RESUMO
OBJECTIVE: Antibiotic resistance is increasing globally, associated with many failures in pneumonia treatment. This study aimed to evaluate antibiotic use in children treated for outpatient CAP (Community-Acquired Pneumonia). METHODS: A cross-sectional descriptive retrospective study was conducted, focusing on data from outpatient prescriptions for pneumonia in patients aged 2â192 months in 2019â2021. RESULTS: All antibiotic prescriptions are considered empiric as no documented bacterial and viral tests exist for children with non-severe CAP. Single antibiotic therapy (66%) had a 2-fold higher rate than combination therapy (34%). Amoxicillin/clavulanic acid (50.77%) and azithromycin (30.74%) were the most commonly prescribed in both single and combination therapies, thus determining antibiotic cost (80.15%). Besides, azithromycin (97.92%), cefuroxime (86.26%), and cefpodoxime (60.48%) were prescribed with high adherence to dose guidelines, except for amoxicillin (34.57%). These medicines are prescribed highly compliant (>83%) with dosing interval guidelines. Furthermore, significantly more brand-name antibiotics (56.5%) are prescribed than generic antibiotics (43.5%). In particular, antibiotic class, antibiotic origin, and antibiotic therapies showed significant association with rational antibiotic prescriptions for dose and dose interval (p < 0.05). CONCLUSIONS: Amoxicillin/clavulanic acid is the most frequently prescribed medicine and the most inappropriate due to non-compliance with dose guidelines for CAP treatment. Generic antibiotic use for single therapy should be encouraged based on rapid and accurate diagnostic testing for viruses and bacteria to reduce antibiotic resistance in developing countries. Moreover, the study result has also shown that therapies and antibiotics (class and origin) exhibited significant association with rational prescriptions for CAP treatment for pediatrics.
Assuntos
Antibacterianos , Infecções Comunitárias Adquiridas , Humanos , Antibacterianos/uso terapêutico , Estudos Transversais , Estudos Retrospectivos , Pré-Escolar , Criança , Lactente , Feminino , Masculino , Vietnã , Infecções Comunitárias Adquiridas/tratamento farmacológico , Adolescente , Pacientes Ambulatoriais/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Pneumonia/tratamento farmacológico , Pneumonia/microbiologia , Assistência Ambulatorial/estatística & dados numéricosRESUMO
Background: Children's growth is increasingly considered a key mediator of later life outcomes. When examining weight growth, the correlation between repeated observations on the same subject must be regarded as well-modelled. This study aimed to analyze children's weight growth variations and associated factors in Ethiopia, India, Peru, and Vietnam using a fractional polynomial mixed-effects model. Methods: This study used longitudinal data from the Young Lives Cohort Study conducted from 2002 to 2016 in Ethiopia, India, Peru, and Vietnam. The study included 7,140 children of 1 to 15 years old A fractional polynomial mixed-effects model was used to analyze the data. Results: Ethiopian, Peruvian, and Vietnamese children had significantly higher average body weights than children in India (1.426, P<0.001; 1.992, P<0.001; 1.334, P<0.001, respectively). Girl children's average body weight was significantly 0.15 times less than that of boys (-0.148; P=0.027). The average weight of rural children was significantly 0.671 times less than that of urban children (0.671, P<0.001). Children from Peru and Vietnam had higher rates of weight change than those from India. However, the rate of weight change was lower in Ethiopian children than in Indian children. Children from urban areas had a significantly higher rate of weight gain than those from rural areas. Conclusion: Country, sex, residence, parental education, household size, wealth, good drinking water, and reliable power affected children's longitudinal weight growth. Therefore, WHO and the nation's health ministry should monitor children's weight growth status and these associated factors to plan future action.
