Point-of-care testing (POCT) using rapid diagnostic tests for infectious disease can potentially guide appropriate use of antimicrobials, reduce antimicrobial resistance, and economise use of ...healthcare resources. POCT implementation in private retail settings such as pharmacies and drug shops could lessen the burden on public healthcare. We performed a narrative review on studies of POCTs in low- and middle-income countries (LMICs), and explored uptake, impact on treatment, and feasibility of implementation.
We searched MEDLINE/PubMed for interventional studies on the implementation of POCT for infectious diseases performed by personnel in private retail settings. Data were extracted and analysed by two independent reviewers.
Of the 848 studies retrieved, 23 were included in the review. Studies were on malaria (19/23), malaria and pneumonia (3/23) or respiratory tract infection (1/23). Nine randomised controlled studies, four controlled, non-randomised studies, five uncontrolled interventions, one interventional pre-post study, one cross-over interventional study and three retrospective analyses of RCTs were included. Study quality was poor. Overall, studies showed that POCT can be implemented successfully, leading to improvements in appropriate treatment as measured by outcomes like adherence to treatment guidelines. Despite some concerns by health workers, customers and shop providers were welcoming of POCT implementation in private retail settings. Main themes that arose from the review included the need for well-structured training with post-training certification covering guidelines for test-negative patients, integrated waste management, community sensitization and demand generation activities, financial remuneration and pricing schemes for providers, and formal linkage to healthcare and support.
Our review found evidence that POCT can be implemented successfully in private retail settings in LMICs, but comprehensive protocols are needed. High-quality randomised studies are needed to understand POCTs for infectious diseases other than malaria.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Antibiotic-resistant bacteria are becoming more common due to the overuse of antibiotics in aquaculture. Alternative antibiotic solutions are fascinating and under the consideration in many ...countries. This study's objective was to isolate and identify certain actinomycete isolates with inhibitory action against the hemorrhagic disease-causing Aeromonas hydrophila in intensively cultivated catfish. This investigation isolated ten actinomycete isolates from sediment and water samples of catfish ponds in Vinh Long province. Using the diffusion well method, the study identified all isolates with antogonisttic activity against A. hydrophila. In particular, two isolates, BCA1.2 and BCA1.5, presented the highest inhibitory activity with inhibitory diameter zones of 11±1.0 mm and 10±1.0 mm, respectively. Two actinomycete isolates, BCA1.2 and BCA1.5, had their growth affected by pH, temperature, and NaCl. The findings revealed that two of these isolates showed optimum growth in a pH range of 7.0–8.0 and at 37°C. Two isolates, BCA1.2 and BCA1.5, survived well on medium containing a high salt concentration of NaCl ranging from 3% to 7% and were able to utilize different sources of carbon. They produced a wide range of hydrolytic extracellular enzymes, such as cellulase, amylase, protease, lipase, and chitinase. Isolates BCA1.2 and BCA1.5 were identified as Streptomyces based on morphological, cultural, physiological, and biochemical characteristics and 16S rRNA gene sequencing.
Abstract
Objectives
To review community-level consumption of antibiotics in rural Vietnam, according to the WHO Access, Watch, Reserve (AWaRe) classification of 2019, and identify factors associated ...with the choice of these antibiotics.
Methods
In this cross-sectional study, data on antibiotic purchases were collected through a customer exit survey of 20 community antibiotic suppliers in Ba Vi District, Hanoi, between September 2017 and July 2018. Antibiotic consumption was estimated through the number of antibiotic encounters, the number of DDDs supplied and the number of treatment days (DOTs) with antibiotics, and analysed according to the AWaRe classification. The factors associated with watch-group antibiotic supply were identified through multivariable logistic regression analysis.
Results
In total, there were 1342 antibiotic encounters, with access-group antibiotics supplied in 792 encounters (59.0%), watch-group antibiotics supplied in 527 encounters (39.3%) and not-recommended antibiotics supplied in 23 encounters (1.7%). No reserve-group antibiotics were supplied. In children, the consumption of watch-group antibiotics dominated in all three measures (54.8% of encounters, 53.0% of DOTs and 53.6% of DDDs). Factors associated with a higher likelihood of watch-group antibiotic supply were: private pharmacy (OR, 4.23; 95% CI, 2.8–6.38; P < 0.001), non-prescription antibiotic sale (OR, 2.62; 95% CI, 1.78–3.87; P < 0.001) and children (OR, 2.56; 95% CI, 1.84–3.55; P < 0.001).
Conclusions
High consumption of watch-group antibiotics was observed, especially for use in children. The frequent supply of watch-group antibiotics at private pharmacies reconfirms the need for implementing pharmacy-targeted interventions in Vietnam.
