We previously reported alarmingly high carriage rates of Streptococcus pneumoniae (SP) serotype 19F and serogroup 6 isolates, which were not susceptible to multiple beta-lactams among children under five years of age in Vietnam. Multilocus sequence typing analysis revealed the predominance of two major lineages, ST320 and ST13223, among serotype 19F and serogroup 6 isolates, respectively. Investigating the association between nonsusceptible genotypes and clinical outcomes could help optimize patient care or lead to the development of new diagnostic tests. We performed WGS on SP isolates randomly selected from the two major lineages and their related strains. FASTQ quality control and de novo assembly were performed using CLC Genomics Workbench ver. 7.5.1. Draft genome sequences were annotated using DFAST (DDBJ Fast Annotation and Submission Tool), which revealed the serogroups/serotypes and the sequences of the three major penicillin-binding protein genes and the sequence types. Draft sequences were aligned using MUMmer ver. 3.23, and putative recombination events and phylogenetic relationships excluding recombination regions were identified using Gubbins ver. 2.4.1. Finally, the association between a detected nonsusceptible genotype and the duration of hospital stay was evaluated in patients with acute respiratory infection. WGS analysis (serotype 19F/ST320, n = 22; serogroup 6/ST13223, n = 13; and isolates closely related to ST13223, n = 4) revealed substantial differences in genomic diversity and antimicrobial susceptibility between serogroup 6/ST13223 and serotype 19F/ST320 isolates, particularly the recombination-prone nature of serogroup 6/ST13223. Among the 23 recombination events observed in serogroup 6/ST13223, only those spanning the pbp2x region (15.5 kb and 6.4 kb) were associated with high MICs for multiple beta-lactams. A subset of ST13223 isolates and all ST320 isolates carried the identical pbp2x allele 16, which was significantly associated with a lack of susceptibility to the combination of penicillin, cefotaxime, and meropenem (p < 0.0001; odds ratio 11.5; 95

Objective This study aims to determine the prevalence, associated factors, and molecular epidemiology of HBV infection among schoolchildren and household members (HHMs) in Vietnam. Methods A cross-sectional community survey on hepatitis B virus markers among randomly selected schoolchildren was conducted in Nha Trang City, central Vietnam. Then, a follow-up case-control study was conducted as a household contact investigation among HHMs of children who tested HBsAg-positive (cases) and HHMs of grade-matched children (1:3 ratio) who tested HBsAg-negative (controls). HBV markers, risk factors associated with HBsAg-positive, molecular epidemiology of transmission, and genome mutations were investigated. Results A total of 1,210 schoolchildren enrolled, 57.9% received HepB full vaccination, 1.1% HBsAg-positive, and 20.2% anti-HBs-positive were observed. Among household contacts of HBsAg-positive children, a high prevalence of HBsAg positivity was observed (54.5%), whereas the prevalence among household contacts of HBsAg-negative children was substantially lower (2.5%), indicating marked intra-household clustering of HBV infection. HBV-positive schoolchildren and their mothers were predominantly grouped within the same genetic clusters. Genotypes B4 (68.0%) and C1 (32.0%) were detected. No HBV drug resistance mutations were found, but vaccine-escape mutants (VEMs) and occult HBV infection (OBI)-associated mutations in preS/S, as well as other mutations, were observed. Conclusions Schoolchildren had a low HBV-positive rate, and HHMs of HBsAg-positive schoolchildren had a higher rate of HBV infection. Mutations previously associated in the literature with advanced liver disease were identified.

BACKGROUND:Current methods for controlling the spread of dengue in endemic settings typically rely on vector control in and around the homes of reporting cases, with varying levels of success. We aimed to evaluate the role of the household as a source of infection risk and assess the spatial scale of dengue virus transmission to understand why targeted vector control might not work effectively. METHODS:In this index-household contact cohort study, dengue virus NS1-positive index cases reporting to a polyclinic or Tropical Medicine Hospital, together with their household contacts (aged >18 years), were enrolled, and followed up, in Nha Trang, Viet Nam between Oct 1, 2016, and May 15, 2019. Epidemiological (case reporting dates, questionnaires, and geographical locations), serological (ELISA and plaque reduction neutralisation tests), and molecular (serotyping PCR, quantitative PCR, and whole viral genome sequencing) data were collected, where possible, from all enrolled individuals. We then implemented an analysis framework, using viral pairwise genetic distance and modelling of the serial interval (duration between symptom onsets) between infected individuals, to identify individuals in chains of transmissions within the cohort, and define the transmission routes between humans via Aedes spp mosquitoes. FINDINGS:During the study period, 838 index cases and 1241 household contacts were enrolled. Within the same household, we found evidence that only nine (29·0%) of the 31 pairs of concurrently infected individuals could be identified as plausible transmissions via the same infected mosquito. Using our genomic and time-modelling framework, we showed limited clustering of transmission chains at the mosquito flight range (150 m), using the home address location of infected individuals. Infections with identical, or near-identical genomes, consistent with our definition of plausible transmission, are identified in this dataset with a median home address distance of 1274 m (IQR 543-2016). INTERPRETATION:Our results emphasise human movement as a major driver of dengue transmission in an urbanised setting, underscoring the importance of understanding mobility patterns to locate the sites of infected mosquitoes. Human daytime activity locations and social contacts should be examined more closely to better understand transmission networks, rather than relying solely on reactive, reporting index household-directed vector control. FUNDING:Johnson & Johnson, London School of Hygiene and Tropical Medicine, Japan Program for Infectious Diseases Research and Infrastructure, and Japan Agency for Medical Research and Development.

