Districts Of Hanoi Research Articles

Conceptualizing depression in Vietnam: Primary health care providers' explanatory models of depression.

The purpose of this qualitative study was to elicit the explanatory models (EMs) of primary healthcare providers (PHPs) in Vietnam in order to (a) understand if and how the concept of depression is understood in Vietnam from the perspective of nonspecialist providers and community members, and (b) to inform the process of introducing services for depression in primary care in Vietnam. We conducted semistructured interviews with 30 PHPs in one rural and one urban district of Hanoi, Vietnam in 2014. We found that although PHPs possess low levels of formal knowledge about depression, they provide consistent accounts of its symptoms and aetiology among their patient population, suggesting that depression is a relevant concept in Vietnam. PHPs describe a predominantly psychosocial understanding of depression, with little mention of either affective symptoms or neurological aetiology. This implies that, with enhanced training, psychosocial approaches to depression care would be appropriate and acceptable in this context. Distinctions were identified between rural and urban populations in both understandings of depression and help-seeking, suggesting that enhanced services should account for the diversity of the Vietnamese context. Alcohol misuse among men emerged as a considerable concern, both in relation to depression and as stand-alone issue facing Vietnamese communities, indicating the need for further research in this area. Low help-seeking for depression in primary care implies the need for enhanced community outreach. The results of this study demonstrate the value of eliciting EMs to inform planning for enhanced mental health service delivery in a global context.

Wealth gradient-based divergence in the prevalence of underweight among women by marital status in Quoc Oai district, Vietnam

ABSTRACTBackground: The prevalence of underweight is high among women in Asian countries, despite nutritional changes in the region. Previous studies have demonstrated independent associations between female body weight, marital status and economic status. However, few studies have investigated possible interaction between marital and economic status in relation to Asian women’s body weight.Objective: This study aimed to test associations between household wealth, marital status and underweight among women living in the Quoc Oai district of Vietnam and to identify wealth–marital status interaction in relation to body weight in these women.Methods: Data from 1087 women aged 19–60 years were collected via a baseline community survey conducted in the Quoc Oai district of Hanoi, Vietnam, in 2016. Underweight was defined using an Asian-specific body mass index cut-off (<18.5 kg/m2). Marital status was dichotomized into ‘never married’ and ‘ever married.’ Economic status was measured using household wealth index quintiles. Multivariable logistic regressions tested association between wealth and underweight after adjusting for marital status and other confounders. An interaction term (wealth index*marital status) was fitted to determine whether the association between wealth and body weight is modified by marital status.Results: Our results show that underweight was independently associated with a wealth status (odds ratio [OR]: 0.88, 95% confidence interval [CI]: 0.79–0.98, p = 0.026) and ever-married status (OR: 0.50, 95% CI: 0.34–0.75, p = 0.002). A significant interaction effect (OR: 0.67, 95% CI: 0.50–0.90, p = 0.010) indicated that wealthy married women were less likely to be underweight, whereas wealthy never-married women were more likely to be underweight.Conclusions: Our results suggest that the interaction between wealth and marital status has divergent effects on underweight among Asian women. Interventions to reduce underweight among Asian women should simultaneously consider economic and marital status.

Health Status and the Demand for Healthcare among the Elderly in the Rural Quoc-Oai District of Hanoi in Vietnam

Background Vietnam is experiencing an unprecedented demographic transition. Its proportion of elderly people is growing rapidly. Objective This study explored the health status and health-related quality of life (HRQoL) of rural elderly Vietnamese and assessed their needs for healthcare services. Design This study used a survey with stratified proportion sampling and quota assignment. In 2016, data was collected from 713 people in the rural Quoc-Oai district of Hanoi aged 60 or older. Results The mean age of the respondents was 70.9. Both self-rated health status and functional status decreased with age. Women reported more functional limitations than men. Musculoskeletal disorders were the most frequently reported chronic diseases, followed by hypertension, gastrointestinal diseases, and cardiovascular diseases. Age, self-rated health status, BMIs, and the number of noncommunicable diseases (NCDs) were found to be significant determinants of HRQoL, after controlling for socioeconomic effects. More than half the respondents requested more healthcare information, particularly on disease management. Conclusions Vietnam's healthcare system is being challenged to make health services easily accessible and meet the growing needs for chronic illness management, risk reduction, promoting healthy lifestyles, and improving the aging population's quality of life.

