International Journal of Environmental Research and Public Health
Xuan Thi Thanh Le, Phuong Thi Ngoc Nguyen, Toan Thi Thanh Do, Thang Huu Nguyen, Huong Thi Le, Cuong Tat Nguyen, Giang Hai Ha, Chi Linh Hoang, Bach Xuan Tran, Carl A. Latkin, Roger C.M. Ho, Cyrus S.H. Ho
International Journal of Environmental Research and Public Health
The intention to pay for human papillomavirus (HPV) vaccination among women of
childbearing age in Vietnam, where cervical cancer remains a significant public health concern, has
been mostly lacking. To examine this issue, we conducted a cross-sectional study of 807 pregnant women in an urban and a rural district (Dong Da and Ba Vi) of Hanoi, Vietnam. The vast percentage of our respondents expressed a firm intention to vaccinate, especially women in rural areas (over 90.0%). However, on being informed of the current price of the HPV vaccine, their intention to vaccinate dropped to about one-fifth of overall respondents, i.e., only 4.4% of women in rural areas. It was also observed that the initial intention to get the HPV vaccination among women in the rural district was about ten times higher than that of women living in the metropolitan district. Those participants who had greater knowledge of cervical cancer and HPV vaccinations also had a significantly higher intention to vaccinate. Our findings underscore the need to develop a well-designed vaccination program in Vietnam and other countries in a similar situation to increase the adoption of HPV vaccination.
Journal of Evaluation in Clinical Practice
Rationale, aims and objectives: Changes in, and predictors of, quality of life (QoL) among unstable angina patients are informative for both clinical and public health practice. However, there is little research on this topic, especially in health care set- tings with limited resources. This study aims to detect changes in QoL and its associ- ated factors among patients with unstable angina after percutaneous coronary intervention.
Methods: A longitudinal design was conducted with two repeated rounds of mea- surements, 1 and 3 months after intervention, using the generic SF-36 questionnaire, in 120 patients from Vietnam National Heart Institute. A linear mixed-effects model was used to assess changes in patient QoL over time while adjusting for other covariates.
Results: Only two out of eight QoL subscales (social functioning and emotional well- being) declined after 1 month, but these tended to rise again after 3 months, while scores of all other QoL subscales increased. Adjusting for covariates, QoL increased slightly after 1 month of intervention (β = 0.65, 95%CI = −0.86 to 2.16) but improved by almost six QoL points after 3 months (β = 5.99, 95%CI = 4.48 to 7.50). Four con- founders significantly associated with a decline in QoL were older age, being retired, living in rural areas, and having abnormal troponin level.
Conclusion: QoL of the patients with unstable angina improves significantly 3 months after intervention, rather than after 1 month. More attention should be given to patients, who are old, retired, live in rural areas and have abnormal troponin level.
BMC Public Health
Background: Organisational culture (OC) has increasingly become a crucial factor in defining healthcare practice and management. However, there has been little research validating and adapting OCAI (organisational culture assessment instrument) to assess OC in healthcare settings in developing countries, including Vietnam. The purpose of this study is to validate the OCAI in a hospital setting using key psychometric tests and confirmatory factor analysis (CFA).
Methods: This is a cross-sectional study. Self-administered structured questionnaire was completed by 566 health professionals from a Vietnamese national general hospital, the General Hospital of Quang Nam province. The psychometric tests and CFA were utilized to detect internal reliability and construct validity of the instrument.
Results: The Cronbach’s alpha coefficients (α-reliability statistic) ranged from 0.6 to 0.8. In current culture, the coefficient was 0.80 for clan and 0.60 for adhocracy, hierarchy and market dimension, while in expected culture, the coefficient for clan, adhocracy, hierarchy, and market dimension was 0.70, 0.70, 0.70 and 0.60, respectively. The CFA indicated that most factor loading coefficients were of moderate values ranging from 0.30 to 0.60 in both current and expected culture model. These models are of marginal good fit.
Conclusions: The study findings suggest that the OCAI be of fairly good reliability and construct validity in measuring four types of organisational culture in healthcare setting in resource-constrained countries such as Vietnam. This result is a first step towards developing a valid Vietnamese version of the OCAI which can also provide a strong case for future research in the field of measuring and managing organisational culture.
