Publications by authors named "Tran Huu Bich"

18 Publications

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Community-based father education intervention on breastfeeding practice-Results of a quasi-experimental study.

Matern Child Nutr 2019 01;15 Suppl 1:e12705

Hanoi University of Public Health, Hanoi, Vietnam.

Although the benefits of breastfeeding are well-documented, little is known about how best to encourage fathers to support breastfeeding. A quasi-experimental study of a community-based intervention was designed to examine whether health education to promote fathers' involvement in supporting women is associated with early initiation and exclusive breastfeeding practices. At baseline, 802 couples of fathers with pregnant wives from 12 to 27 weeks of gestational age were recruited to either the intervention group (n = 390) or a control group (n = 412) consisting of couples seeking care through routine maternal and child health services. Fathers in the intervention area received breastfeeding education and counselling services in health facilities and at home visits during the antenatal, delivery, and post-partum periods. Peer education and social exchange concerning breastfeeding were organized in fathers' clubs. After 1 year of the intervention, mothers in the intervention group were more likely to initiate early breastfeeding 49.2 and 35.8% in the intervention and control group respectively, P < 0.001. At 1, 4, and 6 months after birth, 34.8, 18.7, and 1.9% of the mothers in the intervention group were exclusively breastfeeding their children because of birth, respectively, compared with 5.7, 4.0, and 0.0% of those in the control group (P < 0.001). Those practices were associated with the intervention in bivariate and multivariate logistic and Cox regression analyses. Intervention targeting fathers at antenatal and postnatal periods may positively influence the breastfeeding practices of mothers, and it should be an important component of breastfeeding programs.
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http://dx.doi.org/10.1111/mcn.12705DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199053PMC
January 2019

Prevalence of Self-Treatment Practice and Related Factors Among Workers Aged 15 to 60 Years in Chi Linh Town, Hai Duong Province, Vietnam.

Asia Pac J Public Health 2017 Jul;29(5_suppl):62S-71S

1 Hanoi University of Public Health, Hanoi, Vietnam.

Self-treatment is particularly prevalent in Vietnam. However, the prevalence of this practice among the working population is unclear. This study aims to describe the prevalence of self-treatment and related factors among workers aged 15 to 60 years in the suburban area of Chi Linh, Hai Duong, Vietnam. Secondary data of 3128 respondents was retrieved from the CHILILAB HDSS 2016 survey for analysis using logistic regression with a significance level of .05. Results show that 47.5% of respondents treated themselves at least once during one previous year. While rural residence and the presence of acute health symptoms and chronic diseases significantly associate with the choice of self-treatment among all investigated workers, lower education level and health insurance status only significantly relate to this practice among the formally employed workers. The findings imply the need for specific measures to manage self-treatment practices among different groups of workers.
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http://dx.doi.org/10.1177/1010539517718332DOI Listing
July 2017

Clinical characteristics of pediatric HIV-1 patients treated with first-line antiretroviral therapy in Vietnam: a nested case-control study.

Int J Public Health 2017 Feb 3;62(Suppl 1):113-119. Epub 2017 Feb 3.

Hanoi University of Public Health, Hanoi, Vietnam.

Objectives: Over the past decades, Vietnam has made great strides in reducing the rate of mortality in HIV-related deaths, due to increased access of antiretroviral therapy (ART); however, given the significantly high level of treatment failure (TF), it is essential to identify markers that describe the failure of ART in HIV-1 infected children.

Methods: A nested case-control study was conducted with clinical data collected from 101 HIV-infected children [26 TF and 75 treatment success (TS)] at National Hospital of Pediatrics, Vietnam (2008-2012).

Results: The results showed that certain factors including height, weight, vaccination with Hepatitis B, and platelet were significantly different between TF and TS before starting the treatment. In addition, age to start the treatment, CD4 percentage, and opportunistic infection were found to significantly predict treatment outcome most frequently, implying the importance of clinical markers in the treatment response by Cox regression analysis.

Conclusions: There is an inherent complexity within clinical markers that is challenging to determine HIV-pediatric failure and further research is needed to build a complete picture to guide clinical, evidence-based practice.
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http://dx.doi.org/10.1007/s00038-016-0937-2DOI Listing
February 2017

Ascaris lumbricoides egg die-off in an experimental excreta storage system and public health implication in Vietnam.

