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Tan Do,1 Do N Hon,1 Tin Aung,2 Nguyen DTN Hien,1 Claude L Cowan Jr3 1Vietnam National Institute of Ophthalmology, Hanoi, Vietnam; 2Singapore National Eye Center, Singapore; 3Georgetown University Medical Center, Washington, DC, USA Background/aims: To compare treatment outcomes with and without silicone oil tamponade in patients undergoing pars plana vitrectomy (PPV) for severe endogenous bacterial endophthalmitis (BEE). Methods: One hundred and eight consecutive patients with severe BEE (defined by the absence of pupil red reflex at presentation and/or dense vitreous opacity on ultrasound and no improvement after 24–36 hours of medical treatment) were randomly assigned to two treatment groups: Group 1, standard PPV with intravitreal antibiotics; and Group 2, PPV with intravitreal antibiotics and silicone tamponade. Overall success was defined as: a visual acuity ≥ count fingers at 1 meter, with an attached retina, and no intraocular oil. Results: Fifty three patients were randomized to Group 1 and 55 patients to Group 2. The mean age of study subjects was 32 years and baseline clinical characteristics were similar in both groups. At the final follow-up visit at 9 months, the overall success rate of Group 2 (67.3%) was significantly better than Group 1 (43.4%; P=0.01). There were also fewer devastating complications (such as inoperable retinal detachment, phthisis bulbi) in Group 2 compared with Group 1 (21.8% versus 43.4%; P=0.01). Conclusion: The outcome at 9 months of patients with BEE treated by vitrectomy with silicone oil was better than those treated by vitrectomy alone. Keywords: bacterial endogenous endophthalmitis, vitrectomy, silicone oil endotamponade, randomized controlled trial

Introduction: This study provides an analysis of head and neck cancer (HNC) cases over a 20-year period in Ho Chi Minh City, Vietnam. It aims to shed light on HNC's characteristics and trends in this highly populated urban region., Methods: The analysis encompasses 8974 HNC cases, emphasising incidence rates, gender distribution, and the prevalence of different subtypes, including oral cavity, nasopharyngeal, oropharyngeal, and laryngeal/pharyngeal cancers. Ho Chi Minh City was chosen due to its extensive cancer reporting systems and its role as a major urban healthcare centre attracting a wide range of patients., Results: The study reveals an increasing incidence of HNC in Ho Chi Minh City, with a notable predominance of male patients (73 %). The breakdown of HNC cases shows oral cavity cancer at 34 %, nasopharyngeal at 33 %, oropharyngeal at 12 %, and laryngeal/pharyngeal at 21 %. Compared to global averages, Vietnamese patients are diagnosed at an earlier age, with a noticeable trend of decreasing mean age of diagnosis over the study period., Conclusion: This comprehensive study provides valuable insights into the HNC landscape in Ho Chi Minh City, revealing a slightly lower overall incidence but an earlier age of diagnosis compared to global trends. These findings suggest the need for region-specific public health initiatives and further research to clarify the epidemiological features of HNC in Vietnam., Competing Interests: Declaration of Competing Interest No interest to declare, (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

In this paper, the magneto-optical transport (MOT) properties of III-nitride Pöschl-Teller quantum well (QW) semiconductors, including AlN, GaN, and InN, resulting from the acoustic phonon interaction are thoroughly investigated and compared by applying the technique of operator projection. In particular, a comparison is made between the Pöschl-Teller QW results and the square QW ones. The findings demonstrate that the MOT properties of III-nitride QW semiconductors resulting from acoustic phonon scattering are strongly influenced by the quantum system (QS) temperature, applied magnetic field, and QW width. When the applied magnetic field and QS temperature increase, the absorbing FWHM in AlN, GaN, and InN increases; on the other hand, it diminishes when the QW's width increases. The absorbing FWHM in GaN is smaller and varies slower compared with AlN; inversely, it is larger and varies faster compared with InN. In other words, the absorbing FWHM in AlN is the largest and the smallest in InN. Compared to the square QW in AlN, GaN, and InN, the absorbing FWHMs in the Pöschl-Teller QW vary more quickly and have greater values. The absorbing FWHMs resulting from the acoustic phonon interaction in III-nitrides are strongly dependent on the nanostructure's geometric shape and parameters. Our findings provide useful information for the development of electronic devices., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