International Journal of Environmental Research and Public Health
Promoting age-friendly environment is one of the appropriate approaches to support quality of life toward ageing populations. However, the information regarding age-friendly environments in the Association of Southeast Asian Nations (ASEAN) Plus Three countries is still limited. This study aimed to survey the perceived age-friendly environments among ASEAN Plus Three older populations. The study employed cross-sectional quantitative research using multistage cluster sampling to select a sample of older adults in the capital cities of Japan, Malaysia, Myanmar, Vietnam and Thailand. The final sample was composed of 2171 older adults aged 55 years and over, including 140 Japanese, 510 Thai, 537 Malaysian, 487 Myanmarese, and 497 Vietnamese older adults. Data collection was conducted using a quantitative questionnaire with 20 items of perceived age-friendly environments with the rating scale based on the World Health Organization (WHO) standard. The score from the 20 items were analyzed and examined high-risk groups of “bad perception level” age-friendly environments using ordinal logistic regression. The research indicated the five highest inadequacies of age-friendly environments including: (1) participating in an emergency-response training session or drill which addressed the needs of older residents; (2) enrolling in any form of education or training, either formal or non-formal in any subject; (3) having opportunities for paid employment; (4) involvement in decision making about important political, economic and social issues in the community; and (5) having personal care or assistance needs met in the older adult’s home setting by government/private care services. Information regarding the inadequacy of age-friendliness by region was evidenced to guide policy makers in providing the right interventions towards older adults’ needs.
Studies on Ethno-Medicine
The purpose of this paper was to determine the use of herbal remedies and supplementary products among chronic disease patients in Vietnam. A cross-sectional study was conducted in a health care setting using a random sample of 1601 adult patients (Mean age: 50.5 years, SD=22.7). From the total sample 43.6 percent indicated that they had been using herbal home remedies. In multivariate logistic regression analysis, older age, urban residence, having medium income, not engaging in problem drinking, having three or more chronic conditions, low drug medication adherence and poor health status was associated with herbal home remedy use. Commonly used herbal remedies included Curcumin, Gynostemma pentaphyllum, Ganoderma lucidum, Aloe Vera, Artichoke, Globe artichoke Cynara scolymus L.,1753,– Asteraceae and Styphnolobium japonicum. This paper confirms a high prevalence and a wide variety of herbal remedy use.
Toan Thanh Thi Do, Anh Ngoc Nguyen Xuan Thanh Thi Le, Ann Pongsakul, Quang Nhat Nguyen, Thanh Van Nguyen, Thang Huu Nguyen, Tri Minh Do, Huong Thi Le, Huong Lan Thi Nguyen, Nu Thi Truong, Chi Linh Hoang, Giang Thu Vu, Tung Thanh Tran, Tung Hoang Tran, Bach Xuan Tran, Carl A. Latkin, Cyrus SH Ho, Roger CM Ho
International Journal of Environmental Research and Public Health
Despite the availability of effective and safe rubella vaccines for women of childbearing age, prevention and control of congenital rubella syndrome in children remains challenging in Vietnam. In order to examine this issue, we conducted a cross-sectional study, examining the current coverage of rubella vaccination before pregnancy among 807 pregnant women and women with children under 12 months of age in urban and rural districts, Dong Da and Ba Vi, in Hanoi, Vietnam. In this population, we observed an alarming non-compliance rate with rubella vaccination before pregnancy in both localities. Among the 82.0% of participants who remained unvaccinated against this contagious viral infection, 95.8% of them were in Ba Vi district, compared to 68.0% in Dong Da district (p < 0.001). Besides the differences in age, number of children, education levels, primary occupations and monthly incomes among the participants between the two districts, other reasons for noncompliance with rubella vaccination includeddisinterest in rubella vaccination, the high cost and long distance to vaccination sites as well as unawareness of vaccination locations. In addition to addressing the unique socio-economicchallenges behind one’s accessibility to vaccination services in urban and rural areas, our study supports a continued effort in ensuring proper access to and education about pre-pregnancy vaccines and vaccination among women of childbearing age in order to achieve and sustain sufficient immunization coverage of rubella and other vaccine-preventable diseases in both settings.
BMC Cardiovascular Disorders
Background: Existing evidence suggests that the cardiovascular morbidities are increasing among pre-hypertensive individuals compared to normal. The aim of this study was to evaluate the prevalence of prehypertension, hypertension and to identify psychosocial risk factors for prehypertension among university students in Association of South East Asian Nation (ASEAN) countries.
