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Tran NN, Pham-The T, Pham TN, Vu HT, Luong KN, Nishijo M. Neurodevelopmental Effects of Perinatal TCDD Exposure Differ from Those of Other PCDD/Fs in Vietnamese Children Living near the Former US Air Base in Da Nang, Vietnam. Toxics 2023; 11:103. [PMID: 36850978 PMCID: PMC9961255 DOI: 10.3390/toxics11020103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
This study reports that children exposed to 2,3,7,8-tetra-chlorodibenzo-p-dioxin (TCDD), the major toxin in Agent Orange, from the breast milk of mothers residing near the former Da Nang US air base in Vietnam may have specific alterations in higher brain functions, resulting in social and communication deficits, including autism spectrum disorder (ASD). After the age of 8 years, girls with high TCDD showed increased attention deficit hyperactivity disorder (ADHD)-like behaviors and altered mirror neuron activity, which is often observed in children with ASD. However, no significant relationship between autistic traits and toxic equivalency values of polychlorinated dibenzodioxins and polychlorinated dibenzofurans (TEQ-PCDD/Fs) was found in these children. Notably, boys with high levels of TEQ-PCDD/Fs showed poor language and motor development in the first 3 years of life, although boys with high TCDD levels did not. However, at 8 years of age, boys with high TCDD showed reading learning difficulties, a neurodevelopmental disorder. These findings suggest that perinatal TCDD exposure impacts social-emotional cognitive functions, leading to sex-specific neurodevelopmental disorders-learning difficulty in boys and ADHD in girls. Future studies with a greater number of children exposed to high levels of TCDD are necessary to estimate the threshold values for neurodevelopmental effects.
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Affiliation(s)
- Nghi Ngoc Tran
- Ministry of Health, Vietnam Government, Hanoi 10000, Vietnam
| | - Tai Pham-The
- Faculty of Medicine, Vietnam Military Medical University, Hanoi 10000, Vietnam
| | - Thao Ngoc Pham
- Faculty of Medicine, Vietnam Military Medical University, Hanoi 10000, Vietnam
| | - Hoa Thi Vu
- Department of Public Health, Kanazawa Medial University, Uchinada 252-0815, Ishikawa, Japan
| | - Khue Ngoc Luong
- Ministry of Health, Vietnam Government, Hanoi 10000, Vietnam
| | - Muneko Nishijo
- Department of Public Health, Kanazawa Medial University, Uchinada 252-0815, Ishikawa, Japan
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Nguyen DT, Luong KN, Phan HT, Tran AT, Dao ST, Poudel AN, Hoang TM, Do VV, Le DM, Pham GH, Nguyen LT, Duong AT, Hoang MV. Cost-Effectiveness of Population-Based Tobacco Control Interventions on the Health Burden of Cardiovascular Diseases in Vietnam. Asia Pac J Public Health 2021; 33:854-860. [PMID: 33764194 DOI: 10.1177/1010539521999873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study sought to assess the cost-effectiveness of population-based tobacco control interventions, which included health promotion and education, smoke-free models, cessation programs, warning on package, marketing bans, and raising tax. Standardized activity-based costing ingredient approach was applied with the provider perspective to calculate interventions cost from 2013 to 2017. The potential health impacts of the aforementioned interventions were calculated through a Microsoft Excel-based modeling adapted from Higashi et al and Ngalesoni et al. All six population-based tobacco control interventions were highly cost-effective with ranges from 1405 VND (Vietnamese Dong) to 135 560 VND per DALY (disability-adjusted life year) averted. It was identified that raising cigarette taxes and applying health warnings on tobacco packages are the most favorable, cost-effective interventions. The results from this study provide a robust message that calls for increased attention and efforts in developing an appropriate policy agenda, which jointly integrates both political and community-based interventions, to maximize intervention impact on tobacco use.
