Cuong Duy Do

Objectives: to investigate the association of IL-18 and CXCL10 levels with disease severity in Vietnamese patients infected with Dengue virus. Methods: A total of 295 serum samples were collected from patients with clinical presentation of Dengue virus infection during the 2022–2023 outbreaks in Hanoi, Vietnam. Clinical and laboratory parameters were recorded at the time of admission. IL-18 and CXCL-10 were measured by standard ELISA assays. The clinical outcome of Dengue infection was classified into three groups according to the WHO 2009 criteria. Results: Among the 295 patients, 140 were diagnosed with Dengue without warning signs, 134 with Dengue with warning signs, and 21 with severe Dengue according to the WHO 2009 criteria. Patients with SD had a greater proportion of warning signs than those with DwoWS and DwWS (bleeding: 57.1% versus 47.8% and 1.4%, p < 0.001) and (hepatomegaly: 23.8% versus 9.7% and 1.4%, p < 0.001). Higher levels of liver enzymes were observed in the SD group than in the DwoWS and DwWS groups (p < 0.001). Of note, elevated levels of IL-18 and CXCL-10 levels were found in the SD group compared to the DwoWS and DwWS groups (p < 0.01 and p = 0.037). Further ROC analysis revealed that the cut-off values for distinguishing severe Dengue from non-severe Dengue for IL-18 and CXCL-10 were both 669.65 pg/mL, whereas that of CXCL-10 was 3739.5 pg/mL. Conclusions: The present study showed that IL-18 and CXCL-10 are associated with Dengue severity. This finding suggests that IL-18 and CXCL-10 may be biomarkers for disease progression and disease severity in Dengue infection.

Analysis of 13 imported malaria cases revealed 87.5% diagnostic failure rate at primary care facilities, with 38.5% progressing to severe malaria, emphasizing critical gaps in Vietnam's malaria elimination strategy.

A 46‐year‐old diabetic Vietnamese engineer presented with a 2‐month fever and left foot swelling. Chest imaging showed bilateral nodules with right apical cavitation, prompting empirical anti‐tuberculosis therapy. Despite positive Xpert MTB/RIF and 1 month of treatment, his condition worsened. Bronchoscopy culture isolated Burkholderia pseudomallei. Treatment with ceftazidime and trimethoprim‐sulfamethoxazole led to complete recovery. Negative MGIT culture excluded tuberculosis co‐infection. This case highlights the diagnostic challenge when melioidosis mimics tuberculosis in endemic regions, particularly in diabetic patients. Positive molecular tuberculosis tests may reflect the previous infection, emphasising the need for culture confirmation and clinical correlation.

Objectives To investigate the serum IL-6 levels and their rate of change in predicting the mortality of critically ill patients with COVID-19 in Vietnam. Design A single-centre, cross-sectional study. Setting An Intensive Care Centre for the Treatment of Critically Ill Patients with COVID-19 in Ho Chi Minh City, Vietnam. Participants We included patients aged 18 years or older who were critically ill with COVID-19 and presented to the study centre from 30 July 2021 to 15 October 2021. We excluded patients who did not have serum IL-6 measurements between admission and the end of the first day. Primary outcome measures The primary outcome was hospital all-cause mortality. Results Of 90 patients, 41.1% were men, the median age was 60.5 years (Q1–Q3: 52.0–71.0), and 76.7% of patients died in the hospital. Elevated IL-6 levels were observed on admission (41.79 pg/mL; Q1–Q3: 20.68–106.27) and on the third day after admission (72.00 pg/mL; Q1–Q3: 26.98–186.50), along with a significant rate of change in IL-6 during that period (839.5%; SD: 2753.2). While admission IL-6 level (areas under the receiver operator characteristic curve (AUROC): 0.610 (95% CI: 0.459 to 0.761); cut-off value ≥15.8 pg/mL) and rate of change in IL-6 on the third day of admission (AUROC: 0.586 (95% CI: 0.420 to 0.751); cut-off value ≥−58.7%) demonstrated poor discriminatory ability in predicting hospital mortality, the third day IL-6 rate of change from admission ≥−58.7% (adjusted OR: 12.812; 95% CI: 2.104 to 78.005) emerged as an independent predictor of hospital mortality. Conclusions This study focused on a highly selected cohort of critically ill COVID-19 patients with a high IL-6 level and mortality rate. Despite the poor discriminatory value of admission IL-6 levels, the rate of change in IL-6 proved valuable in predicting mortality. To identify critically ill COVID-19 patients with the highest risk for mortality, monitoring the serial serum IL-6 measurements and observing the rate of change in serum IL-6 levels over time are needed.