In this work, we report a detailed comparison of electron-acoustic-phonon (EAP) interaction strength in symmetric (parabolic) and asymmetric (semi-parabolic) quantum-wells (QWs) for both GaAs and GaN materials. The operator projection method will be utilized to calculate the acoustic-phonon-assisted cyclotron resonance (CR) absorption power. The EAP interaction strength is determined by measuring the full width at half maximum (FWHM) of the acoustic-phonon-assisted CR absorption peak based on the profile of the curve describing the dependence of the acoustic-phonon-assisted CR absorption power on the photon energy. The studied result reveals that the EAP interaction strengths in the symmetric and asymmetric QWs are functions of the electron temperature (ET), external magnetic field (EMF), and confined potential frequency (CPF). Namely, the larger the ET, the EMF, and the CPF, the stronger the EAP interaction strengths in the symmetric and asymmetric QWs are for both GaN and GaAs materials. More importantly, the obtained result demonstrates that under the influence of the structural (CPF) and external (ET and EMF) parameters, the EAP interaction strength in the symmetric QW is always much stronger than that in the asymmetric QW for both GaN and GaAs materials. Simultaneously, the EAP interaction strength in the GaN material is much stronger than that in the GaAs material for both the symmetric and asymmetric QWs., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Rotavirus (RV), norovirus (NoV), sapovirus (SaV), and human astrovirus (HAstV) are the most common viral causes of gastroenteritis in children worldwide. From 2016 to 2021, we conducted a cross-sectional descriptive study to determine the prevalence of these viruses in hospitalized children under five years old in Nam Dinh and Thua Thien Hue provinces in Vietnam during the pilot introduction of the RV vaccine, Rotavin-M1 (POLYVAC, Hanoi, Vietnam). We randomly selected 2317/6718 (34%) acute diarrheal samples from children <5 years of age enrolled at seven sentinel hospitals from December 2016 to May 2021; this period included one year surveillance pre-vaccination from December 2016 to November 2017. An ELISA kit (Premier Rotaclone ® , Meridian Bioscience, Inc., Cincinnati, OH, USA) was used to detect RV, and two multiplex real-time RT-PCR assays were used for the detection of NoV, SaV and HAstV. The prevalence of RV (single infection) was reduced from 41.6% to 22.7% ( p < 0.0001) between pre- and post-vaccination periods, while the single NoV infection prevalence more than doubled from 8.8% to 21.8% ( p < 0.0001). The SaV and HAstV prevalences slightly increased from 1.9% to 3.4% ( p = 0.03) and 2.1% to 3.3% ( p = 0.09), respectively, during the same period. Viral co-infections decreased from 7.2% to 6.0% ( p = 0.24), mainly due to a reduction in RV infection. Among the genotypeable samples, NoV GII.4, SaV GI.1, and HAstV-1 were the dominant types, representing 57.3%, 32.1%, and 55.0% among the individual viral groups, respectively. As the prevalence of RV decreases following the national RV vaccine introduction in Vietnam, other viral pathogens account for a larger proportion of the remaining diarrhea burden and require continuing close monitoring.

Two-dimensional (2D) structures can stably exist in different allotropes. In this manuscript, we propose a new series of Janus structures based on the β-phase of germanium monochalcogenides, namely, β-Ge 2 XY (X/Y = S, Se, and Te) monolayers. Our calculations indicate that Janus β-Ge 2 XY monolayers have a stable crystal structure and possess anisotropic mechanical properties. At the ground state, β-Ge 2 XY monolayers are semiconductors with a large bandgap and their electronic properties depend strongly on a biaxial strain. Strains not only change the bandgap but can also lead to a change in the bandgap characteristic, namely transitions from indirect to direct bandgap. Our findings not only introduce a new structure of germanium chalcogenide compounds but also show that they have superior physical properties suitable for applications in nanoelectronics., Competing Interests: There are no conflicts of interest to declare., (This journal is © The Royal Society of Chemistry.)

