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To assess the role of in-flight transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we investigated a cluster of cases among passengers on a 10-hour commercial flight. Affected persons were passengers, crew, and their close contacts. We traced 217 passengers and crew to their final destinations and interviewed, tested, and quarantined them. Among the 16 persons in whom SARS-CoV-2 infection was detected, 12 (75%) were passengers seated in business class along with the only symptomatic person (attack rate 62%). Seating proximity was strongly associated with increased infection risk (risk ratio 7.3, 95% CI 1.2-46.2). We found no strong evidence supporting alternative transmission scenarios. In-flight transmission that probably originated from 1 symptomatic passenger caused a large cluster of cases during a long flight. Guidelines for preventing SARS-CoV-2 infection among air passengers should consider individual passengers' risk for infection, the number of passengers traveling, and flight duration.

Surgical antibiotic prophylaxis (SAP) is considered an important interventional tool for antimicrobial resistance. Guideline compliance was poor across different countries and this results in an inappropriate and overuse of antibiotics. The study was cross-sectional, combining qualitative and quantitative. The Research used the MOH’s Antibiotic Preventive Medicine Guidelines as the standard to verify surgical preventive treatment compliance from patient medical records. Research performed on 373 medical records with surgical indications. The study was conducted from January to June 2019. Data were entered using Epidata software and processed by SPSS software version 19.0. Analysis: calculating OR for related factors. The compliance rate of using prophylactic antibiotics was 83.1%. There is a relationship between the type of incision, the length of time surgery, and compliance with surgical prophylactic use of antibiotics ( P

Introduction Community engagement (CE) is an effective public health strategy for improving health outcomes. There is limited published knowledge about effective approaches to CE in ensuring effective responses to COVID-19 throughout lockdowns, travel restrictions and social distancing. In this paper, we contribute to bridging this gap by highlighting experience of CE in Vietnam, specifically focusing on migrant workers in Vietnam. Methods A cross-sectional qualitative study design was used with qualitative data collection was carried out during August-October 2020. Two districts were purposefully selected from two large industrial zones. Data was collected using in-depth interviews (n = 36) with individuals and households, migrants and owners of dormitories, industrial zone factory representatives, community representatives and health authorities. Data was analyzed using thematic analysis approach. The study received ethics approval from the Hanoi University Institutional Review Board. Results The government’s response to COVID-19 was spearheaded by the multi-sectoral National Steering Committee for the Prevention and Control of COVID-19, chaired by the Vice Prime Minister and comprised different members from 23 ministries. This structure was replicated throughout the province and local levels and all public and private organizations. Different activities were carried out by local communities, following four key principles of infection control: early detection, isolation, quarantine and hospitalization. We found three key determinants of engagement of migrant workers with COVID-19 prevention and control: availability of resources, appropriate capacity strengthening, transparent and continuous communication and a sense of trust in government legitimacy. Discussion and conclusion Our results support the current literature on CE in infection control which highlights the importance of context and suggests that future CE should consider five key components: multi-sectoral collaboration with a whole-of-community approach to strengthen governance structures with context-specific partnerships; mobilization of resources and decentralization of decision making to encourage self-reliance and building of local capacity; capacity building through training and supervision to local institutions; transparent and clear communication of health risks and sensitization of local communities to improve compliance and foster trust in the government measures; and understanding the urgent needs ensuring of social security and engaging all parts of the community, specifically the vulnerable groups.

The COVID-19 pandemic is spreading fast globally. Vietnam’s strict containment measures have significantly reduced the spread of the epidemic in the country. This was achieved through the use of emergency control measures in the epidemic areas and integration of resources from multiple sectors including health, mass media, transportation, education, public affairs, and defense. This paper reviews and shares specific measures for successful prevention and control of COVID-19 in Vietnam, which could provide useful learning for other countries.