Co-Creative Urbanism The production of plural evolutionary spatialities through conflicts and complicities between public and private in the streets of Hanoi, Vietnam

Under the impact of economic globalization, today cities put a high priority to improve their attractiveness and become ideal destinations for global capital and elites (William S.W. Lim, 2014). Results of these “improvements” are often severe gentrification and spectacularisation processes that compromise resilience of local communities. These have an important impact on the materiality of tradition that constitutes complex of historical, social and cultural linkages is being gradually decontextualized and commodified, severely damaging local identity, community and knowledge (William S. W. Lim, 2013). Epitomes of these disruptions of complex rooted linkages are the “creative,” post-consumerist landscapes of consumption, ubiquitously emerging in public spaces of ancient central city streets.Contrasting such tendency of producing deterritorialised places of consumption, trapping people for hours at a time in hyper-real spaces, relevant socio-spatial instances of resistance are found. This paper explores the complex spatialities of conceptions, everyday practices and actions of one of these places that preserves genuine rhythms of daily lives. The historical central district of Hanoi is chosen as case study, where local inhabitants develop idiosyncratic tactics to engage with public space, encroaching sidewalks with complex set of practices. These are places where local inhabitants everyday actualise complex sets of conceptions, practices and actions that notably exemplifies those that produce differential spaces - using the notion proposed by Henri Lefebvre. Disassociating from regulated, limited, planned and homogenized environments as occurring in present shopping malls and theme parks, the central district of Hanoi sidewalks offer chances for accidental encounters, unexpected events and support a very diverse range of local inhabitants in an extremely active and dynamic play. The sidewalks appear as a loosen space (Franck &amp; Stevens, 2007), where unpredictable uses, intermingled spatial interconnections and complex social interrelations generate.This paper discusses the findings of a research aimed to explore (how – what – why) the interaction between the multifarious spatial activities of residents and transients, and describe the patterns of such inclusionary relations. Particularly, the study intends to demonstrate how there is a (ambivalent condition in witch) complex networks of social activities produce and are produced by a distinct set of spatialities that involve inclusive networks of local agencies. So as to achieve the target, the theoretical lenses of Lefebvre’s spatialities and Kim’s spatial ethnography are useful, on the one hand to comprehensively decode and interpret “social space” and on the other hand to clearly describe such space.

Poly-victimisation and health risk behaviours, symptoms of mental health problems and suicidal thoughts and plans among adolescents in Vietnam.

BackgroundLimited evidence is available about poly-victimisation (exposure to multiple forms of victimisation) and mental health among adolescents in low and lower-middle-income countries. The aim of this study was to examine the associations between lifetime exposure to poly-victimisation, health risk behaviours, symptoms of common mental health problems and suicidal ideas in the previous year among high school students in Vietnam.MethodsParticipants were high school students in rural and urban districts of Hanoi, Vietnam. The data source was an anonymously-completed structured self-report survey. Lifetime exposure to poly-victimisation was assessed using the juvenile victimisation questionnaire revised 2 (JVQ R-2); mental health symptoms by the depression, anxiety and stress scale-21 (DASS-21); involvement in health risk behaviours and previous year suicidal thoughts and plans by questions adapted from the 2013 youth risk behaviour survey. Data were collected between October, 2013 and January, 2014 and were analysed using generalised structural equation modelling.ResultsIn total 1616/1745 (92.6 %) eligible students provided complete data. Prior year suicidal thoughts were reported by 21.4 % (95 % CI 18.5–24.5 %) of the female respondents and 7.9 % (95 % CI 6.2–9.8 %) of the male respondents. Prior year suicidal plans were reported by 7.8 % (95 % CI 5.9–9.8 %) of the girls and 4.0 % (95 % CI 2.7–5.3 %) of the boys. Poly-victimisation was associated with increased likelihood of involvement in health risk behaviours and symptoms of common mental health problems among both sexes, which increased adolescents’ risk of having suicidal ideas in the previous year. Compared to non-victims or victims of fewer forms, poly-victims were also more likely to report suicidal thoughts and plans among both girls and boys (p < 0.05).ConclusionsOverall, the results revealed that poly-victimisation was associated with increased involvement in health risk behaviours, poorer mental health and increased risks of suicidal ideas among Vietnamese adolescents. Suicidal ideas were prevalent among the students. Interventions to assist victims of violence and prevention of violence, especially poly-victimisation, among adolescents in Vietnam is therefore important.