Background: Chicken infectious anemia (CIA) caused by the CIA virus (CIAV) is considered one of the most important immunosuppressive diseases affecting chickens and recently poses a great economic burden to the poultry industry worldwide., Aim: This study aims to identify the presence of CIAV in the Mekong Delta (MD), Vietnam, and to determine genotypes of CIAVs that are currently circulating in this area., Methods: Organ samples (spleen, liver, and thymus) of 144 chickens suspected with CIA from 47 poultry farms were collected. A total of 47 pooled samples, each containing 2-4 chickens from each farm, were tested for the presence of CIAV., Results: Twenty out of 47 pooled organ samples (pool of 2-4 chickens per farm) were positive for CIAV using polymerase chain reaction targeting the viral VP1 gene. The VP1 amplicons of eight representative CIAVs were subjected to sequencing and genetic characterization. Phylogenetic analysis based on partial VP1 gene sequence revealed that the CIAVs detected in the MD grouped into different genotypes of II, IIIa, and IIIc together with CIAVs previously detected in the northern Vietnam and other Asian countries. The phylogenetic analysis also confirmed that detected CIAVs genetically differed from vaccine strains. In addition, deduced amino acids of the VP1 identified several critical amino acid substitutions in the VP1 protein that are likely associated with the virulence of CIAV., Conclusion: This is the first report to detect and determine the genetic characterization of the circulating CIAVs in the MD. Therefore, this study provides an important understanding of the evolution of CIAVs and highlights the importance of implementing prompt control measures against CIAVs in the MD and Vietnam., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this article.

Background: Half of diarrhea hospitalizations in children aged <5 years in Vietnam are due to rotavirus. Following introduction of a locally developed and licensed oral rotavirus vaccine, Rotavin-M1, into the routine immunization program in two Vietnamese provinces, Nam Dinh and TT Hue, we describe changes in rotavirus positivity among children hospitalized for diarrhea and calculate vaccine effectiveness against moderate-to-severe rotavirus hospitalizations., Methods: Active rotavirus surveillance among children <5 years began in December 2016 at sentinel hospitals in districts where rotavirus vaccine was introduced in December 2017. To estimate reductions in rotavirus detection, we calculated risk ratios comparing rotavirus positivity pre- and post-vaccine introduction. We used a test-negative case-control design to calculate vaccine effectiveness., Findings: From December 2016 to May 2021, 7228 children <5 years hospitalized for diarrhea were enrolled. Following introduction, Rotavin-M1 coverage was 77% (1066/1377) in Nam Dinh and 42% (203/489) in TT Hue. In Nam Dinh, rotavirus positivity among children <5 years significantly declined by 40.6% (95% CI: 34.8%-45.8%) during the three-year post-vaccine introduction period. In TT Hue, no change in rotavirus positivity was observed. Among children aged 6-23 months, a 2-dose series of Rotavin-M1 was 57% (95% CI: 39%-70%) effective against moderate-to-severe rotavirus hospitalizations., Interpretation: Higher vaccination coverage in Nam Dinh than TT Hue likely contributed to substantial declines in rotavirus positivity observed in Nam Dinh following rotavirus vaccine introduction. Robust vaccine effectiveness was observed through the second year of life. National rotavirus vaccine introduction with high coverage may have substantial impact on reducing rotavirus disease burden in Vietnam., Funding: Bill and Melinda Gates Foundation., Competing Interests: Huong Thuy Nguyen, Thao Phuong Thi Pham, Nguyen Dang Hien are the member of POLYVAC-Vietnam.

