Estimating the welfare loss to households from natural disasters in developing countries: a contingent valuation study of flooding in Vietnam

Background: Natural disasters have severe impacts on the health and well-being of affected households. However, we find evidence that official damage cost assessments for floods and other natural disasters in Vietnam, where households have little or no insurance, clearly underestimate the total economic damage costs of these events as they do not include the welfare loss from mortality, morbidity and reduced well-being experienced by the households affected by the floods. This should send a message to the local communities and national authorities that higher investments in flood alleviation, reduction and adaptive measures can be justified since the social benefits of these measures in terms of avoided damage costs are higher than previously thought. Methods: We pioneer the use of the contingent valuation (CV) approach of willingness-to-contribute (WTC) labour to a flood prevention program, as a measure of the welfare loss experienced by household due to a flooding event. In a face-to-face household survey of 706 households in the Quang Nam province in Central Vietnam, we applied this approach together with reported direct physical damage in order to shed light of the welfare loss experienced by the households. We asked about households’ WTC labour and multiplied their WTC person-days of labour by an estimate for their opportunity cost of time in order to estimate the welfare loss to households from the 2007 floods. Results: The results showed that this contingent valuation (CV) approach of asking about willingness-to-pay in-kind avoided the main problems associated with applying CV in developing countries. Conclusion: Thus, the CV approach of WTC labour instead of money is promising in terms of capturing the total welfare loss of natural disasters to households, and promising in terms of further application in other developing countries and for other types of natural disasters

Randomized controlled trial of artesunate or artemether in Vietnamese adults with severe falciparum malaria

<p>Abstract</p> <p>Background</p> <p>Both artemether and artesunate have been shown to be superior to quinine for the treatment of severe falciparum malaria in Southeast Asian adults, although the magnitude of the superiority has been greater for artesunate than artemether. These two artemisinin derivatives had not been compared in a randomized trial.</p> <p>Methods</p> <p>A randomized double blind trial in 370 adults with severe falciparum malaria; 186 received intramuscular artesunate (2.4 mg/kg immediately followed by 1.2 mg/kg at 12 hours then 24 hours then daily) and 184 received intramuscular artemether (3.6 mg per kilogram immediately followed by 1.8 mg per kilogram daily) was conducted in Viet Nam. Both drugs were given for a minimum of 72 hours.</p> <p>Results</p> <p>There were 13 deaths in the artesunate group (7 percent) and 24 in the artemether group (13 percent); P = 0.052; relative risk of death in the patients given artesunate, 0.54; (95 percent confidence interval 0.28-1.02). Parasitaemia declined more rapidly in the artesunate group. Both drugs were very well tolerated.</p> <p>Conclusions</p> <p>Intramuscular artesunate may be superior to intramuscular artemether for the treatment of severe malaria in adults.</p

Scalar meson and glueball decays within a effective chiral approach

We study the strong and electromagnetic decay properties of scalar mesons above 1 GeV within a chiral approach. The scalar-isoscalar states are treated as mixed states of quarkonia and glueball configurations. A fit to the experimental decay rates listed by the Particle Data group is performed to extract phenomenological constraints on the nature of the scalar resonances. A comparison to other theoretical approaches in the scalar meson sector is discussed.Comment: 13 pages, accepted for publication in PL

Survival and health status of DOTS tuberculosis patients in rural Lao PDR

<p>Abstract</p> <p>Background</p> <p>Contact tracing of tuberculosis (TB) patients is rarely performed in low-income countries. Our objective was to assess the outcome of and compliance with directly observed treatment (DOTS) of TB patients over a 3 year period in rural Lao PDR.</p> <p>Methods</p> <p>We performed a retrospective cohort study in which we enrolled TB patients who started DOTS treatment at Attapeu Provincial Hospital. We traced, through hospital records, all patients in their residential village. We conducted a standardized questionnaire with all TB patients and performed physical and anthropometric examinations as well as evaluations of compliance through counting of treatment pills at home and at the health facilities.</p> <p>Results</p> <p>Of 172 enrolled TB patients (sex ratio female/male: 0.52, mean age: 46.9 years ± 16.9), 26 (15.1%) died. These had a lower weight at the start (34.6 <it>vs</it>. 40.8 kg, p < 0.001) and were less compliant (91.6% <it>vs</it>. 19.2%, p < 0.001) than survivors. Low compliance was associated with poor accessibility to health care (p = 0.01) and symptomatic improvement (p = 0.02). Survivors had persistently poor health status. They were underweight (54.7%), and still had clinical symptoms (53.5%), including dyspnoea (28.8%) and haemoptysis (9.5%).</p> <p>Conclusion</p> <p>Our study suggests a lower rate of survival than expected from official statistics. Additionally, it showed that follow-up of TB patients is feasible although the patients lived in very remote area of Laos. Follow-up should be strengthened as it can improve patient compliance, and allow contact tracing, detection of new cases and collection of accurate treatment outcome information.</p

The context of HIV risk behaviours among HIV-positive injection drug users in Viet Nam: Moving toward effective harm reduction

