Publications by authors named "Le Thi Thanh Xuan"

17 Publications

  • Page 1 of 1

Characterization of a thermophilic cytochrome P450 of the CYP203A subfamily from Binh Chau hot spring in Vietnam.

FEBS Open Bio 2021 Jan 30;11(1):124-132. Epub 2020 Nov 30.

Department of Biochemistry, Saarland University, Saarbrucken, Germany.

Cytochromes P450 (CYPs or P450s) comprise a superfamily of heme-containing monooxygenases that are involved in a variety of biological processes. CYPs have broad utilities in industry, but most exhibit low thermostability, limiting their use on an industrial scale. Highly thermostable enzymes can be obtained from thermophiles in geothermal areas, including hot springs, offshore oil-producing wells and volcanoes. Here, we report the identification of a gene encoding for a thermophilic CYP from the Binh Chau hot spring metagenomic database, which was designated as P450-T2. The deduced amino acid sequence showed the highest identity of 73.15% with CYP203A1 of Rhodopseudomonas palustris, supporting that P450-T2 is a member of the CYP203A subfamily. Recombinant protein expression yielded 541 nm. The optimal temperature and pH of P450-T2 were 50 °C and 8.0, respectively. The half-life of P450-T2 was 50.2 min at 50 °C, and its melting temperature was 56.80 ± 0.08 °C. It was found to accept electrons from all tested redox partners systems, with BmCPR-Fdx2 being the most effective partner. Screening for putative substrates revealed binding of phenolic compounds, such as l-mimosine and emodin, suggesting a potential application of this new thermophilic P450 in the production of the corresponding hydroxylated products.
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http://dx.doi.org/10.1002/2211-5463.13033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7780096PMC
January 2021

Knowledge of Cervical Cancer and Human Papillomavirus Vaccines among Child-Bearing Aged Women in Hanoi, Vietnam.

Asian Pac J Cancer Prev 2020 Jul 1;21(7):1951-1957. Epub 2020 Jul 1.

Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, 10408, Republic of Korea.

Objectives: The study sought to examine knowledge of cervical cancer and human papillomavirus (HPV) vaccines among child-bearing aged women in Hanoi, Vietnam.

Methods: In 2016, 807 women aged 18 to 49 years were recruited from one urban area and one rural area in 2016 and were examined through face-to-face paper-based interviews. Pearson's chi-square test and an independent t-test were utilized to compare awareness of cervical cancer and HPV vaccination among women according residential status.

Results: Overall, 83.8% and 71.3% women had heard about cervical cancer and HPV vaccination, respectively. Mean knowledge scores for cervical cancer and HPV vaccination were 4.60±1.43 out of 7 and 1.53±1.35 out of 5, respectively. Women living in an urban area were more likely to be aware of cervical cancer and to be more knowledgeable of HPV vaccination than women in a rural area.

Conclusions: Despite strong awareness, we found knowledge on cervical cancer and HPV vaccination to be alarmingly insufficient among Vietnamese women.
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http://dx.doi.org/10.31557/APJCP.2020.21.7.1951DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7573401PMC
July 2020

Occupational Stress Among Health Worker in a National Dermatology Hospital in Vietnam, 2018.

Front Psychiatry 2019 24;10:950. Epub 2020 Jan 24.

Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.

A cross-sectional study was conducted among 171 doctors and nurses in a National Dermatology hospital using the Karasek's Job Content Questionnaire which has been validated in Vietnamese (JCQ-V), to assess the prevalence of occupational stress and to explore the association with some associated factors among them. The result showed that doctors and nurses with occupational stress accounted for 6.4%. This proportion was higher among nurse compared to doctor (8.0% vs. 2.2%); among those with diploma literacy compared to bachelor and above (10.6% and 2.3%). This rate was also higher in health workers under 30 years old (12.9%), health workers under 5 years at work (12.1%), working night shift from 3-4 nights (33.3%), temporary employment (12.8%), heavy workload occasionally (12.5%), and working hard occasionally (17.2%) compared to those in the comparison groups with p value <0,05. This prevalence concentrated in some departments such as surgery (11.9%), internal medicine (6.7%), dermatology, and others (1.5%). The study has not found the significant association between the prevalence of occupational stress and heavy workload and skill level. Therefore, it is essential for hospital should conduct screening all doctors, nurses, and medical staffs to identify subjects having occupational stress and give appropriate intervention.
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http://dx.doi.org/10.3389/fpsyt.2019.00950DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6992594PMC
January 2020

Cigarette Smoking among Adolescents aged 13-15 in Viet Nam and Correlates of Current Cigarette Smoking: Results from GYTS 2014 Data.