The objectives of this study were to describe the epidemiology of African swine fever (ASF) and to identify factors that increased commune-level risk for ASF in Can Tho, a province in the Mekong River Delta of Vietnam. In 2019, a total of 2377 of the 5220 pig farms in Can Tho were ASF positive, an incidence risk of 46 (95% CI 44-47) ASF positive farms for every 100 farms at risk. Throughout the outbreak ASF resulted in either the death or culling of 59,529 pigs out of a total population size of 124,516 (just under half of the total pig population, 48%). After the first detection in Can Tho in May 2019, ASF spread quickly across all districts with an estimated dissemination ratio (EDR) of greater than one up until the end of July 2019. A mixed-effects Poisson regression model was developed to identify risk factors for ASF. One hundred unit increases in the number of pigs per square kilometre was associated with a 1.28 (95% CrI 1.05-1.55) fold increase in commune-level ASF incidence rate. One unit increases in the number of pig farms per square kilometre was associated with a 0.91 (95% CrI 0.84-0.99) decrease in commune-level ASF incidence rate. Mapping spatially contiguous communes with elevated (unaccounted-for) ASF risk provide a means for generating hypotheses for continued disease transmission. We propose that the analyses described in this paper might be run on an ongoing basis during an outbreak and disease control efforts modified in light of the information provided., Competing Interests: Declaration of Competing Interest None., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Due to the breaking of the mirror symmetry, two-dimensional layered Janus materials possess many extraordinary mechanical and electronic properties that cannot exist in symmetric structures. In this paper, we propose and investigate the structural and electronic properties of Janus T'-RuXY (X/Y = S, Se, and Te) monolayers using the first-principles simulations. Our calculated results indicate that the T'-RuXY is found to be dynamically and mechanically stable through the phonon dispersion analysis and examination of elastic properties. The T'-RuXY exhibits high anisotropic elastic characteristics due to its in-plane anisotropic atomic structure. Besides, the vertical asymmetry of T'-RuXY leads to the appearance of a difference in the vacuum level between its two different surfaces. At the ground state, all three structures of the Janus T'-RuXY are semiconductors with indirect bandgaps. The bandgaps of T'-RuXY can be modulated by a biaxial strain. Particularly, the semiconductor-to-metal phase transitions are observed in all studied structures at a large compressive strain. Our calculation results not only provide important structural and electronic features of the Janus T'-RuXY monolayers but also show the prospect of their application in nanoelectromechanical devices., Competing Interests: There are no conflicts of interest to declare., (This journal is © The Royal Society of Chemistry.)

The objective of this study is to report the complete-genome sequence of a field African swine fever (ASF) virus (ASFV), namely ASF/VN/CanTho-OM/2021, which caused a fatal outbreak in domestic pigs in the Mekong Delta. Complete-genome sequencing detected an 18 bp nucleotide deletion in the EP402R gene (encoding for serotype-specific proteins CD2v) of ASF/VN/CanTho-OM/2021, which was determined to belong to genotype 2 and serotype 8. This mutation pattern was confirmed as unique in GenBank; thus, ASF/VN/CanTho-OM/2021 can be considered a novel variant, with a potential change of sero-characteristics within genotype 2. An additional unique mutation of 78 bp nucleotide insertion was also observed in the B475L gene. Additionally, four copies of tandem repeat sequences were found in the intergenic region (IGR) located between I73R and I329L, previously assigned as the IGR III variant. This study is the first to report the complete genome of ASFV in the Mekong Delta, and it highlights the necessity of strengthening molecular surveillance to provide further knowledge on the evolution and incursion of ASFV in the Mekong Delta and Vietnam.

Marek's disease (MD) is a common lymphomatous and neuropathic disease of birds, especially chickens, and has caused significant losses to chicken production as a result of high mortality and morbidity. This study aims to determine the status of MD in backyard flocks in the Mekong Delta of Vietnam and to analyze clinical cases occurring during a year. The study was carried out from August 2018 to July 2019, during which time 16 suspected cases of chicken flocks with MD were observed, 40 chickens were subjected to anatomopathological examination, and PCR was performed for diagnosis of MD and determination of Marek's disease virus (MDV) serotypes. The results showed that all of the examined flocks were confirmed as experiencing MD. Nearly all cases were in an acute form with typical lesions of visceral lymphomas. Besides the presence of Marek's disease virus serotype 1 (MDV-1) from 100.0% of tested chicken flocks (16/16), nononcogenic turkey herpesvirus serotype 3 (MDV-3) was also found from 8 of 16 (50.0%) of examined chicken flocks. Morbidity and mortality at sampling time varied from 1% to 42.11% and 0.6% to 10%, respectively. Chicken flocks with MD vaccination had lower morbidity and mortality. These first findings confirm endemic MD in backyard chicken populations in Vietnam and confirm it continues to be a threat to chickens in backyard flocks and poultry production in general.