Int J Public Health 2017 Feb 22;62(Suppl 1):103-111. Epub 2016 Nov 22.

Center for Public Health and Ecosystem Research (CENPHER), Hanoi University of Public Health, Hanoi, Vietnam.

Objectives: We studied the influence of different additive materials (lime, and rice husk) and aeration conditions on Ascaris lumbricoides egg die-off in 24 vaults of an experimental excreta storage unit.

Methods: Excreta samples were collected once every two weeks over a 181-day period. Temperature, pH, and moisture content were recorded. A. lumbricoides eggs were quantitatively analyzed by the Romanenko method, which identified and counted live and dead eggs.

Results: From the first sampling (0 storage day) to the final sampling (181 storage days) the average percentage of viable A. lumbricoides eggs decreased gradually from 76.72 ± 11.23% (mean ± SD) to 8.26 ± 5.20%. The storage time and the high pH value significantly increased the die-off of helminth eggs. Over 181 storage days, all vaults option effectively reduced A. lumbricoides eggs die-off.

Conclusions: The best vault option, with aeration and 10% lime per total weight, met the WHO standard for excreta treatment on the 111th storage day.
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http://dx.doi.org/10.1007/s00038-016-0920-yDOI Listing
February 2017

Changes in knowledge, attitude and involvement of fathers in supporting exclusive breastfeeding: a community-based intervention study in a rural area of Vietnam.

Int J Public Health 2017 Feb 1;62(Suppl 1):17-26. Epub 2016 Sep 1.

Hanoi School of Public Health, 138 GiangVo Street, BaDinh, Hanoi, Vietnam.

Objectives: To test the hypotheses of positive changes of fathers' knowledge, attitude and involvement in supporting exclusive breastfeeding (EBF) after receiving breastfeeding education materials and counseling services.

Methods: A quasi-experimental, pre-test-post-test, non-equivalent control group design was used. At baseline, 251 and 241 pregnant women and their husbands were enrolled into the intervention and control groups, respectively. The 1-year intervention targeting fathers included mass media, game show-style community events, group and individual counseling at health facilities and home visits.

Results: Compared to fathers in the control group, fathers in the intervention group had higher BF knowledge scores and higher attitude scores reflecting more positive attitudes toward early initiation of BF and 6 months EBF. Fathers in the intervention group were also more likely to report active involvement in supporting mothers to practice EBF during antenatal and postpartum periods.

Conclusions: The community-based education model should be maintained and considered for conducting further test in wider application to mobilize fathers in supporting EBF.
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http://dx.doi.org/10.1007/s00038-016-0882-0DOI Listing
February 2017

Father's involvement and its effect on early breastfeeding practices in Viet Nam.

Matern Child Nutr 2016 10 11;12(4):768-77. Epub 2015 Aug 11.

International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Fathers have an important but often neglected role in the promotion of healthy breastfeeding practices in developing countries. A community-based education intervention was designed to mobilize fathers' support for early breastfeeding. This study aimed to evaluate an education intervention targeting fathers to increase the proportion of early breastfeeding initiation and to reduce prelacteal feeding. Quasi-experimental study design was used to compare intervention and control areas located in two non-adjacent rural districts that shared similar demographic and health service characteristics in northern Viet Nam. Fathers and expectant fathers with pregnant wives from 7 to 30 weeks gestational age were recruited. Fathers in the intervention area received breastfeeding education materials, counselling services at a commune health centre and household visits. They were also invited to participate in a breastfeeding promotion social event. After intervention, early breastfeeding initiation rate was 81.2% in the intervention area and 39.6% in the control area (P < 0.001). Babies in the intervention area were more likely to be breastfed within the first hour after birth [odds ratio (OR) 7.64, 95% confidence interval (CI) 4.81-12.12] and not to receive any prelacteal feeding (OR 4.43, 95% CI 2.88-6.82) compared with those in the control area. Fathers may positively influence the breastfeeding practices of mothers, and as a resource for early childcare, they can be mobilized in programmes aimed at improving the early initiation of breastfeeding.
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http://dx.doi.org/10.1111/mcn.12207DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6860122PMC
October 2016

Comparison of behaviors regarding live poultry exposure among rural residents in Vietnam and Thailand.