Asian Pac J Cancer Prev 2016 ;17(S1):17-23

Institute of Preventive Medicine and Public Health, Hanoi Medical University, Viet Nam E-mail :

The aim of this paper is to report the rate of current and ever cigarette smoking and explore correlates of current cigarette smoking among adolescents aged 13-15 in Viet Nam. This analysis was derived from GYTS survey, which comprised of 3,430 adolescents aged 13-15, conducted in 2014 in 13 cities and provinces of Viet Nam. We calculated the weighted rates of current and ever cigarette smoking and reported patterns of smoking behavior. We also performed logistic regression to explore correlates of current cigarette smoking behavior. The weighted rate of ever cigarette smoking was 9.5% (95% confidence interval (CI): 8.5 %-10.5%), in which the weighted rate among males (15.4%; 95% CI: 13.6%-17.0%) was higher than that among females (4.2%; 95% CI: 3.3%-5.1%). The weighted rate of current cigarette smoking was relatively low at 2.5% (95%CI: 2.0%- 3.0%) with higher weighted rate among males (4.9%; 95% CI: 3.8%-5.9%) compared to the corresponding figure among females (0.2%; 95% CI: 0.0 %-0.5%). Current cigarette smoking was significantly higher among males than females, in students aged 15 versus 13 years old, and in students who had several or all close friends smoking and students with daily observation of smoking at school. For greater smoking reduction outcomes, we recommend that tobacco interventions for adolescents should consider targeting more male students at older ages, establish stricter adherence to school-based banning of cigarette smoking, engage both smoking and nonsmoking adolescents and empower adolescents to resist peer smoking influence as well as changing their norms or beliefs towards smoking benefits.
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http://dx.doi.org/10.7314/apjcp.2016.17.s1.17DOI Listing
August 2017

Diet and nutritional status among children 24-59 months by seasons in a mountainous area of Northern Vietnam in 2012.

Glob Health Action 2014 8;7:23121. Epub 2014 Dec 8.

Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.

Background: Seasonal variation affects food availability. However, it is not clear if it affects dietary intake and nutritional status of children in Vietnam.

Objectives: This paper aims at examining the seasonal variation in nutrition status and dietary intake of children aged 24-59 months.

Design: A repeated cross-sectional study design was used to collect data of changes in nutritional status and diets of children from 24 to 59 months through four seasons in Chiem Hoa district, Tuyen Quang province, a predominately rural mountainous province of northern Vietnam. The quantitative component includes anthropometric measurements, 24 hours dietary recall and socio-economic characteristics. The qualitative component was conducted through focus group discussions (FGDs) with mothers of the children surveyed in the quantitative component. The purpose of FGDs was to explore the food habits of children during the different seasons and the behaviours of their mothers in relation to the food that they provide during these seasons.

Results: The prevalence of underweight among children aged 24-59 months is estimated at around 20-25%; it peaked in summer (24.9%) and reached a low in winter (21.3%). The prevalence of stunting was highest in summer (29.8%) and lowest in winter (22.2%). The prevalence of wasting in children was higher in spring and autumn (14.3%) and lower in summer (9.3%). Energy intake of children was highest in the autumn (1259.3 kcal) and lowest in the summer (996.9 kcal). Most of the energy and the nutrient intakes during the four seasons did not meet the Vietnamese National Institute of Nutrition recommendation.