Methods: Based on a cross-sectional survey, the total sample included 4649 undergraduate university students (females = 65.3%; mean age 20.5, SD = 2.9, age range of 18–30 years) from 7 ASEAN countries (Indonesia, Laos, Malaysia, Myanmar, Philippines, Thailand and Vietnam). Blood pressure, anthropometric, health behaviour and psychosocial variables were measured.
Results: Overall, 19.0% of the undergraduate university students across ASEAN countries had prehypertension, 6.7% hypertension and 74.2% were normotensives. There was country variation in prehypertension prevalence, ranging from 11.3% in Indonesia and 11.5% in Malaysia to above 18% in Laos, Myanmar and Thailand. In multivariate analysis, sociodemographic variables (male gender, living in an upper middle income country, and living on campus or off campus on their own), nutrition and weight variables (not being underweight and obese, having once or more times soft drinks in a day and never or rarely having chocolate or candy), heavy drinking and having depressive symptoms were associated with prehypertension.
Conclusion: The study found a high prevalence of prehypertension in ASEAN university students. Several psychosocial risk factors including male gender, obesity, soft drinks consumption, heavy drinking and depression symptoms have been identified which can help in intervention programmes.
Iranian Journal of Psychiatry and Behavioral Sciences
Human Resources for Health
Background: Motivation is an important driver for health professionals to maintain their professional competencies, continue in the workforce and make a positive contribution to their workplace. While there is some research about the motivation of health workers in low- to middle-income countries, maternal morbidity and mortality remains high and this can be lowered by improving the quality of maternal health services and the training and maintenance of the skills of maternal health workers. This study examines the impact of motivation on maintenance of professional competence among maternal health workers in Vietnam using mixed methods.
Methods: The study consisted of a survey using a self-administered questionnaire of 240 health workers in five districts across two Vietnamese provinces and in-depth interviews with 43 health workers and health managers at the commune, district and provincial level to explore external factors that influenced motivation. The questionnaire includes a 23-item motivation instrument based on the Kenyan health context, modified for Vietnamese language and culture.
Results: The 240 responses represented an estimated 95% of the target sample. Multivariate analysis showed that three factors contributed to the motivation of health workers: access to training (β = −0.14, P = 0.03), ability to perform key tasks (β = 0.22, P = 0.001) and shift schedule (β = −0.13, P = 0.05). Motivation was higher in health workers self-identifying as competent or who were enabled to provide more maternal care services. Motivation was lower in those who worked more frequent night shifts and those who had received training in the last 12 months. The interviews identified that the latter was because they felt the training was irrelevant to them, and in some cases, they do not have the opportunity to practice their learnt skills. The qualitative data also showed other factors relating to service context and organisational management practices contributed to motivation.
Conclusions: The study demonstrates the importance of understanding the motivations of health workers and the factors that contribute to this and may contribute to more effective management of the health workforce in low- and middle-income countries.
Tam Minh Thi Nguyen, Bach Xuan Tran, Mercerdes Fleming, Manh Duc Pham, Long Thanh Nguyen, Huong Thi Le, Anh Lan Thi Nguyen, Huong Thi Le, Thang Huu Nguyen, Van Hai Hoang, Xuan Thanh Thi Le, Quan Hoang Vuong, Manh Tung Ho, Van Nhue Dam, Thu Trang Vuong, Ha Ngoc Do, Vu Nguyen, Huong Lan Thi Nguyen, Huyen Phuc Do, Phuong Linh Doan, Hai Hong Nguyen, Carl A. Latkin, Cyrus SH Ho, Roger CM Ho
International Journal of Environmental Research and Public Health
Methadone Maintenance Treatment (MMT) program has been considered a medium through which human immunodeficiency virus (HIV) risks assessment and prevention on drug use/HIV-infected population can be effectively conducted. Studies concerning the implementation of such idea on patients in remote, under-developed areas, however, have been limited. Having the clinics established in three mountainous provinces of Vietnam, this study aimed to evaluate the changes in knowledge of HIV, perceived risk, and HIV testing uptake of the patients. A longitudinal study was conducted at six MMT clinics in three provinces with a pre- and post-assessments among 300 patients. Outcomes of interest were compared between baseline and after 12 months. The magnitude of changes was extrapolated. The proportion of participants reporting that their HIV knowledge was not good fell by 4.4% (61.3% at the baseline vs. 56.8% at 12 months). The significant improvement seen was in the knowledge that needle sharing was a mode of transmission (82.7% vs. 89.6%). Nevertheless, the majority of participants reportedly considered mosquitoes/insect and eating with the HIV-infected patient were the route of transmission at both time points (84.7% vs. 89.1%, 92.2% vs. 93.3%, respectively). This study found a limited improvement in HIV knowledge and testing uptake among MMT patients following a 12-month period. It also highlighted some shortcomings in the knowledge, attitudes and practices (KAP) of these patients, in particular, incorrect identification of HIV transmission routes, among patients both at program initiation and follow-up. The findings lent support to the argument for enhancing education and counseling efforts at MMT clinics regarding HIV, as well as for improving access to preventive and health care services through the integration of MMT/HIV services
