Concomitant Bacteremia in Adults With Severe Falciparum Malaria.

BackgroundApproximately 6% of children hospitalized with severe falciparum malaria in Africa are also bacteremic. It is therefore recommended that all children with severe malaria should receive broad-spectrum antibiotics in addition to parenteral artesunate. Empirical antibiotics are not recommended currently for adults with severe malaria.MethodsBlood cultures were performed on sequential prospectively studied adult patients with strictly defined severe falciparum malaria admitted to a single referral center in Vietnam between 1991 and 2003.ResultsIn 845 Vietnamese adults with severe falciparum malaria admission blood cultures were positive in 9 (1.07%: 95% confidence interval [CI], .37-1.76%); Staphylococcus aureus in 2, Streptococcus pyogenes in 1, Salmonella Typhi in 3, Non-typhoid Salmonella in 1, Klebsiella pneumoniae in 1, and Haemophilus influenzae type b in 1. Bacteremic patients presented usually with a combination of jaundice, acute renal failure, and high malaria parasitemia. Four bacteremic patients died compared with 108 (12.9%) of 836 nonbacteremic severe malaria patients (risk ratio, 3.44; 95% CI, 1.62-7.29). In patients with >20% parasitemia the prevalence of concomitant bacteremia was 5.2% (4/76; 95% CI, .2-10.3%) compared with 0.65% (5/769; 0.08-1.2%) in patients with ConclusionsIn contrast to children, the prevalence of concomitant bacteremia in adults with severe malaria is low. Administration of empirical antibiotics, in addition to artesunate, is warranted in the small subgroup of patients with very high parasitemias, emphasizing the importance of quantitative blood smear microscopy assessment, but it is not indicated in most adults with severe falciparum malaria

A Retrospective Analysis of the Haemodynamic and Metabolic Effects of Fluid Resuscitation in Vietnamese Adults with Severe Falciparum Malaria

BACKGROUND: Optimising the fluid resuscitation of patients with severe malaria is a simple and potentially cost-effective intervention. Current WHO guidelines recommend central venous pressure (CVP) guided, crystalloid based, resuscitation in adults. METHODS: Prospectively collected haemodynamic data from intervention trials in Vietnamese adults with severe malaria were analysed retrospectively to assess the responses to fluid resuscitation. RESULTS: 43 patients were studied of whom 24 received a fluid load. The fluid load resulted in an increase in cardiac index (mean increase: 0.75 L/min/m(2) (95% Confidence interval (CI): 0.41 to 1.1)), but no significant change in acid-base status post resuscitation (mean increase base deficit 0.6 mmol/L (95% CI: -0.1 to 1.3). The CVP and PAoP (pulmonary artery occlusion pressure) were highly inter-correlated (r(s) = 0.7, p<0.0001), but neither were correlated with acid-base status (arterial pH, serum bicarbonate, base deficit) or respiratory status (PaO(2)/FiO(2) ratio). There was no correlation between the oxygen delivery (DO(2)) and base deficit at the 63 time-points where they were assessed simultaneously (r(s) = -0.09, p = 0.46). CONCLUSIONS: In adults with severe falciparum malaria there was no observed improvement in patient outcomes or acid-base status with fluid loading. Neither CVP nor PAoP correlated with markers of end-organ perfusion or respiratory status, suggesting these measures are poor predictors of their fluid resuscitation needs

Risk Factors of Streptococcus suis Infection in Vietnam. A Case-Control Study

Background: Streptococcus suis infection, an emerging zoonosis, is an increasing public health problem across South East Asia and the most common cause of acute bacterial meningitis in adults in Vietnam. Little is known of the risk factors underlying the disease. Methods and Findings: A case-control study with appropriate hospital and matched community controls for each patient was conducted between May 2006 and June 2009. Potential risk factors were assessed using a standardized questionnaire and investigation of throat and rectal S. suis carriage in cases, controls and their pigs, using real-time PCR and culture of swab samples. We recruited 101 cases of S. suis meningitis, 303 hospital controls and 300 community controls. By multivariate analysis, risk factors identified for S. suis infection as compared to either control group included eating "high risk" dishes, including such dishes as undercooked pig blood and pig intestine (OR1 = 2.22; 95% CI = [1.15-4.28] and OR2 = 4.44; 95% CI = [2.15-9.15]), occupations related to pigs (OR1 = 3.84; 95% CI = [1.32-11.11] and OR2 = 5.52; 95% CI = [1.49-20.39]), and exposures to pigs or pork in the presence of skin injuries (OR1 = 7.48; 95% CI = [1.97-28.44] and OR2 = 15.96; 95% CI = [2.97-85.72]). S. suis specific DNA was detected in rectal and throat swabs of 6 patients and was cultured from 2 rectal samples, but was not detected in such samples of 1522 healthy individuals or patients without S. suis infection. Conclusions: This case control study, the largest prospective epidemiological assessment of this disease, has identified the most important risk factors associated with S. suis bacterial meningitis to be eating 'high risk' dishes popular in parts of Asia, occupational exposure to pigs and pig products, and preparation of pork in the presence of skin lesions. These risk factors can be addressed in public health campaigns aimed at preventing S. suis infectio