Conclusions: Our study describes some seasonal variation in nutrition status and energy intake among children in a mountainous area northern Vietnam. Our study indicated that the prevalence of stunting and underweight was higher in summer and autumn, while the prevalence of wasting was higher in spring and autumn. Energy intake did not always meet national recommendations, especially in summer.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265645PMC
http://dx.doi.org/10.3402/gha.v7.23121DOI Listing
April 2015

Estimates of meteorological variability in association with dengue cases in a coastal city in northern Vietnam: an ecological study.

Glob Health Action 2014 8;7:23119. Epub 2014 Dec 8.

Department of Biostatistics and Medical Informatics, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.

Background: Dengue fever (DF) is a vector-borne disease that is sensitive to weather and climate variability. To date, however, this relationship in coastal northern Vietnam has not been well documented.

Objectives: This paper aims to examine the associations between meteorological variables and dengue incidence in Haiphong, Vietnam, over the period 2008-2012.

Methods: Monthly data on dengue incidence from all commune health stations and hospitals of Haiphong (with a total population of ~1.8 million) were obtained in accordance with the WHO's recommendations over a 5-year period (2008-2012). Temperature, rainfall, and humidity were recorded as monthly averages by local meteorological stations. The association between ecologic weather variables and dengue cases was assessed using a Poisson regression model. The estimation of regression parameters was based on the method of maximum likelihood using the R program package.

Results: From 2008 through 2012, 507 cases of dengue were reported. The risk of dengue was increased by sevenfold during the September-December period compared with other months over the period 2008-2012. DF cases in Haiphong were correlated with rainfall and humidity. In the multivariable Poisson regression model, an increased risk of dengue was independently associated with months with a higher amount of rainfall (RR=1.06; 95% CI 1.00-1.13 per 50 mm increase) and higher humidity (RR=1.05; 95% CI 1.02-1.08 per 1% increase).

Conclusion: These data suggest that rainfall and relative humidity could be used as ecological indicators of dengue risk in Haiphong. Intensified surveillance and disease control during periods with high rainfall and humidity are recommended. This study may provide baseline information for identifying potential long-term effects and adaptation needs of global climate change on dengue in the coming decades.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265646PMC
http://dx.doi.org/10.3402/gha.v7.23119DOI Listing
April 2015

Seasonality in mortality and its relationship to temperature among the older population in Hanoi, Vietnam.

Glob Health Action 2014 8;7:23115. Epub 2014 Dec 8.

Department of Nutrition and Food Safety, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.

Background: Several studies have established a relationship between temperature and mortality. In particular, older populations have been shown to be vulnerable to temperature effects. However, little information exists on the temperature-mortality relationship in Vietnam.

Objectives: This article aims to examine the monthly temperature-mortality relationship among older people in Hanoi, Vietnam, over the period between 2005 and 2010, and estimate seasonal patterns in mortality.

Methods: We employed Generalized Additive Models, including smooth functions, to model the temperature-mortality relationships. A quasi-Poisson distribution was used to model overdispersion of death counts. Temporal trends, seasonality, and population size were adjusted for while estimating changes in monthly mortality over the study period. A cold month was defined as a month with a mean temperature below 19°C.

Results: This study found that the high peak of mortality coincided with low temperatures in the month of February 2008, during which the mean temperature was the lowest in the whole study period. There was a significant relationship between mean monthly temperature and mortality among the older people (p<0.01). Overall, there was a significant decrease in the number of deaths in the year 2009 during the study period. There was a 21% increase in the number of deaths during the cold season compared to the warm season. The increase in mortality during the cold period was higher among females compared to males (female: IRR [incidence relative risk] =1.23; male: IRR=1.18).

Conclusions: Cold temperatures substantially increased mortality among the older population in Hanoi, Vietnam, and there were gender differences. Necessary preventive measures are required to mitigate temperature effects with greater attention to vulnerable groups.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265647PMC
http://dx.doi.org/10.3402/gha.v7.23115DOI Listing
April 2015

Factors associated with exposure to antismoking information among adults in Vietnam, Global Adult Tobacco Survey, 2010.

Prev Chronic Dis 2013 Sep 12;10:E153. Epub 2013 Sep 12.

Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.