© 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: The Lancet Commission on Global Surgery established the Three Delays framework, categorising delays in accessing timely surgical care into delays in seeking care (First Delay), reaching care (Second Delay), and receiving care (Third Delay). Globally, knowledge gaps regarding delays for fracture care, and the lack of large prospective studies informed the rationale for our international observational study. We investigated delays in hospital admission as a surrogate for accessing timely fracture care and explored factors associated with delayed hospital admission. Methods: In this prospective observational substudy of the ongoing International Orthopaedic Multicenter Study in Fracture Care (INORMUS), we enrolled patients with fracture across 49 hospitals in 18 low-income and middle-income countries, categorised into the regions of China, Africa, India, south and east Asia, and Latin America. Eligible patients were aged 18 years or older and had been admitted to a hospital within 3 months of sustaining an orthopaedic trauma. We collected demographic injury data and time to hospital admission. Our primary outcome was the number of patients with open and closed fractures who were delayed in their admission to a treating hospital. Delays for patients with open fractures were defined as being more than 2 h from the time of injury (in accordance with the Lancet Commission on Global Surgery) and for those with closed fractures as being a delay of more than 24 h. Secondary outcomes were reasons for delay for all patients with either open or closed fractures who were delayed for more than 24 h. We did logistic regression analyses to identify risk factors of delays of more than 2 h in patients with open fractures and delays of more than 24 h in patients with closed fractures. Logistic regressions were adjusted for region, age, employment, urban living, health insurance, interfacility referral, method of transportation, number of fractures, mechanism of injury, and fracture location. We further calculated adjusted relative risk (RR) from adjusted odds ratios, adjusted for the same variables. This study was registered with ClinicalTrials.gov, NCT02150980, and is ongoing. Findings: Between April 3, 2014, and May 10, 2019, we enrolled 31 255 patients with fractures, with a median age of 45 years (IQR 31–62), of whom 19 937 (63·8%) were men, and 14 524 (46·5%) had lower limb fractures, making them the most common fractures. Of 5256 patients with open fractures, 3778 (71·9%) were not admitted to hospital within 2 h. Of 25 999 patients with closed fractures, 7141 (27·5%) were delayed by more than 24 h. Of all regions, Latin America had the greatest proportions of patients with delays (173 [88·7%] of 195 patients with open fractures; 426 [44·7%] of 952 with closed fractures). Among patients delayed by more than 24 h, the most common reason for delays were interfacility referrals (3755 [47·7%] of 7875) and Third Delays (cumulatively interfacility referral and delay in emergency department: 3974 [50·5%]), while Second Delays (delays in reaching care) were the least common (423 [5·4%]). Compared with other methods of transportation (eg, walking, rickshaw), ambulances led to delay in transporting patients with open fractures to a treating hospital (adjusted RR 0·66, 99% CI 0·46–0·93). Compared with patients with closed lower limb fractures, patients with closed spine (adjusted RR 2·47, 99% CI 2·17–2·81) and pelvic (1·35, 1·10–1·66) fractures were most likely to have delays of more than 24 h before admission to hospital. Interpretation: In low-income and middle-income countries, timely hospital admission remains largely inaccessible, especially among patients with open fractures. Reducing hospital-based delays in receiving care, and, in particular, improving interfacility referral systems are the most substantial tools for reducing delays in admissions to hospital. Funding: National Health and Medical Research Council of Australia, Canadian Institutes of Health Research, McMaster Surgical Associates, and Hamilton Health Sciences.