Tại Việt Nam, hiện rất ít nghiên cứu đánh giá thực trạng triển khai và hiệu quả của mô hình quản lý áp dụng nguyên lý Quản lý chất lượng toàn diện, đặc biệt tại khoa Khám bệnh, nơi tiếp nhận lượng lớn bệnh nhân ngoại trú hàng ngày. Nghiên cứu can thiệp có đối chứng, định lượng kết hợp định tính. Nghiên cứu nhằm mục tiêu đánh giá hiệu quả can thiệp Quản lý chất lượng toàn diện năm 2024 trên 54 nhân viên y tế tại khoa Khám bệnh của một bệnh viện can thiệp, so sánh với 90 nhân viên y tế thuộc nhóm đối chứng. Mô hình hồi quy Difference-in-Differences (DiD), được sử dụng để phân tích sự thay đổi điểm số Quản lý chất lượng toàn diện qua 5 yếu tố, với p < 0,05 được coi là có ý nghĩa thống kê. Sau can thiệp, nhóm can thiệp có cải thiện, nhóm đối chứng giảm nhẹ hoặc không cải thiện. Hệ số DiD dương ở tất cả câu hỏi với giá trị DiD dao động từ 0,37 đến 1,46, với p < 0,05 ở 38/40 câu. Phân tích hồi quy DiD xác nhận hiệu quả can thiệp, đặc biệt là nhóm nhân tố “Lấy đối tượng phục vụ làm trung tâm” (DiD=1,18) và “Đào tạo” (DiD=1,01). Nghiên cứu chứng minh rằng can thiệp Quản lý chất lượng toàn diện đã mang lại hiệu quả trong việc nâng cao chất lượng quản lý dịch vụ y tế tại khoa Khám bệnh.