Introduction: The media play a critical role in tobacco control. Knowledge about the exposure of a population to antismoking information can provide information for planning communication activities in tobacco control. We examined exposure to antismoking information associated with socioeconomic and demographic factors among adults (≥15 years) in Vietnam.

Methods: The Global Adult Tobacco Survey (GATS) is a nationally representative household survey of noninstitutionalized men and women aged 15 years or older and was conducted in Vietnam in 2010 (N = 9,925). We used GATS data on exposure to sources of antismoking information and analyzed associations among socioeconomic and demographic groups.

Results: An estimated 91.6% of the adult population was exposed to at least 1 source of antismoking information, and the mean number of sources of exposure was 3.7. Compared with their counterparts, respondents who were older, had higher education levels, higher economic status, and higher knowledge levels about the health consequences of smoking were more likely to be exposed to any source of antismoking information and to more informational sources. The most common source of exposure was television (85.9%). Respondents of higher social class (education, occupation, wealth) had more exposure through modern media sources (television), and respondents of lower social class were exposed to more traditional sources such as radio or loudspeakers.

Conclusion: Exposure to at least 1 source of antismoking information is high in Vietnam, and the number and type of source varied by sociodemographic group. Use of multiple communication channels is recommended to reinforce antismoking messages and to reach different groups in the population.
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http://dx.doi.org/10.5888/pcd10.120348DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3775359PMC
September 2013

Teaching handwashing with soap for schoolchildren in a multi-ethnic population in northern rural Vietnam.

Glob Health Action 2013 04 24;6:1-12. Epub 2013 Apr 24.

Department of Environmental Health, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.

Background: In Vietnam, initiatives have been started aimed at increasing the practice of handwashing with soap (HWWS) among primary schoolchildren. However, compliance remains low.

Objective: This study aims to investigate responses to a teacher-centred participatory HWWS intervention in a multi-ethnic population of primary schoolchildren in northern rural Vietnam.

Design: This study was implemented in two phases: a formative research project over 5 months (July-November 2008) and an action research project with a school-based HWWS intervention study in two rural communes during 5 months (May, September-December 2010). Based upon knowledge from the formative research in 2008, schoolteachers from four selected schools in the study communes actively participated in designing and implementing a HWWS intervention. Qualitative data was collected during the intervention to evaluate the responses and reaction to the intervention of teachers, children and parents. This included semi-structured interviews with children (15), and their parents (15), focus group discussions (FGDs) with schoolchildren (32) and school staff (20) and observations during 15 HWWS involving children.

Results: Observations and interview data from children demonstrated that children were visibly excited and pleased with HWWS sessions where teachers applied active teaching methods including rewards, games and HWWS demonstrations. All children, schoolteachers and parents also viewed the HWWS intervention as positive and feasible, irrespective of ethnicity, gender of schoolchildren and background of schoolteachers. However, some important barriers were indicated for sustaining and transferring the HWWS practice to the home setting including limited emphasis on hygiene in the standard curriculum of schools, low priority and lack of time given to practical teaching methods and lack of guidance and reminding HWWS on a regular basis at home, in particular by highland parents, who spend most of their time working away from home in the fields. Access to soap and water at the household level did not seem a barrier for the uptake of HWWS but continuous access to these might be a challenge at schools.

Conclusions: This study demonstrated that it is feasible to engage teachers and implement active teaching methods for behaviour change of HWWS in a group of multi-ethnic primary schoolchildren without the need for major investments in water and hygiene infrastructures. However, in those areas there was limited transfer of practice from school promotion to home. Continuous access to soaps at schools needs to be invested.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3636419PMC
http://dx.doi.org/10.3402/gha.v6i0.20288DOI Listing
April 2013

Prevalence of waterpipe tobacco smoking among population aged 15 years or older, Vietnam, 2010.

Prev Chronic Dis 2013 Apr 18;10:E57. Epub 2013 Apr 18.

Institute of Preventive Medicine and Public Health, Hanoi Medical University, No 1 Ton That Tung, Dong Da, Hanoi, Vietnam.