A hospital-based, case–control study was conducted to investigate the association between lifestyle patterns and risk of colorectal cancer (CRC) in the north of Vietnam. Demographic factors employed for the models were age, sex, marital status, occupation, education, income, smoking status, alcohol consumption, vegetable consumption, tea, coffee consumption, and physical activity (PA). Individuals of both groups (n = 154 for the control group and n = 136 for the CRC group) were interviewed using a questionnaire by trained interviewers. The findings showed that moderate PA was inversely associated with CRC risk: odds ratio (OR) = 0.19, 95% confidence interval (CI) = 0.10 to 0.36 with P < .01. The total PA showed that the highest tertile (>2.7 MET-h/d) was associated with the reduced risk of CRC compared with the lowest tertile one after controlling for confounding factors: adjusted OR = 0.25, 95% CI = 0.09 to 0.74, P < .01. Sedentary time was associated with an increased level of CRC risk by 57% as compared between the highest tertile and the lowest one after controlling for confounding factors. Daily consumption of vegetables and 1 to 3 cups of tea per day or more were also associated with decreased risk of CRC. Despite promising findings, a limitation of this research is that it did not establish a temporal relationship between risk factors and CRC due to its retrospective design. However, this is the first analytic study highlighting the role of the active lifestyle pattern associated with reduced CRC risk in Vietnamese adults.

Objective: To describe the recovery time and related factors among COVID-19 patients in Vietnam. Methods: We used the secondary data obtained from the official database of the Ministry of Health of Vietnam and other public data sources that were available by April 9th, 2020. Cox proportional hazards model was carried out to identify factors related to recovery time among COVID-19 patients. Results: By April 9th, 2020, the cumulative number of COVID-19 cases detected in Vietnam was 255, of which 129 (50.6%) patients had fully recovered. The median recovery time of patients was 17 (95% CI=16-19) days. Older patients had a lower likelihood of recovery (HR=0.98, 95% CI=0.97-0.99, P

Background Health insurance is an important social protection mechanism to insure vulnerable populations against health shocks caused by injury. This study aims to examine disparities in the availability of health insurance by socioeconomic status, and the association between health insurance and long-term injury-related disability in Vietnam. Methods We conducted a prospective cohort study of moderate to severely injury patients recruited from a public hospital in Ninh Binh, Vietnam. We administered a baseline and four follow-up surveys (at 1, 2, 4, 12 months after discharge) to participants. The surveys sought to understand injury characteristics, economic status, costs incurred for treatment, availability of health insurance or other form of social protection and self-assessed disability. Propensity score matching methods with mixed-effects models were used to examine the association between insurance status and average disability score over time. Results A total of 1094 patients were enrolled in the study. 611 (44%) had health insurance and 483 (56%) did not. Patients that belong to households in the second, middle, and fourth quintiles of income distribution were more likely to be uninsured when compared with the highest income quintile. Insured patients had significantly higher WHODAS global average score, 1.86 (SD: 4.8), on a scale of 0–48 (0 for no functional limitation and 48 for extreme limitation) than the uninsured patients (0.49, SD: 2.1) (p Conclusions Health insurance may be associated with healthcare access prior to injury, and may influence the medical care and rehabilitation services throughout the functional recovery. Households in the second and middle-income quintiles have the highest uninsured proportions, suggesting that public policy should be enacted to increase financial protection and avoid catastrophic and improvising out-of-pocket expenditures for these households.

Objective Viet Nam is experiencing a shift in its burden of disease profile with injuries becoming more prominent. A history of high alcohol involvement in road traffic crashes despite stringent laws led to increased enforcement by police, enhanced public education messaging and targeted social marketing campaigns in Ha Nam and Ninh Binh provinces in Viet Nam. This study aims to illustrate the changes in prevalence (November 2010 to December 2011) and knowledge, attitudes and practices (KAP) around alcohol use and drink-driving for the year 2011. Methods Breath Alcohol Concentration (BrAC) was collected through police enforcement checkpoints in the two provinces. The proportion of drivers with BrAC above the legal limit was plotted over time for both provinces. The trend in prevalence of drink-driving over time was further assessed using Poisson regression models. Prevailing KAPs were determined through surveying randomly selected road users over the age of 17 years at gas stations at quarterly intervals. Cross tabulations of key variables as well Chi-Square statistic were used to assess associations. Results A total of 8,404 drivers were tested for BrAC levels of which less than 0.25% were female. Of 1,639 drivers displaying BrAC levels in excess of the legal limit, 87.3% were car drivers, 7.9% motorcyclists and 86% were between the ages of 25 and 44 years. KAP surveys captured 1,661 drivers over the study period. The prevalence of self-reported drink-driving increased 6 percentage points among respondents aged 27–36. Between 44% (January 2011) and 49% (December 2011) of respondents indicated awareness of a drinking and driving Blood Alcohol Concentration (BAC) or BrAC limit and only 25% of all study participants recalled being penalized for a traffic violation – none of which were for drink-driving. Conclusion While there has been some reduction in drink-driving prevalence, inadequate or incorrect knowledge on drink-driving legislation appears to be an impediment to greater gains. Increased attention needs to be paid to enforcement activities and social marketing campaigns need to be part of a multi-faceted programme that also works on improving existing legislation, takes into consideration gender issues, and enhances visible enforcement of the laws.

