Hanoi School Of Public Health

About: Hanoi School Of Public Health is a education organization based out in Hanoi, Vietnam. It is known for research contribution in the topics: Population & Public health. The organization has 182 authors who have published 266 publications receiving 23330 citations.

Trends in socioeconomic inequalities in child malnutrition in Vietnam: findings from the Multiple Indicator Cluster Surveys, 2000-2011.

Abstract: Background : Child malnutrition is not only a major contributor to child mortality and morbidity, but it can also determine socioeconomic status in adult life. The rate of under-five child malnutrition in Vietnam has significantly decreased, but associated inequality issues still need attention. Objective : This study aims to explore trends, contributing factors, and changes in inequalities for under-five child malnutrition in Vietnam between 2000 and 2011. Design : Data were drawn from the Viet Nam Multiple Indicator Cluster Survey for the years 2000 and 2011. The dependent variables used for the study were stunting, underweight, and wasting of under-five children. The concentration index was calculated to see the magnitude of child malnutrition, and the inequality was decomposed to understand the contributions of determinants to child malnutrition. The total differential decomposition was used to identify and explore factors contributing to changes in child malnutrition inequalities. Results : Inequality in child malnutrition increased between 2000 and 2011, even though the overall rate declined. Most of the inequality in malnutrition was due to ethnicity and socioeconomic status. The total differential decomposition showed that the biggest and second biggest contributors to the changes in underweight inequalities were age and socioeconomic status, respectively. Socioeconomic status was the largest contributor to inequalities in stunting. Conclusions : Although the overall level of child malnutrition was improved in Vietnam, there were significant differences in under-five child malnutrition that favored those who were more advantaged in socioeconomic terms. The impact of socioeconomic inequalities in child malnutrition has increased over time. Multifaceted approaches, connecting several relevant ministries and sectors, may be necessary to reduce inequalities in childhood malnutrition. Keywords: trend; malnutrition; inequality; decomposition; Vietnam (Published: 29 February 2016) Citation: Glob Health Action 2016, 9 : 29263 - http://dx.doi.org/10.3402/gha.v9.29263 This paper is part of the Special Issue: Millennium Development Goals in Vietnam: the Progress and Social Determinants . More papers from this issue can be found at www.globalhealthaction.net

Outcomes of Antiretroviral Therapy in Vietnam: Results from a National Evaluation

Abstract: Objectives: Vietnam has significantly scaled up its national antiretroviral therapy (ART) program since 2005. With the aim of improving Vietnam’s national ART program, we conducted an outcome evaluation of the first five years of the program in this concentrated HIV epidemic where the majority of persons enrolled in HIV care and treatment services are people who inject drugs (PWID). The results of this evaluation may have relevance for other national ART programs with significant PWID populations. Design: Retrospective cohort analysis of patients at 30 clinics randomly selected with probability proportional to size among 120 clinics with at least 50 patients on ART. Methods: Charts of patients whose ART initiation was at least 6 months prior to the study date were abstracted. Depending on clinic size, either all charts or a random sample of 300 charts were selected. Analyses were limited to treatment-nao ¨ve patients. Multiple imputations were used for missing data. Results: Of 7,587 patient charts sampled, 6,875 were those of treatment-nao ¨ve patients (74.4% male, 95% confidence interval [CI]: 72.4–76.5, median age 30, interquartile range [IQR]: 26–34, 62.0% reported a history of intravenous drug use, CI: 58.6–65.3). Median baseline CD4 cell count was 78 cells/mm 3 (IQR: 30–162) and 30.4% (CI: 25.8–35.1) of patients were at WHO stage IV. The majority of patients started d4T/3TC/NVP (74.3%) or d4T/3TC/EFV (18.6%). Retention rates after 6, 12, 24, and 36 months were 88.4% (CI: 86.8–89.9), 84.0% (CI: 81.8–86.0), 78.8% (CI: 75.7–81.6), and 74.6% (CI: 69.6–79.0). Median CD4 cell count gains after 6, 12, 24, and 36 months were 94 (IQR: 45–153), 142 (IQR: 78–217), 213 (IQR: 120–329), and 254 (IQR: 135–391) cells/mm 3 . Patients who were PWID showed significantly poorer retention. Conclusions: The study showed good retention and immunological response to ART among a predominantly PWID group of patients despite advanced HIV infections at baseline.