BackgroundAssessing the capacity of a healthcare institution to conduct and manage clinical research studies is challenging, especially in developing countries where resources are limited. The ...objective of this study was to develop a practical and transparent tool for the Vietnam Ministry of Health (MOH) to assess institutions’ capacity to lead clinical trials in line with local and international regulations.MethodsWe reviewed the literature, relevant official international and national guidelines, regulations and checklists for clinical sites’ assessment to identify key indicators of clinical research capacity. We developed a Good Clinical Practice (GCP) inspection checklist consisting of a questionnaire with 30 key criteria, including 16 core criteria and 14 recommended criteria, related to four central aspects of clinical research management (ie, governance, operations, infrastructures and human resources). Following a detailed review and assessment by a panel of experts, sponsors and academic investigators, we assessed the checklist’s applicability in a pilot study involving 10 sites with various clinical research experiences.ResultsIndependently of their clinical research experience, all participating institutions fulfilled most of the core criteria. In contrast, a significant variability was observed in the compliance to recommended capacity criteria, especially those related to governance (certifications and reporting) as well as operations (existence of a clinical research coordination unit or electronic trial management system).ConclusionsA GCP inspection checklist was successfully developed to support the MOH in the assessment of institutions’ capacity to conduct clinical research. Additional efforts from all stakeholders are now warranted to provide local sites with sustainable capacity development resources that will further build up and harmonise Vietnamese clinical research settings.
Summary Background In February 2013, a retired French professor of medicine published a book denying the benefits of statins for cardiovascular prevention. The book was the subject of extensive media ...coverage and multiple public discussions and debate. Aims To investigate the impact of this media event on use of statins among regular users. Methods This repeated cohort study used the French claims database sample Échantillon généraliste des bénéficiaires to identify regular statin users and quantify the number who discontinued statins after February 2013, compared to discontinuation patterns in previous years (2011 and 2012). Discontinuation was defined as a gap of at least 2 months without statin exposure. Results In 2013, 30,725 regular statin users were identified; 29,517 in 2012 and 28,272 in 2011. Statin discontinuation at 9-month follow-up in 2013 was 11.9% (95% confidence interval CI 11.5–12.2), compared with 8.5% (95% CI 8.2–8.8) in 2012 and 8.5% (95% CI 8.2–8.8) in 2011. Discontinuation varied according to cardiovascular risk: 19.4% (95% CI 18.2–20.6) in low risk, 11.6% (95% CI 11.1–12.0) in moderate risk, and 7.4% (95% CI 6.8–8.1) in high risk for the 2013 cohort. These discontinuation rates were, respectively, 1.53 (95% CI 1.36–1.72), 1.40 (95% CI 1.31–1.49), and 1.25 (95% CI 1.08–1.46) times higher in 2013 than in 2012 for low risk, moderate risk, or high risk patients. Conclusions The rate of statin discontinuation, overall and in each cardiovascular risk group, was greater in 2013 after the media event than in previous years. The clinical impact of the increased discontinuation could be important.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
This study aims to investigate patterns of antibiotic prescribing and to determine patient-specific factors associated with the choice of antibiotics by the World Health Organization's ...Access-Watch-Reserve (WHO AWaRe) class for acute respiratory infections (ARIs) in rural primary care settings in northern Vietnam.
We retrospectively reviewed health records for outpatients who were registered with the Vietnamese Health Insurance Scheme, visited one of 112 commune health centres in 6 rural districts of Nam Dinh province, Vietnam during 2019, and were diagnosed with ARIs. Patient-level prescription data were collected from the electronic patient databases. We used descriptive statistics to investigate patterns of antibiotic prescribing, with the primary outcomes including total antibiotic prescriptions and prescriptions by WHO AWaRe group. We identified patient-specific factors associated with watch-group antibiotic prescribing through multivariable logistic regression analysis.
Among 193,010 outpatient visits for ARIs observed in this study, 187,144 (97.0%) resulted in an antibiotic prescription, of which 172,976 (92.5%) were access-antibiotics, 10,765 (5.6%) were watch-antibiotics, 3366 (1.8%) were not-recommended antibiotics. No patients were treated with reserve-antibiotics. The proportion of watch-antibiotic prescription was highest amongst children under 5-years old (18.1%, compared to 9.5% for 5–17-years, 4.9% for 18–49-years, 4.3% for 50–64-years, and 3.7% for 65-and-above-years). In multivariable logistic regression, children, district, ARI-type, comobid chronic respiratory illness, and follow-up visit were associated with higher likelihood of prescribing watch-group antibiotics.
The alarmingly high proportion of antibiotic prescriptions for ARIs in primary care, and the frequent use of watch-antibiotics for children, heighten concerns around antibiotic overuse at the community level. Antimicrobial stewardship interventions and policy attention are needed in primary care settings to tackle the growing threat of antibiotic resistance.
This work was supported through Australian government and UK aid from the UK government funding to FIND (Foundation for Innovative New Diagnostics) grant number FO17-0015, in addition to a Wellcome Trust grant (213920/Z/18/Z), and an Oxford University Clinical Research Unit internal grant from the Wellcome Trust Africa Asia Programme core grant in Vietnam (106680/Z/14/Z).