Hindawi BioMed Research International
Family Medicine and Medical Science Research
Vietnam is among a few countries which have established a model of Commune Health Centers (CHCs) to serve primary health care for all people. Using quota sampling technique, 30 CHCs per each among nine provinces nationwide were equally selected for data collection to assess human resources for CHCs as national standards in Vietnam. A total of 239 CHCs finally completed the survey. Overall, the average number of Health Care Workers (HCWs) in each CHC was 6.3 ± 1.7, which met the national standards (at least five HCWs per CHC). However, only 24.4% of CHCs had 5 required job positions, and 59.7% of CHCs had at least one doctor. These shortages were more emerging in mountainous and remote areas. Further, mountainous and remote areas have been underrepresented of female HCWs, as compared to those in rural and urban areas. Our data provide a quite strong case for policy makers and health managers to improve human resources structure for CHCs.
Child Studies in Asia-Pacific Contexts
The aim of this study was to retrospectively estimate the prevalence of childhood emotional abuse (CEA), childhood physical abuse (CPA), and childhood contact sexual abuse (CCSA) in relation to adult poor mental health, addictive behavior, and other health-risk behaviors among university students in five ASEAN countries (Indonesia, Malaysia, Myanmar, Thailand, and Vietnam). In a cross-sectional survey, 3,240 undergraduate university students were randomly selected (M age = 20.5 years, SD = 1.6 years) to respond to a questionnaire including the Abuse section of the World Health Organization (WHO) Version 1 “Adverse Childhood Experiences International Questionnaire” (ACE-IQ) and other measures. The students reported 17.9% CEA, 28.2% CPA, and 22.4% CCSA, with the highest prevalence of CEA in Myanmar (30.9%) and CPA and CCSA in Vietnam (55.8% and 41.6%, respectively). In logistic regression models, adjusting for sociodemographic and social variables, the separate and cumulative effects of three types of child abuse (emotional, physical, and sexual) were found to increase the risks for poor adult mental health, addictive, and other health-risk behaviors.
Human Resources for Health
Background: Many Asia-Pacific countries are experiencing rapid changes in socio-economic and health system development. This study aims to describe the strategies supporting rural health worker attraction and retention in Cambodia, China, and Vietnam and explore the context influencing their outcomes.
Methods: This paper is a policy analysis based on key informant interviews with stakeholders about a rural province of Cambodia, China, and Vietnam, coupled with a broad review of the literature.
Results: Cambodia, China, and Vietnam have implemented medical education, provided financial incentives, and provided personal and professional support to attract and retain rural health workers. More socio-economic development was related to a wider range of interventions and their scope. The health system context influenced the outcomes. Increased autonomy of public hospitals attracted more health workers from rural primary health facilities in China and Vietnam. Health financing policies for universal health coverage in China and Vietnam have increased the utilization of health services. Subsidies for poor people to access health services in Cambodia have provided financial incentives to retain rural health workers. However, the dismantling of the referral system in China and Vietnam has resulted in a high rate of health workers moving from primary health facilities to higher-level hospitals while clear definition of primary healthcare package in Cambodia guided its planning of primary health workforce. The prosperous private health sector in Cambodia and Vietnam attracted more health workers from rural primary health facilities, impeded implementation and determined effectiveness of financial incentives.
Conclusions: Socio-economic and health system reforms including health financing, public hospital autonomy, abolition of referral system and prosperous private sector have both positive and negative impacts on the design, implementation, and effectiveness of interventions to attract and retain rural health workers. Interventions to attract and retain health workers in rural and remote areas need to be considered within overall health system reform.
