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Objective: We conducted a descriptive analysis of multi-drug resistant tuberculosis (MDR-TB) in Vietnam's two largest cities, Hanoi and Ho Chi Minh city., Methods: All patients with rifampicin resistant tuberculosis were recruited from Hanoi and surrounding provinces between 2020 and 2022. Additional patients were recruited from Ho Chi Minh city over the same time period. Demographic data were recorded from all patients, and samples collected, cultured, whole genome sequenced and analysed for drug resistance mutations. Genomic susceptibility predictions were made on the basis of the World Health Organization's catalogue of mutations in Mycobacterium tuberculosis associated with drug resistance, version 2. Comparisons were made against phenotypic drug susceptibility test results where these were available. Multivariable logistic regression was used to assess risk factors for previous episodes of tuberculosis., Results: 233/ 265 sequenced isolates were of sufficient quality for analysis, 146 (63 %) from Ho Chi Minh City and 87 (37 %) from Hanoi. 198 (85 %) were lineage 2, 20 (9 %) were lineage 4, and 15 (6 %) were lineage 1. 17/211 (8 %) for whom HIV status was known were infected, and 109/214 (51 %) patients had had a previous episode of tuberculosis. The main risk factor for a previous episode was HIV infection (odds ratio 5.1 (95 % confidence interval 1.3-20.0); p = 0.021). Sensitivity for predicting first-line drug resistance from whole genome sequencing data was over 90 %, with the exception of pyrazinamide (85 %). For moxifloxacin and amikacin it was 50 % or less. Among rifampicin-resistant isolates, prevalence of resistance to each non-first-line drug was < 20 %., Conclusions: Drug resistance among most MDR-TB strains in Vietnam's two largest cities is confined largely to first-line drugs. Living with HIV is the main risk factor among patients with MDR-TB for having had a previous episode of tuberculosis., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Estuaries of Southeast Asia are increasingly impacted by land-cover changes and pollution. Here, our research objectives were to (1) determine the origins of nutrient loads along the Can Gio estuary (Vietnam) and (2) identify the processes that affect the nutrient pools during the monsoon. We constructed four 24-h time-series along the salinity gradient measuring nutrient concentrations and stable isotopes values. In the upper estuary, urban effluents from Ho Chi Minh City were the main input of nutrients, leading to dissolved oxygen saturation <20%. In the lower estuary, ammonium and nitrite concentration peaks were explained by mangrove export. No contribution from aquaculture was detected, as it represents <0.01% of the total river discharge. Along the salinity gradient, nutrient inputs were rapidly consumed, potentially by phytoplankton while nitrate dual-stable isotopes indicated that nitrification occurred. Thus, even in a large and productive estuary, urban wastewater can affect nutrient dynamics with potentially important ecological risks., (Copyright © 2020 Elsevier Ltd. All rights reserved.)