J Infect Dev Ctries 2014 Apr 15;8(4):526-34. Epub 2014 Apr 15.

Behavioural Health Division, School of Public Health, The University of Hong Kong, Hong Kong, China.

Introduction: Live poultry exposure and risk behaviors are more prevalent in rural communities, increasing the risk of influenza A/H5N1 infection. We examined the economic and socio-cultural influences on poultry-related practices by comparing the poultry-related practices among Vietnamese and Thai rural residents by family income and consumption preference.

Methods: Stratified cluster sampling was performed to select households. Within each household, one adult was randomly selected for a face-to-face interview in five Vietnamese and five Thai rural districts. Using a standardized questionnaire to assess domestic poultry husbandry, live poultry purchase, and demographics, logistic regression enabled comparisons of behaviors related to live poultry exposure and examination of associated factors.

Results: Among 994 Vietnamese and 907 Thai rural residents, live poultry exposure (prevalence of raising poultry, improper handling of sick or dead poultry, touching live poultry before buying, and slaughtering poultry at home) was more prevalent among Vietnamese than Thai respondents. After adjusting for other demographics, respondents with higher family incomes were less likely to rear backyard poultry in both Vietnam and Thailand, and with more likely to buy live poultry in Vietnam, but not in Thailand. Consumption preference for live poultry was associated with being more likely to rear backyard poultry in Vietnam and Thailand, and with being more likely to buy live poultry in Thailand, but not in Vietnam.

Conclusion: The findings suggest important roles of economic imperatives and cultural preference for live poultry for consumption in supporting poultry rearing and live poultry purchase among rural residents.
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http://dx.doi.org/10.3855/jidc.3545DOI Listing
April 2014

Fathers as supporters for improved exclusive breastfeeding in Viet Nam.

Matern Child Health J 2014 Aug;18(6):1444-53

Hanoi School of Public Health, 138 GiangVo Street, Ba Dinh, Hanoi, Vietnam,

To determine the extent of exclusive breastfeeding practices among mothers of 4 and 6 month old infants whose fathers received breastfeeding education materials and counseling services. A quasi-experimental design was used. At the baseline, 251 and 241 couples were recruited into the intervention and control sites respectively. Fathers in the intervention area received breastfeeding education materials, counseling services at commune health centers and household visits. In the control site, where mothers routinely receive services on antenatal and postpartum care, fathers did not receive any intervention services on promoting breastfeeding. Primary indicators were exclusive breastfeeding at 4 and 6 months. At 6 months of age, based on 24-hour recall, 16.0% (38/238) of mothers in the intervention group were exclusively breastfeeding their children, compared to 3.9% (10/230) of those mothers in the control group (p < 0.001). Significant differences were found based on last-week recall (8.8% in the intervention group vs. 1.3% in the control group, p < 0.001) and since-birth recall (6.7% in the intervention group vs. 0.9% in the control group, p < 0.01). At 4 months of age, based on since birth recall, the breastfeeding proportion was significantly higher in the intervention group than in control group (20.6% in the intervention group vs. 11.3% in the control group, p < 0.01). An intervention targeting fathers might be effective in increasing exclusive breastfeeding practices at 4 and 6 months. To improve exclusive breastfeeding, health care staff working in maternal and child health units, should consider integrating fathers with services delivered to mothers and children.
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http://dx.doi.org/10.1007/s10995-013-1384-9DOI Listing
August 2014

Impacts of flood on health: epidemiologic evidence from Hanoi, Vietnam.

Glob Health Action 2011 23;4:6356. Epub 2011 Aug 23.

Department of Epidemiology, Hanoi School of Public Health, Hanoi, Vietnam.

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.
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http://dx.doi.org/10.3402/gha.v4i0.6356DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3160808PMC
December 2011

Using the INDEPTH HDSS to build capacity for chronic non-communicable disease risk factor surveillance in low and middle-income countries.

Glob Health Action 2009 Sep 28;2. Epub 2009 Sep 28.

Purworejo Health and Demographic Surveillance System, Indonesia.