BACKGROUND:A cluster-randomised trial in Nha Trang, Viet Nam, previously showed non-inferiority of a reduced two-dose (1p + 1) pneumococcal conjugate vaccine 10 (PCV10) schedule compared with three-dose schedules (2p + 1, 3p + 0) for controlling vaccine-type (VT) nasopharyngeal carriage after 3·5 years, but the long-term sustainability of reduced-dose schedules and their indirect effects on unvaccinated age groups remain incompletely understood. We aimed to assess the sustained and indirect effects of reduced-dose PCV10 schedules on VT carriage 5·5 years after vaccine introduction. METHODS:This study presents long-term follow-up data from a cluster-randomised controlled trial conducted in 24 communes in Nha Trang, Viet Nam. These communes were randomly assigned (1:1:1:1; six communes per group) by automated rejection sampling to one of four PCV10 vaccination schedules for infants: 0p + 1 (single dose at age 12 months), 1p + 1 (doses at ages 2 and 12 months), 2p + 1 (doses at ages 2, 4, and 12 months), or 3p + 0 (doses at ages 2, 3, and 4 months); three unvaccinated communes provided observational comparison. The prespecified primary outcome for this follow-up study was non-inferiority of 1p + 1 versus standard-dose (2p + 1, 3p + 0) schedules for prevalence of VT carriage in vaccine-eligible infants (aged 4-11 months) and toddlers (aged 14-24 months) in 2022 (5·5 years after vaccine introduction. A prespecified secondary objective evaluated the 0p + 1 schedule. Indirect effects on VT carriage prevalence in adult caregivers and preschool children (aged 3-4 years) were also assessed. Non-inferiority was defined as the upper bound of the 95% CI of the difference in VT carriage prevalence not exceeding 5 percentage points (pp). Age-specific trends in VT carriage proportion over the trial period were estimated using Poisson regression models with intervention groups pooled. This trial was completed and is registered with ClinicalTrials.gov, NCT02961231. FINDINGS:Between Oct 10, 2016, and Aug 23, 2022, 49 644 participants were enrolled, including 10 423 infants (aged 4-11 months), 10 988 toddlers (aged 14-24 months), 9580 preschool children (aged 3-4 years), and 18 653 caregivers. Among the 30 991 children, 15 018 (48·5%) were female and 15 973 (51·5%) were male. 27 384 (88·4%) were enrolled in vaccinated communes (0p + 1: 6984, 1p + 1: 6906, 2p + 1: 6972, 3p + 0: 6522) and 3607 (11·6%) in the unvaccinated communes. At 5·5 years, prevalence of PCV10-type carriage in infants was 0·7% (2/286) in the 1p + 1 group, 1·9% (6/314) in the 2p + 1 group, and 0·9% (2/226) in the 3p + 0 group; in toddlers, it was 0·9% (3/332) in the 1p + 1 group, 0·6% (2/344) in the 2p + 1 group, and 1·0% (3/300) in the 3p + 0 group. The 1p + 1 schedule remained non-inferior to three-dose schedules in all infant and toddler comparisons (differences in infants of -1·2 pp [95% CI -3·0 to 0·6] for 1p + 1 vs 2p + 1 and -0·2 pp [-1·7 to 1·4] for 1p + 1 vs 3p + 0; differences in toddlers of 0·3 pp [-1·0 to 1·6] for 1p + 1 vs 2p + 1 and -0·1 pp [-1·6 to 1·4] for 1p + 1 vs 3p + 0). The 0p + 1 schedule met non-inferiority in seven of eight intention-to-treat comparisons. The proportion of pneumococcal carriers carrying PCV10-type serotypes declined in infants (from 52·1% [160/307] to 7·6% [12/157]), toddlers (from 50·0% [246/492] to 4·0% [15/378]), and adult caregivers (from 39·4% [28/71]) to 10·5% [12/114]), at similar rates across age groups. During the trial period, 50 serious adverse events were reported within 1 month after vaccination, none of these events was deemed related to PCV10 vaccination. All children recovered without sequelae. INTERPRETATION:The 1p + 1 schedule remained non-inferior to standard three-dose schedules after 5·5 years. Across all intervention groups, VT carriage proportion declined at comparable rates in vaccinated children and unvaccinated adult caregivers, demonstrating that reduced-dose schedules can generate population-level indirect protection similar to standard schedules. These findings are most applicable to settings with established pneumococcal conjugate vaccine programmes following a catch-up campaign, and support 1p + 1 as a viable strategy for maintaining pneumococcal disease control while reducing programmatic costs and delivery complexity. FUNDING:Gates Foundation. TRANSLATIONS:For the Vietnamese translations of the abstract see Supplementary Material section.

Background Understanding human movement patterns and their association with risk factors for the acquisition and transmission of pathogens can inform guidance for disease control. In Vietnam, acute encephalitis syndrome (AES) has a wide-ranging etiology; however, it is hypothesized that many causes are due to vector-borne diseases. Methods We undertook a study in Ha Nam province, northern Vietnam, to determine the acceptability and feasibility of using i-gotU GT-120 GPS devices to understand the mobility patterns of healthy residents and evaluate the time spent in areas deemed to be at risk of bites from vectors. Focus group discussions (FGDs) were carried out to understand the knowledge and perceptions of GPS devices. Following this, 48 participants wore a GPS device for eight 72-hour periods over a year from which movement data and feedback were obtained. Results Concerns about the GPS included risks to privacy and health, and losing the device. However, compliance was good with 80,831 unique coordinates obtained and participants carrying the devices for 13,411 km over the study period. All groups of participants (adults and children, and those from urban and rural settings) travelled outside of Ha Nam province however, most spent the greatest proportion of time in areas with a low normalized difference vegetation index (NDVI) which was associated with a decreased risk of bites from vectors. Conclusions Our study demonstrates that the use of GPS devices in this setting was a feasible method for collecting data on movement patterns. However, for future studies, given the cost and logistics of using the GPS devices, we recommend exploring methods which allow for a larger sample size.