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Affiliation(s)
| | - Khue Ngoc Luong
- Vietnam Tobacco Control Fund, Ministry of Health, Hanoi, Vietnam
| | - Hai Thi Phan
- Vietnam Tobacco Control Fund, Ministry of Health, Hanoi, Vietnam
| | | | | | | | | | - Vuong Van Do
- Hanoi University of Public Health, Hanoi, Vietnam
| | - Dat Minh Le
- Hanoi University of Public Health, Hanoi, Vietnam
| | | | - Linh Thuy Nguyen
- Vietnam Tobacco Control Fund, Ministry of Health, Hanoi, Vietnam
| | - Anh Tu Duong
- Vietnam Tobacco Control Fund, Ministry of Health, Hanoi, Vietnam
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Tran NTT, Blizzard CL, Luong KN, Truong NLVN, Tran BQ, Otahal P, Nelson MR, Magnussen CG, Van Bui T, Srikanth V, Au TB, Ha ST, Phung HN, Tran MH, Callisaya M, Gall S. Sex differences in total cholesterol of Vietnamese adults. PLoS One 2021; 16:e0256589. [PMID: 34415963 PMCID: PMC8378708 DOI: 10.1371/journal.pone.0256589] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 08/10/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The mid-life emergence of higher levels of total cholesterol (TC) for women than for men has been observed in different Western and Asian populations. The aim of this study was to investigate whether there is evidence of this in Vietnam and, if so, whether it can be explained by ageing, by body size and fatness, or by socio-demographic characteristics and behavioural factors. METHODS Participants (n = 14706, 50.9% females) aged 25-64 years were selected by multi-stage stratified cluster sampling from eight provinces each representing one of the eight geographical regions of Vietnam. Measurements were made using the World Health Organization STEPS protocols. Linear regression was used to assess the independent contributions of potential explanatory factors to mean levels of TC. Data were analysed using complex survey methods. RESULTS Men and women had similar mean levels of body mass index (BMI), and men had modestly higher mean levels of waist circumference (WC), in each 5-year age category. The mean TC of women increased more or less continuously across the age range but with a step-up at age 50 years to reach higher concentrations on average than those of their male counterparts. The estimated step-up was not eliminated by adjustment for anthropometric indices including BMI or WC, or by adjustment for socio-demographic characteristics or behavioural factors. The estimated step-up was least for women with the greatest weight. CONCLUSION There is a marked step-up in TC at age 50 years for Vietnamese women that cannot be explained by their age, or by their body fatness or its distribution, or by their socio-demographic characteristics or behavioural factors, and which results in greater mean levels of TC for middle-aged women than for their male counterparts in Vietnam.
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Affiliation(s)
- Nga Thi Thu Tran
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | | | - Khue Ngoc Luong
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Hanoi, Vietnam
| | - Ngoc Le Van Ngoc Truong
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Hanoi, Vietnam
| | - Bao Quoc Tran
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Hanoi, Vietnam
| | - Petr Otahal
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Mark R. Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Costan G. Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Tan Van Bui
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Velandai Srikanth
- Department of Medicine, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Thuy Bich Au
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Son Thai Ha
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Hanoi, Vietnam
| | - Hai Ngoc Phung
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Mai Hoang Tran
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Michele Callisaya
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Department of Medicine, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Seana Gall
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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Minh Dao AT, Thi Thu Nguyen H, Kim GB, Phan HT, Van Nguyen H, Doan HT, Luong KN, Nguyen LT, Van Hoang M, Pham NTQ, Nguyen QT. Knowledge and Determinants of Health Consequences of Cigarette Smoking Among Vietnamese Adults, 2015. Asia Pac J Public Health 2019; 31:463-475. [PMID: 31189347 DOI: 10.1177/1010539519854878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. Vietnam was one of 16 countries that implemented the second round of the GATS (Global Adult Tobacco Survey) in 2015. Aims. To assess knowledge and determinants of health consequences of different types of cigarette smoking among Vietnamese adults. Methods. A cross-sectional study among adults aged 15 years combined with using 15% of the master sample from the national sampling frame of the population and housing census was conducted. Multilevel analysis using Poisson regression was undertaken. Results. Knowledge on the health consequences of cigarette smoking has not significantly improved in the GATS-2015. Adults believe that active smoking had more of an impact on health than secondhand smoking and 24.5% and 43% of them answered that smoking light and e-cigarettes, respectively, causes less harm than regular cigarettes, and 17.3% and 18.1% of adults are not aware of the difference between them, respectively. Conclusion. Household and community's role had little impact in the adult knowledge of smoking health consequences. It is necessary to disseminate information on the "other tobacco product" and to improve public knowledge on specific health consequences, to enhance household and community's role in conveying health education messages to individuals.