<p>Abstract</p> <p>Background</p> <p>Injection drug users represent the largest proportion of all HIV reported cases in Viet Nam. This study aimed to explore the perceptions of risk and risk behaviours among HIV-positive injection drug users, and their experiences related to safe injection and safe sex practices.</p> <p>Methods</p> <p>This study used multiple qualitative methods in data collection including in-depth interviews, focus group discussions and participant observation with HIV-positive injection drug users.</p> <p>Results</p> <p>The informants described a change in the sharing practices among injection drug users towards more precautions and what was considered 'low risk sharing', like sharing among seroconcordant partners and borrowing rather than lending. However risky practices like re-use of injection equipment and 'syringe pulling' i.e. the use of left-over drugs in particular, were frequently described and observed. Needle and syringe distribution programmes were in place but carrying needles and syringes and particularly drugs could result in being arrested and fined. Fear of rejection and of loss of intimacy made disclosure difficult and was perceived as a major obstacle for condom use among recently diagnosed HIV infected individuals.</p> <p>Conclusion</p> <p>HIV-positive injection drug users continue to practice HIV risk behaviours. The anti-drug law and the police crack-down policy appeared as critical factors hampering ongoing prevention efforts with needle and syringe distribution programmes in Viet Nam. Drastic policy measures are needed to reduce the very high HIV prevalence among injection drug users.</p

Risk of latent tuberculosis infection in children living in households with tuberculosis patients: a cross sectional survey in remote northern Lao People's Democratic Republic

ABSTRACT: BACKGROUND: Tuberculosis is highly prevalent in Laos (289 per 100,000). We evaluated the risk of latent tuberculosis infection (LTBI) among children (0-15 years) living with tuberculosis patients in rural northern Laos. METHODS: In a cross sectional survey of 30 randomly selected villages, 72 tuberculosis patients were traced and their 317 contacts (148 were children) investigated using a questionnaire, a tuberculin skin tests (positive: <= 10mm), a 3-day sputum examination for acid-fast bacilli (AFB), and chest radiography. RESULTS: None of the 148 contact-children received prophylaxis, one had cervical tuberculosis; the risk for LTBI was 31.0%. Awareness of the infectiousness of tuberculosis was low among patients (31%) and their contacts (31%), and risky behavior was common. After multivariate logistic analysis, increased LTBI was found in children with contact with sputum positive adults (OR: 3.3, 95% CI: 1.4-7.7), patients highly positive sputum prior to treatment (AFB <2+; OR: 4.7, 95% CI: 1.7-12.3), and living in ethnic minorities (OR: 5.4, 95% CI: 2.2-13.6). CONCLUSION: The study supports the importance of contact tracing in remote settings with high TB prevalence. Suggestions to improve the children's detection rate, the use of existing guidelines, chemoprophylaxis of contact-children and the available interventions in Laos are discussed. Improving education and awareness of the infectiousness of TB in patients is urgently needed to reduce TB transmissio

Clinical and Virological Features of Dengue in Vietnamese Infants

Dengue is a major public health problem in tropical and subtropical countries, including Vietnam. Dengue cases occur in children and young adults; however, severe dengue also occurs in infants less than 1 year of age. Prompt recognition of dengue is important for appropriate case management, particularly in infants in whom febrile illness from other causes is common. We describe the clinical picture, virological and immunological characteristics of infants with dengue admitted to three hospitals in southern Vietnam, compared with infants admitted with fever not due to dengue. We show that infants with dengue are difficult to distinguish from those with other febrile illnesses based on signs and symptoms at presentation, and so laboratory tests to confirm dengue virus infection may be useful for diagnosis and management. Conventional diagnostic methods for dengue have low sensitivity early in infection, and we show that an alternative antigen-detection assay that has demonstrated good sensitivity and specificity in older age groups also performs well in infants. This study will help to inform the diagnosis and management of dengue in infants

The Role of Imported Cases and Favorable Meteorological Conditions in the Onset of Dengue Epidemics

Dengue/dengue hemorrhagic fever is the world's most widely spread mosquito-borne arboviral disease and threatens more than two-thirds of the world's population. Cases are mainly distributed in tropical and subtropical areas in accordance with vector habitats for Aedes aegypti and Ae. albopictus. However, the role of imported cases and favorable meteorological conditions has not yet been quantitatively assessed. This study verified the correlation between the occurrence of indigenous dengue and imported cases in the context of weather variables (temperature, rainfall, relative humidity, etc.) for different time lags in southern Taiwan. Our findings imply that imported cases have a role in igniting indigenous outbreaks, in non-endemics areas, when favorable weather conditions are present. This relationship becomes insignificant in the late phase of local dengue epidemics. Therefore, early detection and case management of imported cases through timely surveillance and rapid laboratory-diagnosis may avert large scale epidemics of dengue/dengue hemorrhagic fever. An early-warning surveillance system integrating meteorological data will be an invaluable tool for successful prevention and control of dengue, particularly in non-endemic countries

Negotiating the modern cross-class ‘model home’:domestic experiences in Basil Spence’s Claremont Court

This article investigates the spatial articulation of architecture and home through the exploration of current domestic experiences in Basil Spence’s Claremont Court housing scheme (1959-1962), Edinburgh. How architecture and home are both idealized and lived is the backdrop for a discussion that draws on the concept of “model home,” or physical representation of a domestic ideal. The article reads Claremont Court as an architectural prototype of the modern domestic ideal, before exploring its reception by five of its households through the use of visual methods and semistructured interviews. Receiving the model home involves negotiating between ideal and lived homes. Building on this idea, the article contributes with a focus on the spatiality of such reception, showing how it is modulated according to the architectural affordances that the “model home” represents. The article expands on scholarship on architecture and home with empirical evidence that argues the reciprocal spatiality of home