Staphylococcus aureus (S. aureus), especially Methicillin-resistant Staphylococcus aureus (MRSA), remains a major public health concern both in hospital and community settings. The MRSA carriage situation among schoolchildren in Vietnam is limited. A cross-sectional study was conducted in March 2023 to assess the prevalence, antimicrobial resistance patterns, and molecular characteristics of MRSA among schoolchildren in Nha Trang, Vietnam. Schoolchildren from grades 1 to 12 (ages 6-18 yrs) were enrolled. Background epidemiological data and nasal swabs were collected. Nasal samples were processed at the Pasteur Institute in Nha Trang, Vietnam, for S. aureus culture. Out of 1210 participants enrolled, S. aureus prevalence was 18.3% (222/1210), of which 41% (91/222) were MRSA. Primary school children showed the highest prevalence of MRSA colonization (48%), 32.8% in secondary, and 27.8% in high school. Among MRSA isolates, high levels of resistance were detected against trimethoprim-sulfamethoxazole (100%), erythromycin (68.2%) and clindamycin (45.1%). Multidrug resistance (MDR) occurred in 30% (27/90) of MRSA isolates. Staphylococcal cassette chromosome mec (SCCmec) subtype IVa was dominant (66.0%), followed by type IV (7.0%) and type V (6.0%). MLST data revealed genetic diversity whereby ST45 dominated, followed by ST546 and ST188. Continuous MRSA surveillance is essential to monitor emerging strains in the communities.

Dengue virus (DENV), Japanese encephalitis virus (JEV), and Zika virus (ZIKV) are mosquito-borne flaviviruses of global concern, causing illnesses ranging from mild fever to severe neurological or hemorrhagic disease. Antibodies against these viruses exhibit complex cross-reactivity, influencing both neutralization and antibody-dependent enhancement (ADE). DENV comprises four serotypes (65-70% sequence identity) with multiple genotypes. Secondary heterologous infections increase the risk of dengue with or without warning signs and severe dengue, largely mediated by pre-existing antibodies from prior infection or vaccination. We assessed total antibody levels, neutralizing antibody (NAb) titers, and ADE activity of serum samples from Vietnamese patients with confirmed DENV infection and evaluated potential cross-reactivities with JEV and ZIKV. In primary infections, NAb titers were generally low (<1:10), except for JEV. Secondary infections showed the highest NAb titers against DENV-4, followed by DENV-2, DENV-3, and the lowest against DENV-1. In ADE assays, DENV-2 exhibited the highest enhancement, followed by DENV-1 and DENV-3, whereas DENV-4 showed minimal ADE. ADE was also detected for JEV and ZIKV, demonstrating that cross-reactive antibodies can facilitate infection across flaviviruses. These findings underscore the impact of pre-existing cross-reactive antibodies in endemic regions and highlight the importance of evaluating vaccine-induced cross-reactive immunity.

Nghiên cứu cắt ngang này sử dụng dữ liệu giám sát HIV thường quy tại tỉnh Thái Nguyên (HIVINFO) nhằmmô tả Đặc điểm dịch tễ học các trường hợp HIV mới phát hiện và các yếu tố liên quan đến nhiễm mới HIVtheo phân loại xét nghiệm trong giai đoạn 2020–2024. Trong thời gian nghiên cứu, hệ thống giám sát ghinhận 734 trường hợp HIV mới phát hiện, trong đó 388 trường hợp được xét nghiệm phát hiện nhiễm mới,tỷ trọng nhiễm mới chiếm 6,5%. Phân tích xu hướng cho thấy lây truyền qua đường máu giảm, trong khi lâytruyền qua quan hệ tình dục tăng, chủ yếu ở nhóm MSM và vợ/chồng/bạn tình của người nhiễm HIV. Cáctrường hợp nhiễm mới HIV tập trung ở nhóm tuổi 16–24 và MSM/nam bán dâm. Trong mô hình hồi quylogistic đa biến, so với nhóm 16–24 tuổi, nhóm 25–34 tuổi và ≥35 tuổi có khả năng được phân loại là nhiễmmới HIV thấp hơn (aOR tương ứng 0,44 và 0,04), trong khi nhóm vợ/chồng/bạn tình của người nhiễm HIVhoặc người có hành vi nguy cơ cao có khả năng nhiễm mới HIV cao hơn so với nhóm nghiện chích matúy (aOR=2,72). Mối liên quan quan sát được ở nhóm MSM/nam bán dâm giảm rõ rệt sau khi hiệu chỉnh,phản ánh ảnh hưởng của yếu tố nhiễu là tuổi. Kết quả nghiên cứu gợi ý cần đa dạng hóa các mô hình xétnghiệm HIV hướng tới nhóm tuổi trẻ, đặc biệt là nhóm MSM/nam bán dâm.

