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Research on coping strategies and social support among Vietnamese cancer caregivers remains limited. In this study, we aim to examine the relationships between types of coping strategies utilized and social support among cancer caregivers. This was a cross-sectional study conducted in three main cancer hospitals in the Northern, Central and Southern regions of Vietnam. The 28-item Brief COPE Inventory (BCI) Scale and the Multidimensional Scale of Perceived Social Support (MSPSS) were utilized. Descriptive statistics and multivariate linear regression were performed. Active coping, acceptance and positive reframing were the most used coping strategies among participants, while substance use was the least commonly used. Level of social support was positively correlated with the utilization of coping mechanisms. Receiving high social support and utilizing positive coping strategies enables caregivers to mitigate their caregiving burden, control the situation and enhance their own quality of life.

Mental health disorders among university students have been a serious issue in many countries and can negatively affect academic performance and all aspects of daily living, relationships, and physical health. In this study, we aim to estimate the prevalence of severe symptoms of mental disorders and examine associated factors among students majoring in foreign languages in Vietnam. We used the Depression, Anxiety, and Stress Scales (DASS-21) to detect severe symptoms of mental disorders in 1,788 students, including severe symptoms of depression, anxiety, and stress. The Financial-Study-Family-Friend (FSFF) scale was utilized to assess how much students worried about finance, academic, and social support from family and friends. Multiple logistic regressions were carried out to evaluate the relationship between severe symptoms of mental disorders and FSFF factors. The prevalence of severe levels of depression, anxiety, and stress were 21.1, 35.0, and 16.3%, respectively. While varying somewhat due to students' demographic characteristics, all four aspects of the FSFF scale were related to the severe symptoms of mental disorders of students. Concerns about study had the largest effects (ORs ranging from 2.84 to 3.72) while difficulty in finance had the smallest effects (ORs ranging from 1.23 to 1.37) on students' depression, anxiety, and stress. The prevalence of severe symptoms of mental disorders in students was high in our study. Teachers and universities should focus more attention on students' mental health. Social support from family and friends also plays a crucial role in the mental health of students.

Background: In 2016-2017, 68 women in Southern Vietnam had RT-PCR confirmed Zika virus (ZIKV) infection during pregnancy. We report here the outcomes of the pregnancies and the virological analyses related to this outbreak. Methods: We collected clinical and epidemiological information from the women who were enrolled in the study. Medical records related to the pregnancy in 2016–2017 were retrieved for those who were not able to be enrolled in the study. Children born to women with ZIKV infection during pregnancy were also enrolled. Serum samples were evaluated for presence of ZIKV antibodies. Phylogenetic analyses were performed on Zika virus genomes sequenced from the 2016–2017 serum samples. Findings: Of the 68 pregnancies, 58 were livebirths and 10 were medically terminated. Four of the medical records from cases of fetal demise were able to be retrieved, of which one was consistent with congenital ZIKV infection. Of the 58 women with a livebirth, 21 participated in the follow-up investigation. All but two women had serologic evidence of ZIKV infection. Of the 21 children included in the study (mean age: 30.3 months), 3 had microcephaly at birth. No other clinical abnormalities were reported and no differences in neurodevelopment were observed compared to a control group. Phylogenetic analysis revealed a clade within the ZIKV Asian lineage and branch at the root of samples from the 2013–2014 French Polynesian outbreak. The prM S139N mutation was not observed. Interpretation: We have been able to demonstrate a clade within the ZIKV Asian lineage implicated in adverse pregnancy outcomes in Southern Vietnam. Funding: INCEPTION project (PIA/ANR-16-CONV-0005) and a grant received from BNP Paribas Simplidon.

