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Vietnam is endemic for dengue. We conducted a series of retrospective and prospective studies to characterize the epidemiology of dengue and population mobility patterns in Nha Trang city, Vietnam, with a view to rational design of trials of community-level interventions. A 10-year time series of dengue case notifications showed pronounced interannual variability, as well as spatial heterogeneity in ward-level dengue incidence (median annual coefficient of variation k = 0.47). Of 451 children aged 1–10 years enrolled in a cross-sectional serosurvey, almost one-third had evidence of a past dengue virus (DENV) infection, with older children more likely to have a multitypic response indicative of past exposure to ≥ 1 serotype. All four DENV serotypes were detected in hospitalized patients during 8 months of sampling in 2015. Mobility data collected from 1,000 children and young adults via prospective travel diaries showed that, although all ages spent approximately half of their daytime hours (5:00 am–9:00 pm) at home, younger age groups (≤ 14 years) spent a significantly greater proportion of their time within 500 m of home than older respondents. Together these findings inform the rational design of future trials of dengue preventive interventions in this setting by identifying 1) children < 7 years as an optimal target group for a flavivirus-naive serological cohort, 2) children and young adults as the predominant patient population for a study with a clinical end point of symptomatic dengue, and 3) substantial spatial and temporal variations in DENV transmission, with a consequent requirement for a trial to be large enough and of long enough duration to overcome this heterogeneity.

Background: The wMel strain of Wolbachia has been successfully introduced into Aedes aegypti mosquitoes and subsequently shown to reduce transmission of dengue and other pathogens, under both laboratory and field conditions. Here we describe the entomological outcomes of wMel Wolbachia mosquito releases in two small communities in Nha Trang City in central Vietnam. Methods: The wMel strain of Wolbachia was backcrossed into local Aedes aegypti genotype and mosquito releases were undertaken by community members or by staff. Field monitoring was undertaken to track Wolbachia establishment in local Ae. aegypti mosquito populations. Ecological studies were undertaken to assess relationships between environmental factors and the spatial and temporal variability in Wolbachia infection prevalence in mosquitoes. Results: Releases of wMel Wolbachia Ae. aegypti mosquitoes in two small communities in Nha Trang City resulted in the initial establishment of Wolbachia in the local Ae. aegypti mosquito populations, followed by seasonal fluctuations in Wolbachia prevalence. There was significant small-scale spatial heterogeneity in Wolbachia infection prevalence in the Tri Nguyen Village site, resulting in the loss of wMel Wolbachia infection in mosquitoes in north and center areas, despite Wolbachia prevalence remaining high in mosquitoes in the south area. In the second site, Vinh Luong Ward, Wolbachia has persisted at a high level in mosquitoes throughout this site despite similar seasonal fluctuations in wMel Wolbachia prevalence. Conclusion: Seasonal variation in Wolbachia infection prevalence in mosquitoes was associated with elevated temperature conditions, and was possibly due to imperfect maternal transmission of Wolbachia. Heterogeneity in Wolbachia infection prevalence was found throughout one site, and indicates additional factors may influence Wolbachia establishment.

Background It is uncertain whether vitamin D can reduce respiratory infection. Objective To determine whether vitamin D supplementation reduces influenza and other upper viral respiratory tract infections. Methods A total of 1300 healthy children and adolescents between the ages of 3 and 17 years were randomized to vitamin D (14 000 U weekly) or placebo for 8 months in Vietnam. The primary outcome was reverse transcriptase (RT)-PCR-confirmed influenza infection, and the coprimary outcome was multiplex PCR-confirmed non-influenza respiratory viruses. Participants, caregivers, and those assessing outcomes were blinded to group assignment. Results A total of 650 children and adolescents were randomly assigned to vitamin D and 650 to placebo. The mean baseline serum 25-hydroxyvitamin D levels were 65.7 nmol/L and 65.2 nmol/L in the intervention and placebo groups, respectively, with an increase to 91.8 nmol/L in the vitamin D group and no increase, 64.5 nmol/L, in the placebo group. All 1300 participants randomized contributed to the analysis. We observed RT-PCR-confirmed influenza A or B occurred in 50 children (7.7%) in the vitamin D group and in 43 (6.6%) in the placebo group (hazard ratio [HR]: 1.18, 95% CI: 0.79-1.78). RT-PCR-confirmed non-influenza respiratory virus infection occurred in 146 (22.5%) in the vitamin D group and in 185 (28.5%) in the placebo group (hazard ratio [HR]: 0.76, 95% CI: 0.61-0.94). When considering all respiratory viruses, including influenza, the effect of vitamin D in reducing infection was significant, HR: 0.81, 95% CI: 0.66-0.99. Conclusion Vitamin D supplementation did not reduce the incidence of influenza but moderately reduced non-influenza respiratory viral infection.