Background:Enterovirus D68 (EVD68) causes respiratory disease, yet the risk of severe respiratory disease remains incompletely quantified, especially when stratified by comorbidity status. This study aims to describe the clinical features and risk of severe disease in children with EVD68 compared with those with other Rhinoviruses/Enteroviruses, accounting for comorbidity. Methods:We analyzed 1100 pediatric EV-positive cases from surveillance in Vietnam (2019-2022), excluding viral coinfections. EVD68 was confirmed by real-time PCR. We examined clinical features, treatments, and comorbidities. Standardization methods estimated risk differences (RDs) and risk ratios (RRs) stratified by (1) general comorbidity, (2) asthma, and (3) either of these. Time-to-recovery in intensive care unit (ICU) was compared using Kaplan-Meier methods. Results:EVD68 was detected in 55/1100 cases (5.0%). Children with EVD68 more often had wheeze, pneumonia, oxygen therapy, and ICU admission. For wheeze, EVD68 was associated with similar elevated risk with and without general comorbidity (RR 1.40 in both; RD 0.27). Pneumonia risk was likewise elevated with EVD68 (with comorbidity: RR 1.17; RD 0.12; without: RR 1.73; RD 0.14). By asthma status, EVD68 increased wheeze risk in both groups; however, the excess was smaller in asthma (RR 1.10; RD 0.09) than non-asthma (RR 1.43; RD 0.29), consistent with baseline wheeze susceptibility in asthma. Pneumonia risk was similar regardless of asthma status. During ICU stay, wheeze persisted longest in both groups. Time-to-recovery was similar between groups. Conclusions:EVD68 infection was associated with a higher risk of severe disease than Rhinoviruses/Enteroviruses, independent of documented comorbidity, indicating substantial risk even among previously healthy children.

Nghiên cứu cắt ngang được thực hiện năm 2024 tại huyện Lý Nhân và thành phố Phủ Lý, tỉnh Hà Nam, trên 738 người từ 60 tuổi trở lên nhằm xác định một số yếu tố liên quan đến nghe kém. Số liệu được thu thập thông qua phỏng vấn trực tiếp và đo thính lực đơn âm (PTA) để xác định tình trạng nghe kém. Nghiên cứu đánh giá các yếu tố liên quan đến mức độ nghe kém từ trung bình trở lên (PTA≥35dB) - mức độ ảnh hưởng đáng kể đến giao tiếp và chức năng sống. Phân tích hồi quy logistic đa biến cho thấy nhóm tuổi (nhóm 70-79 tuổi cao gấp 2,05 lần, nhóm từ 80 tuổi trở lên cao hơn gấp 9,4 lần so với nhóm 60-69 tuổi); nam giới (aOR=2,79); cảm thấy giảm sức nghe nhanh chóng (aOR=3,06); cảm giác nghe chủ quan không tốt (aOR=3,7); ù tai (aOR=1,68); màng tai bất thường/không quan sát được (aOR=1,76) là các yếu tố làm tăng khả năng nghe kém. Bên cạnh đó, những người đã từng hút thuốc lá/thuốc lào và đã từng đau tai có khả năng nghe kém thấp hơn với aOR lần lượt là 0,32 và 0,45 lần. Kết quả nghiên cứu cho thấy các đặc điểm về tuổi cao, nam giới, có các triệu chứng cơ năng và thực thể cần được lưu ý trong việc sàng lọc, dự phòng và can thiệp nghe kém ở người cao tuổi.

Điều trị ARV sớm cho người nhiễm HIV giúp cải thiện kết quả điều trị và giảm nguy cơ lây truyền HIV,khuyến cáo điều trị trong vòng 7 ngày sau chẩn đoán mang lại nhiều lợi ích. Nghiên cứu cắt ngang sử dụngdữ liệu từ hệ thống giám sát ca bệnh HIV/AIDS (HIVINFO 4.0) tại tỉnh Thái Nguyên giai đoạn 2020–2024nhằm mô tả thực trạng điều trị ARV sớm và một số yếu tố liên quan ở người nhiễm HIV. Tổng cộng 734trường hợp nhiễm HIV mới phát hiện được phân tích, trong đó 81,6% được điều trị ARV trong 7 ngày. Phântích Kaplan–Meier ở các trường hợp đã điều trị cho thấy trung vị thời gian đến điều trị ARV là 0,5 ngày(IQR: 0,5–7 ngày). Hồi quy Poisson với sai số chuẩn robust cho thấy nữ giới có tỷ lệ điều trị sớm cao hơnnam giới (aPR=1,17; KTC 95%: 1,03–1,35), nhóm tuổi 25–34 ít có tỷ lệ điều trị ARV sớm hơn nhóm ≤24(aPR=0,86; KTC 95%: 0,79–0,94), nhóm nam có quan hệ tình dục đồng giới có tỷ lệ điều trị sớm cao hơnso với nhóm nghiện chích ma túy (aPR=1,16; KTC 95%: 1,04–1,30). Kết quả gợi ý cần tăng cường hỗ trợcho nhóm nghiện chích ma túy và người lớn tuổi nhằm nâng cao tiếp cận điều trị ARV sớm.