INTRODUCTION: Data on HIV treatment outcomes in people who inject drugs (PWID) in the Asia‐Pacific are sparse despite the high burden of drug use. We assessed immunological and virological responses, AIDS‐defining events and mortality among PWID receiving antiretroviral therapy (ART).METHODS: We investigated HIV treatment outcomes among people who acquired HIV via injecting drug use in the TREAT Asia HIV Observational Database (TAHOD) between January 2003 and March 2019. Trends in CD4 count and viral suppression (VS, HIV viral load <1000 copies/mL) were assessed. Factors associated with mean CD4 changes were analysed using repeated measures linear regression, and combined AIDS event and mortality were analysed using survival analysis.RESULTS: Of 622 PWID from 12 countries in the Asia‐Pacific, 93% were male and the median age at ART initiation was 31 years (IQR, 28 to 34). The median pre‐ART CD4 count was 71 cells/µL. CD4 counts increased over time, with a mean difference of 401 (95% CI, 372 to 457) cells/µL at year‐10 (n = 78). Higher follow‐up HIV viral load and pre‐ART CD4 counts were associated with smaller increases in CD4 counts. Among 361 PWID with ≥1 viral load after six months on ART, proportions with VS were 82%, 88% and 93% at 2‐, 5‐ and 10‐years following ART initiation. There were 52 new AIDS‐defining events and 50 deaths during 3347 person‐years of follow‐up (PYS) (incidence 3.05/100 PYS, 95% CI, 2.51 to 3.70). Previous AIDS or TB diagnosis, lower current CD4 count and adherence <95% were associated with combined new AIDS‐defining event and death.CONCLUSIONS: Despite improved outcomes over time, our findings highlight the need for rapid ART initiation and adherence support among PWID within Asian settings.

This study aimed to examine the effectiveness of Human Immunodeficiency Virus (HIV)-assisted smartphone applications in the treatment of HIV/AIDS patients in Vietnam. A cross-sectional study was performed in two urban outpatient clinics in Hanoi from May to December 2019. A simple random sampling method and a structured questionnaire were used to recruit 495 eligible participants and to collect data. Multivariable modified Poisson regression and multivariable linear regression models were employed to investigate the factors associated with the willingness to pay (WTP) and amount of money patients were willing to pay. Approximately 82.8% of respondents were willing to pay for the hypothetical applications, with the mean amount the participants were willing to pay of Vietnam Dong (VND) 72,100/month. Marital status (separate/divorced/widow: Odds ratio (OR) = 1.28, 95% confidence interval (CI) = (1.09; 1.50) and having spouse/partner: OR = 1.18, 95% CI = (1.03; 1.36)) and using health services (OR = 1.03, 95% CI = (1.01; 1.04)) were positively associated with nominating they would be WTP for the app, whereas the duration of antiretroviral treatment (ART) (OR = 0.98, 95% CI = (0.96; 0.99)) had a negative association. The frequency of using health services (β = 0.04, 95% CI = (−0.07; −0.01)) was negatively associated with the amount of WTP. High levels of WTP revealed the feasibility of implementing smartphone-based apps for HIV treatment. This study implied the necessity to consider a co-payment system to reach populations who were in need but where such applications may be unaffordable in lieu of other treatment-associated expenses. Developers also need to pay attention to privacy features to attract single people living with HIV/AIDS and additional measures to initiate people with a long duration on ART into using the applications.