Objectives. We implemented an intervention to reduce drug use in an urban commune in northern Vietnam. Methods. We encouraged the intervention commune to accept responsibility for developing their own intervention strategies based on a community mobilization model used in southern, rural China. We selected a comparison commune, which had demographic characteristics and a drug history similar to the intervention commune. The 2-year incidence of new drug users was estimated retrospectively in the intervention and comparison communes between baseline (2003) and follow-up (2009). Results. Increased incidence of new (noninjecting) drug users between 2003 and 2009 in the intervention commune was lower than that in the comparison commune, and these participants expressed more positive attitudes toward local authority and people with drug use and HIV/AIDS. Increased condom use during last intercourse with female sex workers and with female casual partners was observed in the intervention commune. HIV prevalence and positive opioid tests decreased more in the intervention commune. Conclusions. Our results suggested that the community mobilization had a positive influence in the intervention commune.

Candida albicans is a species commonly associated with biofilm formation. The aim of this study was to identify liposomal formulation variables influencing the adhesion of liposomes to C. albicans in biofilm. C. albicans was grown on microtiter plates. Charged liposomes containing a fluorescent phospholipid (fatty acid labeled) were adsorbed onto biofilms of C. albicans in the wells. The adsorption was quantified by fluorescence measurements. Statistical experimental design and multivariate evaluation were used in the studies. The liposomal formulation factors investigated were the type of the main phospholipid (egg-PC, DMPC, and DPPC), the amount of charged component in the liposomes, and the type of the charged lipid (diacyl-TAP, DC-chol, diacyl-PA, diacyl-PG, diacyl-PS, and PI). Full factorial mixed levels designs were created. Saturated positively charged liposomes, with diacyl-TAP as the charged component and a low level of positive charge, was found to be the best choice for interaction with C. albicans. When formulating negatively charged liposomes, liposomes with DPPC as the main lipid adsorbed significantly better than liposomes with egg-PC. The amount of charge and the nature of the charged component were not found to influence the adsorption of the negatively charged liposomes to C. albicans. No synergy was detected between any of the formulation variables studied.

In 2006, national influenza surveillance was implemented in Vietnam. Epidemiologic and demographic data and a throat swab for influenza testing were collected from a subset of outpatients with influenza-like illness (ILI). During January 1, 2006 through December 31, 2007, of 184,521 ILI cases identified at surveillance sites, 11,082 were tested and 2112 (19%) were positive for influenza by reverse transcription polymerase chain reaction. Influenza viruses were detected year-round, and similar peaks in influenza activity were observed in all surveillance regions, coinciding with cooler and rainy periods. Studies are needed to ascertain the disease burden and impact of influenza in Vietnam.

The influence of both pH and complexation by hydroxypropyl-beta-cyclodextrin (HP-beta-CD) on the overall solubility of camptothecin (CPT) was studied, with particular focus on the equilibrium between its lactone- and carboxylate-form. Phase solubility studies at therapeutically relevant pH values (pH 5.5-7.0) and physiologically acceptable HP-beta-CD-concentrations (0-25% (w/v)) were performed, and amounts of solubilized CPT quantified by HPLC. The solubility of CPT increased with both increasing pH and HP-beta-CD-concentration. The apparent complexation constant (KC) decreased with increasing pH (245 M(-1) at pH 5.5; 184 M(-1) at pH 7.0). The lactone-carboxylate equivalence point shifted from a pH value of 6.8-7.0 and 7.1 with 0, 10 and 25% HP-beta-CD, respectively. The lactone-carboxylate-ratios from the equilibrium study were applied to the phase-solubility data, and the lactone- and carboxylate concentrations at 0, 10 and 25% HP-beta-CD calculated. Separate complexation constants (KC) for the carboxylate-CPT and lactone-CPT could thus be derived, and found to be 113 +/- 7 and 260 +/- 18 M(-1), respectively. This allows the prediction of amounts of both lactone- and carboxylate-CPT solubilized at any HP-beta-CD concentration and pH-combination.