Although O is an element of chalcogen group, the study of two-dimensional (2D) O-based Janus dichalcogenides/monochalcogenides, especially their 1T-phase, has not been given sufficient attention. In this work, we systematically investigate the structural, electronic, and optical properties of 1T Janus GeSO monolayer by using the density functional theory. Via the analysis of phonon spectrum and evaluation of elastic constants, the GeSO monolayer is confirmed to be dynamically and mechanically stable. Calculated results for the elastic constants demonstrate that the Janus GeSO monolayer is much mechanically flexible than other 2D materials due to its small Young's modulus. At the ground state, while both GeS 2 and GeO 2 monolayers are indirect semiconductors, the Janus GeSO monolayer is found to be a direct band gap semiconductor. Further, effective masses of both electrons and holes are predicted to be directionally isotropic. The Janus GeSO monolayer has a broad absorption spectrum, which is activated from the visible light region and its absorption intensity is very high in the near-ultraviolet region. The calculated results not only systematically provide the fundamental physical properties of GeSO monolayer, but also stimulate scientists to further studying its importance both theoretically and experimentally., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Background and Aims: ROTAVIN-M1® (licensed, frozen vaccine) and ROTAVIN (second-generation, liquid candidate vaccine) are two rotavirus vaccine formulations developed from a live attenuated G1P8 (KH0118) strain by Center for Research and Production of Vaccines and Biologicals (POLYVAC), Vietnam. This study compared the safety and immunogenicity of these two formulations., Methods: A Phase 3, randomized, partially double-blinded, active-controlled study was conducted in healthy infants aged 60-91 days in Vietnam. Infants received two doses of ROTAVIN or ROTAVIN-M1 in a ratio of 2:1 with an interval of 8 weeks. Solicited reactions were collected for 7 days after each vaccination. Blood samples were collected pre-vaccination and 4 weeks after the second vaccination in a subset of infants. Non-inferiority criteria required that the lower bound of 95% confidence intervals (CIs) of the post-vaccination anti-rotavirus IgA GMC (Geometric Mean Concentration) ratio of ROTAVIN/ROTAVIN-M1 should be >0.5. A co-primary objective was to compare the safety of the two vaccines in terms of solicited reactions., Results: A total of 825 infants were enrolled. The post-vaccination GMC was 48.25 (95% CI: 40.59, 57.37) in the ROTAVIN group and 35.04 (95% CI: 27.34, 44.91) in the ROTAVIN-M1 group with an IgA GMC ratio of 1.38 (95% CI: 1.02, 1.86) thus meeting the pre-set criteria for non-inferiority. A total of 605 solicited reactions were reported in 297 (36.0%) participants with 35.4% in the ROTAVIN group and 37.2% in the ROTAVIN-M1 group. There were no cases of intussusception or death reported in the study., Conclusions: Based on the data generated, it can be concluded that ROTAVIN is immunologically non-inferior and has similar safety profile to ROTAVIN-M1 when administered to infants in a two-dose schedule. Therefore, it can be considered as a more suitable option for programmatic use to prevent rotavirus diarrhoea in Vietnam and the Mekong region., Trial Registration Number: ClinicalTrials.gov identifier: NCT03703336, October 11, 2018., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr Nguyen Dang Hien and Dr Nguyen Thuy Huong are employed by Center for Research and Production of Vaccines and Biologicals (POLYVAC), Vietnam, which manufactures the study vaccines Rotavin and Rotavin-M1., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Measles-associated deaths have been reported in infants <9 months during outbreaks. A cohort study was conducted on 210 infants aged 6-8 months to evaluate the immunogenicity and safety of the AIK-C measles vaccine containing 10 4.21 plaque-forming units (PFU)/0.5 mL produced in Vietnam. Paired serum samples were obtained from 196 subjects. Seropositivity was defined as ≥120 mIU/mL. The seroresponse rate was 173/196 (88.27%, 95% confidence interval (CI): 83.77-92.77%) with geometric mean titer (GMT) of 511 mIU/mL (95% CI: 688-880 mIU/mL), and no significant differences were observed by different age groups. Among 196 paired sera, they were categorized into four groups: 122 subjects <14 IU/mL, 28 subjects 14-<60 mIU/mL, 30 subjects 60-<120 mIU/mL, and 16 subjects ≥ 120 mIU/mL. The seroresponse rate was 112/122 (91.8%, 95% CI: 86.94-96.67%) with GMT (597 mIU/mL, 95% CI: 749-1002 mIU/mL) in the <14 mIU/L group. In the 14-<60 mIU/mL group, the seroresponse rate was 18/28 (64.29%) with 184 mIU/L of GMT and was significantly lower (p < 0.01) than that in the <14 mIU/mL group. In the 16 seropositive group, all subjects showed seroconversion (4-fold higher than before) with a higher GMT of 1078 mIU/mL. Local pain and itching at the injection site were observed in 8 subjects (3.8%) within 7 days of the vaccination. Regarding systemic adverse reactions, febrile illness ≥37.5 °C was observed in 14 subjects (6.7%). These results indicate that the AIK-C measles vaccine is effective and safe for infants aged 6-8 months and will contribute to reducing the number of measles-associated deaths in future outbreaks., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