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Affiliation(s)
| | | | | | - Hai Thi Phan
- Vietnam Steering Committee on Smoking and Health, Hanoi, Vietnam
| | | | - Huyen Thu Doan
- Vietnam Steering Committee on Smoking and Health, Hanoi, Vietnam
| | - Khue Ngoc Luong
- Vietnam Steering Committee on Smoking and Health, Hanoi, Vietnam
| | - Lam Tuan Nguyen
- World Health Organization Office in Viet Nam, Hanoi, Vietnam
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Tran NTT, Blizzard CL, Luong KN, Truong NLV, Tran BQ, Otahal P, Nelson M, Magnussen C, Gall S, Bui TV, Srikanth V, Au TB, Ha ST, Phung HN, Tran MH, Callisaya M. The importance of waist circumference and body mass index in cross-sectional relationships with risk of cardiovascular disease in Vietnam. PLoS One 2018; 13:e0198202. [PMID: 29813112 PMCID: PMC5973604 DOI: 10.1371/journal.pone.0198202] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 05/15/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Waist circumference (WC) is an indicator of intra-abdominal adipose tissue, high levels of which confer an increased risk of cardiometabolic disease. Population data on WC should be more informative than data on body mass index (BMI), which is a general indicator of body size. This study aimed to evaluate the importance of WC relative to BMI in cross-sectional relationships with blood pressure (BP), glucose, and total cholesterol (TC) in the adult population of Vietnam. METHODS The data were collected in a population-based survey conducted during 2009-10 using the "WHO STEPwise approach to surveillance of risk factors for non-communicable disease" (STEPS) methodology. The survey participants (n = 14 706 aged 25 to 64 years) were selected by multi-stage stratified cluster sampling from eight provinces representative of the eight geographical regions of Vietnam. All measurements were performed in accordance with the STEPS protocols. All analyses were performed using complex survey methods. RESULTS The measurements of WC and BMI were highly correlated (men r = 0.80, women r = 0.77). For men, the strongest and predominant associations with BP, glucose, and TC were for WC or an index based on WC. For women, this was true for glucose but BMI was more important for BP and TC. WC or an index based on WC provided better discrimination than BMI of hypertension and elevated glucose, and of raised TC for men. Information on four new anthropometric indices did not improve model fit or subject discrimination. CONCLUSION For BP/hypertension, glucose/elevated glucose, and TC/raised TC, WC was more informative than BMI for Vietnamese men, but both WC and BMI were important for Vietnamese women. Both WC and BMI need to be assessed for estimation of CVD risk in Vietnam.
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Affiliation(s)
- Nga Thi Thu Tran
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | | | - Khue Ngoc Luong
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Ha Noi, Vietnam
| | - Ngoc Le Van Truong
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Ha Noi, Vietnam
| | - Bao Quoc Tran
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Ha Noi, Vietnam
| | - Petr Otahal
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Mark Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Costan Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Seana Gall
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Tan Van Bui
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.,Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam
| | - Velandai Srikanth
- Department of Medicine, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Thuy Bich Au
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Son Thai Ha
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Ha Noi, Vietnam
| | - Hai Ngoc Phung
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Mai Hoang Tran
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Michele Callisaya
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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Bui TV, Blizzard CL, Luong KN, Truong NLV, Tran BQ, Otahal P, Gall S, Nelson MR, Au TB, Ha ST, Phung HN, Tran MH, Callisaya M, Srikanth V. National survey of risk factors for non-communicable disease in Vietnam: prevalence estimates and an assessment of their validity. BMC Public Health 2016; 16:498. [PMID: 27286818 PMCID: PMC4902939 DOI: 10.1186/s12889-016-3160-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 05/13/2016] [Indexed: 11/10/2022] Open
Abstract
Background To estimate the prevalence of non-communicable disease (NCD) risk factors at a provincial level in Vietnam, and to assess whether the summary estimates allow reliable inferences to be drawn regarding regional differences in risk factors and associations between them. Methods Participants (n = 14706, 53.5 % females) aged 25–64 years were selected by multi-stage stratified cluster sampling from eight provinces each representing one of the eight geographical regions of Vietnam. Measurements were made using the World Health Organization STEPS protocols. Data were analysed using complex survey methods. Results Differences by sex in mean years of schooling (males 8.26 ± 0.20, females 7.00 ± 0.18), proportions of current smokers (males 57.70 %, females 1.73 %), and binge-drinkers (males 25.11 %, females 0.63 %), and regional differences in diet, reflected the geographical and socio-cultural characteristics of the country. Provinces with a higher proportion of urban population had greater mean levels of BMI (r = 0.82), and lesser proportions of active people (r = −0.89). The associations between the summary estimates were generally plausible (e.g. physical activity and BMI, r = −0.80) but overstated, and with some anomalous findings due to characterisation of smoking and hypertension by STEPS protocols. Conclusions This report provides an extensive description of the sex-specific and regional distribution of NCD risk factors in Vietnam and an account of some health-related consequences of industrialisation in its early stages. The STEPS protocols can be utilized to provide aggregate data for valid between-population comparisons, but with important caveats identified.