Vietnamese mother's conceptions of childhood overweight: findings from a qualitative study

BackgroundChildhood overweight and obesity is a new and emerging problem in Vietnam. The so far observed prevalence increases have pointed to the need for public health intervention strategies with parents as crucial resources for change.ObjectiveThe aim of this study was to understand mothers’ conceptions of childhood overweight.DesignFour focus group discussions were conducted with a total of 33 mothers of preschool children, 4–6 years old, living in urban and rural districts of Hanoi, Vietnam. The discussions were audio taped and transcribed verbatim. The obtained data were analyzed using the principles of phenomenography.ResultsFour main categories with 13 subcategories emerged in the process of analysis. The first category, called ‘Concept of overweight’, contained mothers’ views on childhood overweight. A major concern was the negative aspects of overweight such as impaired social interaction and health problems. The second category, ‘Identification of overweight’, described the ways mothers use to recognize overweight in children: own experience, growth chart, and public or health care system's information. The third category, ‘Causes of overweight’, showed mothers’ understanding of factors possibly contributing to overweight development: unhealthy food and lifestyle, genetic susceptibility, parent's lack of knowledge, and limited time to take care of children as well as economic improvement. The fourth category, ‘Management of overweight’, described the ways mothers use to manage a child's weight problem: control of their food intake, increasing their physical activity, and encouraging their child self-control. However, they find such strategies difficult to implement and their intentions are sometimes challenged by the child's grandparents.ConclusionsThe study gives an understanding of the mothers’ conceptions of four important and practically useful aspects of overweight in children. The findings highlight the roles of media and the health care system in enhancing a social awareness of the problem and the need for prevention. Growth charts need to be used more regularly and consciously in child health care for early detection of children at risk and as a tool for information to parents. When designing intervention programs, the entire extended families, especially grandparents and their roles, need to be considered.

Decreasing In-home Smoking of Adults-Results from a School-based Intervention Program in Viet Nam.

It is indicated that children are involuntarily exposed to secondhand smoke from adults, mainly at their home environment. This study aimed at describing the effectiveness of the school-based intervention to decrease the in-home smoking situation of adults so as to decrease children's exposure to secondhand smoke at home during the year 2011–2012 in a rural district in Hanoi, Viet Nam. This school-based intervention program (intervention and control group) involved 804 children aged 8 to 11 years from August 2011 to May 2012 in a rural district of Hanoi, Viet Nam. Children were taught in class about the harmful effects of secondhand smoke and about how to negotiate with fathers not to smoke in-home. Then children applied what they learnt, including staying away from secondhand smoke and persuading fathers not to smoke in-home in order to decrease children's exposure to secondhand smoke. Chi square test, t-test and multinominal logistic regression were applied in data analysis. The results showed that children's reported their father's in-home smoking decreased from 83.0% pre-intervention to 59.8% post-intervention (p < 0.001) in the intervention school while no change happened in the control school. The study found that the better changed smoking location of adult smokers as reported by children associated with the school who received intervention activities (adjusted OR = 2.04; 95% CI: 1.28–3.24). Poorer changed attitudes towards secondhand smoke of children associated with a lower percentage of better change in smoking location of their fathers/other adult smokers (aOR = 0.51, 95% CI: 0.28–0.96). Children's poorer changed knowledge towards secondhand smoke also associated with poorer changed smoking location of adult smokers (aOR = 2.88, 95% CI: 1.07–7.76). It is recommended by this study that similar school based intervention approaches should be applied in primary schools in Viet Nam to increase children's awareness on the adverse health effects of secondhand smoke and to help them to be able to avoid their exposure to secondhand smoke at their home environment.

