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BACKGROUND: Hookworm infections are significant public health issues in South-East Asia. In women of reproductive age, chronic hookworm infections cause iron deficiency anaemia, which, upon pregnancy, can lead to intrauterine growth restriction and low birth weight. Low birth weight is an important risk factor for neonatal and infant mortality and morbidity. METHODOLOGY: We investigated the association between neonatal birth weight and a 4-monthly deworming and weekly iron-folic acid supplementation program given to women of reproductive age in north-west Vietnam. The program was made available to all women of reproductive age (estimated 51,623) in two districts in Yen Bai Province for 20 months prior to commencement of birth weight data collection. Data were obtained for births at the district hospitals of the two intervention districts as well as from two control districts where women did not have access to the intervention, but had similar maternal and child health indicators and socio-economic backgrounds. The primary outcome was low birth weight. PRINCIPAL FINDINGS: The birth weights of 463 infants born in district hospitals in the intervention (168) and control districts (295) were recorded. Twenty-six months after the program was started, the prevalence of low birth weight was 3% in intervention districts compared to 7.4% in control districts (adjusted odds ratio 0.29, 95% confidence interval 0.10 to 0.81, p = 0.017). The mean birth weight was 124 g (CI 68 - 255 g, p

Dengue has become a global public health problem and a sensitive diagnostic test for early phase detection can be life saving. An internally controlled, generic real-time PCR was developed and validated by testing serial dilutions of a DENV positive control RNA in the presence of a fixed amount of IC with results showing a good linearity (R2=0.9967) and a LOD of at least 1.95×104 copies/mL. Application of the generic PCR on 136 patient samples revealed a sensitivity of 95.8% and specificity of 100%. A newly developed multiplex real-time PCR with serotype-specific probes allowed the serotyping of DENV for 80 out of 92 (87%) generic real-time PCR positive patients. Combined these real-time PCRs offer a convenient diagnostic tool for the sensitive and specific quantification of DENV in clinical specimens with the possibility for serotyping.

BackgroundTo estimate the cost and cost-effectiveness of a project administering de-worming and weekly iron-folic acid supplementation to control anaemia in women of reproductive age in Yen Bai province, Vietnam.Methods and findingsCost effectiveness was evaluated using data on programmatic costs based on two surveys in 2006 and 2009 and impact on anaemia and iron status collected in 2006, 2007, and 2008. Data on initial costs for training and educational materials were obtained from the records of the National Institute of Malariology, Parasitology and Entomology and the Yen Bai Malaria Control Program. Structured questionnaires for health workers at district, commune and village level were used to collect ongoing distribution and monitoring costs, and for participants to collect transport and loss of earnings costs. The cost per woman treated (defined as consuming at least 75% of the recommended intake) was USD0.76 per annum. This estimate includes financial costs (for supplies, training), and costs of health care workers' time. Prevalence of anaemia fell from 38% at baseline, to 20% after 12 months. Thus, the cost-effectiveness of the project is assessed at USD 4.24 per anaemia case prevented per year. Based on estimated productivity gains for adult women, the benefit:cost ratio is 6.7∶1. Cost of the supplements and anthelminthics was 47% of the total, while costs of training, monitoring, and health workers' time accounted for 53%.ConclusionThe study shows that weekly iron-folic acid supplementation and regular de-worming is a low-cost and cost-effective intervention and would be appropriate for population-based introduction in settings with a high prevalence of anaemia and iron deficiency and low malaria infection rates.

BACKGROUND: The prevalence of anaemia and iron deficiency in women remains high worldwide. WHO recommends weekly iron-folic acid supplementation where anaemia rates in non-pregnant women of reproductive age are higher than 20%. In 2006, a demonstration project consisting of weekly iron-folic acid supplementation and regular de-worming was set up in two districts in a northern province in Vietnam where anaemia and hookworm rates were 38% and 76% respectively. In 2008 the project was expanded to all districts in the province, targeting some 250,000 women. The objectives of this study were to: 1) examine changes in haemoglobin, iron stores and soil transmitted helminth infection prevalence over three years and 2) assess women's access to and compliance with the intervention. METHODS AND FINDINGS: The study was a semi-cross-sectional, semi-longitudinal panel design with a baseline survey, three impact surveys at three-, twelve- and thirty months after commencement of the intervention, and three compliance surveys after ten weeks, eighteen and thirty six months. RESULTS: After thirty months, mean haemoglobin stabilised at 130.3 g/L, an increase of 8.2 g/L from baseline, and mean serum ferritin rose from 23.9 µg/L to 52 µg/L. Hookworm prevalence fell from 76% to 22% over the same period. After thirty six months, 81% of the target population were receiving supplements and 87% were taking 75% or more of the supplements they received. CONCLUSIONS: Weekly iron-folic acid supplementation and regular de-worming was effective in significantly and sustainably reducing the prevalence of anaemia and soil transmitted helminth infections and high compliance rates were maintained over three years.