Background: Chronic non-communicable diseases (NCDs) are the leading cause of morbidity, mortality, and disability worldwide. More than 80% of chronic disease deaths occur in low-income and middle-income countries. Epidemiological data on the burden of chronic NCD and the risk factors which predict them are lacking in most low-income countries. The INDEPTH Network (http://www.indepth-network.org) which includes the Health and Demographic Surveillance System (HDSS) with many surveillance sites in low-middle income countries provided an opportunity to establish surveillance of the major chronic NCD risk factors in 2005 using a standardised approach.

Objective: This paper presents the conceptual framework and research design of the chronic NCD risk factor surveillance within nine rural INDEPTH HDSS settings in Asia.

Methods: This multi-site study was designed as a baseline cross-sectional survey with sufficient sample size to measure trends over time. In each of nine HDSS sites in five Asian countries, a sample of 2,000 men and women aged 25-64 years, using the WHO STEPwise approach to Surveillance (http://who.int/chp/steps), was selected using stratified random sampling (in each 10-year interval) from the HDSS sampling frame.

Results: A total of 18,494 men and women from the nine sites were interviewed with an overall response rate of 98%. The major NCDs risk factors included self-reported information on tobacco and alcohol consumption, fruit and vegetable intake, physical activity patterns, and measured body weight, height, waist circumference, and blood pressure. A series of training sessions were conducted for research scientists, supervisors, and surveyors in each site. Data quality was ensured through spot check, re-check, and data validation procedures, including accuracy and completeness of data obtained. Standardised data entry programme, created using the EPIDATA software, was used to ensure uniform database structure across sites. The data merging and analysis were done using STATA Version 10.

Conclusion: This multi-site study confirmed the feasibility of conducting chronic NCD risk factor surveillance in the low and middle-income settings by integrating the chronic NCDs risk factor surveillance into an existing HDSS data collection and management setting. This collaborative work has provided reliable epidemiological data as a basis for developing chronic NCD prevention and control activities.
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http://dx.doi.org/10.3402/gha.v2i0.1984DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2785135PMC
September 2009

Prevalence of physical inactivity in nine rural INDEPTH Health and Demographic Surveillance Systems in five Asian countries.

Glob Health Action 2009 Sep 28;2. Epub 2009 Sep 28.

Purworejo Health and Demographic Surveillance System, Indonesia.

Background: Physical inactivity leads to higher morbidity and mortality from chronic non-communicable diseases (NCDs) such as stroke and heart disease. In high income countries, studies have measured the population level of physical activity, but comparable data are lacking from most low and middle-income countries.

Objective: To assess the level of physical inactivity and its associated factors in selected rural sites in five Asian countries.

Methods: The multi-site cross-sectional study was conducted in nine rural Health and Demographic Surveillance System (HDSS) sites within the INDEPTH Network in Bangladesh, India, Indonesia, Thailand, and Vietnam. Using the methodology from the WHO STEPwise approach to Surveillance (STEPS), about 2,000 men and women aged 25-64 years were selected randomly from each HDSS sampling frame. Physical activity at work and during leisure time, and on travel to and from places, was measured using the Global Physical Activity Questionnaire version 2 (GPAQ2). The total activity was calculated as the sum of the time spent in each domain of activities in metabolic equivalent-minutes per week, and was used to determine the level of physical activity. Multivariable logistic regression was used to assess demographic factors associated with a low level of physical activity.

Results: The prevalence of physical inactivity ranged from 13% in Chililab HDSS in Vietnam to 58% in Filabavi HDSS in Vietnam. The majority of men were physically active, except in the two sites in Vietnam. Most of the respondents walked or cycled for at least 10 minutes to get from place to place, with some exceptions in the HDSSs in Indonesia and Thailand. The majority of respondents, both men and women, were inactive during their leisure time. Women, older age, and high level of education were significantly associated with physical inactivity.

Conclusion: This study showed that over 1/4 men and 1/3 women in Asian HDSSs within the INDEPTH Network are physically inactive. The wide fluctuations between the two HDSS in Vietnam offer an opportunity to explore further urbanisation and environmental impacts on physical activity. Considering the importance of physical activity in improving health and preventing chronic NCDs, efforts need to be made to promote physical activity particularly among women, older people, and high education groups in these settings.
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http://dx.doi.org/10.3402/gha.v2i0.1985DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2785136PMC
September 2009

Clustering of chronic non-communicable disease risk factors among selected Asian populations: levels and determinants.