Assessing Health Risk due to Exposure to Arsenic in Drinking Water in Hanam Province, Vietnam

Abstract: We assessed health risks related to Arsenic (As) in contaminated drinking water in Hanam, applying the Australian Environmental Health Risk Assessment Framework, which promotes stakeholder involvement in risk assessments. As concentrations in 300 tube-well water samples, before and after filtration, were analyzed and the water consumption levels in 150 households were estimated. Skin cancer risk was characterized using Cancer Slope Factor index and lifetime average daily dose with a probabilistic approach. The results showed that arsenic concentrations in tube-well water ranged from 8–579 ppb (mean 301 ppb) before filtration and current sand filters used by the households did not meet the standard for As removal. Arsenic daily consumption of 40% of the adults exceeded the level of TDI (Tolerable Daily Intake) at 1 µg/kg/day. The average skin cancer risk in adults due to consuming filtered tube-well water for drinking purpose were 25.3 × 10−5 (using only well water) and 7.6 × 10−5 (using both well and rain water). The skin cancer risk would be 11.5 times higher if the water was not filtered. Improvement of filtration measures or the replacement of the current drinking water sources to minimize the health risks to the local population is urgently needed.

The economic burden of road traffic injuries: evidence from a provincial general hospital in Vietnam

Abstract: Objective To examine the costs of road traffic injuries (RTIs) in Vietnam and factors associated with increased costs. Method RTI data were collected in a prospective cohort study on the impact of injuries in Vietnam. Participants were persons admitted to the Thai Binh General Hospital because of RTI. All costs incurred by participants and their family members during hospitalisation were collected, including direct medical costs, direct non-medical costs and indirect costs. Generalised linear models were employed to examine predictors of increased costs including demographic and injury context characteristics. Results Each RTI hospitalisation costs the patient and family on average US$363 or 6 months of average salary. Income, injury severity, principal region of injury and length of hospital stay were statistically significant predictors of increased costs; age, gender, occupation and road user group were not. After controlling for injury characteristics and income, participants with principal injuries to the lower extremities had a cost 1.28 (95% CI 1.07 to 1.54) times higher than those with principal injuries to the face. Analyses of motorcycle-related RTIs with principal injury to the head also showed increased costs among those without a helmet (1.41 times higher, 95% CI 1.17 to 1.71). Conclusions RTIs can cause a substantial economic burden to the patient and family. During hospitalisation on average, an RTI would cost approximately 6 months of salary. In addition to interventions to decrease the risk of RTIs, those reducing the severity, such as wearing a motorcycle helmet, should be enforced to minimise the economic and health consequences of injury.

Sustainability and cost of a community-based strategy against Aedes aegypti in northern and central Vietnam.

Abstract: We previously reported a new community-based mosquito control that resulted in the elimination of Aedes aegypti in 40 of 46 communes in northern and central Vietnam. During 2007 and 2008, we revisited Nam Dinh and Khanh Hoa provinces in northern and central Vietnam, respectively, to evaluate whether or not these programs were still being maintained 7 years and 4.5 years after formal project activities had ceased, respectively. Using a previously published sustainability framework, we compared 13 criteria from Tho Nghiep commune in Nam Dinh where the local community had adopted our community-based project model using Mesocyclops from 2001. These data were compared against a formal project commune, Xuan Phong, where our successful intervention activities had ceased in 2000 and four communes operating under the National Dengue Control Program with data available. In Khanh Hoa province, we compared 2008 data at Ninh Xuan commune with data at project completion in 2003 and benchmarked these, where possible, against an untreated control commune, Ninh Binh, where few control activities had been undertaken. The three communes where the above community-based strategy had been adopted were rated as well-sustained with annual recurrent total costs (direct and indirect) of $0.28-0.89 international dollars per person.