HIV-Associated TB in An Giang Province, Vietnam, 2001–2004: Epidemiology and TB Treatment Outcomes

BACKGROUND: Mortality is high in HIV-infected TB patients, but few studies from Southeast Asia have documented the benefits of interventions, such as co-trimoxazole (CTX), in reducing mortality during TB treatment. To help guide policy in Vietnam, we studied the epidemiology of HIV-associated TB in one province and examined factors associated with outcomes, including the impact of CTX use. METHODOLOGY/PRINCIPAL FINDINGS: We retrospectively abstracted data for all HIV-infected persons diagnosed with TB from 2001-2004 in An Giang, a province in southern Vietnam in which TB patients receive HIV counseling and testing. We used standard WHO definitions to classify TB treatment outcomes. We conducted multivariate analysis to identify risk factors for the composite outcome of death, default, or treatment failure during TB treatment. From 2001-2004, 637 HIV-infected TB patients were diagnosed in An Giang. Of these, 501 (79%) were male, 321 (50%) were aged 25-34 years, and the most common self-reported HIV risk factor was sex with a commercial sex worker in 221 (35%). TB was classified as smear-positive in 531 (83%). During TB treatment, 167 (26%) patients died, 9 (1%) defaulted, and 6 (1%) failed treatment. Of 454 patients who took CTX, 116 (26%) had an unsuccessful outcome compared with 33 (70%) of 47 patients who did not take CTX (relative risk, 0.4; 95% confidence interval [CI], 0.3-0.5). Adjusting for male sex, rural residence, TB smear status and disease location, and the occurrence of adverse events during TB treatment in multivariate analysis, the benefit of CTX persisted (adjusted odds ratio for unsuccessful outcome 0.1; CI, 0.1-0.3). CONCLUSIONS/SIGNIFICANCE: In An Giang, Vietnam, HIV-associated TB was associated with poor TB treatment outcomes. Outcomes were significantly better in those taking CTX. This finding suggests that Vietnam should consider applying WHO recommendations to prescribe CTX to all HIV-infected TB patients

A Multi-Center Randomised Controlled Trial of Gatifloxacin versus Azithromycin for the Treatment of Uncomplicated Typhoid Fever in Children and Adults in Vietnam

BACKGROUND: Drug resistant typhoid fever is a major clinical problem globally. Many of the first line antibiotics, including the older generation fluoroquinolones, ciprofloxacin and ofloxacin, are failing. OBJECTIVES: We performed a randomised controlled trial to compare the efficacy and safety of gatifloxacin (10 mg/kg/day) versus azithromycin (20 mg/kg/day) as a once daily oral dose for 7 days for the treatment of uncomplicated typhoid fever in children and adults in Vietnam. METHODS: An open-label multi-centre randomised trial with pre-specified per protocol analysis and intention to treat analysis was conducted. The primary outcome was fever clearance time, the secondary outcome was overall treatment failure (clinical or microbiological failure, development of typhoid fever-related complications, relapse or faecal carriage of S. typhi). PRINCIPAL FINDINGS: We enrolled 358 children and adults with suspected typhoid fever. There was no death in the study. 287 patients had blood culture confirmed typhoid fever, 145 patients received gatifloxacin and 142 patients received azithromycin. The median FCT was 106 hours in both treatment arms (95% Confidence Interval [CI]; 94-118 hours for gatifloxacin versus 88-112 hours for azithromycin), (logrank test p = 0.984, HR [95% CI] = 1.0 [0.80-1.26]). Overall treatment failure occurred in 13/145 (9%) patients in the gatifloxacin group and 13/140 (9.3%) patients in the azithromycin group, (logrank test p = 0.854, HR [95% CI] = 0.93 [0.43-2.0]). 96% (254/263) of the Salmonella enterica serovar Typhi isolates were resistant to nalidixic acid and 58% (153/263) were multidrug resistant. CONCLUSIONS: Both antibiotics showed an excellent efficacy and safety profile. Both gatifloxacin and azithromycin can be recommended for the treatment of typhoid fever particularly in regions with high rates of multidrug and nalidixic acid resistance. The cost of a 7-day treatment course of gatifloxacin is approximately one third of the cost of azithromycin in Vietnam. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN67946944