Cu2O/Fe3O4/UiO-66 nanocomposite as an efficient fenton-like catalyst: Performance in organic pollutant degradation and influencing factors based machinelearning

The persistent presence of organic pollutants like dyes in water environment necessitates innovative approaches for efficient degradation. In this research, we developed an advanced hybrid catalyst by combining metal oxides (Cu2O, Fe3O4) with UiO-66, serving as a heterogeneous Fenton catalyst for for efficient RB19 breakdown in water with H2O2. The control factors to the catalytic behavior were also quantified by machine learning. Experimental results show that the catalytic performance was much better than its individual components (P < 0.05 &amp; non-zero 95% C.I). The improved catalytic efficiency was linked to the occurrence of active metal centers (Fe, Cu, and Zr), with Cu(I) from Cu2O playing a crucial role in promoting increased production of HO•. Also, UiO-66 served as a catalyst support, attracting pollutants to the reaction center, while magnetic Fe3O4 aids catalyst recovery. The optimal experimental parameters for best performance were pH at 7, catalyst loading of 1.6 g/L, H2O2 strength of 0.16 M, and reaction temperature of 25 °C. The catalyst can be magnetically separated and regenerated after five recycling times without significantly reducing catalytic activity. The reaction time and pH were ranked as the most influencing factors on catalytic efficiency via Random Forest and SHapley Additive exPlanations models. The findings show that developed catalyst is a suitable candidate to remove dyes in water by Fenton heterogeneous reaction

New Orchids (Orchidaceae: Cymbidieae and Vandeae) in the Flora of Vietnam

The paper continues publication of new original data on orchid diversity in Vietnam (tribes Cymbidieae and Vandeae) obtained in 2016–2018. It includes data on 2 genera and 10 species new for the flora of Vietnam. Among them, six species are new to science (Ascocentrum hienii, Biermannia canhii, Cymbidium tamphianum, Gastrochilus setosus, Malleola luongii, Robiquetia orlovii). Four other species are found on the territory of Vietnam for the first time (Bogoria raciborskii, Lesliea mirabilis, Pennilabium struthio, Uncifera obtusifolia). Two genera, Bogoria and Lesliea, are newly recorded for the flora of Vietnam. One new nomenclature combination (Ascocentropsis malipoensis), one new name (Ascocentropsis yunnanensis) and one lectotype (for Uncifera obtusifolia) are proposed. When the new data presented in this paper are included, the known orchid flora of Vietnam comprises about 1220 documented species from 174 genera

Research and training partnership to assist policy and capacity building in improving food safety in Vietnam

This paper evaluated the implementation of an initiative for promoting risk-based approaches to improve food safety management in Vietnam. A Taskforce of Risk Assessment for Food Safety (Taskforce) was formed and consisted of researchers working on risk assessment and food safety, and representatives of the related ministries of Health and of Agriculture. We used the OECD Development Assistance Committee Evaluation Criteria as a framework for assessing the impact of the Taskforce with five evaluation areas – relevance, effectiveness, efficiency, impact and sustainability. They analysed current food safety policies, identified key constraints and opportunities, and conducted action research and capacity building to address these challenges in food safety. Stakeholder workshops helped determine priority food safety issues and activities. A series of hands-on training based on real-world case studies were organized and risk assessment curricula were developed and taught at universities to promote sustainability. Practical guidelines, text books, a special edition and policy briefs were published. The Taskforce provided technical support to a national food safety assessment commissioned by the World Bank and evidence for development partners. The Taskforce was institutionalized by a national university to have a formal role in implementing its activities. In conclusion, the Taskforce has brought experts in Vietnam to work together on prioritized topics of food safety risk assessment, assisted and informed ministries in implementing risk-based approaches for food safety management. It can be recommended as a way of institutionalising risk-based methods in countries new to the approach