Showing papers by "Hanoi School Of Public Health published in 2009"

Patterns of alcohol consumption in diverse rural populations in the Asian region.

Abstract: Background: Alcohol abuse, together with tobacco use, is a major determinant of health and social well-being, and is one of the most important of 26 risk factors comparatively assessed in low and middle income countries, surpassed only by high blood pressure and tobacco. Objectives: The alcohol consumption patterns and the associations between consumption of alcohol and socio-demographic and cultural factors have been investigated in nine rural Health and Demographic Surveillance System (HDSS) located in five Asian countries. Methods: The information was collected from multiple study sites, with sample sizes of sufficient size to measure trends in age and sex groups over time. Adopting the WHO STEPwise approach to Surveillance (WHO STEPS), stratified random sampling (in each 10-year interval) from the HDSS sampling frame was undertaken. Information regarding alcohol consumption and demographic indicators were collected using the WHO STEPwise standard surveillance form. The data from the nine HDSS sites were merged and analysed using STATA software version 10. Results: Alcohol was rarely consumed in five of the HDSS (four in Bangladesh, and one in Indonesia). In the two HDSS in Vietnam (Chililab, Filabavi) and one in Thailand (Kanchanaburi), alcohol consumption was common in men. The mean number of drinks per day during the last seven days, and prevalence of at-risk drinker were found to be highest in Filabavi. The prevalence of female alcohol consumption was much smaller in comparison with men. In Chililab, people who did not go to school or did not complete primary education were more likely to drink in comparison to people who graduated from high school or university. Conclusions: Although uncommon in some countries because of religious and cultural practices, alcohol consumption patterns in some sites were cause for concern. In addition, qualitative studies may be necessary to understand the factors influencing alcohol consumption levels between the two sites in Vietnam and the site in Thailand in order to design appropriate interventions.

What causes H5N1 avian influenza? Lay perceptions of H5N1 aetiology in South East and East Asia.

Abstract: Background Health education to reduce population poultry exposures has limited effect. Lay beliefs about H5N1 highly pathogenic avian influenza (HPAI) causes could provide insights helpful for improving public health interventions. Methods Qualitative interviews of poultry farmers, retailers, market stall holders and consumers in Hong Kong (n ¼ 20), Guangzhou (n ¼ 25), Vietnam (n ¼ 38) and Thailand (n ¼ 40) were conducted using purposive sampling and analysed using ethnographic principles. Results Each location produced three comparable themes: ‘viruses’: HPAI exemplified a periodic, natural, disease process therefore, deserving little concern. For some, science had ‘discovered’ something long known to farmers and lived with for generations. Others believe the virus to be new. Viral ecology was reasonably well understood among farmers, but less so by retailers and consumers; ‘husbandry practices’ included poor hygiene, overcrowding and industrial farming, modern commercial feed and veterinary drugs; ‘vulnerability factors’ included uncontrollable ‘external’ explanations involving the weather, seasonal changes, bird migrations and pollution. Conclusions Lay explanations were generally ecologically consistent. Nonetheless, beliefs that HPAI is a normal, recurrent process, external factors and roles of industrialized poultry rearing countered health worker claims of H5N1 seriousness for smallholders. These causal beliefs incorporate contemporary models of H5N1 ecology, but in a manner that contradicts public health efforts at control.

Tobacco farming in rural Vietnam: questionable economic gain but evident health risks

Abstract: In order to provide evidence on health impacts of the tobacco industry on cultivators in Vietnam, this study aims to provide comparison between tobacco cultivation related revenue and expenditure in selected areas in rural Vietnam and examine the relationship between tobacco cultivation and self-reported illness in the study population. Two tobacco farming communes and two non-tobacco farming communes were selected for this study. In each selected commune, 120 households were sampled using two-stage cluster sampling technique. Local health workers were recruited and trained to conduct household interviews using structured questionnaire. Where the expenditure figures do not include personnel costs (as the farming work was almost always responsible by the family members themselves), it appeared that the average tobacco farmer did benefit financially from tobacco cultivation. However, if a personal opportunity cost was added to give a financial value to their labour, the profit from tobacco cultivation was seen to be minimal. The occurrences of 9 out of the 16 health problems were statistically significant higher among tobacco growing farmers compared to that among non-tobacco farmers. Tobacco farming was shown to be the second strong predictor of self-reported health problems among the farmer (after the effect of old age). The present study provides evidence that can be used to increase public awareness about the harmful effects of tobacco growing.

Premarital sex and condom use among never married youth in Vietnam

Abstract: UNLABELLED Premarital sex and unprotected sexual intercourse are issues of growing concern in Vietnam. The present study aims to explore the factors associated with the onset and delay of premarital sex among youth in Vietnam. METHODS A cross-sectional in-home survey was undertaken in a suburb of Hanoi, Vietnam among a sample of 2,394 never married youth ages 15 to 24 years in the end of 2003. RESULTS Cox regression analyses showed that youth who had ever experienced sexual abuse were 35 times more likely to report having had premarital sex. Connectedness to mother likewise was associated with a decreased likelihood of having sex before marriage. A medium level of school connectedness was also a factor associated with the delay of premarital sex (OR = 0.27). Peer social deviance, on the other hand, increased the likelihood by at least 2.6 times. Separate models for each sex confirmed: the protective effect of mother connectedness among females; the negative effect of peer social deviance among males; and the predominant risk of past sexual abuse in both sexes for premarital sex. When factors associated with condom use among sexually active never married youth were explored, males were found more likely to use condom at first sexual intercourse. CONCLUSIONS These results reaffirm a growing body of literature from around the world that has shown connectedness to a parent to be associated with delay of premarital sex, while peer social deviance and exposure of previous sexual abuse have been both associated with early sexual debut.

The quality of injury data from hospital records in Vietnam.

Abstract: The objective of this research was to examine the level of agreement of coders for ICD-10 coding of injury discharges in Danang General Hospital in Vietnam. Two hundred and five medical records of children hospitalised in this facility due to injury were randomly selected and recoded. Information from medical records abstracted by two trained staff was recoded by external coders in Hanoi and in Australia, using ICD-10. The completeness and detail of external cause of injury recorded in medical records was poor. Agreement between coders for injury coding was average, with 32% to 40% discrepancy in the main diagnosis codes at three character level, and 57% to 60% discrepancy at four character level, depending on which coders were being compared. It was concluded that as hospital data represent a cost-effective source of information regarding injuries, with significant costs incurred in collecting such information through special studies and censuses (especially for a developing country such as Vietnam), it is important to establish the quality and value of hospital data for injury surveillance and prevention research and to explore ways in which these data can be improved.

Overdose beliefs and management practices among ethnic Vietnamese heroin users in Sydney, Australia.

Abstract: Background Ethnic Vietnamese injecting drug users (IDUs) in Australia draw on a range of beliefs and etiologic models, sometimes simultaneously, in order to make sense of health and illness. These include understandings of illness as the result of internal imbalances and Western concepts of disease causation including germ/pollution theory.