Background: Drinking water quality affects directly human health. Assessment and prevention of water-borne diseases are crucial for primary prevention, especially for children. Objective: The main aim of this study was to investigate the quality of drinking water from tap water in preschools and primary schools in a district area in Hanoi City, Vietnam. Methods: A cross-sectional study was performed from August to October 2019. Water samples from tap water of 154 schools in a district area of Hanoi were collected to determine the quality of drinking water. From each school, at least 2 bottles of water samples were collected on the basis of a standard operating procedure (SOP). Each water sample was analyzed for microbial and physicochemical parameters, including Color, Taste and Odor, Turbidity, pH, Nitrite, Nitrate, Ammonium, Total Iron, Permanganate, Chloride, Hardness, Total Manganese, Sulfate, Arsenic, Coliform , and E.coli , by analytical methods. The obtained values of each parameter were compared with the standard values set by WHO and National Technical Regulation on Domestic Water Quality of Vietnam. Results: All of the schools employed community water system as a main source for drinking water. The results showed that all tested samples were found to be within the standards for some physicochemical properties, including Color, Taste and Odor, Hardness, Chloride, Total Iron (Fe 2+ và Fe 3+ ), Total Manganese (Mn), Nitrate (NO 3 – ), Sulfate (SO 4 2– ), and Total Arsenic (As). On the other hand, some samples did not meet the allowable limits of the national standard, due to pH (3.9%), Turbidity (0.6%), Nitrite (3.2%), Permanganate (6.5%), and Ammonium (5.8%). Furthermore, the microbial data revealed that the substandard water samples from municipal water systems were contaminated by Coliform (9.7%) and/or E.coli ( 7.8%). Conclusions and recommendations: Contaminants such as bacterial and chemical agents in to drinking water could be occurred during transport, storage and handling before using by the consumer without regular surveillance. A periodic treatment procedure and monitoring system to keep the level of microbial and chemical contamination of drinking water in schools under control should be performed.

Background: Since the beginning of 2014, there have been nearly 6,000 confirmed measles cases in northern Vietnam. Of these, more than 86% had neither been immunized nor was their vaccination status confirmed. Objective: To establish the likelihood that children under five in Vietnam had ‘timely immunization completion’ (2000–2011) and identify factors that account for variations in timely immunization completion. Design: Secondary data from the Multiple Indicator Cluster Survey (MICS), which sampled women aged 15–49 from the 1999 Vietnamese Population and Housing Census frame, were analyzed. Multilevel analysis using Poisson regression was undertaken. Results: Proportions of children under five who had timely immunization completion were low, especially for HBV dose 2 and HBV dose 3, which decreased between 2000 and 2011. Among seven vaccines used in the National Expanded Program of Immunization (EPI) in 2000, 2006, and 2011, measles dose 1 had the highest timely immunization completion at 65.3%, 66.7%, and 73.6%, respectively, and hepatitis B dose 1 had the lowest at 17.5%, 19.3%, and 45.5%, respectively. Timely immunization completion was less common among children whose mothers had relatively less household wealth, were from ethnic minorities, lived in rural areas, and had less education. At the community level, the child's region of residence was the main predictor of timely immunization completion, and the availability of hospital delivery and community prenatal care in the local community were also determinants. Conclusion: The EPI should include ‘timely immunization completion’ as a quality indicator. There should also be greater focus and targeting in rural areas, and among women who have relatively low education, belong to minority groups, and have less household wealth. Further research on this topic using multilevel analysis is needed to better understand how these factors interact.

Background: Dengue fever (DF) is a growing public health problem in Vietnam. The disease burden in Vietnam has been increasing for decades. In Hanoi, in contrast to many other regions, extrinsic drivers such as weather have not been proved to be predictive of disease frequency, which limits the usefulness of such factors in an early warning system. Aims: The purpose of this research was to review the epidemiology of DF transmission and investigate the role of weather factors contributing to occurrence of DF cases. Methods: Monthly data from Hanoi (2002–2010) were used to test the proposed model. Descriptive time-series analysis was conducted. Stepwise multivariate linear regression analysis assuming a negative binomial distribution was established through several models. The predictors used were lags of 1–3 months previous observations of mean rainfall, mean temperature, DF cases, and their interactions. Results: Descriptive analysis showed that DF occurred annually and seasonally with an increasing time trend in Hanoi. The annual low occurred from December to March followed by a gradual increase from April to July with a peak in September, October. The amplitude of the annual peak varied between years. Statistically significant relationships were estimated at lag 1–3 with rainfall, autocorrelation, and their interaction while temperature was estimated as influential at lag 3 only. For these relationships, the final model determined a correlation of 92% between predicted number of dengue cases and the observed dengue disease frequencies. Conclusions: Although the model performance was good, the findings suggest that other forces related to urbanization, density of population, globalization with increasing transport of people and goods, herd immunity, government vector control capacity, and changes in serotypes are also likely influencing the transmission of DF. Additional research taking into account all of these factors besides climatic factors is needed to help developing and developed countries find the right intervention for controlling DF epidemics, and to set up early warning systems with high sensitivity and specificity. Immediate action to control DF outbreak in Hanoi should include an information, communication, and education program that focuses on training Hanoi residents to more efficiently eliminate stagnant puddles and water containers after each rainfall to limit the vector population growth.