Pham Quang Thai, Do Thi Thanh Toan, Dinh Thai Son, Hoang Thi Hai Van, Luu Ngoc Minh, Le Xuan Hung, Ngo Van Toan, Luu Ngoc Hoat, Duong Huy Luong, Luong Ngoc Khue, Nguyen Trong Khoa, Le Thi Huong
Epidemiology and Infection
Background. The median duration of hospital stays due to COVID-19 has been reported in several studies on China as 10−13 days. Global studies have indicated that the length of hos- pitalisation depends on different factors, such as the time elapsed from exposure to symptom onset, and from symptom onset to hospital admission, as well as specificities of the country under study. The goal of this paper is to identify factors associated with the median duration of hospital stays of COVID-19 patients during the second COVID-19 wave that hit Vietnam from 5 March to 8 April 2020.
Method. We used retrospective data on 133 hospitalised patients with COVID-19 recorded over at least two weeks during the study period. The Cox proportional-hazards regression model was applied to determine the potential risk factors associated with length of hospital stay. Results. There were 65 (48.9%) females, 98 (73.7%) patients 48 years old or younger, 15 (11.3%) persons with comorbidities, 21 (16.0%) severely ill patients and 5 (3.8%) indivi- duals with life-threatening conditions. Eighty-two (61.7%) patients were discharged after test- ing negative for the SARS-CoV-2 virus, 51 were still in the hospital at the end of the study period and none died. The median duration of stay in a hospital was 21 (IQR: 16–34) days. The multivariable Cox regression model showed that age, residence and sources of contamination were significantly associated with longer duration of hospitalisation. Conclusion. A close look at how long COVID-19 patients stayed in the hospital could provide an overview of their treatment process in Vietnam, and support the country’s National Steering Committee on COVID-19 Prevention and Control in the efficient allocation of resources over the next stages of the COVID-19 prevention period.
Journal of Behavioral Health Services & Research
UNAIDS recommends integration of medications for substance use disorders (SUD) with HIV care to improve HIV outcomes. Yet, integration of HIV and SUD services remains limited in many countries. The objective of this study was to assess provider perceptions of care integration in Vietnam. Qualitative interviews were conducted with 43 providers (nurses, physicians, counselors, pharmacists, and clinic managers) in 8 HIV clinics in northern Vietnam, 2013–2015. Providers identified five themes informing HIV and SUD treatment integration: (1) treatment for alcohol use disorder is often neglected compared to other SUD treatment; (2) structural challenges must be addressed to increase integration feasibility; (3) workforce limitations; (4) societal and healthcare stigmatization of SUD; and (5) providers’ conflicting views regarding integration challenges. The experience of providers in Vietnam may be useful to other countries attempting to integrate HIV and SUD services.
International Journal of Public Health and Clinical Sciences
Background: This study aims to determine the validity of self-reported hypertension and to identify factors affecting discordance between self-reported hypertension and objective measures of blood pressure among adults in Vietnam.
Materials and Methods: A total of 4,219 people 18 years old and above reported their hypertension status and had their blood pressure measured. The inter-reliability between self- reported hypertension and measured hypertension was assessed using Cohen’s kappa statistics. The univariate and multivariate logistic regressions were used to examine the affecting factors of discordance.
Result: Self-reported hypertension prevalence was 13.2% (557/4,219) while measured hypertension was 20.9 % (881/4,219). An agreement between self-reported and measured data was moderate for hypertension of participants (κ=0.39, 95% CI 0.36-0.43). Self-reports for hypertension showed high specificity (93.9 %, 95% CI 93.0-94.7) but low sensitivity (40.1%; 95 CI 36.8-43.4). Percentage of decordance of hypertension (number of false positives and false negatives between self-reported and measured data) among adults in Vietnam was 17.3%. Multiple analysis showed that younger respondents, who were female, who were Kinh ethnicity, who were senior officials and professionals, BMI lower than 25 showing stronger agreements than their counterparts.
Conclusion: In this study, our findings showed there was the discordance of hypertension between self-reported and measured data. The discordance of hypertension was observed more frequently in men, people older than 40, minority ethnic groups, farmers and who has BMI mỏe than 25kg/m2.