Introduction: The prevalence of waterpipe tobacco smoking is increasing globally and is associated with adverse outcomes requiring tobacco control interventions. We estimated the prevalence of waterpipe tobacco use among adult populations in Vietnam in 2010 and examined its association with sociodemographic factors.

Methods: We used data from the Global Adult Tobacco Survey (GATS) conducted in Vietnam in 2010. GATS surveyed a national representative sample of adults aged 15 years or older from 11,142 households by using a 2-phase sampling design analogous to a 3-stage stratified cluster sampling. Descriptive statistical analyses and multivariate logistic regression modeling were conducted.

Results: A total of 6.4% of Vietnamese aged 15 years or older (representing about 4.1 million adult waterpipe smokers) reported current waterpipe tobacco smoking. The prevalence of waterpipe tobacco smoking was significantly higher among men than women (13% vs 0.1%). Area of residence (rural or urban), age group, asset-based wealth quintile, and geographic region of residence were significantly associated with waterpipe tobacco smoking among men. The significant correlates of current waterpipe tobacco smoking among men were lower education levels, being middle-aged (45-54 years), lower asset-based wealth levels, living in rural areas, not living in the South East and the Mekong River Delta geographic regions, and the belief that smoking does not causes diseases.

Conclusion: Rural dwellers who are poor should be targeted in tobacco control programs. Further studies are needed that examine perceptions of the adverse health effects and the cultural factors of waterpipe tobacco smoking.
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http://dx.doi.org/10.5888/pcd10.120100DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3638612PMC
April 2013

Knowledge of the health consequences of tobacco smoking: a cross-sectional survey of Vietnamese adults.

Glob Health Action 2013 Jan 31;6:1-9. Epub 2013 Jan 31.

Department of Epidemiology, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.

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.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3562361PMC
http://dx.doi.org/10.3402/gha.v6i0.18707DOI Listing
January 2013

Handwashing among schoolchildren in an ethnically diverse population in northern rural Vietnam.

Glob Health Action 2013 01 31;6:1-8. Epub 2013 Jan 31.

Department of Environmental Health, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.

Background: Handwashing with soap (HWWS) is a simple and effective measure to prevent transmission of fecal-oral disease and other infectious diseases in school-age children. To promote the behavior, we need to understand their HWWS compliance. The aim of this article is to describe handwashing behavior and HWWS compliance and to identify associated factors among schoolchildren in the multiethnic rural area of northern Vietnam.

Methods: The study was conducted in six primary and secondary schools and in the homes of four ethnic villages in northern Vietnam. Quantitative methods included face-to-face interviews with, and demonstration of handwashing protocol to, 319 schoolchildren in first, fourth, and seventh grades. Qualitative methods included structured observations at six schools and 20 homes comprising 24 children. The dependent variable was the self-reported HWWS behavior (yes/no). The independent variables included grade, school type, gender, ethnicity group, owning home latrine, and household assets. Logistic regression modelling was performed to examine associations between HWWS behavior and demographic factors.

Results: Among the 319 schoolchildren interviewed, 66% reported HWWS. Through the demonstration protocol, only 10 out of 319 schoolchildren, performed HWWS satisfactorily. The percentage of students who washed their hands at recommended times (30-60 sec) was 58%. This proportion increased by grade (from 34% among grade 1 to 67% among grade 7; p<0.05). Correlates of self-reported HWWS were more common in higher grades [grade 4 vs. grade 1: odds ratio (OR)=4.14 (2.00-8.56), grade 7 vs. grade 1: OR=7.76 (3.67-16.4)] and less common in ethnic minority groups [Xa Phó vs. Kinh-Tay: OR=0.28 (0.11-0.70)]. All 20 homes of schoolchildren visited had soap and water but none of the six schools had soap for handwashing.

Conclusions: This article describes poor compliance of schoolchildren with HWWS in a multiethnic population in Vietnam. Education on handwashing needs to be prioritized among multiethnic children at school.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3562359PMC
http://dx.doi.org/10.3402/gha.v6i0.18869DOI Listing
January 2013

Attitudes toward nonsmoking policies and tobacco tax increases: a cross-sectional study among Vietnamese adults.