Background: Seasonal influenza affects from 5 to 15% of the world's population annually and causes an estimated 250,000–500,000 deaths worldwide. The World Health Organization (WHO) recommends ‘sentinel surveillance’ for influenza-like illness (ILI) because it is simple and calls for standardized methods at a relatively low cost that can be implemented throughout the world. In Vietnam, ILI is a key priority for public health also because of its annually recurring temporal pattern. Two major factors, on which the spread of influenza depends, are the strain of the virus and its rate of mutation, since flu strains constantly mutate as they compete with host immune systems. In the context of global climate change, the role of climatic factors has been discussed, as they may significantly contribute to the cause of large outbreaks of ILI. Objectives: 1) To describe the epidemiology of ILI in Ha Nam province, Vietnam; 2) to seek scientific evidence on the association of ILI occurrence with weather factors in Ha Nam province; and 3) to analyze factors from the Ha Nam ILI surveillance system that contribute to explaining the correlation between the ILI and the weather factors. Design: A data set of 89,270 monthly reported ILI cases from 2008 to 2012 in Ha Nam was used to describe ILI epidemiological characteristics. Spearman correlation analyses between ILI cases and weather factors were conducted to identify which preceding period of months and weather patterns influenced the occurrence of ILI cases. Ten in-depth interviews with health workers in charge of recording and reporting ILI cases at different levels of the ILI surveillance system were conducted to gain a deeper understanding of factors contributing to explaining the relation between the ILI and the weather factors. Results: The results indicated that the ILI occurred annually in all districts of the Ha Nam province in the five studied years. An epidemic occurred in 2009 with the number of cases three times higher than the average threshold. There was a relation between the ILI cases in the previous 1 month with ILI cases of the following month. A seasonal cycle of ILI and correlation between weather elements were not clearly detected. A qualitative study showed that the number of ILI cases reported by the Provincial Preventive Medicine Centre (PPMC) in Ha Nam might not have reflected the accurate number of seasonal ILI occurring in this area. This was due to three gaps in the ILI surveillance system that initially were detected through key in-depth interviews in the Duy Tien and Binh Luc districts. They reported inconsistent ways of recording and reporting ILI cases among communes, lack of ILI survey forms, and irregular and delayed feedback from the PPMC. Conclusions: There were no clear patterns of association between weather factors and ILI cases detected from the five studied years. The number of ILI cases reported by the PPMC in Ha Nam may not reflect adequately the actual number of seasonal ILI occurring in this area due to three weak points in the ILI surveillance system initially detected through the case of the Duy Tien and Binh Luc districts. These three weak points of the system should be examined by a study conducted in the remaining districts in Ha Nam.

Background: Although substantial efforts have been made to curtail smoking in Vietnam, the 2010 Global Adult Tobacco Survey (GATS) revealed that the proportion of male adults currently smoking remains high at 47.4%. Objectives: To determine the level of, and characteristics associated with, knowledge of the health consequences of smoking among Vietnamese adults. Design: GATS 2010 was designed to survey a nationally representative sample of Vietnamese men and women aged 15 and older drawn from 11,142 households using a two-stage sampling design. Descriptive statistics were calculated and multivariate logistic regression was used to examine associations between postulated exposure factors (age, education, access to information, ethnic group etc.) and knowledge on health risks. Results: General knowledge on the health risks of active smoking (AS) and exposure to second hand smoke (SHS) was good (90% and 83%, respectively). However, knowledge on specific diseases related to tobacco smoking (stroke, heart attack, and lung cancer) appeared to be lower (51.5%). Non-smokers had a significantly higher likelihood of demonstrating better knowledge on health risks related to AS (OR 1.6) and SHS (OR 1.7) than smokers. Adults with secondary education, college education or above also had significantly higher levels knowledge of AS/SHS health risks than those with primary education (AS: ORs 1.6, 1.7, and 1.9, respectively, and SHS: ORs 2.4, 3.9, and 5.7 respectively). Increasing age was positively associated with knowledge of the health consequences of SHS, and access to information was significantly associated with knowledge of AS/SHS health risks (ORs 2.3 and 1.9 respectively). Otherwise, non-Kinh ethnic groups had significantly less knowledge on health risks of AS/SHS than Kinh ethnic groups. Conclusions: It may be necessary to target tobacco prevention programs to specific subgroups including current smokers, adults with low education, non-Kinh ethnics in order to increase their knowledge on health risks of smoking. Comprehensive messages and/or images about specific diseases related to AS/SHS should be conveyed using of different channels and modes specific to local cultures to increase knowledge on smoking health consequences for general population.