In parts of Asia, including Vietnam, Rotavirus alphagastroenteritidis (formerly known as Rotavirus A ; RVA) strains of porcine origin, particularly G4P[6] strains, have been detected in humans at relatively high frequencies. This study investigated the origins of G4P[6] strains identified in Vietnamese children and examined possible factors underlying their frequent detection, based on molecular epidemiological analyses. Among the 1,252 RVA-positive faecal specimens collected over a 2-year period, 28 (2.2%) contained only the G4P[6] strain. Of these, 23 (1.8%) G4P[6] strains were successfully sequenced for their whole genomes, all of which were confirmed to be entirely of porcine RVA origin, with no evidence of genomic reassortment with human RVA strains. Two distinct clusters of G4P[6] strains (comprising two and three strains, respectively) shared identical genome sequences, suggesting the possibility of limited human-to-human transmission. In contrast, the remaining 18 G4P[6] strains were genetically distinct from one another, indicating multiple, independent interspecies transmission events from pigs to humans. Phylogenetic analysis revealed that the P[6] genome segments of porcine RVA or porcine-like human RVA strains, including those identified in this study, were genetically distinct from those of typical human RVA strains and showed notable geographic variation in detection frequency. Comparative analysis of the variable regions of P[6] amino acid sequences identified characteristic residues that distinguish porcine RVA-like P[6] from human RVA-like P[6], some of which correspond to known glycan-binding sites. This study revealed a high frequency of pig-to-human spillover transmission of porcine-derived G4P[6] rotavirus strains in Vietnamese children. The findings suggest that these cases were not the result of newly emerging strains capable of sustained human-to-human transmission. Furthermore, distinct amino acid characteristics in the porcine RVA P[6] protein were identified that may play a role in facilitating the cross-species transmission of rotavirus from pigs to humans.

Quản lý chất lượng toàn diện là một phương pháp quản lý nhằm cải thiện hiệu suất bệnh viện. Để triển khai một cách hiệu quả, các tổ chức y tế cần công cụ đo lường khoa học, đáng tin cậy và hợp lệ để đánh giá một cách toàn diện từ quá trình cải tiến đến sự hài lòng của người bệnh. Nghiên cứu cắt ngang nhằm mục tiêu chuẩn hoá bộ công cụ đánh giá mức độ triển khai Quản lý chất lượng toàn diện tại khoa Khám bệnh các bệnh viện tuyến quận/huyện tại thành phố Hồ Chí Minh. Bộ công cụ được xây dựng dựa trên tham khảo bộ công cụ của tác giả Emad A.Al-Shdaifat áp dụng thang đo Likert 5 mức độ, gồm 40 mục, chia thành 5 nguyên lý cốt lõi của Quản lý chất lượng toàn diện. Dữ liệu thu thập từ 537 nhân viên y tế tại 19 khoa Khám bệnh bệnh viện tuyến quận/huyện tại thành phố Hồ Chí Minh. Kết quả cho thấy bộ công cụ có độ tin cậy cao (Cronbach’s Alpha: 0,925–0,982). Phân tích nhân tố khám phá xác định cấu trúc 5 nhân tố giải thích 69,4% phương sai. Phân tích nhân tố khẳng định cho thấy mô hình phù hợp tốt (CFI = 0,901; TLI = 0,900; RMSEA = 0,075; KTC 90%: 0,072–0,079; SRMR = 0,02). Các giá trị AVE (Average Variance Extracted) ≥ 0,5 xác nhận tính hội tụ của thang đo. Qua mô hình phương trình cấu trúc (Structural Equation Modeling – SEM) cho thấy các yếu tố có sự liên kết chặt chẽ với tương quan dao động từ 0,749 đến 0,874. Tất cả các câu hỏi đều có tải nhân tố cao, cấu trúc nhân tố tốt. AVE ≥ 0,5 xác nhận giá trị hội tụ. Bộ công cụ có tính tin cậy và mức độ phù hợp chấp nhận được, có thể áp dụng trong quản lý chất lượng cơ sở y tế.