Assuntos
Peso Corporal , População Rural , Humanos , Etiópia , Vietnã/epidemiologia , Peru , Masculino , Feminino , Criança , Índia , Pré-Escolar , Adolescente , Lactente , População Rural/estatística & dados numéricos , Estudos Longitudinais , População Urbana/estatística & dados numéricos , Desenvolvimento Infantil/fisiologia , Aumento de Peso , Estudos de CoortesRESUMO
We estimated the effect of community-level natural hazard exposure during prior developmental stages on later anxiety and depression symptoms among young adults and potential differences stratified by gender. We analyzed longitudinal data (2002-2020) on 5585 young adults between 19 and 26 years in Ethiopia, India, Peru, and Vietnam. A binary question identified community-level exposure, and psychometrically validated scales measured recent anxiety and depression symptoms. Young adults with three exposure histories ("time point 1," "time point 2," and "both time points") were contrasted with their unexposed peers. We applied a longitudinal targeted minimum loss-based estimator with an ensemble of machine learning algorithms for estimation. Young adults living in exposed communities did not exhibit substantially different anxiety or depression symptoms from their unexposed peers, except for young women in Ethiopia who exhibited less anxiety symptoms (average causal effect [ACE] estimate = - 8.86 [95% CI: - 17.04, - 0.68] anxiety score). In this study, singular and repeated natural hazard exposures generally were not associated with later anxiety and depression symptoms. Further examination is needed to understand how distal natural hazard exposures affect lifelong mental health, which aspects of natural hazards are most salient, how disaster relief may modify symptoms, and gendered, age-specific, and contextual differences.
Assuntos
Ansiedade , Depressão , Humanos , Feminino , Masculino , Depressão/epidemiologia , Depressão/etiologia , Ansiedade/epidemiologia , Adulto Jovem , Adulto , Etiópia/epidemiologia , Estudos Longitudinais , Vietnã/epidemiologia , Peru/epidemiologia , Índia/epidemiologia , Países em DesenvolvimentoRESUMO
Helicobacter pylori is the most common cause of gastroduodenal diseases. The concept that cagA-positive H. pylori is a risk factor for gastric cancer appears to be true only for H. pylori strains from Western countries. Other virulent genes may have a synergistic interaction with cagA during pathogenesis. This study aims to investigate H. pylori cagA, vacA, and iceA prevalence, genotypes, and their association to clinical outcomes in Vietnamese patients. The cagA status and vacA and iceA genotypes were determined using the PCR technique on DNA extracted from gastric biopsies of 141 patients with gastroduodenal diseases. After performing molecular analysis for cagA, vacA, and iceA genes, samples with mixed H. pylori strains, positivity, or negativity for both cagA and cagPAI-empty site, or unidentified genotypes were excluded. Finally, 107 samples were examined. The presence of the cagA, vacA, and iceA genes were detected in 77.6%, 100%, and 80.4% of cases, respectively. Notably, cagA( +) with EPIYA-ABD, vacA s1i1m1, vacA s1i1m2, iceA1, and iceA2 accounted for 73.8%, 44.9%, 33.6%, 48.6%, and 31.8% of cases, respectively. Four iceA2 subtypes (24-aa, 59-aa, 94-aa, and 129-aa variants) were found, with the 59-aa variant the most prevalent (70.6%). The cagA( +)/vacAs1i1m1/iceA1 and cagA( +)/vacAs1i1m2/iceA1 combinations were found in 26.2% and 25.1% of cases, respectively. A multivariable logistic regression analysis was performed, after adjusting for age and gender, with the gastritis group was used as a reference control. Statistically significant associations were found between the vacA s1i1m2 genotype, the iceA1 variant, and the cagA( +)/vacAs1i1m2/iceA1 combination and gastric cancer; the adjusted ORs were estimated as 18.02 (95% CI: 3.39-95.81), 4.09 (95% CI: 1.1-15.08), and 16.19 (95% CI: 3.42-76.66), respectively. Interestingly, for the first time, our study found that vacA s1i1m2, but not vacA s1i1m1, was a risk factor for gastric cancer. This study illustrates the genetic diversity of the H. pylori cagA, vacA, and iceA genes across geographical regions and contributes to understanding the importance of these genotypes for clinical outcomes.