We theoretically address the electronic structure of mono- and simple bi-layer armchair graphene nanoribbons (AGNRs) when they are infected by extrinsic charged dilute impurity. This is done with the aid of the modified tight-binding method considering the edge effects and the Green's function approach. Also, the interplay of host and guest electrons are studied within the full self-consistent Born approximation. Given that the main basic electronic features can be captured from the electronic density of states (DOS), we focus on the perturbed DOS of lattices corresponding to the different widths. The modified model says that there is no metallic phase due to the edge states. We found that the impurity effects lead to the emergence of midgap states in DOS of both systems so that a semiconductor-to-semimetal phase transition occurs at strong enough impurity concentrations and/or impurity scattering potentials. The intensity of semiconductor-to-semimetal phase transition in monolayer (bilayer) ultra-narrow (realistic) ribbons is sharper than bilayers (monolayers). In both lattices, electron-hole symmetry breaks down as a result of induced-impurity states. The findings of this research would provide a base for future experimental studies and improve the applications of AGNRs in logic semiconductor devices in industry.

The development of live-attenuated vaccines against Dengue virus (DENV) has been problematic. Dengvaxia, licensed in several countries where DENV is endemic, has shown low efficacy profiles and there are safety concerns prohibiting its administration to children younger than 9 years old, and the live-attenuated tetravalent vaccine (LATV) developed by NIAID has proven too reactogenic during clinical trialing. In this work we examined whether the combination of TV005, a LATV-derived formulation, with Tetra DIIIC, a subunit vaccine candidate based on fusion proteins derived from structural proteins from all four DENV serotypes, can overcome the respective limitations of these two vaccine approaches. Rhesus macaques were first primed with one or two doses of Tetra DIIIC and then boosted with TV005, following the time course of the appearance of virus-binding and neutralizing antibodies, and evaluating protection by means of a challenge experiment with wild-type viruses. Although the two evaluated prime-boost regimes were equivalent to a single administration of TV005 in terms of the development of virus-binding and neutralizing antibodies as well as the protection against viral challenge, both regimes reduced vaccine viremia to undetectable levels. Thus, the combination of Tetra DIIIC with TV005 offers a potential solution to the reactogenicity problems, which have beset the development of the latter vaccine candidate.

One of the major problems faced for the development of a vaccine against Dengue virus is the lack of a suitable animal model. Although non-human primates do not show overt signs of disease, these animals develop viremia after the infection and are the best model to evaluate vaccine candidates against this pathogen. However, for that purpose, the screening of all animals is mandatory to discard those with previous natural immunity. The most common technique used in the screening is the plaque reduction neutralization test (PRNT). However, most recent studies points to the cell-mediated immunity (CMI) as an important player in the process of controlling Dengue virus (DENV) infections. Here we presented the results from the screening of 55 rhesus monkeys housed in an animal breeding facility at Quang Ninh province, Vietnam. We evaluated the neutralizing antibody response by PRNT and determined the levels of interferon γ (IFNγ)-secretion after the viral stimulation of monkey-peripheral blood mononuclear cells, by enzyme-linked immunosorbent assay (ELISA). We found no correspondence between PRNT and IFNγ-ELISA. In fact, 19 animals were positive only by IFNγ-ELISA. Moreover, to study the protective capacity of the CMI detected, three animals with positive response by IFNγ-ELISA and negative by PRNT were inoculated with an infective preparation of DENV-3 and, as a result, no viremia was detected during 10 days after the challenge. This fact points to the importance of screening non-human primates through a CMI assay together with PRNT. This procedure should discard those false-negative cases which would be protected after the viral challenge in the immunization schedule., Competing Interests: The authors declare no conflict of interest.