Glob Health Action 2009 Sep 28;2. Epub 2009 Sep 28.

WATCH Health and Demographic Surveillance System, Bangladesh.

Background: The major chronic non-communicable diseases (NCDs) operate through a cluster of common risk factors, whose presence or absence determines not only the occurrence and severity of the disease, but also informs treatment approaches. Primary prevention based on mitigation of these common risk factors through population-based programmes is the most cost-effective approach to contain the emerging epidemic of chronic NCDs.

Objectives: This study was conducted to explore the extent of risk factors clustering for the major chronic NCDs and its determinants in nine INDEPTH Health and Demographic Surveillance System (HDSS) sites of five Asian countries.

Design: Data originated from a multi-site chronic NCD risk factor prevalence survey conducted in 2005. This cross-sectional survey used a standardised questionnaire developed by the WHO to collect core data on common risk factors such as tobacco use, intake of fruits and vegetables, physical inactivity, blood pressure levels, and body mass index. Respondents included randomly selected sample of adults (25-64 years) living in nine rural HDSS sites in Bangladesh, India, Indonesia, Thailand, and Vietnam.

Results: Findings revealed a substantial proportion (>70%) of these largely rural populations having three or more risk factors for chronic NCDs. Chronic NCD risk factors clustering was associated with increasing age, being male, and higher educational achievements. Differences were noted among the different sites, both between and within country.

Conclusions: Since there is an extensive clustering of risk factors for the chronic NCDs in the populations studied, the interventions also need to be based on a comprehensive approach rather than on a single factor to forestall its cumulative effects which occur over time. This can work best if it is integrated within the primary health care system and the HDSS can be an invaluable epidemiological resource in this endeavor.
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http://dx.doi.org/10.3402/gha.v2i0.1986DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2785214PMC
September 2009

Fruit and vegetable consumption in rural adults population in INDEPTH HDSS sites in Asia.

Glob Health Action 2009 Sep 28;2. Epub 2009 Sep 28.

Kanchanaburi Health and Demographic Surveillance System, Thailand.

Background: Low fruit and vegetable consumption is among the top 10 risk factors contributing to mortality worldwide. WHO/FAO recommends intake of a minimum of 400 grams (or five servings) of fruits and vegetables per day for the prevention of chronic diseases such as heart diseases, cancer, diabetes, and obesity.

Objective: This paper examines the fruit and vegetable consumption patterns and the prevalence of inadequate fruit and vegetable consumption (less than five servings a day) among the adult population in rural surveillance sites in five Asian countries.

Data And Methods: The analysis is based on data from a 2005 cross-site study on non-communicable disease risk factors which was conducted in nine Asian INDEPTH Health and Demographic Surveillance System (HDSS) sites. Standardised protocols and methods following the WHO STEPwise approach to risk factor surveillance were used. The total sample was 18,429 adults aged 25-64 years. Multivariate logistic regression analysis was performed to assess the association between socio-demographic factors and inadequate fruit and vegetable consumption.

Results: Inadequate fruit and vegetable consumption was common in all study sites. The proportions of inadequate fruit and vegetable consumption ranged from 63.5% in men and 57.5% in women in Chililab HDSS in Vietnam to the whole population in Vadu HDSS in India, and WATCH HDSS in Bangladesh. Multivariate logistic regression analysis in six sites, excluding WATCH and Vadu HDSS, showed that being in oldest age group and having low education were significantly related to inadequate fruit and vegetable consumption, although the pattern was not consistent through all six HDSS.

Conclusions: Since such a large proportion of adults in Asia consume an inadequate amount of fruits and vegetables, despite of the abundant availability, education and behaviour change programmes are needed to promote fruit and vegetable consumption. Accurate and useful information about the health benefits of abundant fruit and vegetable consumption should be widely disseminated.
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http://dx.doi.org/10.3402/gha.v2i0.1988DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2785138PMC
September 2009

Social factors and overweight: evidence from nine Asian INDEPTH Network sites.

Glob Health Action 2009 Sep 28;2. Epub 2009 Sep 28.