Predictors of condom use behaviour among male street labourers in urban Vietnam using a modified Information-Motivation-Behavioral Skills (IMB) model

HIV risk in vulnerable groups such as itinerant male street labourers is often examined via a focus on individual determinants. This study provides a test of a modified Information-Motivation-Behavioral Skills (IMB) model to predict condom use behaviour among male street workers in urban Vietnam. In a cross-sectional survey using a social mapping technique, 450 male street labourers from 13 districts of Hanoi, Vietnam were recruited and interviewed. Collected data were first examined for completeness; structural equation modelling was then employed to test the model fit. Condoms were used inconsistently by many of these men, and usage varied in relation to a number of factors. A modified IMB model had a better fit than the original IMB model in predicting condom use behaviour. This modified model accounted for 49% of the variance, versus 10% by the original version. In the modified model, the influence of psychosocial factors was moderately high, whilst the influence of HIV prevention information, motivation and perceived behavioural skills was moderately low, explaining in part the limited level of condom use behaviour. This study provides insights into social factors that should be taken into account in public health planning to promote safer sexual behaviour among Asian male street labourers.

Impact of Urban Heat Island under the Hanoi Master Plan 2030 on Cooling Loads in Residential Buildings

This study aims to evaluate the influence of urban heat island (UHI) under the Hanoi Master Plan 2030 on the energy consumption for space cooling in residential buildings. The weather conditions under the current and future status (master plan condition) simulated in the previous study (Trihamdani et al., 2014) were used and cooling loads in all the residential buildings in Hanoi over the hottest month were estimated under the simulated current and future conditions by using the building simulation program, TRNSYS (v17). Three most typical housing types in the city were selected for the simulation. The cooling loads of respective housing types were obtained in each of the districts in Hanoi. The results show that the total cooling loads over June 2010 is approximately 683 Terajoule (TJ) under the current status, but it is predicted to increase to 903 TJ under the master plan condition. The increment is largely due to the increase in number of households (203 TJ or 92%), but partially due to the increase in urban temperature, i.e. UHI effect (17 TJ or 8%). The increments in new built-up areas were found to be larger than those in existing built-up areas. The cooling load in apartment is approximately half of that in detached house, which is approximately half of that in row house. Moreover, it was seen that although sensible cooling loads increased with the increase in outdoor temperature, the latent cooling loads decreased due to the decrease in absolute humidity and the increase in air temperature.

Factors associated with HIV testing among male motorbike taxi drivers in urban Vietnam

Using the Attitude-Skills-Knowledge (ASK) model, this study examined the prevalence of, and factors associated with, human immunodeficiency virus (HIV) testing among male motorbike taxi drivers (MMTDs). In a cross-sectional design, using quantitative approaches, 291 MMTDs were recruited from 135 sites across 13 districts in Hanoi, Vietnam, for a face-to-face interview. Applying the ASK model modified as a central theory, logistic regression was used to identify determinants of HIV testing. Although many MMTDs engaged in multiple risk behaviours for HIV, only 20.6% had been tested for HIV during the past 12 months. The tested model included one factor of the ASK model, HIV prevention knowledge (adjusted odds ratio [AOR] = 4.76; 95% confidence interval [CI] = 2.12–10.7) and five additional factors: being married (AOR = 3.13; 95% CI = 1.25–4.78), preferring sex with men or with both men and women (AOR = 8.72; 95% CI = 1.48–51.5), having lower number of lifetime sex partners (AOR = 0.66; 95% CI = 0.49–0.88), higher number of past year sex partners (AOR = 2.97: 95% CI = 1.21–7.31) and discussing condom use when having sex with partners (AOR = 0.08; 95% CI = 0.01–7.31). This modified ASK model provided better fit than the ASK model, as it explained more variance in HIV testing (47 vs. 29.8%). Recognising factors associated with HIV testing among MMTDs enables us to create suitable public health intervention strategies.