Mục tiêu: Nghiên cứu được thực hiện nhằm xác định tỉ lệ mắc viêm gan vi rút B ở nhân viên y tế (NVYT) tại Bệnh viện Bạch Mai năm 2019, đồng thời cung cấp các bằng chứng cho can thiệp dự phòng tiêm vắc xin cho NVYT trong năm 2020. Đối tượng và phương pháp: Nghiên cứu định lượng mô tả cắt ngang được thực hiện vào tháng 11 và 12 năm 2019 trên 3.167 cán bộ viên chức đang công tác tại Bệnh viện Bạch Mai. Số liệu về HBsAg và Anti-HBs được hồi cứu từ cơ sở dữ liệu của Khoa Vi sinh, Bệnh viện Bạch Mai. Phân tích hồi quy logistic được sử dụng để xác định yếu tố liên quan đến tình trạng nhiễm và Anti-HBs trên đối tượng nghiên cứu. Kết quả và kết luận: Tổng số 3.167 trường hợp được đưa vào phân tích. Trong đó tỉ lệ mắc viêm gan B là 5,56% (176/3167 trường hợp). Tỉ lệ có Anti-HBs trên 100 IU/mL chiếm 50,93%. 1554 trường hợp còn lại (49,07%) cần phải tiêm vắc xin hoặc tiêm nhắc lại. Trong khối Nội, các Khoa Da liễu, Trung tâm (TT) Bệnh Nhiệt đới và Khoa Y học cổ truyền có tỉ lệ nhiễm viêm gan B cao nhất, lần lượt là 13,04%, 11,84% và 10,00%. Các khoa khác chiếm tỉ lệ thấp hơn, trong đó, Khoa Cấp cứu là 4,41%, Khoa Gây mê – Hồi sức là 3,52%, Khoa Hồi sức tích cực là 5.19%, Khoa Tiêu hoá là 5,06% và Khoa Thận – Nhân tạo là 3,66%. Ở khối Ngoại, Khoa Sản chiếm tỉ lệ cao nhất với 13,33%%. Trong khối cận lâm sàng, Khoa Thăm dò chức năng và TT. Giải phẫu bệnh chiếm tỉ lệ cao nhất với 11,11% và 10,53%. Nam giới và nhân viên trên 28 tuổi có xu hướng mắc viêm gan B cao hơn các nhóm còn lại (OR=0,57 và OR=1,92, p Tỉ lệ nhiễm viêm gan B chung của NVYT tại Bệnh viện Bạch Mai năm 2019 là 5,56%. Kiến nghị: 32,65% NVYT tại Bệnh viện Bạch Mai cần tiêm đầy đủ 3 liều và 14.62% cần tiêm nhắc lại 1 liều vắc xin VGB.

Purpose: Mental health is an important component of the protection strategy for healthcare workers (HCWs). However, it has not been well described in Vietnam during the COVID-19 outbreak. This study aims to measure the psychological distress and health-related quality-of-life among frontline healthcare workers during the peak of the outbreak in Vietnam. Patients and Methods: We conducted a cross-sectional survey on 173 health workers at two national tertiary hospitals in Hanoi, Vietnam from March to April 2020. The psychological distress was measured by the Depression, Anxiety, and Stress Scale – 21 Items (DASS-21), Impact of Event Scale – Revised (IES-R), and the Insomnia Severity Index (ISI). EQ-5D-5L was used to determine the health-related quality-of-life (HRQoL) outcomes. Results: Among 173 HCWs, the proportion of reported depression symptoms, anxiety symptoms, and stress was 20.2%, 33.5%, and 12.7%, respectively. The median EQ-5D-5L index score was 0.93 (IQR=0.85– 0.94), and the anxiety/depression aspect had the highest reported problems. The most COVID-19-specific concerns among frontline HCWs were the reduction of income (59%) and the increase of living costs (54.3%). HCWs working in the COVID-19-designated hospital had a significantly higher rate of mental health problems and had a lower HRQoL outcome than those working in non-COVID-19-designated hospitals. Other factors associated with psychological distress and sleep problems include age, job title, income, chronic diseases status, and years of working in healthcare settings. HCWs who were ≥ 30 years old, had higher working years, had higher incomes, and had mental health and sleep problems were more likely to have lower HRQoL scores. Conclusion: We reported a moderate rate of psychological distress and lower HRQoL outcomes among frontline HCWs during the COVID-19 outbreak in Vietnam. Various factors were found to be associated with mental health and HRQoL that might be useful for implementing appropriate interventions for HCWs in low-resource settings.

Upon the outbreak of the COVID-19 pandemic, countries worldwide face a critical shortage of human resources in the health sector. Medical students are a potential task force with the capability to support the stretched health sector. This study aims to evaluate their training need for epidemic control in order to employ them effectively. A cross-sectional study was conducted using a web-based survey from December 2019 to February 2020. There were 5,786 observations collected using the snowball sampling technique. Logistic regression was applied to identify factors associated with training participation in epidemic prevention and disaster prevention. Multiple Poisson regression model was constructed to examine factors associated with the number of times they participated in sanitation training and disaster prevention activities in the previous 12 months. Sanitation and health education communication activities had the highest proportion of participants, with 76.5 and 38.4%, followed by examining and treating diseases in the community (13.4%). Those who participated in community activities had a higher number of times to participate in epidemic sanitation training and be involved in disaster prevention. This study informed the need for training programs to prepare medical students for COVID-19 epidemic responses. The training curriculum should include both theoretical approaches and contextual approaches to achieve efficient epidemic control.