Objective To follow malaria prospectively in an ethnic minority commune in the south of Viet Nam with high malaria transmission and seasonal fluctuation, during malaria control interventions using insecticide-treated bednets (ITBNs) and early diagnosis and treatment (EDT) of symptomatic patients. Methods From 1994 onwards the following interventions were used: distribution of ITBNs to all households with biannual reimpregnation; construction of a health post and appointment of staff trained in microscopic diagnosis and treatment of malaria; regular supply of materials and drugs; annual cross-sectional malaria surveys with treatment of all parasitaemic subjects, and a programme of community involvement and health education. Surveys were held yearly at the end of the rainy season. During the surveys, demographic data were updated. Diagnosis and treatment of malaria were free of charge. Plasmodium falciparum infection was treated with artesunate and P. vivax infection with chloroquine plus primaquine. Findings The baseline survey in 1994 recorded 716 inhabitants. Of the children under 2 years of age, 37% were parasitaemic; 56% of children aged 2-10 years, and 35% of the remaining population were parasitaemic. P. falciparum accounted for 73-79% of these infections. The respective splenomegaly rates for the above-mentioned age groups were 20%, 56%, and 32%. In 1999, the proportion of parasitaemic subjects was 4%, 7% and 1%, respectively, of which P. falciparum contributed 56%. The splenomegaly rate was 0%, 5% and 2%, respectively. Conclusions A combination of ITBNs and EDT, provided free of charge, complemented by annual diagnosis and treatment during malaria surveys and community involvement with health education successfully brought malaria under control. This approach could be applied to other regions in the south of Viet Nam and provides a sound basis for further studies in other areas with different epidemiological patterns of malaria. Keywords Malaria, Falciparum/prevention and control/diagnosis/drug therapy; Malaria, Vivax/prevention and control/diagnosis/drug therapy; Sesquiterpenes/therapeutic use; Chloroquine/therapeutic use; Primaquine/therapeutic use; Pyrethrins/Bedding and linens/ utilization; Knowledge, attitudes, practice; Health education; Ethnic groups; Prospective studies; Viet Nam (source: MeSH, NLM). Mots cles Paludisme plasmodium falciparum/prevention et controle/diagnostic/chimiotherapie; Paludisme plasmodium vivax/ prevention et controle/diagnostic/chimiotherapie; Sesquiterpenes/usage therapeutique; Chloroquine/usage therapeutique; Primaquine/usage therapeutique; Pyrethrine; Literie et linge/utilisation; Connaissance, attitude, pratique; Education sanitaire; Groupes ethniques; Etude prospective; Viet Nato (source: MESH, INSERM). Palabras clave Paludismo falciparum/prevencion y control/diagnostico/quimioterapia; Paludismo vivax/prevencion y control/ diagnostico/quimioterapia; Sesquiterpenos/uso terapeutico; Cloroquina/uso terapeutico; Primaquina/uso terapeutico; Piretrinas; Ropa de cama y ropa blanca/utilizacion; Conocimientos, actitudes y practica; Educacion en salud; Grupos etnicos; Estudios prospectivos; Viet Nam (fuente: DeCS, BIREME). Bulletin of the World Health Organization 2002;80:660-666., Voir page 665 le resume en francais. En la pagina 665 figura un resumen en espanol. Introduction Malaria remains a threat to almost 50% of the world's population. With 200 [...]

An atomic absorption spectrometric (AAS) method was performed to determine the total, inorganic, and organic arsenic in fish sauce. The total organic arsenic was calculated from the total and inorganic arsenic values quantified using the hydride generation AAS (HG-AAS). Under optimal experimental conditions at the absorbance wavelength of 193.7 nm, the concentration of inorganic arsenic in fish sauce ranged from 0.05 to 1.2 mg/L, with a limit of detection (LOD) of 0.015 mg/L. The detectable total arsenic concentrations varied widely, ranging from 0.03 to 2.5 mg/L with the LOD of 0.01 mg/L. The practical applicability of the method was demonstrated with the recovery in the range from 97 to 102% for inorganic arsenic, and 97 to 101% for organic arsenic. The method was applied to the analysis of commercial products from Nha Trang, Phan Thiet, and Phu Quoc City, Vietnam. The total organic arsenic in fish sauce samples determined by HG-AAS was compared with the results of liquid chromatography-inductively coupled plasma-mass spectrometry (HPLC-ICP/MS). The The f-test and t-test showed null hypothesis acceptable for variance and mean at a confidence level of 95%. The results showed that the HG-AAS method had high efficiency, accuracy, and sensitivity in quantifying inorganic and total organic arsenic in fish sauce using simple instrumentation. [ABSTRACT FROM AUTHOR]