antimicrobial resistance (AMR), diagnostic uncertainty, prescription-based reimbursement policy, inadequate medication supplies, insufficient financing, patients’ perception of health insurance medication as an entitlement, and maintaining doctor-patient relationships. Potential factors facilitating AMS activities include time availability for in-person patient consultation, experience in health communication, and willingness to take action against AMR. Conclusion: Utilizing the TDF to systematically analyze and present behavioral determinants offers a structured foundation for designing impactful AMS interventions in primary care. The findings underscore the importance of not only enhancing knowledge and skills but also implementing environmental restructuring, regulation, and enablement measures to effectively tackle unnecessary antibiotic prescribing in this context

Understanding Acceptability and Willingness-to-pay for a C-reactive Protein Point-of-care Testing Service to Improve Antibiotic Dispensing for Respiratory Infections in Vietnamese Pharmacies: A Mixed-methods Study

Background: Pharmacies are popular first points of contact for mild infections in the community. Pharmacy services in many countries have expanded to include vaccines and point-of-care tests. In low- and middle-income countries such as Vietnam, poor enforcement of regulations results in substantial volumes of over-the-counter antibiotic sales. Point-of-care tests could provide an economically viable way to reduce antibiotic sales, while still satisfying customer demand for convenient healthcare. C-reactive protein point-of-care testing (CRP-POCT) can reduce antibiotic prescribing for respiratory illness in primary care. Here, we explore the acceptability and feasibility of implementing CRP-POCT in pharmacies in Vietnam. Methods: We conducted a mixed-methods study between April and June 2021. A customer exit survey with 520 participants seeking acute respiratory infection treatment at 25 pharmacies evaluated acceptability and willingness-to-pay (WTP) for CRP-POCT and post-service satisfaction. Factors driving customers” acceptance and WTP were explored through mixed-effects multivariable regression. Three focus group discussions with customers (20 participants) and 12 in-depth interviews with pharmacists and other stakeholders were conducted and analyzed thematically. Results: Antibiotics were sold to 81.4% of patients with CRP levels <10 mg/L (antibiotics not recommended). A total of 96.5% of customers who experienced CRP-POCT supported its future introduction at pharmacies. Patients with antibiotic transactions (adjusted odds ratio [aOR], 2.25; 95% confidence interval [CI], 1.13–4.48) and those suffering acute respiratory infection symptoms for more than 3 days (aOR, 2.10; 95% CI, 1.08–4.08) were more likely to accept CRP-POCT, whereas customers visiting for children (aOR, 0.20; 95% CI, .10–.54) and those with preference for antibiotic treatment (aOR, 0.45; 95% CI, 0.23–0.89) were less likely to accept CRP-POCT. A total of 78.3% (95% CI, 74.8–81.7) of customers were willing to pay for CRP-POCT, with a mean cost of US$2.4 (±1.1). Customer's income and cost of total drug treatment were associated with increased WTP. Enablers for implementing CRP-POCT included customers’ and pharmacists’ perceived benefits of CRP-POCT, and the impact of COVID-19 on perceptions of POCT. Perceived challenges for implementation included the additional burden of service provision, lack of an enabling policy environment, and potential risks for customers. Conclusions: Implementing CRP-POCT at pharmacies is a feasible and well-accepted strategy to tackle the overuse of antibiotics in the community, with appeal for both supply and demand sides. Creating an enabling policy environment for its implementation, and transparent discussion of values and risks would be key for its successful implementation

Two cases of bacteriemia caused by nontoxigenic, non-O1, non-O139 Vibrio cholerae isolates in Ho Chi Minh City, Vietnam.