Asia Pac J Public Health 2015 Mar 2;27(2):NP947-57. Epub 2012 Oct 2.

Center for Disease Control and Prevention, Atlanta, GA, USA.

Following the 2009 update of the 2005 Framework Convention on Tobacco Control, Vietnam issued a new policy to ban smoking at workplaces and public places. This cross-sectional survey explored public attitudes toward this new regulation and provides evidence to inform future laws. Using stratified cluster sampling, 10 383 Vietnamese people older than 15 years were drawn from 11 142 selected households. Policies mandating "no smoking at workplaces" were supported by 88.7% of Vietnamese adults, whereas "no smoking in public places" and "increasing the tobacco tax" received less support. Educational level, knowledge of health effects, access to information on quitting and smoking health risks, smoking status, ethnicity, and region had significant associations with positive attitudes toward all 3 tobacco control policies. Adults belonging to the non-Kinh ethnic group, those who do not live in the Red river delta, people with lower educational levels, and current smokers should be targeted in tobacco control communication programs.
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http://dx.doi.org/10.1177/1010539512460568DOI Listing
March 2015

Exposure to second-hand smoke at home and its associated factors: findings from the Global Adult Tobacco Use survey in Vietnam, 2010.

Cancer Causes Control 2012 Mar 29;23 Suppl 1:99-107. Epub 2012 Feb 29.

Institute for Preventive Medicine and Public Health, Hanoi Medical University, No 1- Ton That Tung, Dong Da, Hanoi, Vietnam.

Objective: The paper describes the pattern of exposure to second-hand smoke (SHS) at home among the adult population of Vietnam and examines associated socio-demographic factors.

Methods: A total of 11,142 households were selected for this survey using a two-phase sampling design analogous with three-stage stratified cluster sampling. The dependent variable was the status of exposure to SHS at home. Independent variables included gender, age, occupation, asset-based wealth quintile, ethnicity, marital status, residence. Logistic regression modelling was performed to examine the association with relevant factors of patterns of exposure to second-hand smoke among non-smokers.

Results: Of adults aged 15 years and above (representing approximately 47 million people) 73.1% reported they were exposed to SHS at home at least monthly. Considering non-smokers only, the prevalence of exposure to SHS at home was 67.6% (equivalent to approximately 33 million non-smokers). The significant correlates of the status of exposure to SHS at home among non-smokers were female gender, ethnic minority, low education, and lack of smoking restriction at home.

Conclusion: The study showed that a high percentage of people are exposed to second-hand smoke at home. Disadvantaged people were more likely than the better-off to be exposed to SHS at home.
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http://dx.doi.org/10.1007/s10552-012-9907-zDOI Listing
March 2012

Sanitation behavior among schoolchildren in a multi-ethnic area of Northern rural Vietnam.

BMC Public Health 2012 Feb 21;12:140. Epub 2012 Feb 21.

Department of Environmental Health, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.

Background: In Vietnam, efforts are underway to improve latrine use in rural and remote areas with particular focus on increasing coverage of sanitation in schools. However, there is a lack of information on how the school program affects latrine use by schoolchildren and at community level. This paper analyzes sanitation use among schoolchildren in a multi-ethnic area to inform future school-based sanitation promotion programmes.

Methods: A combination of quantitative and qualitative methods was applied during a 5 months period in six primary and secondary schools and in the homes of schoolchildren in four different ethnic villages in Northern rural Vietnam. Using a structured questionnaire, 319 children were interviewed face-to-face to collect quantitative data. Qualitative methods included extensive observations at schools and in the homes of 20 children, a single day's diary writings of 234 children, in-depth interviews with children (20), their parents (20) and school staff (10), and focus group discussions with parents (4) and teachers (6), and picture drawing with children (12).

Results: All surveyed schools had student latrines. However, the observed schoolchildren most commonly urinated and defecated in the open. Main barriers for latrine use included inadequate number of latrines, limited accessibility to latrines, lack of constant water supply in latrines and lack of latrine maintenance by school management. Programs promoting latrine use for children were not conducted in either schools or communities and were not established as a preferred social norm in such settings. Children perceived existing school latrines as unappealing and expressed a wish to have basic, functional, clean, and colorful school latrines with privacy.