Matlab Health and Demographic Survillance System, Bangladesh.

Background: Overweight/obesity increases the risk of morbidity and mortality from a number of chronic conditions, including heart disease, stroke, diabetes and some cancers. This study examined the distribution of body mass index (BMI) in nine Health and Demographic Surveillance System (HDSS) sites in five Asian countries and investigated the association between social factors and overweight.

Data And Methods: This cross-sectional study was conducted in nine HDSS sites in Bangladesh, India, Indonesia, Thailand and Vietnam. The methodology of the WHO STEPwise approach to Surveillance with core risk factors (Step 1) and physical measurements for weight, height and waist circumference (Step 2) were included. In each site, about 2,000 men and women aged 25-64 years were selected randomly using the HDSS database. Weight was measured using electronic scales, height was measured by portable stadiometers and waist circumference was measured by measuring tape. Overweight/obesity was assessed by BMI defined as the weight in kilograms divided by the square of the height in metres (kg/m(2)).

Results: At least 10% people were overweight (BMI >/= 25) in each site except for the two sites in Vietnam and WATCH HDSS in Bangladesh where few men and women were overweight. After controlling for all the variables in the model, overweight increases with age initially and then declines, with increasing education, and with gender with women being heavier than men. People who eat vegetables and fruits below the recommended level and those who do high level of physical activity are, on the whole, less heavy than those who eat more and do less physical activity.

Conclusions: As the proportion of the population classified as being overweight is likely to increase in most sites and overweight varies by age, sex, and social and behavioural factors, behavioural interventions (physical exercise, healthy diet) should be developed for the whole population together with attention to policy around nutrition and the environment, in order to reduce the adverse effects of overweight on health.
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http://dx.doi.org/10.3402/gha.v2i0.1991DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2785100PMC
September 2009

Self-reported use of tobacco products in nine rural INDEPTH Health and Demographic Surveillance Systems in Asia.

Glob Health Action 2009 Sep 28;2. Epub 2009 Sep 28.

AMK Health and Demographic Surveillance System, Bangladesh.

Background: Tobacco use is the most preventable cause of premature death and disability. Even though tobacco use is common in many Asian countries, reliable and comparable data on the burden imposed by tobacco use in this region are sparse, and surveillance systems to track trends are in their infancy.

Objective: To assess and compare the prevalence of tobacco use and its associated factors in nine selected rural sites in five Asian countries.

Methods: Tobacco use among 9,208 men and 9,221 women aged 25-64 years in nine Health and Demographic Surveillance System (HDSS) sites in five Asian countries of the INDEPTH Network were examined in 2005 as part of a broader survey of the major chronic non-communicable disease risk factors. All sites used a standardised protocol based on the WHO STEPS approach to risk factor surveillance; expanded questions of local relevance, including chewing tobacco, were also included. Multivariable logistic regression was used to assess demographic factors associated with tobacco use.

Results: Tobacco use, whether smoked or chewed, was common across all sites with some notable variations. More than 50% of men smoked daily; this applied to almost all age groups. Few women smoked daily in any of the sites. However, women were more likely to chew tobacco than men in all sites except Vadu in India. Tobacco use in men began in late adolescence in most of the sites and the number of cigarettes smoked daily ranged from three to 15. Use of both forms of tobacco, smoked and chewed, was associated with age, gender and education. Men were more likely to smoke compared to women, smoking increased with age in the four sites in Bangladesh but not in other sites and with low level of education in all the sites.

Conclusion: The prevalence of tobacco use, regardless of the type of tobacco, was high among men in all of these rural populations with tobacco use started during adolescence in all HDSS sites. Innovative communication strategies for behaviour change targeting adolescents in schools and adult men and women at work or at home, may create a mass awareness about adverse health consequences of tobacco smoking or chewing tobacco. Such efforts, to be effective, however, need to be supported by strong legislation and leadership. Only four of the five countries involved in this multi-site study have ratified the Framework Convention on Tobacco Control, and even where it has been ratified, implementation is uneven.
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http://dx.doi.org/10.3402/gha.v2i0.1997DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2785137PMC
September 2009

Blood pressure in adult rural INDEPTH population in Asia.