The toxigenic bacterium Vibrio cholerae belonging to the O1 and O139 serogroups is commonly associated with epidemic diarrhea in tropical settings; other diseases caused by this environmental pathogen are seldom identified. Here we report two unassociated cases of nonfatal, nontoxigenic V. cholerae non-O1, non-O139 bacteremia in patients with comorbidities in Ho Chi Minh City, Vietnam, that occurred within a 4-week period

Elevated Levels of Cell-Free Circulating DNA in Patients with Acute Dengue Virus Infection

BACKGROUND: Apoptosis is thought to play a role in the pathogenesis of severe dengue and the release of cell-free DNA into the circulatory system in several medical conditions. Therefore, we investigated circulating DNA as a potential biomarker for severe dengue. METHODS AND FINDINGS: A direct fluorometric degradation assay using PicoGreen was performed to quantify cell-free DNA from patient plasma. Circulating DNA levels were significantly higher in patients with dengue virus infection than with other febrile illnesses and healthy controls. Remarkably, the increase of DNA levels correlated with the severity of dengue. Additionally, multivariate logistic regression analysis showed that circulating DNA levels independently correlated with dengue shock syndrome. CONCLUSIONS: Circulating DNA levels were increased in dengue patients and correlated with dengue severity. Additional studies are required to show the benefits of this biomarker in early dengue diagnosis and for the prognosis of shock complication

Rifampicin resistant 'Mycobacterium tuberculosis' in Vietnam, 2020–2022

Objective: We conducted a descriptive analysis of multi-drug resistant tuberculosis (MDR-TB) in Vietnam’s two largest cities, Hanoi and Ho Chi Minh city. Methods: All patients with rifampicin resistant tuberculosis were recruited from Hanoi and surrounding provinces between 2020 and 2022. Additional patients were recruited from Ho Chi Minh city over the same time period. Demographic data were recorded from all patients, and samples collected, cultured, whole genome sequenced and analysed for drug resistance mutations. Genomic susceptibility predictions were made on the basis of the World Health Organization’s catalogue of mutations in Mycobacterium tuberculosis associated with drug resistance, version 2. Comparisons were made against phenotypic drug susceptibility test results where these were available. Multivariable logistic regression was used to assess risk factors for previous episodes of tuberculosis. Results: 233/265 sequenced isolates were of sufficient quality for analysis, 146 (63 %) from Ho Chi Minh City and 87 (37 %) from Hanoi. 198 (85 %) were lineage 2, 20 (9 %) were lineage 4, and 15 (6 %) were lineage 1. 17/211 (8 %) for whom HIV status was known were infected, and 109/214 (51 %) patients had had a previous episode of tuberculosis. The main risk factor for a previous episode was HIV infection (odds ratio 5.1 (95 % confidence interval 1.3–20.0); p = 0.021). Sensitivity for predicting first-line drug resistance from whole genome sequencing data was over 90 %, with the exception of pyrazinamide (85 %). For moxifloxacin and amikacin it was 50 % or less. Among rifampicin-resistant isolates, prevalence of resistance to each non-first-line drug was < 20 %. Conclusions: Drug resistance among most MDR-TB strains in Vietnam’s two largest cities is confined largely to first-line drugs. Living with HIV is the main risk factor among patients with MDR-TB for having had a previous episode of tuberculosis

A Phase 2/3 double blinded, randomized, placebo-controlled study in healthy adult participants in Vietnam to examine the safety and immunogenicity of an inactivated whole virion, alum adjuvanted, A(H5N1) influenza vaccine (IVACFLU-A/H5N1)

Abstract Background A global shortfall of vaccines for avian influenza A(H5N1) would occur, especially in low- and-middle income countries, if a pandemic were to occur. To address this issue, development of a pre-pandemic influenza vaccine was initiated in 2012, leveraging a recently established influenza vaccine manufacturing capacity in Vietnam. Methods This was a Phase 2/3, double-blinded, randomized, placebo-controlled study to test the safety and immunogenicity of IVACFLU-A/H5N1 vaccine in healthy adults. Phase 2 was a dose selection study, in which 300 participants were randomized to one of the three groups (15 mcg, 30 mcg, or placebo). Safety and immunogenicity were assessed in all participants. In Phase 3, 630 participants were randomized to receive the IVACFLU-A/H5N1 vaccine dose selected in Phase 2 (15 mcg, n = 525) or placebo (n = 105). Safety was assessed in all Phase 3 participants and immunogenicity was measured in a subset of participants. Results The vaccine was well tolerated and most of the adverse events were mild and of short duration. Mild pain at the injection site was the most common adverse event seen in 60 percent of participants in the vaccine group in Phase 3. In Phase 2, both 15 mcg and 30 mcg doses were immunogenic, so the lower dose was selected for further testing in Phase 3. In Phase 3 overall seroconversion rates were 68 percent for hemagglutination inhibition (HI), 51 percent for microneutralization (MN) and 56 percent for single radial hemolysis (SRH). The seroprotection rates were 44 percent for HI, 41 percent for MN and 55 percent for SRH. The GMT ratio was 5.31 and 3.7 for HI and MN respectively; GMA was 4.75 for the SRH. Conclusion The IVACFLU A/H5N1 was safe and immunogenic. Development of this pandemic avian influenza vaccine is a welcome addition to the limited global pool of these vaccines. ClinicalTrials.gov register NCT02612909