Livelihood Strategies for Coping with Land Loss among Households in Vietnam's Sub-Urban Areas

Using a novel data set from my household survey in a sub-urban district of Hanoi, Vietnam, this study is the first attempt using an econometric approach to investigate the relationship between farmland loss (due to urbanization and industrialization) and households’ livelihood strategies. The results from the multinomial logit model provide the first econometric evidence that land loss increases with the probability of households adopting a strategy specializing in a single nonfarm activity (informal paid jobs or household businesses) or diversifying in many activities. This suggests that many households have actively coped with the shock of losing land. Such adaptation strategies in the new context can help mitigate their dependence on farmland as well as might help improve their welfare. Therefore, a possible implication here is that the rising of land loss should not be seen as an absolutely negative phenomenon because it can improve household welfare by motivating households to change or diversify their livelihoods. Besides, some household asset-related variables such as education, farmland, and the prime location of houses were found to be closely associated with participation in nonfarm activities. Based on evidence from the econometric analyses, the study proposes some policy recommendations that may help households diversify or specialize in lucrative nonfarm activities, given the context of shrinking farmland due to rapid urbanization in Hanoi’s sub-urban areas.

Risks for HIV Infection Among Male Street Laborers in Urban Vietnam

Risks for HIV infection remain unknown in male street laborers. This research investigates patterns of self-reported risk behaviors among these men in urban Vietnam. In a cross-sectional survey using a social mapping technique, 450 men, mostly low-skilled and unregistered migrant laborers across 13 districts in Hanoi were approached for interviews. The study revealed that male street laborers were at high risk of acquiring and transmitting HIV. One in every 12 men reported homosexual or bisexual behavior. These men on average had three sexual partners within the preceding year, and condom use was inconsistent. Close to 95% of the men had reported sexual encounters with regular partners. One-third with commercial sex workers (CSW) and 24.2% with casual partners, but just under one-third had ever used condoms with regular partners and CSWs and very few (17.6%) with casual partners at their last sexual encounter. 17.11% used illicit drugs sometimes, with 66.7% of them frequently sharing injecting equipment with peers. These men had limited HIV knowledge; 51.4% incorrectly believed that, once you trust your partner, you no longer need to use condoms and 42.4% believed that you can tell by looking at someone if they have HIV. Access to HIV prevention was also limited; only 19.8% of men had been tested for HIV during the previous 12months, almost 10% of whom neither returned for the result nor knew their HIV status. The study provides interesting directions for future research and suggests ways to effectively design prevention strategies for these men.

Factors associated with job satisfaction among commune health workers: implications for human resource policies

Background: Job satisfaction among health workers is an important indicator in assessing the performance and efficiency of health services.Objective: This study measured job satisfaction and determined associated factors among health workers in 38 commune health stations in an urban district and a rural district of Hanoi, Vietnam. A total of 252 health workers (36 medical doctors and 216 nurses and technicians; 74% female) were interviewed. A job satisfaction measure was developed using factor analysis, from which four dimensions emerged, namely ‘benefits and prospects,’ ‘facility and equipment,’ ‘performance,’ and ‘professionals.’Results: The results demonstrate that respondents were least satisfied with the following categories: salary and incentives (24.0%), benefit packages (25.1%), equipment (35.7%), and environment (41.8%). The average satisfaction score was moderate across four domains; it was the highest for ‘performance’ (66.6/100) and lowest for ‘facility and equipment’ (50.4/100). Tobit-censored regression models, constructed using stepwise selection, determined significant predictors of job satisfaction including age, areas of work and expertise, professional education, urban versus rural setting, and sufficient number of staff.Conclusion: The findings highlight the need to implement health policies that focus on incentives, working conditions, workloads, and personnel management at grassroots level.