Nghiên cứu cắt ngang được thực hiện với 738 người từ 60 tuổi trở lên tại huyện Lý Nhân và thành phố Phủ Lý tỉnh Hà Nam năm 2024 nhằm mô tả thực trạng nghe kém ở người cao tuổi. Thông tin được thu thập thông qua phỏng vấn trực tiếp, đánh giá tình trạng nghe theo phân loại của WHO năm 2021 thông qua khám lâm sàng kết hợp đo thính lực đơn âm. Kết quả cho thấy tỷ lệ nghe kém mức độ nhẹ cao nhất với 45,39% (KTC95%: 41,82% - 49,01%), trung bình 18,83% (KTC95%: 16,17% - 21,83%) và mức độ từ trung bình-nặng trở lên là 5,83% (KTC95%: 4,35% - 7,77%). Nhóm tuổi càng cao có tỷ lệ và mức độ nghe kém càng cao. Kết quả nghiên cứu cũng cho thấy mức độ nghe kém cao hơn có ý nghĩa thống kê ở các nhóm: nam giới, nhóm tự nhận thấy không nghe rõ, nhóm có triệu chứng ù tai trong 12 tháng qua, nhóm đã từng chảy mủ tai, nhóm có ống tai ngoài, màng tai và tai giữa bất thường hoặc không quan sát được. Các kết quả này nhấn mạnh sự cần thiết của việc sàng lọc thính lực định kỳ cho người cao tuổi tại cộng đồng, chú trọng khai thác các triệu chứng cơ năng và khám phát hiện các triệu chứng thực thể để gợi ý chẩn đoán nghe kém, đặc biệt nghe kém mức độ nhẹ.

OBJECTIVES:To assess geographical variation in maternal measles antibody levels from birth to nine months of age, to inform recommendations for the timing of the first measles vaccine dose. METHODS:Stored infant serum samples from 11 countries taken at delivery and/or follow-up time points prior to measles vaccination (N=2845) were tested for measles plaque reduction neutralisation (PRNT) and measles, mumps, and rubella immunoglobulin G at a central laboratory. Antibody decay in infants was modelled using linear mixed effects models with participant-level random intercepts and random slopes. Proportions of infants with antibody concentrations above the clinical protection threshold (0.12 IU/mL) were estimated at each age. RESULTS:At birth, most (94%, 519/552) infants had PRNT ≥0.12 IU/mL, but geometric mean concentrations ranged from 0.32 IU/mL (Guatemala) to 1.60 IU/mL (Pakistan). There was no geographical variation in the decay rate of PRNT nor immunoglobulin G. Geometric mean PRNT fell below 0.12 IU/mL between ages 2.5 months (Guatemala) and 6.2 months (Pakistan). At age 6 months, <50% of infants had PRNT ≥0.12 IU/mL in all countries except Pakistan. CONCLUSIONS:Reliance on maternal antibodies for protection until age 9 months or later leaves most infants with insufficient direct protection against measles infection between ages 6-9 months.