Experiência de aprendizagem de estudantes de enfermagem na prevenção e controlo de infeções associadas aos cuidados de saúde (PC-IACS) em países asiáticos: um estudo qualitativo exploratório

Background: Healthcare-associated infection prevention and control (HAI-PC) education programs in Asian countries seem limited and require improvement and support. Objective: This study explored students’ learning experiences with HAI-PC education programs in Asian countries (two Vietnamese and two Cambodian universities) to support a pedagogical model in HAI-PC. Method: A qualitative exploratory study design was employed, and inductive content analysis was conducted. Students were selected to participate in the focus group to investigate their experiences with HAI-PC using five structured questions. There were 48 nursing students in total from four universities, 28 from 2 universities in Cambodia, and 20 from two universities in Vietnam. Results: The summary results gained from the four universities were synthesized by grouping them into sub-categories and four primary categories, which were students’ HAI-PC competence, students’ current learning methods in HAI-PC Education, the HAI-PC teaching and learning environment, students’ capacity, and entrepreneurial skills in HAI-PC development. Conclusion: This study revealed evidence to improve nursing education in HAI-PC in Asian countries. The new learning method of the simulation scenario and the model fascinated the students; they were happy and more confident about their future careers in practicing HAI-PC skills in their clinical practicum and hospital practice. The current HAI-PC education faces issues related to education and healthcare systems in Asian countries, highlighting the need for improvement.Enquadramento: Os programas de educação em prevenção e controlo de infeções associadas aos cuidados de saúde (PC-IAS) em países asiáticos parecem ser limitados e necessitam de melhorias e apoio. Objetivo: Este estudo explorou as experiências de aprendizagem dos estudantes com programas de educação em PC-IAS em países asiáticos (duas universidades vietnamitas e duas universidades cambojanas) para apoiar um modelo pedagógico em PC-IAS. Método: Foi utilizado um desenho de estudo exploratório qualitativo, e foi realizada uma análise de conteúdo indutiva. Os estudantes foram selecionados para participar no grupo focal para investigar as suas experiências com PC-IAS usando cinco perguntas estruturadas. No total, participaram 48 estudantes de enfermagem de quatro universidades, sendo 28 de duas universidades no Camboja e 20 de duas universidades no Vietname. Resultados: Os resultados resumidos das quatro universidades foram sintetizados agrupando-os em subcategorias e quatro categorias principais, que eram competência dos estudantes em PC-IAS, métodos de aprendizagem atuais dos estudantes em Educação em PC-IAS, ambiente de ensino e aprendizagem em PC-IAS, capacidade dos estudantes e habilidades empreendedoras no desenvolvimento de PC-IAS. Conclusão: Este estudo revelou evidências para melhorar a educação em enfermagem em PC-IAS em países asiáticos. O novo método de aprendizagem do cenário de simulação e o modelo cativaram os estudantes; eles ficaram felizes e mais confiantes em relação às suas futuras carreiras na prática de habilidades em PC-IAS no estágio clínico e na prática hospitalar. A educação atual em PC-IAS enfrenta questões relacionadas aos sistemas de educação e saúde em países asiáticos, destacando a necessidade de melhorias