Conclusions: The paper shows that the current school based sanitation promotion is insufficient to change sanitation behavior of school children irrespective of their ethnicity. It is important that schools, households and communities work more closely together to increase use and uptake of latrine use among schoolchildren. Also, the contractors of latrine facilities must work more closely with local school management when constructing latrines, including identifying location, design and appropriate systems of water supply. A separate budget needs to be allocated to allow the school to maintain the sanitation infrastructure and keep it hygienic and appealing for users.
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http://dx.doi.org/10.1186/1471-2458-12-140DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3305623PMC
February 2012

Hygiene and sanitation promotion strategies among ethnic minority communities in northern Vietnam: a stakeholder analysis.

Health Policy Plan 2012 Oct 17;27(7):600-12. Epub 2012 Jan 17.

Department of International Health, Immunology and Microbiology, University of Copenhagen, Øster Farimagsgade 5, Bld. 9, DK-1014 Copenhagen, Denmark.

Effective rural hygiene and sanitation promotion (RHSP) is a major challenge for many low-income countries. This paper investigates strategies and stakeholders' roles and responsibilities in RHSP implementation in a multi-ethnic area of northern Vietnam, in order to identify lessons learned for future RHSP. A stakeholder analysis was performed, based on 49 semi-structured individual interviews and one group interview with stakeholders in RHSP in a northern province of Vietnam. Participants came from three sectors (agriculture, health and education), unions supported by the Vietnamese government and from four administrative levels (village, commune, district and province). The study villages represented four ethnic minority groups including lowland and highland communities. Stakeholders' roles, responsibilities and promotion methods were outlined, and implementation constraints and opportunities were identified and analysed using thematic content analysis. Effective RHSP in Vietnam is severely constrained despite supporting policies and a multi-sectorial and multi-level framework. Four main barriers for effective implementation of RHSP were identified: (1) weak inter-sectorial collaborations; (2) constraints faced by frontline promoters; (3) almost exclusive information-based and passive promotion methods applied; and (4) context unadjusted promotion strategies across ethnic groups, including a limited focus on socio-economic differences, language barriers and gender roles in the target groups. Highland communities were identified as least targeted and clearly in need of more intensive and effective RHSP. It is recommended that the Vietnamese government gives priority to increasing capacities of and collaboration among stakeholders implementing RHSP activities. This should focus on frontline promoters to perform effective behaviour change communication. It is also recommended to support more participatory and community-based initiatives, which can address the complex socio-economic and cultural determinants of health in multi-ethnic population groups. These lessons learned can improve future RHSP in Vietnam and are also of relevance for health promotion in other minority population groups in the region and globally.
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http://dx.doi.org/10.1093/heapol/czr082DOI Listing
October 2012

Effects of a long-term volunteer surgical program in a developing country: the case in Vietnam from 1993 to 2003.

Cleft Palate Craniofac J 2006 Sep;43(5):616-9

Research Institute of Advanced Oral Science, Aichi-Gakuin University, Nagoya, Japan.

Objective: This study evaluates the activities of the Japanese Cleft Palate Foundation from 1993 to 2003 in southern Vietnam.

Design: We assessed trends associated with patient age at first operation for primary lip repair and palate repair by using medical records of the patients.

Participants: This study consisted of 790 patients with nonsyndromic cleft lip and/or palate (CL/P).

Results: The median patient age for lip repair was reduced from 14.0 years in 1993 to 1.3 years by 2003. For palate repair, the median age was reduced from 13.5 years in 1993 to 5.0 years in 1999 through 2003. The age distributions of both lip and palate repair in the later years became smaller than the age distributions in 1993. The number of adult patients declined throughout the period.

Conclusions: The Japanese Cleft Palate Foundation contributed to lowering the age at first operation for CL/P and to reducing the number of adult patients in Ben Tre province, southern Vietnam. However, appropriate supports will be necessary to maintain CL/P treatment and to improve locally supported health care for patients with CL/P.
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http://dx.doi.org/10.1597/05-120DOI Listing
September 2006