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Affiliation(s)
- Tan Van Bui
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia.,Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Christopher Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia.
| | - Khue Ngoc Luong
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Ha Noi, Vietnam
| | - Ngoc Le Van Truong
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Ha Noi, Vietnam
| | - Bao Quoc Tran
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Ha Noi, Vietnam
| | - Petr Otahal
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Seana Gall
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Mark R Nelson
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Thuy Bich Au
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Son Thai Ha
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Ha Noi, Vietnam
| | - Hai Ngoc Phung
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Mai Hoang Tran
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Michele Callisaya
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia.,Department of Medicine, Southern Clinical School, Monash Medical Centre, Monash University, Clayton, VIC, Australia
| | - Velandai Srikanth
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia.,Department of Medicine, Southern Clinical School, Monash Medical Centre, Monash University, Clayton, VIC, Australia
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Bui TV, Blizzard CL, Luong KN, Truong NLV, Tran BQ, Otahal P, Srikanth V, Nelson MR, Au TB, Ha ST, Phung HN, Tran MH, Callisaya M, Gall S. Physical Activity in Vietnam: Estimates and Measurement Issues. PLoS One 2015; 10:e0140941. [PMID: 26485044 PMCID: PMC4618512 DOI: 10.1371/journal.pone.0140941] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 09/30/2015] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Our aims were to provide the first national estimates of physical activity (PA) for Vietnam, and to investigate issues affecting their accuracy. METHODS Measurements were made using the Global Physical Activity Questionnaire (GPAQ) on a nationally-representative sample of 14706 participants (46.5% males, response 64.1%) aged 25-64 years selected by multi-stage stratified cluster sampling. RESULTS Approximately 20% of Vietnamese people had no measureable PA during a typical week, but 72.9% (men) and 69.1% (women) met WHO recommendations for PA by adults for their age. On average, 52.0 (men) and 28.0 (women) Metabolic Equivalent Task (MET)-hours/week (largely from work activities) were reported. Work and total PA were higher in rural areas and varied by season. Less than 2% of respondents provided incomplete information, but an additional one-in-six provided unrealistically high values of PA. Those responsible for reporting errors included persons from rural areas and all those with unstable work patterns. Box-Cox transformation (with an appropriate constant added) was the most successful method of reducing the influence of large values, but energy-scaled values were most strongly associated with pathophysiological outcomes. CONCLUSIONS Around seven-in-ten Vietnamese people aged 25-64 years met WHO recommendations for total PA, which was mainly from work activities and higher in rural areas. Nearly all respondents were able to report their activity using the GPAQ, but with some exaggerated values and seasonal variation in reporting. Data transformation provided plausible summary values, but energy-scaling fared best in association analyses.
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Affiliation(s)
- Tan Van Bui
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | | | - Khue Ngoc Luong
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Ha Noi, Vietnam
| | - Ngoc Le Van Truong
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Ha Noi, Vietnam
| | - Bao Quoc Tran
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Ha Noi, Vietnam
| | - Petr Otahal
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Velandai Srikanth
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Department of Medicine, Southern Clinical School, Monash Medical Centre, Monash University, Melbourne, Victoria, Australia
| | - Mark Raymond Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Thuy Bich Au
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Son Thai Ha
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Ha Noi, Vietnam
| | - Hai Ngoc Phung
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Mai Hoang Tran
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Michele Callisaya
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Department of Medicine, Southern Clinical School, Monash Medical Centre, Monash University, Melbourne, Victoria, Australia
| | - Seana Gall
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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Van Bui T, Blizzard CL, Luong KN, Van Truong NL, Tran BQ, Otahal P, Srikanth V, Nelson MR, Au TB, Ha ST, Phung HN, Tran MH, Callisaya M, Gall S. Alcohol Consumption in Vietnam, and the Use of 'Standard Drinks' to Measure Alcohol Intake. Alcohol Alcohol 2015; 51:186-95. [PMID: 26884509 DOI: 10.1093/alcalc/agv082] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Accepted: 06/18/2015] [Indexed: 11/14/2022] Open
Abstract
AIMS To provide nationally representative data on alcohol consumption in Vietnam and to assess whether reported numbers of 'standard drinks' consumed have evidence of validity (particularly in rural areas where home-made alcohol is consumed from cups of varying size). METHODS A nationally representative population-based survey of 14,706 participants (46.5% males, response proportion 64.1%) aged 25-64 years in Vietnam. Measurements were made in accordance with WHO STEPS protocols. Data were analysed using complex survey methods. RESULTS Among men, 80% reported drinking alcohol during the last year, and 40% were hazardous/harmful drinkers. Approximately 60% of men and <5% of women had consumed alcohol during the last week, with one-in-four of the men reporting having consumed at least five standard drinks on at least one occasion. Numbers of standard drinks reported by men were associated with blood pressure/hypertension, particularly in rural areas (P < 0.001 for trend). Most of the calibration and discrimination possible from self-reported information on alcohol consumption was provided by binary responses to questions on whether or not alcohol had been consumed during the reference period. CONCLUSION Alcohol use and harmful consumption were common among Vietnamese men but less pronounced than in Western nations. Self-reports of quantity of alcohol consumed in terms of standard drinks had predictive validity for blood pressure and hypertension even in rural areas. However, using detailed measures of consumption resulted in only minor improvements in prediction compared to simple measures.