Background Antimicrobial resistance (AMR) is a silent pandemic causing 1.27 million deaths in 2019, disproportionately affecting low- and middle-income countries, but resistance among commensal microbiota and the determinants of carriage have not been widely reported. This cross-sectional household study aimed to determine the prevalence of carbapenem-resistant (CRE) and third-generation cephalosporin-resistant Enterobacterales (C3GRE) in a rural community in Ha Nam northern Vietnam, as well as the socio-demographic, behavioural, and environmental determinants of carriage. Methods 1502 individuals across 324 households were surveyed between July 2018 and April 2019. Faecal samples were cultured on meropenem and ceftazidime supplemented media to identify CRE and C3GRE, respectively. Logistic regression models were used to explore risk factors for CRE and C3GRE carriage compared to susceptible strains. Findings Colonisation with C3GRE and CRE was 94.0% (95% Confidence Interval (CI) 93.5%-94.4%) and 1.9% (1.6%-2.2%), respectively. The CRE prevalence was too low to explore determinants. Antibiotic use in the last month (adjusted OR 1.22 [95% CI 0.45-3.31]) and recent illness (aOR 1.48 [0.34-6.51]) were not associated with C3GRE carriage. Variables associated with C3GRE carriage were high-income (OR 0.29 [0.12-0.74]), worse sanitary conditions (aOR 4.35 [1.07-17.43]), and frequent beef consumption (aOR 6.56 [2.16-19.98]). A protective association between C3GRE carriage and animal husbandry was observed in children under 5-years (aOR 0.27 [0.09-0.84]). For participants 5-years and older, chicken consumption was associated with increased likelihood of C3GRE carriage (aOR 3.45 [1.45-8.22]), while a protective association was observed for regular tofu (aOR 0.32 [0.14-0.74]) and fermented food consumption (aOR 0.55 [0.31-0.96]). Interpretation In this high-prevalence setting, colonisation with C3GRE was not associated with individual antibiotic use, while environmental exposures, including food and sanitary conditions, were associated with C3GRE colonisation. Further research is required to understand the mechanisms behind these associations. Funding This work was supported by Oxford University Clinical Research Unit internal grants in Vietnam from the Wellcome Trust Africa Asia Programme core grants (2015-2022-106680/Z/14/Z, and 2022-2029-225167/Z/22/Z). Copyright (c) 2025 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Objectives This study aimed to investigate the characteristics and management of influenza-like illnesses (ILIs) in the outpatient and inpatient settings in Vietnam.Design A cross-sectional, observational study.Setting and participants We conducted a questionnaire survey of 407 individuals with ILI symptoms who presented to public community health centres and the paediatric ward of a public hospital in the city of Nha Trang, Khanh Hoa Province, Vietnam, from December 2022 to March 2023.Interventions Not applicable.Primary and secondary outcome measures No primary and secondary outcomes were pre-specified because this study was an explanatory study. The basic characteristics of the participants are presented using descriptive statistics. We conducted multivariable logistic regression analysis to examine the factors associated with the prescription of antibiotics to outpatients with ILIs.Results A total of 198 outpatients and 200 inpatients were enrolled in the study. Most inpatients were children under 5 years of age and experienced longer illness durations and higher costs, with almost all patients receiving antibiotics. The rate of antimicrobial prescription for ILIs was 79.3% for outpatients and 99.5% for inpatients. The median health-related quality of life score of participants aged ≥18 years during illness was 0.796 (IQR 0.674–0.922). Logistic regression analysis indicated a negative association between a definite diagnosis of viral infection by rapid diagnostic test and outpatient antibiotic prescription (OR: 0.20, p=0.006).Conclusions This study underscores the widespread inappropriate antimicrobial use for ILIs in a community in Vietnam, which contributes to an avoidable economic and health burden. The results of this study suggest that implementing diagnostic tools may support antimicrobial stewardship efforts.

Influenza-like illness (ILI) is one of the most common illnesses caused by various respiratory viruses and directly or indirectly incurs high expenses to households. However, the pathogen-specific incidence and health-seeking behaviour in communities have not been well described. A longitudinal cohort study using a self-recorded health calendar among 1000 households was performed in South-central Vietnam from October 2009 to September 2012. Endemic respiratory viruses in the community were monitored using random sampling in public health clinics (polyclinics). The monthly incidence of specific pathogens was calculated using the Bayesian method. Among 5,016 household members, 3,687 ILI episodes were reported during the study period. The incidence rate of ILI was 21.7 (95

Purpose This study aims to investigate how two different types of brand-to-brand dialogues – “roasting” versus “toasting” – impact consumers’ brand perceptions, particularly perceived entertainment, and influence brand attitudes. Design/methodology/approach The research design comprises four studies. The preliminary study involves Web scraping to gauge consumer perception about the two communication approaches followed by two well-known brands. Study 1 involves an online experiment to compare these communication types within each brand tested in the pilot study and examines the mediation effect of perceived entertainment. Study 2, also an online experiment, investigates the role of message neutralization, demonstrating that “roasting” can be acceptable when the humor is neutralized. Study 3 further tests the effects of neutralized “roasting” at different levels of brand familiarity and personality. Findings Roasting can lead to more favorable consumer perceptions than toasting. The effect can be explained by roasting’s higher level of perceived entertainment. However, this positive outcome is contingent on the successful neutralization of the aggressive humor in the “roasting” messages. When it comes to brand familiarity and personality, familiar brands benefit more from neutralized “roasting,” whereas brand personality does not have a strong influence. Research limitations/implications The findings suggest that “roasting” can be effective when messages are neutralized, and “toasting” works best when spontaneous and genuine. It highlights how brand familiarity and personality influence consumer reactions, thus, offering strategic insights for both established and lesser-known brands. The study also prompts further research to examine other brand traits, cultural factors and behavioral dimensions in brand-to-brand dialogue, signifying the complexity and richness of this growing research area. Practical implications This study advises lesser-known brands to adopt “toasting” strategies to build a positive image, while established brands can try “roasting,” ensuring message neutrality to avoid negativity. The research emphasizes the role of brand familiarity and personality in shaping brand dialogues. Marketers must consider these to make humor strategies effective and bolster positive brand image. Originality/value This research uniquely examines message neutralization through contextual cues as a strategy brands can use to aid their sensitive dialogues with others on social media. The findings provide new insights into how brands can use different types of messages in digital communications to attract consumers and ensure positive reception, offering valuable guidance for academics and practitioners in brand-to-brand dialogue.