Economic Burden Attributed to Children Presenting to Hospitals With Hand, Foot, and Mouth Disease in Vietnam

BACKGROUND: Hand, foot, and mouth disease (HFMD) has become a major public health concern in the Asia-Pacific region. Knowledge of its economic burden is essential for policy makers in prioritizing the development and implementation of interventions. METHODS: A multi-hospital-based study was prospectively conducted at 3 major hospitals in Ho Chi Minh City, Vietnam, during 2016-2017. Data on direct and productivity costs were collected alongside clinical information and samples and demographic information from study participants. RESULTS: A total of 466 patients were enrolled. Two hundred three of 466 (43.6%) patients lived in Ho Chi Minh City, and 72/466 (15.5%) had severe HFMD. An enterovirus was identified in 74% of 466 patients, with EV-A71, CV-A6, CV-A10, and CV-A16 being the most common viruses identified (236/466, 50.6%). The mean economic burden per case was estimated at US$400.80 (95$353.80-$448.90), of which the total direct (medical) costs accounted for 69.7$90 761 749 (95% CI, $79 033 973-$103 009 756). CONCLUSIONS: Our findings are of public health significance because for the first time we demonstrate that HFMD causes a substantial economic burden in Vietnam, and although multivalent vaccines are required to control HFMD, effective EV-A71 vaccine could substantially reduce the burden posed by severe HFMD. The results will be helpful for health policy makers in prioritizing resources for the development and implementation of intervention strategies to reduce the burden of HFMD

New genetic sources of resistance in the genus Phaseolus to individual and combined aluminium toxicity and progressive soil drying stresses

Bean species and genotypes show wide phenotypic variability in relation to aluminium (Al) resistance and progressive soil drying. The objective of this study was to identify and characterize sources of resistance to Al toxicity and progressive soil drying among six genotypes of common bean (Phaseolus vulgaris), four of runner bean (P. coccineus), and one of tepary bean (P. acutifolius), using hydroponic and soil cylinder screening methods. One experiment on hydroponic screening of Al resistance was carried out using a basal nutrient solution with and without 20 lM Al. Two experiments were carried out using two oxisols in 80 cm long soil cylinders with high Al (HAl) and low Al (LAl) saturation treatments. The three experiments showed an average of 36.9–53.5% inhibition of root growth with HAl compared with LAl treatments. Differences in root development and distribution were observed among genotypes and species. Two accessions of P. coccineus (G35346-2Q, G35464-5Q) and one Andean common bean genotype (ICA Quimbaya) were outstanding in root and shoot growth in the HAl treatments. P. coccineus accession (G35346-3Q) was outstanding under combined stress of Al-toxic acid soil and progressive soil drying. Accessions of P. coccineus may represent unique sources of Al resistance for the improvement of common bean through interspecific crosses