EVALUATION OF FAMOTIDINE LOADED 3D-NANO-CELLULOSE NETWORK USED FOR ORAL ADMINISTRATION

Objective: Evaluation Of Famotidine Loaded 3D-Nano-Cellulose Network three dimensional nano-cellulose network (3DNC) Used For Oral Administration. 3DNC is produced from bacteria living in fermented green tea and is the material containing nano-sized fibers, which is capable of loading Famotidine to form a prolonged release therapy to improve drug bioavailability. Methods: Used healthy white rabbits, weight approximately 2.5-2.7 kg, the same age, laboratory standard, is supplied from The National Institute of Drug Quality Control. The rabbits have adapted to laboratory conditions at least one week and have starveling in 12 h, supplied fully water during the preparation. Rabbits are divided into 4 groups (n=3 for each group). Every rabbit is given 1 capsule or 1 tablet with a single dose of 20 mg/rabbit: group 1 (commercial drugs), group 2 (3DNC-standard medium (SM) loaded drug), group 3 (3DNC-coconut medium (CM) loaded drug) Group 4 (3DNC-rice medium (RM) loaded drug). Results: The results have shown that 3DNC has the involvement of the nano-sized cellulose fibers with three-dimensional networks that are capable of loading Famotidine and prolonged drug release. The 3DNC cultured in the drug-loaded SM with slow-release and slow-release catalysts, the 3DNC was cultured in CMs and tablets with medium release rates, in comparison with the 3DNC was cultured in RM loaded at a rapid release rate in the same pH = 2. Conclusion: Experiment on rabbits showed that the drug-loaded 3DNCs could help to prolong the drug release, in which the extended-release time of the 3DNC cultured in SM and CM was higher than that of the 3DNC grown in RM. The 3DNC loaded drugs help improve Famotidine bioavailability compared to commercial tablets

Characteristics and dynamics of backyard poultry raising systems in five Asian countries in relation to the reduction and management of avian influenza risk : final report

Despite rapid growth of the poultry sector, small holders still constitute the vast majority of poultry keepers, marketed through associated informal trade networks. The research aims to better understand backyard poultry raising systems, the variations among them, their roles in rural livelihoods, and to work with stakeholders in this sector to devise practical, equitable and sustainable options to reduce the likelihood of a human Avian influenza (AI) pandemic in five Asian Countries: Cambodia, China, Indonesia, Thailand and Vietnam. This report reviews the backyard poultry system in Vietnam in terms of production, trade, gender, marketing and consumption, and information on household income

Trace Metal Element Analysis in Some Seafood in the Coastal Zone of the Red River (Ba Lat Estuary, Vietnam) by Green Sample Preparation and Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

Fisheries and aquaculture production in the coastal zone of Vietnam contribute significantly to the national economy. However, seafood quality and safety, especially in terms of metal contents, are of increasing concern, for both domestic and international markets. This paper presents the results of an investigation in some trace metal elements (iron (Fe), zinc (Zn), manganese (Mn), copper (Cu), arsenic (As), cadmium (Cd), and mercury (Hg)) concentrations in some fishes, crustaceans, and molluscs in the coastal zone of the Red River (in the Ba Lat estuary in Thai Binh and Nam Dinh provinces) during four sampling campaigns in 2020. All samples were treated by a green sample preparation using microwave digestion and then analyzed by inductively coupled plasma-mass spectrometry (ICP-MS). The results showed that the trace metal element concentrations in fish, crustacean, and mollusc samples decreased in the following order: Fe > Zn > Mn > Cu > As > Cd ∼ Hg. In more details, the ranges of trace metal elements in seafood samples were 13.13–202.73; 7.63–82.71; 0.48–22.73; 0.72–15.58; 0.18–5.12; 0.001–1.114; and 0.001–0.923 mg·kg−1 for Fe, Zn, Mn, Cu, As, Cd, and Hg, respectively. The research results contribute to the dataset of the seafood (both fishery and aquacultural seafood) quality in the Red River coastal zone. Although the mean values of different trace metal elements observed in this study were lower than the allowed values of Vietnam’s or European’s threshold for food safety, some high concentrations were detected. The survey results suggest the need to expand the monitoring scope (frequency of monitoring, number of samples, and observed variables) for obtaining a fully comprehensive assessment of seafood quality in this region. Our results also indicate that it is necessary to manage water quality in coastal areas, especially where aquaculture activities are carried out

Change in carbon flux (1960-2015) of the Red River (Vietnam)

Global riverine carbon concentrations and fluxes have been impacted by climate and human-induced changes for many decades. This paper aims to reconstruct the longterm carbon concentrations and carbon fluxes of the Red River, a system under the coupled pressures of environmental change and human activity. Based on (1) the relationships between particulate and dissolved organic carbon (POC, DOC) or dissolved inorganic carbon (DIC), and suspended sediments (TSS) or river water discharge and on (2) the available detailed historical records of river discharge and TSS concentration, the variations of theRed River carbon concentration and flux were estimated for the period 1960-2015. The results show that total carbon flux of the Red River averaged 2555 +/- 639 ktonC year(-1). DIC fluxes dominated total carbon fluxes, representing 64% of total, reflecting a strong weathering process from carbonate rocks in the upstream basin. Total carbon fluxes significantly decreased from 2816 kton C year(-1) during the 1960s to 1372 kton C year(-1) during the 2010s and showed clear seasonal and spatial variations. Organic carbon flux decreased in both quantity and proportion of the total carbon flux from 40.9% in 1960s to 14.9% in 2010s, reflecting the important impact of dam impoundment. DIC flux was also reduced over this period potentially as a consequence of carbonate precipitation in the irrigated, agricultural land and the reduction of the Red River water discharge toward the sea. These decreases in TSS and carbon fluxes are probably partially responsible for different negatives impacts observed in the coastal zone