Hindawi BioMed Research International
The spread of avian influenza virus among Asian countries is becoming a concern after influenza epidemics in recent years. This study is aimed at identifying the subtypes of avian influenza viruses collected from healthy chickens and ducks at two live bird markets in a border province of Vietnam and the Lao People Democratic Republic. Cloacal and tracheal swab samples from 100 chickens and 101 ducks were collected in May 2017. All samples were screened to detect avian influenza virus by real-time reverse transcriptase PCR. Samples that are avian influenza virus-positive were isolated in embryonated chicken eggs, and the subtypes were identified by RT-PCR with the specific primers. The samples positive for influenza virus H5 were sequenced to identify HA and NA genes. The prevalence of avian influenza virus (AIV) among chicken and duck samples was 27.5% (55/200) and 24.8% (50/202), respectively. AIV subtypes identified among 17 samples positive with the hemagglutination test include H3N6, H6N6, and H9N2. Of these 17 samples, 7 duck samples were found to be H6N6, 4 duck samples were infected with both subtypes of H3N6 and H6N6, and two chicken samples were recorded as H9N2. A positive chicken sample with A/H5 contains 99% similarity nucleotide with H5N6 reference strain. Results suggested that while the presence of low pathogenic avian influenza virus is predominant, potential risks of the appearance of high pathogen avian influenza virus in the east-west boundary in Vietnam should be concerned and studied further. Furthermore, prevention activities are needed to reduce such biosecurity threats in Vietnam and other Asian countries.
Health Psychology Open
Mental health problems including depression and suicide among adolescents are among the most important public health concerns globally. Depression, a common mental health disorder, is ranked as one of the leading causes of dis- ability among adolescents (Vos et al., 2016). School-aged stu- dents with major depression may be at a high risk of engaging in suicidal behaviors. The World Health Organization reported that suicide is the third leading cause of death in 15–19-year- olds (WHO, n.d.b). With mild depression, students may have trouble partaking in normal daily activities and may feel as if life is not worth living. The burden of depression and suicide among adolescents is highest in low-income and middle- income countries (Thapar et al., 2012).
Worldwide research has revealed that a considerable num- ber of adolescents experience depressive symptoms and suicidal ideation, although the estimates vary across countries. Recent systematic reviews have indicated that the prevalence of adolescent depression was 43.55% in Iran (Sajjadi et al., 2013) and 23.4% in China (Tang et al., 2019). A descriptive study in Thailand reported that 34.9% of adolescent respond- ents exhibited depressive symptoms (Somrongthong et al., 2013), while an increase of depressive symptoms among
Xian Liang Sun, Rie Okamoto, Teruhiko Kido, Seijiro Honma, Ho Dung Manh, Hoang Viet Nguyen, Le Thai Anh, Hoang Duc Phuc, Nguyen Thi Phuong Oanh, Shoko Maruzeni, Hideaki Nakagawa, Shoji F. Nakayama, Dang Duc Nhu, Dao Van Tung, Ngo Thi Minh Tan, Le Minh Giang
Recent studies have found elevated dioxin levels inside some former US military air bases in Vietnam, known as hotspots. The aim of the present study was to evaluate the association of dioxin exposure and steroid hormone in preschool children in Vietnam. In 2010, 2011, 52 primiparae mothereinfant pairs in the hotspot and 52 pairs in a non-exposure region were enrolled. For the final analysis, 26 vs 26 pairs were selected, who participated at all three surveys. Univariable and multivariable linear regressions were used to evaluate associations between hormone and dioxin congeners. Geometric mean total TEQ of PCDD/DFs in the hotspot were significantly higher than in the non-exposure region, 8.7 and 3.4 pg TEQ/g lipid, respectively. In the hotspot, salivary dehydroepiandrosterone (DHEA) was significantly higher in 1-year-old children (Boys1⁄4123pg/mL, Girls1⁄4120pg/mL) than in the non-exposure region (Boys 1⁄4 28 pg/mL, Girls 1⁄4 27 pg/mL). In contrast, DHEA was significantly lower in 5-year-old children (Boys 1⁄4 70 pg/mL, Girls 1⁄4 106 pg/mL) in the hotspot than in the non-exposure region (Boys 1⁄4 496 pg/mL, Girls 1⁄4 654 pg/mL). Salivary testosterone was significantly lower in the hotspot (Boys 1⁄4 1.9 pg/mL, Girls 1⁄4 1.9 pg/m; Boys 1⁄4 1.0 pg/mL, Girls 1⁄4 1.1 pg/mL, respectively) than in the non-exposure region (Boys 1⁄4 3.7 pg/mL, Girls 1⁄4 3.8 pg/m; Boys 1⁄4 5.7 pg/mL, Girls 1⁄4 7.0 pg/mL, respectively) at 3 years and 5 years of age. Higher levels of highly chlorinated dioxins in breast milk were associated with higher DHEA in 1-year-old and lower DHEA and testosterone levels in 5-year-old children. Our findings indicated that dioxins were associated with changes of DHEA and testosterone levels in preschool Vietnamese children.