Assuntos
Antígenos de Bactérias , Proteínas de Bactérias , Genótipo , Infecções por Helicobacter , Helicobacter pylori , Humanos , Proteínas de Bactérias/genética , Helicobacter pylori/genética , Helicobacter pylori/isolamento & purificação , Helicobacter pylori/classificação , Helicobacter pylori/patogenicidade , Vietnã/epidemiologia , Antígenos de Bactérias/genética , Infecções por Helicobacter/microbiologia , Infecções por Helicobacter/epidemiologia , Estudos Transversais , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Proteínas da Membrana Bacteriana Externa/genética , Idoso , Adulto Jovem , Prevalência , Fatores de Virulência/genéticaRESUMO
This study investigated the occurrence and distribution of per- and polyfluoroalkyl substances (PFASs) in house dust samples from six regions across four continents. PFASs were detected in all indoor dust samples, with total median concentrations ranging from 17.3 to 197 ng/g. Among the thirty-one PFAS analytes, eight compounds, including emerging PFASs, exhibited high detection frequencies in house dust from all six locations. The levels of PFASs varied by region, with higher concentrations found in Adelaide (Australia), Tianjin (China), and Carbondale (United States, U.S.). Moreover, PFAS composition profiles also differed among regions. Dust from Australia and the U.S. contained high levels of 6:2 fluorotelomer phosphate ester (6:2 diPAP), while perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) were predominant in other regions. Furthermore, our results indicate that socioeconomic factors impact PFAS levels. The assessment of human exposure through dust ingestion and dermal contact indicates that toddlers may experience higher exposure levels than adults. However, the hazard quotients of PFASs for both toddlers and adults were below one, indicating significant health risks are unlikely. Our study highlights the widespread occurrence of PFASs in global indoor dust and the need for continued monitoring and regulation of these chemicals.
Assuntos
Poluição do Ar em Ambientes Fechados , Poeira , Fluorocarbonos , Mapeamento Geográfico , Internacionalidade , Poluição do Ar em Ambientes Fechados/efeitos adversos , Poluição do Ar em Ambientes Fechados/análise , Brasil , Poeira/análise , Exposição Ambiental/efeitos adversos , Fluorocarbonos/efeitos adversos , Fluorocarbonos/análise , Fluorocarbonos/química , Fluorocarbonos/classificação , Habitação , Medição de Risco , Vietnã , HumanosRESUMO
OBJECTIVE: To measure the proportion of women's preferences for CS in hospitals with high caesarean section rates and to identify related factors. DESIGN: A cross-sectional hospital-based postpartum survey was conducted. We used multilevel multivariate logistic regression and probit models to analyse the association between women's caesarean section preferences and maternal characteristics. Probit models take into account selection bias while excluding women who had no preference. SETTING: Thirty-two hospitals in Argentina, Thailand, Vietnam and Burkina Faso were selected. PARTICIPANTS: A total of 1,979 post-partum women with no potential medical need for caesarean section were included among a representative sample of women who delivered at each of the participating facilities during the data collection period. FINDINGS: The overall caesarean section rate was 23.3 %. Among women who declared a preference in late pregnancy, 9 % preferred caesarean section, ranging from 1.8 % in Burkina Faso to 17.8 % in Thailand. Primiparous women were more likely to prefer a caesarean section than multiparous women (ß=+0.16 [+0.01; +0.31]; p = 0.04). Among women who preferred caesarean section, doctors were frequently cited as the main influencers, and "avoid pain in labour" was the most common perceived benefit of caesarean section. KEY CONCLUSIONS: Our results suggest that a high proportion of women prefer vaginal birth and highlight that the preference for caesarean section is linked to women's fear of pain and the influence of doctors. These results can inform the development of interventions aimed at supporting women and their preferences, providing them with evidence-based information and changing doctors' behaviour in order to reduce the number of unnecessary caesarean sections. CLINICAL TRIAL REGISTRY: The QUALI-DEC trial is registered on the Current Controlled Trials website (https://www.isrctn.com/) under the number ISRCTN67214403.
Assuntos
Cesárea , Preferência do Paciente , Humanos , Feminino , Cesárea/psicologia , Cesárea/estatística & dados numéricos , Estudos Transversais , Adulto , Gravidez , Preferência do Paciente/estatística & dados numéricos , Preferência do Paciente/psicologia , Burkina Faso , Tailândia , Inquéritos e Questionários , Vietnã , Argentina , Países em Desenvolvimento/estatística & dados numéricosRESUMO
Foot-and-mouth disease is a highly contagious disease that affects cloven-hoofed animals. It has an important socio-economic impact on the livestock industry because it produces a drastic decrease of productivity. The disease has been successfully eradicated from some regions, including North America and Western Europe, but it is still endemic in developing countries. Agriculture plays an important role in the national economy of Vietnam, to which animal production contributes a great proportion. The concurrent circulation of foot-and-mouth disease virus (FMDV) serotypes O, A, and Asia 1 has been detected in recent years, but serotype O remains the most prevalent and is responsible for the highest numbers of outbreaks. Appropriate vaccine strain selection is an important element in the control of FMD and is necessary for the application of vaccination programs in FMD-affected regions. Here, we present updated information about the genetic and antigenic characteristics of circulating strains, collected from endemic outbreaks involving types O and A, between 2010 and 2019. Neutralizing assays showed a good in vitro match between type O strains and the monovalent O1 Campos vaccine strain. High r1 values were obtained (above 0.7) when testing a swine serum pool collected 21 days after vaccination, but the O/VTN/2/2019 strain was an exception. An EPP estimation resulted in a median neutralizing titre of about 1.65 log10, indicating that good protection could be achieved. For type A Asia SEA 97 lineage strains, acceptable individual neutralizing titres were obtained with estimated EPP values over 80% for different combinations of vaccine strains. Taking into account that the r1 value is one tool of a battery of tests that should be considered for estimating the cross-protection of a field strain against a vaccine strain, an in vivo challenge experiment was also performed, yielding a PD50 value of 8.0. The results indicate that South American strains could be potentially used for controlling outbreaks involving these lineages. This study demonstrates the importance of considering strain characteristics when choosing vaccine strains and controls.