Hot spot detection and spatio-temporal dispersion of dengue fever in Hanoi, Vietnam

Introduction: Dengue fever (DF) in Vietnam remains a serious emerging arboviral disease, which generates significant concerns among international health authorities. Incidence rates of DF have increased significantly during the last few years in many provinces and cities, especially Hanoi. The purpose of this study was to detect DF hot spots and identify the disease dynamics dispersion of DF over the period between 2004 and 2009 in Hanoi, Vietnam.Methods: Daily data on DF cases and population data for each postcode area of Hanoi between January 1998 and December 2009 were obtained from the Hanoi Center for Preventive Health and the General Statistic Office of Vietnam. Moran's I statistic was used to assess the spatial autocorrelation of reported DF. Spatial scan statistics and logistic regression were used to identify space–time clusters and dispersion of DF.Results: The study revealed a clear trend of geographic expansion of DF transmission in Hanoi through the study periods (OR 1.17, 95% CI 1.02–1.34). The spatial scan statistics showed that 6/14 (42.9%) districts in Hanoi had significant cluster patterns, which lasted 29 days and were limited to a radius of 1,000 m. The study also demonstrated that most DF cases occurred between June and November, during which the rainfall and temperatures are highest.Conclusions: There is evidence for the existence of statistically significant clusters of DF in Hanoi, and that the geographical distribution of DF has expanded over recent years. This finding provides a foundation for further investigation into the social and environmental factors responsible for changing disease patterns, and provides data to inform program planning for DF control.

Sustainable water resources management in the Long Bien district of Hanoi, Vietnam

The accelerated industrialization of Hanoi, Vietnam, coupled with a high population growth rate and changing climatic conditions create increasing pressure on the local water balance. Despite abundant precipitations, overexploitation endangers the groundwater resources, which are not able to sustain an adequate water supply. The present paper presents a sustainable approach for balancing the lowering of groundwater levels by increasing the rainwater percolation rates through enhanced infiltration. The efficiency of the method was assessed by a scenario analysis based on hydrological and hydrogeological models. Multi-criteria simulations revealed the optimum infiltration sites by considering technical and site-specific aspects and the positive impact of artificial recharge on seasonal groundwater budget.

Impacts of flood on health: epidemiologic evidence from Hanoi, Vietnam

Background Vietnam is one of the most disaster-prone countries in the world. The country suffers from many kinds of natural disasters, of which the most common and serious one is flooding. Long and heavy rainfall during the last days of October and the first week of November 2008 resulted in a devastating flood unseen for over three decades in the capital city of Hanoi. It caused a substantial health impact on residents in and around the city and compromised the capacity of local health services.Objective The aim of this study is to ascertain the vulnerability and health impacts of the devastating flood in Hanoi by identifying the differences in mortality, injuries, and morbidity patterns (dengue, pink eye, dermatitis, psychological problems, and hypertension) between flood affected and non-affected households.Design A cross-sectional study was carried out involving 871 households in four selected communes (two heavily flood affected and two comparatively less affected) from two severely flooded districts of Hanoi. Participants were interviewed and information collected on the social, economic, and health impacts of the devastation within 1 month after the flood.Results The self-reported number of deaths and injuries reported in this study within 1 month after the heavy rainfall were a bit higher in severely affected communes as compared to that of the less affected communes of our study. The findings showed higher incidences of dengue fever, pink eye, dermatitis, and psychological problems in communes severely affected by flood as compared to that of the controlled communes.Conclusions For people in flood prone areas (at risk for flooding), flood prevention and mitigation strategies need to be seriously thought through and acted upon, as these people are exposed to greater health problems such as psychological issues and communicable diseases such as pink eye or dermatitis.

Diarrhoea management by pharmacy staff in retail pharmacies in Hanoi, Vietnam

Abstract A survey was conducted in a sample of 29 pharmacies in the Badinh district of Hanoi, Vietnam, to determine the knowledge and behaviour of pharmacy staff in dealing with cases of acute diarrhoea in children. The survey found that antibiotics and antidiarrhoeal drugs were suggested in the majority of cases (45 per cent and 69 per cent, respectively) while oral rehydration salts (ORS) were suggested in only one case. In about 80 per cent of the observed cases in which antibiotics were supplied, one to four tablets were given, enough for only one to two days. The advice given by pharmacy staff to purchasers was poor. Only about half the pharmacy staff asked for information about the stool, age of the child and frequency of diarrhoea, while questions about medicines that had already been taken, feeding and health status were rarely asked. In about 10 per cent of the cases, no questions at all were asked. The mean cost of the treatment was $ 0.53 (95 per cent CI = 0.37–0.68). Constraints of knowledge, time and finance could be the reasons for this inappropriate management of childhood diarrhoea.