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
PURPOSE: This study aims to clarify the effect mechanism of subjective norms on entrepreneurial intention. The results of how subjective norms contribute to forming start-up intention are ...inconsistent and unclear, which is notable in previous research. By integrating the theory of planned behavior and the theory of self-efficacy, we investigate whether entrepreneurial self-efficacy and attitude toward entrepreneurship serially mediate the relationship between subjective norms and intention to start a business. In addition, this study examines the moderate role of entrepreneurial education on the serial indirect effect of subjective norms on entrepreneurial intention via entrepreneurial self-efficacy and attitude toward entrepreneurship. METHODOLOGY: This study utilized a sample of 958 master’s students in Vietnam to investigate a moderated-serial mediation model of subjective norms on entrepreneurial intention. Confirmatory factor analysis (CFA) was carried out to check the reliability and validity of the scales. Then, the SPSS PROCESS macro developed by Hayes was employed to test the research model. Specifically, Model 6 was used to examine the serial indirect effect of subjective norms on start-up intention and Model 84 was implemented to investigate the moderate effect of entrepreneurial education. FINDINGS: The results of this study found that entrepreneurial self-efficacy and entrepreneurial attitude significantly mediate subjective norms’ effect on entrepreneurial intention. Especially, the results reveal that the serial mediation effect of entrepreneurial self-efficacy and attitude toward entrepreneurship was significant and entrepreneurial self-efficacy and attitude toward entrepreneurship played a fully mediating role in the relationship between subjective norms and start-up intention. In addition, this study found that the serial mediation effect of subjective norms on start-up intention via entrepreneurial self-efficacy and entrepreneurial attitude was negatively moderated by entrepreneurial education. IMPLICATIONS: The results of this study further clarify the relationship between subjective norms and entrepreneurial intention and the role of entrepreneurial education, therefore, contributing to narrowing the notable gap between this relationship. Besides, our study provides several implications for governments and policymakers to promote the intention to start a business. The finding of our study indicates that subjective norms are an important factor in promoting entrepreneurial intention. Therefore, policymakers should take some actions to promote entrepreneurial culture, such as strengthening propaganda activities to promote the image of successful entrepreneurs, praising businesses and entrepreneurs who contribute to society, and giving evidence of their contribution to the development of the country. Promoting an entrepreneurial culture may increase peer group pressure on potential entrepreneurs, thus enhancing the intention to start a business. ORIGINALITY AND VALUE: This study expects to contribute to a better understanding of the effect mechanism of subjective norms on entrepreneurial intention and explain the role of entrepreneurial education in this relationship. This study explores the mediating role of entrepreneurial self-efficacy and entrepreneurial attitude in the relationship between subjective norms and the intention to start a business. Additionally, this study demonstrates that entrepreneurial education weakens the serial mediation model of subjective norms on the intention to start a business.
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IZUM, KILJ, NUK, PILJ, SAZU, UL, UM, UPUK
Civil servants are part of the human resources of the public sector. The contingent of civil servants is an essential component of human social resources whose contributions always play a significant ...role in the overall socio-economic development achievements of the country and the locality. In this study, the research paradigm “citizen satisfaction with the service quality of Khmer civil servants” was used and converted with “the SERVPERF model.” Research data were collected from survey results by questionnaires from 596 citizens in the Mekong Delta, Vietnam. SPSS 20 and AMOS 24 software are used to analyze and evaluate the scale. The results of the research structure show that there are six factors affecting citizen satisfaction with the service quality of Khmer civil servants in the Mekong Delta, Vietnam, including competency, professional qualifications, profession, sense of responsibility and coordination in performing tasks, ethical qualities, working style; sense of organization and discipline; citizen service attitude; progress and results of task performance. From the research findings, the discussion proposes implications for public policy management to improve citizen satisfaction with the service quality of Khmer civil servants in the Mekong Delta, Vietnam.
The Max-Cover is a NP-hard problem. Therefore, the heuristic approach is suitable to solve this problem for large instances. Quantum annealing is a heuristic quantum optimization algorithm that can ...be used to handle the Max-Cover problem. Recent developments in quantum technology allows creating programmable quantum processors to implement the quantum annealing technique. In this article, we apply the quantum annealing approach to solve the Max-Cover problem. The experimental results show that this approach gives better results than Simulated Annealing in terms of both solution quality and annealing time.
We investigate the propagation dynamics of a pair of probe and coupling laser pulses in a three-level type-V atomic medium under the condition of electromagnetically induced transparency (EIT) by ...numerical solving the Maxwell-Bloch equations for atoms and fields. Influences of the intensity and pulse area of the coupling laser on the EIT formation of probe laser pulse are studied in a wide region from micro- to pico-second of pulse duration. It is found that a nearly solition pulse can be established at the smallest pulse area in the pico-second region and with the largest pulse area in the micro-second region. These results can be important for applications in all-optical switching, and quantum information processing and transmission.
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