Assuntos
Vírus da Febre Aftosa , Febre Aftosa , Vacinas Virais , Animais , Suínos , Vietnã/epidemiologia , Vacinas Virais/genética , Febre Aftosa/epidemiologia , Febre Aftosa/prevenção & controle , Antígenos Virais/genética , SorogrupoRESUMO
BACKGROUND: Improving the understanding of non-clinical factors that lead to the increasing caesarean section (CS) rates in many low- and middle-income countries is currently necessary to meet the challenge of implementing effective interventions in hospitals to reverse the trend. The objective of this study was to study the influence of organizational factors on the CS use in Argentina, Vietnam, Thailand and Burkina Faso. METHODS: A cross-sectional hospital-based postpartum survey was conducted in 32 hospitals (8 per country). We selected women with no potential medical need for CS among a random sample of women who delivered at each of the participating facilities during the data collection period. We used multilevel multivariable logistic regression to analyse the association between CS use and organizational factors, adjusted on women's characteristics. RESULTS: A total of 2,092 low-risk women who had given birth in the participating hospitals were included. The overall CS rate was 24.1%, including 4.9% of pre-labour CS and 19.3% of intra-partum CS. Pre-labour CS was significantly associated with a 24-hour anaesthetist dedicated to the delivery ward (ORa = 3.70 [1.41; 9.72]) and with the possibility to have an individual room during labour and delivery (ORa = 0.28 [0.09; 0.87]). Intra-partum CS was significantly associated with a higher bed occupancy level (ORa = 1.45 [1.09; 1.93]): intrapartum CS rate would increase of 6.3% points if the average number of births per delivery bed per day increased by 10%. CONCLUSION: Our results suggest that organisational norms and convenience associated with inadequate use of favourable resources, as well as the lack of privacy favouring women's preference for CS, and the excessive workload of healthcare providers drive the CS overuse in these hospitals. It is also crucial to enhance human and physical resources in delivery rooms and the organisation of intrapartum care to improve the birth experience and the working environment for those providing care. TRIAL REGISTRATION: The QUALI-DEC trial is registered on the Current Controlled Trials website ( https://www.isrctn.com/ ) under the number ISRCTN67214403.
Assuntos
Cesárea , Países em Desenvolvimento , Gravidez , Feminino , Humanos , Estudos Transversais , Argentina , Burkina Faso , Tailândia , Vietnã , HospitaisRESUMO
The chemical constituents and antimic robial activity of the essential oil isolated from the rhizomes of Alpinia menghaiensis S.Q. Tong & Y.M. Xia in S.Q. Tong from Vietnam was studied and reported. The techniques of gas chromatography (GC) and gas chromatography coupled with mass spectrometry (GC/MS) were used to characterize the chemical constituents of the essential oil while the microdilution assay was used to evaluate the antimicrobial activity. The main compounds identified in the rhizome essential oil consist of ß - pinene (46.5%), ß - phellandrene (25.7%) and α - pinene (8.5%). The studied essential oil inhibited the growth of Pseudomonas aeruginosa ATCC27853 with minimum inhibitory concentrations (MIC) value of 15.32 µg/mL ± 0. 01, and median inhibitory concentration (IC50) value of 32.0 ± 0.01 µg/mL. The essential oil also displayed activity against Staphylococcus aureus ATCC25923 (MIC 31.57 ± 0.01 µg/mL) and Bacillus cereus ATCC14579 (MIC, 34.21 µg/mL ± 0.01 µg/mL), and IC 50 va lue of 64.0 ± 0.01 µg/mL. This is the first report on the rhizome oil composition, as well as the antimicrobial of essential oils from A. menghaiensis . The paper discusses further the comparative analysis of essential oils from A. menghaiensis .