Background With 90% of the burden of injuries concentrated in low- and middle-income countries (LMICs), the impact on individuals, families, and society, especially in the case of non-fatal injuries, is exacerbated by the absence of insurance or social support mechanisms. There is a dearth of information in the literature on the occurrence of non-fatal injuries, and their long-term consequences. This study aims to understand the health (disability), social and economic impact of injuries in LMICs. Methods This is a prospective cohort study of 4200 moderate to severely injured patients at seven government hospitals in four LMICs (Cambodia, Kenya, Malaysia, and Vietnam). We administer a baseline and four follow-up surveys at home (at 1, 2, 4, and 12 months after discharge) to participants about their injury, functioning and disability, medical costs, employment, household composition and roles, as well as support systems (social & economic). Results The on-going study has enrolled 2293 individuals at the seven hospitals (Cambodia: 595, Kenya: 320, Malaysia: 284, and Vietnam: 1094). Participants are 72–84% male, with an average age of 30–42 years. The top cause of injury across all countries is road traffic injury (47–72%). The second leading cause is falls (17–20%), except for Kenya, where assaults rank second (20%) and falls rank third (16%). Changes in levels of disability, health care costs, productivity, household economic status, and roles of family members, as well as the respective influencing factors will be examined using marginal models with Generalised Estimating Equations (GEE) approach. Conclusions Injury predominantly affects young males at their prime, having a significant impact not only on themselves, but their family as well as the society. This study will lead to a better understanding of the far reaching health, social, and economic impact of injuries. Data collected could be used to guide policy and programs in each of the implementing countries.

Background Health insurance is an important social protection mechanism to insure vulnerable populations against health shocks caused by injury. This study aims to examine the association between health insurance and long-term injury-related disability in Vietnam. Methods We are conducting a prospective cohort study of 1200 moderate to severe injury patients recruited from a public hospital in Ninh Binh, Vietnam. We administer a baseline and four follow-up surveys (at 1, 2, 4, 12 months after discharge) to participants about health insurance, socio-demographic and injury characteristics, and self-assessed disability (using WHO disability assessment schedule 2.0 (WHODAS). The outcome measure is WHODAS score. Results We have recruited 1094 injury patients at baseline; 611 (44%) had health insurance and 483 (56%) did not. Insured subjects were on average 48 years in age, 64% male, and 40% farmers; while uninsured patients were on average 37 years in age, 77% male, and >50% were farmers. Road traffic and falls were the top two causes of injury for the insured (59% and 27% respectively) and uninsured (71% and 14%, respectively). Insured patients had significantly higher WHODAS global average score, 1.86 (SD: 4.8), on a scale of 0–48 (0 for no functional limitation and 48 for extreme limitation) than the uninsured patients (0.49, SD: 2.1) (p Conclusions Health insurance may be associated with health care access prior to injury, and may influence the medical care and rehabilitation services throughout the functional recovery. This study will provide empirical evidence on how health insurance status is associated with disability related to injury over time in Vietnam.