Optimization of Microwave-Assisted Extraction Process of Callicarpa candicans (Burm. f.) Hochr Essential Oil and Its Inhibitory Properties against Some Bacteria and Cancer Cell Lines

Callicarpa candicans (Burm. f.) Hochr. (Callicarpa cana L.) is a medicinal plant that is distributed mainly in the tropics and subtropics of Asia and finds a wide range of uses in traditional medicine. In this study, we attempted and optimized the microwave-assisted hydro-distillation (MAHD) process to obtain essential oil from the leaves of C. candicans. In addition, the obtained oil was analyzed for volatile composition by gas chromatography–mass spectrometry (GC-MS) and assayed for bioactivity against several bacteria and cancer cell lines. To optimize the extraction process, response surface methodology (RSM) in combination with central composite design (CCD) was adopted. Experimental design and optimization were carried out with respect to three experimental factors including the ratio of water to raw material, extraction time, and microwave power. The optimal extraction conditions were obtained as follows: water to raw material ratio of 6/1 (v/w), extraction time 42 min, and microwave power 440 W. Composition determination of the obtained C. candicans essential oil indicated the presence of predominant components including caryophyllene <b-> (10.45%), cadinene <d-> (10.28%), gurjunene <a-> (8.95%), muurolene <g-> (8.92%), selinene <a-> (7.06%), selinene <b-> (5.59%), and copaene <a-> (5.40%). In comparison with the essential oils obtained via traditional hydro-distillation method, the essential oil extracted by MAHD exhibited superior anti-proliferative activity on all tested cancer cell lines. Current results imply that the MAHD is capable of recovering biologically-active natural products of greater quantity than that recovered by the conventional distillation

Nasal-spraying Bacillus spores as an effective symptomatic treatment for children with acute respiratory syncytial virus infection

Abstract Respiratory syncytial virus (RSV) is a leading cause of Acute Respiratory Tract Infections (ARTIs) in young children. However, there is currently no vaccine or treatment available for children. Here, we demonstrated that nasal-spraying probiotics containing 5 billion of Bacillus spores (LiveSpo Navax) is an effective symptomatic treatment in a 6-day randomized controlled clinical study for RSV-infected children (n = 40–46/group). Navax treatment resulted in 1-day faster recovery-time and 10–50% better efficacy in relieving ARTI symptoms. At day 3, RSV load and level of pro-inflammatory cytokines in nasopharyngeal samples was reduced by 630 folds and 2.7–12.7 folds respectively. This showed 53-fold and 1.8–3.6-fold more effective than those in the control-standard of care-group. In summary, nasal-spraying Bacillus spores can rapidly and effectively relieve symptoms of RSV-induced ARTIs while exhibit strong impacts in reducing viral load and inflammation. Our nasal-spraying probiotics may provide a basis for simple-to-use, low-cost, and effective treatment against viral infection in general

Efficient symptomatic treatment and viral load reduction for children with influenza virus infection by nasal-spraying Bacillus spore probiotics

Abstract Influenza virus is a main cause of acute respiratory tract infections (ARTIs) in children. This is the first double-blind, randomized, and controlled clinical trial examining the efficacy of nasal-spraying probiotic LiveSpo Navax, which contains 5 billion of Bacillus subtilis and B. clausii spores in 5 mL, in supporting treatment of influenza viral infection in pediatric patients. We found that the nasal-spraying Bacillus spores significantly shortened the recovery period and overall treatment by 2 days and increased treatment effectiveness by 58% in resolving all ARTIs’ symptoms. At day 2, the concentrations of influenza virus and co-infected bacteria were reduced by 417 and 1152 folds. Additionally, the levels of pro-inflammatory cytokines IL-8, TNF-α, and IL-6 in nasopharyngeal samples were reduced by 1.1, 3.7, and 53.9 folds, respectively. Compared to the standard control group, treatment regimen with LiveSpo Navax demonstrated significantly greater effectiveness, resulting in 26-fold reduction in viral load, 65-fold reduction in bacterial concentration, and 1.1–9.5-fold decrease in cytokine levels. Overall, nasal-spraying Bacillus spores can support the symptomatic treatment of influenza virus-induced ARTIs quickly, efficiently and could be used as a cost-effective supportive treatment for respiratory viral infection in general. Clinical trial registration no: NCT05378022 on 17/05/2022