Use of Oral Cholera Vaccines in an Outbreak in Vietnam: A Case Control Study

BackgroundKilled oral cholera vaccines (OCVs) are available but not used routinely for cholera control except in Vietnam, which produces its own vaccine. In 2007–2008, unprecedented cholera outbreaks occurred in the capital, Hanoi, prompting immunization in two districts. In an outbreak investigation, we assessed the effectiveness of killed OCV use after a cholera outbreak began.Methodology/Principal FindingsFrom 16 to 28 January 2008, vaccination campaigns with the Vietnamese killed OCV were held in two districts of Hanoi. No cholera cases were detected from 5 February to 4 March 2008, after which cases were again identified. Beginning 8 April 2008, residents of four districts of Hanoi admitted to one of five hospitals for acute diarrhea with onset after 5 March 2008 were recruited for a matched, hospital-based, case-control outbreak investigation. Cases were matched by hospital, admission date, district, gender, and age to controls admitted for non-diarrheal conditions. Subjects from the two vaccinated districts were evaluated to determine vaccine effectiveness. 54 case-control pairs from the vaccinated districts were included in the analysis. There were 8 (15%) and 16 (30%) vaccine recipients among cases and controls, respectively. The vaccine was 76% protective against cholera in this setting (95% CI 5% to 94%, P = 0.042) after adjusting for intake of dog meat or raw vegetables and not drinking boiled or bottled water most of the time.Conclusions/SignificanceThis is the first study to explore the effectiveness of the reactive use of killed OCVs during a cholera outbreak. Our findings suggest that killed OCVs may have a role in controlling cholera outbreaks.

Quantifying the emergence of dengue inCE OF DENGUE IN HANOI, 1998-2009

Background There was a large outbreak of dengue fever (DF)/ dengue hemorrhagic fever (DHF) with 16164 suspected cases in Hanoi in 2009 which was 5.2 fold higher than the same period of 2008. We aim to investigate if DF/ DHF is really re-emerging in Hanoi since the last large outbreak in 1998 by observing the disease incidence and the average age of infection from 1998-2009 because the single bad year is not sufficient to conclude that dengue is re-emerging in Hanoi. Also, the standardized morbidity ratios (SMR) in 14 center districts of Hanoi in 2009 were calculated to identify the high-risk districts after correcting for demographic factors. We also look at the climate factors which can influence the dengue incidence in Hanoi.

Injury and pre-hospital trauma care in Hanoi, Vietnam

In Vietnam, injury is the leading cause of death in children under 18, and road traffic accidents are the fifth leading cause of death. Information systems for pre-hospital trauma care are insufficient. The objective of this study was to assess injury morbidity and mortality, and the existing level of pre-hospital trauma care in Hanoi city. A cross-sectional study was conducted in seven districts in Hanoi in 2006. We studied 2800 households (11,334 members), 9 hospitals and an emergency service centre. The injury morbidity rate was 1134/100,000 (year(-1)), and the injury mortality rate was 23.7/100,000 (year(-1)). There was no significant difference in age or sex between injury severity levels (p>0.05). Road traffic accidents were the leading cause of injury. Causes of injury mortality differed among different age groups. Only 4% of injured cases were transported to hospital by ambulance. Fifty-two percent of victims did not receive first aid at the site. Pre-hospital trauma care was separately provided by the emergency service centre and hospitals. There was no communication network between the emergency service centre and hospitals, ambulances and hospitals, or between different hospitals. The results reveal that injury is a major health problem in Hanoi and that the pre-hospital care system lacks both coordination and many vital components. Study results may assist decision-makers in identifying interventions to improve health and safety for the population of Hanoi.