Background: Alcohol abuse, together with tobacco use, is a major determinant of health and social well-being, and is one of the most important of 26 risk factors comparatively assessed in low and middle income countries, surpassed only by high blood pressure and tobacco. Objectives: The alcohol consumption patterns and the associations between consumption of alcohol and socio-demographic and cultural factors have been investigated in nine rural Health and Demographic Surveillance System (HDSS) located in five Asian countries. Methods: The information was collected from multiple study sites, with sample sizes of sufficient size to measure trends in age and sex groups over time. Adopting the WHO STEPwise approach to Surveillance (WHO STEPS), stratified random sampling (in each 10-year interval) from the HDSS sampling frame was undertaken. Information regarding alcohol consumption and demographic indicators were collected using the WHO STEPwise standard surveillance form. The data from the nine HDSS sites were merged and analysed using STATA software version 10. Results: Alcohol was rarely consumed in five of the HDSS (four in Bangladesh, and one in Indonesia). In the two HDSS in Vietnam (Chililab, Filabavi) and one in Thailand (Kanchanaburi), alcohol consumption was common in men. The mean number of drinks per day during the last seven days, and prevalence of at-risk drinker were found to be highest in Filabavi. The prevalence of female alcohol consumption was much smaller in comparison with men. In Chililab, people who did not go to school or did not complete primary education were more likely to drink in comparison to people who graduated from high school or university. Conclusions: Although uncommon in some countries because of religious and cultural practices, alcohol consumption patterns in some sites were cause for concern. In addition, qualitative studies may be necessary to understand the factors influencing alcohol consumption levels between the two sites in Vietnam and the site in Thailand in order to design appropriate interventions.Keywords: alcohol consumption; risk factor surveillance; INDEPTH; Asia; WHO STEPS(Published: 28 September 2009)Citation: Global Health Action Supplement 1, 2009. DOI: 10.3402/gha.v2i0.2017

Background Injuries a leading cause of death in Vietnam and road traffic crashes account for half of those deaths. Alcohol involvement in road traffic crashes remains high. Aims/Objectives/Purpose This study aims to illustrate the prevalence of drinking and driving, and knowledge, attitudes and practices (KAP) related to it in three provinces in Vietnam. Methods Observational studies to establish the prevalence of drinking and driving were carried out in collaboration with the local police. Roadside KAP surveys were also conducted in all three provinces. Participants were asked questions about awareness of traffic laws, and their own alcohol use and driving practices. Results/Outcomes The prevalence of drinking and driving remains high, ranging from 5% to 52% for the period of November 2010 to July 2011. 4 rounds of KAP interviews conducted in 2011 show that almost all the respondents of the increased risk of a road traffic crash due to alcohol consumption. However, a significant proportion (45%) reported drinking and driving in the past. Most common reasons cited for this practice were: 'feeling conscious', no alternative, and being near home or work. Preferred alternatives to drinking and driving, if available, were: leaving with a non-drinker, resting until 'feeling conscious' and drinking less. Knowledge on drink driving legislation remains low (13-29%). Significance/Contribution to the Field The results of this study highlight the need to increase awareness of legislation against drinking and driving in Vietnam, as well as the need to develop programmes that serve as alternatives to address this problem in Vietnam. This is an abstract of a presentation at Safety 2012, the 11th World Conference on Injury Prevention and Safety Promotion, 1-4 October 2012, Michael Fowler Center, Wellington, New Zealand. Full text does not seem to be available for this abstract.

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. Keywords: food; flooding; natural disaster; health impacts (Published: 23 August 2011) Citation: Global Health Action 2011, 4 : 6356 - DOI: 10.3402/gha.v4i0.6356 This paper is part of the Cluster Health and health systems impact of natural disasters - more papers from this cluster can be found here .

Since 1997, the largest epidemic of highly pathogenic avian influenza (H5N1) ever recorded has caused 172 human and several billion bird deaths. Recently administered questionnaires determined that live poultry exposures have declined by approximately 63% in Hong Kong since 2004 and that, in Vietnam, domestic backyard exposures to poultry are likely more important than retail exposures.