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Affiliation(s)
- Tan Van Bui
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - C Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Khue Ngoc Luong
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Ha Noi, Vietnam
| | - Ngoc Le Van Truong
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Ha Noi, Vietnam
| | - Bao Quoc Tran
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Ha Noi, Vietnam
| | - Petr Otahal
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Velandai Srikanth
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia Department of Medicine, Southern Clinical School, Monash Medical Centre, Monash University, Clayton, VIC, Australia
| | - Mark R Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Thuy Bich Au
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Son Thai Ha
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Ha Noi, Vietnam
| | - Hai Ngoc Phung
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Mai Hoang Tran
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Michele Callisaya
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia Department of Medicine, Southern Clinical School, Monash Medical Centre, Monash University, Clayton, VIC, Australia
| | - Seana Gall
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
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Bui TV, Blizzard L, Luong KN, Truong NLV, Tran BQ, Ha ST, Phung HN, Otahal P, Velandai S, Nelson MR, Au TB, Tran MH, Huynh QL, Callisaya M, Gall S. Declining Prevalence of Tobacco Smoking in Vietnam. Nicotine Tob Res 2014; 17:831-8. [DOI: 10.1093/ntr/ntu202] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 09/26/2014] [Indexed: 11/14/2022]
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Vuong DA, Flessa S, Marschall P, Ha ST, Luong KN, Busse R. Determining the impacts of hospital cost-sharing on the uninsured near-poor households in Vietnam. Int J Equity Health 2014; 13:40. [PMID: 24885268 PMCID: PMC4057622 DOI: 10.1186/1475-9276-13-40] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 05/06/2014] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The study objective was to identify the size of different hospital financing sources for different hospital services and their impact on the uninsured. METHODS A panel dataset of 84 public general hospitals (2005-2008) with cross-section data on hospital activity and hospital revenue was created and used to calculate unit costs of different hospital services by applying multiple regression models. The resulting risk of catastrophic health expenditure (CHE) was estimated based on official income statistics. RESULTS Average user fees (UF) for outpatient visits and inpatient bed days were US$4.13 and US$20.27, while actual full costs (AFC) were US$8.41 and US$36.66, respectively. These unit costs were 2.5 times higher in hospitals at the central versus the provincial level. UF for surgical inpatient bed days were 3.6 times that of non-surgical treatments (US$47.50 vs. 12.87) and AFC 5.0 times (US$101.72 vs. 20.08). UF accounted for 44.6%-77.9% of the AFC, the rest (22.1%-55.4%) was provided by direct government support (DGS). One surgical inpatient treatment at either central or provincial hospital level and one non-surgical inpatient treatment at central hospital level, immediately pushed uninsured near-poor households at risk of CHE. CONCLUSIONS Around 45% of hospital AFC was paid by DGS, the larger rest by UF. UF have become a great financial burden on the uninsured near-poor households, who have to pay for these out-of-pocket and therefore may not utilize even necessary services. If the rate of DGS were reduced, this would have the effect of increasing UF, but the savings to Government could be spent on subsidizing insurance to ensure that a larger part of the population can cover UF through insurance, especially the near-poor households.
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Affiliation(s)
- Duong Anh Vuong
- Department of Medical Service Administration, Vietnam Ministry of Health, Hanoi, Vietnam
| | - Steffen Flessa
- Department of Business Administration and Health Care Management, Ernst-Moritz-Arndt-University of Greifswald, Greifswald, Germany
| | - Paul Marschall
- Department of Business Administration and Health Care Management, Ernst-Moritz-Arndt-University of Greifswald, Greifswald, Germany
| | - Son Thai Ha
- Department of Medical Service Administration, Vietnam Ministry of Health, Hanoi, Vietnam
| | - Khue Ngoc Luong
- Department of Medical Service Administration, Vietnam Ministry of Health, Hanoi, Vietnam
| | - Reinhard Busse
- Department of Health Care Management, Berlin University of Technology, Berlin, Germany
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