Journal of Affective Disorders
Background
Postnatal depressive symptoms measured by the Edinburgh Postnatal Depression Scale (EPDS) are reported to display measurement variance regarding factor structure and the frequency of specific depressive symptoms. However, postnatal depressive symptoms measured by EPDS have not been compared between women representing three continents.
Methods
A cross-sectional study including birth cohort samples from Denmark, Vietnam and Tanzania. Women were included during pregnancy at routine care sites. Depressive symptoms were self- reported 40-90 days postpartum using the EPDS. Exploratory and confirmatory factor analyses and generalized additive regression models were performed.
Results
A total of N=4,516 participated in the study (Denmark N=2,069, Vietnam N=1,278, Tanzania N=1,169). Factor analyses identified three factors (anhedonia, anxiety and depression) that were almost identical in the three study populations. The only variation between countries was that the item „self-harm‟ loaded differently. Women from Tanzania and Denmark were more likely to have an EPDS total score above cut-off 12 (12.6% and 6.4%), compared to women from Vietnam (1.9%)(p<0.001). A low level of education was associated with significantly more depressive symptoms after adjusting for country (p<0.001).
Archives of Women's Mental Health
Intimate partner violence (IPV) perpetrators are often husbands. Understanding factors pertaining to women’s male partners is essential for programming interventions against IPV. The objective of the study was to describe husband-related social and behavioural risk factors and assess how they are associated with IPV during pregnancy. Cross-sectional data were collected among 1309 pregnant women with husbands in Dong Anh district, Vietnam. Information on sociodemographic characteristics of husbands, the husband’s behaviour and the husband’s involvement in pregnancy care was indirectly collected via women’s report at first antenatal care visit. Data on exposure to intimate partner violence during pregnancy were collected when the women returned for antenatal care in 30–34 gestational weeks. Logistic regression analyses were used to measure the relationships between IPV during pregnancy and risk factors from the husband. Pregnant women who had husbands who were younger or blue-collar worker/farmer/unemployed had more likelihood to be exposed to IPV. Women with husbands who drank alcohol before sexual intercourse and gambled were more likely to be exposed to IPV repeated times. Those with husbands who had intentions of having a child had over three times increased OR to be exposed to IPV once (AOR = 3.2, 95% CI 1.1–9.7). If the husband had a preference for sons, the woman had 1.5 times increased OR (AOR = 1.5; 95% CI 1.1–1.9) to be exposed to IPV repeated times during pregnancy. This study highlights significant associations between IPV and maternal perceptions of husbands’ behaviours and involvement in pregnancy. Findings may help to identify at-risk pregnant women to IPV and guide the development of targeted interventions to prevent IPV from husbands.
BMC Health Services Research
Journal of Global Health Science
Background: We aim to assess the prevalence of smoking susceptibility and identify factors at school and individual levels that are associated with individual susceptibility to smoking
among school children aged 13–15 years in Vietnam. Methods: Data came from Vietnam Global Youth Tobacco Survey (GYTS) 2014. A 2-stage sample design and proportion to population size (PPS) technique was employed to select a representative sample of study participants. Independent variables include both individual and school-level characteristics. Both descriptive and inferential statistics were performed. Logistic multilevel models were constructed to analyze the association between independent variables and smoking susceptibility status. Results: The overall percentage of smoking susceptibility status was 11.2%. Boys were more susceptible to smoking than girls. The odds of smoking susceptibility were higher among students who had both of their parents smoking (adjusted odds ratio [aOR], 3.91; 95% confidence interval [CI], 2.17–7.05) and those whose best friends smoked (aOR, 4.79; 95% CI, 2.40–9.54). Knowledge on harmfulness of smoking was associated with lower odds of
smoking susceptibility. Among school level factors, the schools with greater access to anti smoking media were associated with lower susceptibility to smoking among their students (coefficient = −0.028; standard error = 0.011, P < 0.05). Conclusion: This study highlights the importance of contextual exposure to anti-smoking media among the children. With the availability of multilevel modeling as an analytical tool, further refinements in the understanding of contextual effects on smoking status are needed to facilitate the development of school level policy and interventions in addition to individual
level approaches.
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