Se investigaron los componentes químicos y la actividad antimicrobiana del aceite escencial aislado de los rizomas de Alpinia menghaiensis S.Q. Ton g & Y. M. Xia en S.Q. Tong de Vietnam. Se usaron las técnicas de cromatografía de gases (GC) y cromatografía de gases con espectrometría de masas (GC/MS) para caracterizar los componentes químicos del aceite escencial, mientras que se utilizó un ensayo de microdilución para evaluar la actividad antimicrobial. Se identificaron los componentes principales en el aceite escencial del rizoma, compuesto de ß - pineno (46.5%), ß - fellandreno (25.7%) y α - pineno (8.5%). El aceite escencial estudiado inhibió el crecimie nto de Pseudomonas aeruginosa ATCC27853 con concentraciones de actividad mínima inhibitoria (MIC) de 15.32 µg/mL ± 0.01, y una m ediana de concentración inhibitoria (IC 50 ) de 32.0 ± 0.01 µg/mL. El aceite escencial también mostró actividad contra Staphylococ cus aureus ATCC25923 (MIC 31.57 ± 0.01 µg/mL) y Bacillus cereus ATCC14579 (MIC, 34.21 µg/mL ± 0.01 µg/mL), y valor IC 50 de 64.0 ± 0.01 µg/mL. Este es el primer reporte sobre la composición del aceite de rizoma, así como de las propiedades antimicrobianas d e los aceites escenciales de A. menghaiensis . El artículo discute el análisis comparativo de los aceites escenciales de A. menghaiensis .
Assuntos
Óleos Voláteis/química , Alpinia/química , Antibacterianos/química , Sesquiterpenos/análise , Vietnã , Óleos Voláteis/farmacologia , Testes de Sensibilidade Microbiana , Monoterpenos/análise , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Positivas/efeitos dos fármacos , Cromatografia Gasosa-Espectrometria de Massas , Antibacterianos/farmacologiaRESUMO
Panax vietnamensis Ha et Grushv. is a precious medicinal species native to the tropical forests of Vietnam. Due to habitat loss and over-harvesting, this species is endangered in Vietnam. To conserve the species, we investigated genetic variability and population structure using nine microsatellites for 148 individuals from seven populations across the current distribution range of P. vietnamensis in Vietnam. We determined a moderate genetic diversity within populations (HO = 0.367, HE = 0.437) and relatively low population differentiation (the Weir and Cockerham index of 0.172 and the Hedrick index of 0.254) and showed significant differentiation (P < 0.05), which suggested fragmented habitats, over-utilization and over-harvesting of P. vietnamensis. Different clustering methods revealed that individuals were grouped into two major clusters, which were associated with gene flow across the geographical range of P. vietnamensis. This study also detected that ginseng populations can have undergone a recent bottleneck. We recommend measures in future P. vietnamensis conservation and breeding programs.
Panax vietnamensis Ha et Grushv. é uma espécie medicinal preciosa nativa das florestas tropicais do Vietnã. Por causa da perda de hábitat e da colheita excessiva, essa espécie está ameaçada de extinção no Vietnã. Para conservá-la, investigamos a variabilidade genética e a estrutura populacional usando nove microssatélites para 148 indivíduos de sete populações em toda a distribuição atual de P. vietnamensis no Vietnã. Determinamos uma diversidade genética moderada dentro das populações (HO = 0,367 e HE = 0,437) e diferenciação populacional relativamente baixa (índice de Weir e Cockerham de 0,172 e índice de Hedrick de 0,254), com diferenciação significativa (P < 0,05), o que sugeriu fragmentação de hábitats, sobreutilização e sobre-exploração de P. vietnamensis. Diferentes métodos de agrupamento revelaram que os indivíduos foram agrupados em dois agrupamentos principais, que foram associados ao fluxo gênico em toda a área geográfica de P. vietnamensis. Este estudo também detectou que as populações de ginseng podem ter sofrido um gargalo recente. Recomendamos medidas em futuros programas de conservação e melhoramento de P. vietnamensis.