Glob Health Action 2009 Sep 28;2. Epub 2009 Sep 28.

Filabavi Health and Demographic Surveillance System, Vietnam.

Introduction: High blood pressure (BP) is a well-known major risk factor for cardiovascular diseases and is a leading contributor to cardiovascular mortality and morbidity worldwide. Reliable population-based BP data from low-middle income countries are sparse.

Objective: This paper reports BP distributions among adults in nine rural populations in five Asian countries and examines the association between high BP and associated risk factors, including gender, age, education, and body mass index.

Methods: A multi-site cross-sectional study of the major non-communicable disease risk factors (tobacco and alcohol use, fruit and vegetable intake, physical activity patterns) was conducted in 2005 in nine Health and Demographic Surveillance System (HDSS) sites in five Asian countries, all part of the INDEPTH Network. In addition to the self-report questions on risk factors, height and weight, and BP were measured during household visits using standard protocols of the WHO STEPwise approach to Surveillance.

Results: In all the study sites (except among men and women in WATCH and among women in Chililab), the mean levels of systolic BP were greater than the optimal threshold (115 mmHg). A considerable proportion of the study populations - especially those in the HDSS in India, Indonesia, and Thailand - had high BP (systolic BP >/= 140 mmHg or diastolic BP >/= 90 mmHg or on treatment with BP medications). A more conservative definition of high BP (systolic BP >/= 160 mmHg or diastolic BP >/= 100 mmHg) substantially reduced the prevalence rate. The marked differences in the proportion of the populations on high BP medication (range between 0.6 and 10.8%) raised problems in comparing the prevalence of high BP across sites when using the commonly used definition of high BP as in this study. In the four HDSS in Bangladesh, women had a higher prevalence of high BP than men; the reverse was true in the other sites (Chililab, Filabavi in Vietnam; Kanchanaburi, Thailand; and Vadu, India) where men experienced higher prevalence than women. Overweight and obesity were significantly associated with high BP, with odds ratio ranging from two in Chililab to five in Filabavi (both in Vietnam HDSS).

Conclusion: The patterns of BP in these nine cross-sectional surveys were complex, reflecting the fact that the Asian countries are at different stages of the epidemiological transition. Actions to prevent the rise of BP levels are urgently required. An emphasis should be placed on cost-effective interventions to reduce salt consumption in the population as an immediate priority.
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http://dx.doi.org/10.3402/gha.v2i0.2010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2785103PMC
September 2009

Patterns of alcohol consumption in diverse rural populations in the Asian region.

Glob Health Action 2009 Sep 28;2. Epub 2009 Sep 28.

Chililab Health and Demographic Surveillance System, 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.
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http://dx.doi.org/10.3402/gha.v2i0.2017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2785538PMC
September 2009

Self-reported prevalence of chronic diseases and their relation to selected sociodemographic variables: a study in INDEPTH Asian sites, 2005.

Prev Chronic Dis 2008 Jul 15;5(3):A86. Epub 2008 Jun 15.

FilaBavi Demographic Surveillance Site, 1 Ton That Tung Ha Noi, Hanoi 844, Vietnam.

Introduction: Lack of reliable population-based data, especially morbidity data, is a barrier to preventing and controlling chronic diseases in developing countries. We report the self-reported prevalences of major chronic diseases in Southeast Asia and examine their relation to selected sociodemographic variables in adults.

Methods: Data are from a 2005 cross-site study of 8 sites in 5 Asian countries that surveyed 18,484 people aged 25-64 years. Respondents were asked whether they had been told by a health care worker that they had any of 7 chronic health conditions: joint problems, stroke, heart disease, diabetes, pulmonary disease, hypertension, or cancer. Information about participants' sex, age, and educational level was also obtained.

Results: We found that 22.7% of men and 31.6% of women reported having at least 1 of the chronic health conditions of interest, and 5.1% of men and 9.2% of women reported having 2 or more chronic conditions. Multivariate regression analyses showed that women had more chronic conditions than men, the prevalence of chronic conditions increased with age, and people with the least education were more likely to have chronic conditions.

Conclusion: Chronic conditions are commonly reported among adults in Asian countries. Disparities in the prevalence of chronic conditions by sex and education are evident.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2483549PMC
July 2008