We examined clinical and nutritional predictors of weight change over two consecutive 6-month intervals among 99 HIV-positive male injection drug users initiating antiretroviral therapy (ART) in Hanoi, Vietnam. The average weight gain was 3.1 ± 4.8 kg in the first six months after ART and 0.8 ± 3.0 kg in the following six months. Predictors of weight change differed by interval. In the first interval, CD4 < 200 cells/μL, excellent/very good adherence to ART, bothersome nausea, and liquid supplement use were all associated with positive weight changes. Moderate to heavy alcohol use and tobacco smoking were associated with negative weight changes. In the second interval, having a CD4 count <200 cells/μL at the beginning of the interval and tobacco smoking were the only significant predictors and both were associated with negative weight changes. We identified several potential areas for interventions to promote weight gain immediately after starting ART in this population. Studies are needed to determine whether improving weight prior to, or at, ART initiation will result in improved outcomes on ART.

Certain mutations in the connection subdomain and RNase H domain of reverse transcriptase (RT) of subtype B HIV-1 contribute to resistance to nucleoside reverse transcriptase inhibitors (NRTIs). However, the impact of non-B subtype polymorphisms in this region on drug resistance remains unclear. In this study, we determined the frequencies of drug resistance mutations of the entire RT in patients with treatment failure from a cohort of Circulating recombinant form (CRF) 01&#95;AE HIV-1-infected patients in Hanoi, Viet Nam. Subsequently, we assessed the impact of CRF01&#95;AE polymorphisms G335D and A371V with or without thymidine analogue mutations (TAMs) on susceptibility to NRTI with recombinant viruses. In 49 patients with treatment failure, resistance mutations to NRTIs in the N-terminal half of RT were observed in 89.8%. In the C-terminal half, G335D (100%), N348I (36.8%), A371V (100%), A376S (5.3%) and A400T (97.4%) were detected, although G335D, A371V and A400T were considered polymorphisms of CRF01&#95;AE. Drug susceptibility showed G335D, A371V, or both did not confer resistance by themselves but conferred significant resistance to NRTIs with TAMs, especially in mutants containing G335D, A371V and TAM type 2. Our results suggest the important role of CRF01&#95;AE polymorphisms in the C-terminal half of RT in drug resistance., (Copyright © 2010 Institut Pasteur. Published by Elsevier SAS. All rights reserved.)

Background: The first cases of avian influenza A (H5N1) in humans in Vietnam were detected in early 2004, and Vietnam has reported the second highest number of cases globally., Methods: We obtained retrospective clinical data through review of medical records for laboratory confirmed cases of influenza A (H5N1) infection diagnosed in Vietnam from January 2004 through December 2006. Standard data was abstracted regarding clinical and laboratory features, treatment, and outcome., Results: Data were obtained for 67 (72%) of 93 cases diagnosed in Vietnam over the study period. Patients presented to the hospital after a median duration of illness of 6 days with fever (75%), cough (89%), and dyspnea (81%). Diarrhea and mucosal bleeding at presentation were more common in fatal than in nonfatal cases. Common findings were bilateral pulmonary infiltrates on chest radiograph (72%), lymphopenia (73%), and increased serum transaminase levels (aspartate aminotransferase, 69%; alanine aminotransferase, 61%). Twenty-six patients died (case fatality rate, 39%; 95% confidence interval, 27%-51%) and the most reliable predictor of a fatal outcome was the presence of both neutropenia and raised alanine aminotransferase level at admission, which correctly predicted 91% of deaths and 82% of survivals. The risk of death was higher among persons aged < or =16 years, compared with older persons (P < .001), and the risk of death was higher among patients who did not receive oseltamivir treatment (P = .048). The benefit of oseltamivir treatment remained after controlling for potential confounding by 1 measure of severity (odds ratio, 0.15; 95% confidence interval, 0.026-0.893; P = .034)., Conclusion: In cases of infection with Influenza A (H5N1), the presence of both neutropenia and raised serum transaminase levels predicts a poor outcome. Oseltamivir treatment shows benefit, but treatment with corticosteroids is associated with an increased risk of death.

