Tuberculosis in Vietnam: New and renewed insights

In the thesis entitled “ Tuberculosis in Vietnam: New and renewed insights ” written by Hai Viet Nguyen, data from the second national tuberculosis (TB) prevalence survey in Vietnam conducted in 2017, with additions from the first national TB prevalence and tuberculin surveys conducted in 2007, were analysed to provide answers to several research questions that can affect the strategic planning of TB control efforts. By comparing the results from the two surveys, a substantial decline in TB burden from 2007 to 2017 was observed. However, as it used state-of-art diagnostic tools, many more TB patients were found in the second TB prevalence survey, implying that the current prevalence of TB in Vietnam remains high. When used for community TB screening, GeneXpert MTB/Rif, a WHO-endorsed molecular TB diagnostic tool, and MGIT liquid culture, a widely accepted reference standard for TB diagnosis, have a low diagnostic agreement. There is evidence to suggest there are actual biological factor(s) that render men more vulnerable to TB than women, and subclinical TB patients, who have no prolonged cough and either no TB symptoms or only atypical symptoms while still having radiological and microbiological features suggesting TB, likely transmit Mycobacterium tuberculosis to their household members. The empirical chapters of this thesis highlight the need for effective, comprehensive active case finding interventions to promptly find and treat all missing TB cases, in order to end the TB disease in Vietnam by 2035, and provide clues for improved measurement and control of TB worldwide.