We performed a retrospective case-series study of patients with influenza A (H5N1) admitted to the National Institute of Infectious and Tropical Diseases in Hanoi, Vietnam, from January 2004 through July 2005 with symptoms of acute respiratory tract infection, a history of high-risk exposure or chest radiographic findings such as pneumonia, and positive findings for A/H5 viral RNA by reverse transcription-PCR. We investigated data from 29 patients (mean age 35.1 years) of whom 7 (24.1%) had died. Mortality rates were 20% (5/25) and 50% (2/4) among patients treated with or without oseltamivir (p = 0.24), respectively, and were 33.3% (5/15) and 14.2% (2/14) among patients treated with and without methylprednisolone (p = 0.39), respectively. After exact logistic regression analysis was adjusted for variation in severity, no significant effectiveness for survival was observed among patients treated with oseltamivir or methylprednisolone.

In the absence of a parenteral drug, oral oseltamivir is currently recommended by the WHO for treating H5N1 influenza. Whether oseltamivir absorption is adequate in severe influenza is unknown. We measured the steady state, plasma concentrations of nasogastrically administered oseltamivir 150 mg bid and its active metabolite, oseltamivir carboxylate (OC), in three, mechanically ventilated patients with severe H5N1 (male, 30 yrs; pregnant female, 22 yrs) and severe H3N2 (female, 76 yrs). Treatments were started 6, 7 and 8 days after illness onset, respectively. Both females were sampled while on continuous venovenous haemofiltration. Admission and follow up specimens (trachea, nose, throat, rectum, blood) were tested for RNA viral load by reverse transcriptase PCR. In vitro virus susceptibility to OC was measured by a neuraminidase inhibition assay. Admission creatinine clearances were 66 (male, H5N1), 82 (female, H5N1) and 6 (H3N2) ml/min. Corresponding AUC(0-12) values (5932, 10,951 and 34,670 ng.h/ml) and trough OC concentrations (376, 575 and 2730 ng/ml) were higher than previously reported in healthy volunteers; the latter exceeded 545 to 3956 fold the H5N1 IC(50) (0.69 ng/ml) isolated from the H5N1 infected female. Two patients with follow-up respiratory specimens cleared their viruses after 5 (H5N1 male) and 5 (H3N2 female) days of oseltamivir. Both female patients died of respiratory failure; the male survived. 150 mg bid of oseltamivir was well absorbed and converted extensively to OC. Virus was cleared in two patients but two patients died, suggesting viral efficacy but poor clinical efficacy.

Few prospective studies of child growth and its determinants take place in programmatic contexts. We evaluated the effect of Save the Children's (SC) community empowerment and nutrition program (CENP) on child growth, care, morbidity, empowerment, and behavioral determinants. This paper describes the research methods of this community-based study. We used a longitudinal, prospective, randomized design. We selected 12 impoverished communes with documented child malnutrition, three comparison, and three intervention communes in each of two districts in Phu Tho Province, west of Hanoi. SC taught district trainers in November 1999 to train local health volunteers to implement the 10-month CENP, including situation analysis, positive deviance (PD) inquiry, growth monitoring and promotion, nutrition education and rehabilitation program (NERP), deworming, and monitoring. PD inquiries aim to discover successful care practices in poor households that likely promote well-nourished children. NERPs are neighborhood-based, facilitated group learning sessions where caregivers of malnourished children learn and practice PD and other healthy behaviors. We dewormed all intervention and comparison children. We randomly selected 240 children 5 to 25 months of age (120 intervention and 120 comparison). We gathered information on nutritional status, diet, illness, care, behavioral determinants, empowerment, and program quality, monthly for six months with a re-survey at 12 months. We collected most information through maternal interview but also observed hygiene and program quality, and videotaped feedings at home. Some implementation and research limitations will attenuate CENP impact and measurement of its effectiveness.