To assess the role of in-flight transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we investigated a cluster of cases among passengers on a 10-hour commercial flight. ...Affected persons were passengers, crew, and their close contacts. We traced 217 passengers and crew to their final destinations and interviewed, tested, and quarantined them. Among the 16 persons in whom SARS-CoV-2 infection was detected, 12 (75%) were passengers seated in business class along with the only symptomatic person (attack rate 62%). Seating proximity was strongly associated with increased infection risk (risk ratio 7.3, 95% CI 1.2-46.2). We found no strong evidence supporting alternative transmission scenarios. In-flight transmission that probably originated from 1 symptomatic passenger caused a large cluster of cases during a long flight. Guidelines for preventing SARS-CoV-2 infection among air passengers should consider individual passengers' risk for infection, the number of passengers traveling, and flight duration.
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DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Hand-foot-mouth disease (HFMD) is an emerging infectious disease that affects thousands of children every year in Vietnam, especially in the Mekong Delta Region (MDR). This study aims to analyse both ...provincial and regional level effects of climate factors on HFMD in multiple provinces of this high-risk region. Generalized linear models were used to analyse the daily effects of average temperature, humidity and rainfall on HFMD incidence in each province (provincial-level effects), and random-effect meta-analysis was used to estimate the pooled effect size of these climate–HFMD associations (regional-level effects). Daily effects of the climate factors on HFMD were found at both provincial level and regional level. At provincial level, temperature and humidity had statistically significant positive associations with HFMD while rainfall had both positive and negative associations with HFMD at different lag days. At regional level, temperature and humidity were positively associated with HFMD at lag 0 days (1.7%; 95%CI 0.1%–3.3%) and at lag 3 days (0.3%; 95%CI 0.1%–0.5%), respectively. In contrast, rainfall was found to be negatively associated with HFMD at lag 5 days (− 0.3%; 95%CI − 0.4% to − 0.1%). Heterogeneities of the effects of rainfall on HFMD were found to be higher than those of temperature or humidity. This is the first study to address the climate–HFMD associations in multiple provinces of the MDR. These associations draw attention to climate-related health issues and will help in developing an environment-based early warning system for HFMD prevention and control.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Hand-foot-and-mouth disease (HFMD) is a significant public health issue in Asia-pacific countries. Numerous studies have examined the relationship between socio-ecological factors and HFMD however ...the research findings were inconsistent. This study examined the association between socio-ecologic factors and HFMD in multiple provinces across Vietnam.
We applied a spatial autoregressive model using a Bayesian framework to examine the relationship between HFMD and socio-demographic factors. We used a Generalized Linear Model (GLD) with Poisson family to examine the province-specific association between monthly HFMD and climatic factors while controlling for spatial lag, seasonality and long-term trend of HFMD. Then, we used a random-effect meta-analysis to generate pooled effect size of climate-HFMD association for regional and country scale.
One percent increase in newborn breastfed within 1h of birth, households with permanent houses, and households accessed to safe water resulted in 1.57% (95% CI: −2.25, −0.93), 0.96% (−1.66, −0.23), and 1.13% (−2.16, −0.18) reduction in HFMD incidence, respectively. At the country-level, HFMD increased 7% (RR: 1.07; 95%CI: 1.052–1.088) and 3.1% (RR: 1.031, 95%CI: 1.024–1.039) for 1°C increase in monthly temperature above 26°C and 1% increase in monthly humidity above 76%. Whereas, HFMD decreased 3.1% associated with 1mm increase in monthly cumulative rainfalls. The climate-HFMD relationship was varied by regions and provinces across the country.
The findings reflect an important implication for the climate change adaptation strategies and public-health decision, of which development of weather-based early warning systems should be considered to strengthen communicable disease prevention system.
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•There are significant effects of breastfeeding, house condition, safe water on HFMD.•There are significant effects of temperatures and humidity on variation of HFMD.•Findings reflect important implications for climate change adaptation in Vietnam.•HFMD weather-based early warning systems should be considered.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
•Public health interventions for COVID-19 need to be rapid, strict, and adaptive.•Active case-finding and extensive testing reduces community exposure to COVID-19.•Targeted lockdowns and community ...surveillance is effective to contain clusters.•Border control does not prevent but can delay the introduction of COVID-19.•Interventions should be implemented in combination to maximize effectiveness.
Background: Vietnam implemented various public health interventions such as contact tracing and testing, mandatory quarantine, and lockdowns in response to coronavirus disease 2019 (COVID-19). However, the effects of these measures on the epidemic remain unclear.
Methods: This article describes the public health interventions in relation to COVID-19 incidence. Maximum likelihood estimations were used to assess containment delays (time between symptom onset and start of isolation) and multivariable regression was employed to identify associated factors between interventions and COVID-19 incidence. The effective reproductive numbers (Rt) were calculated based on transmission pairs.
Results: Interventions were introduced periodically in response to the epidemic. Overall, 817 (55.4%) among 1474 COVID-19 cases were imported. Based on a serial interval of 8.72 ± 5.65 days, it was estimated that Rt decreased to below 1 (lowest at 0.02, 95% CI 0–0.12) during periods of strict border control and contact tracing, and increased ahead of new clusters. The main method to detect cases shifted over time from passive notification to active case-finding at immigration or in lockdown areas, with containment delays showing significant differences between modes of case detection.
Conclusions: A combination of early, strict, and consistently implemented interventions is crucial to control COVID-19. Low-middle income countries with limited capacity can contain COVID-19 successfully using non-pharmaceutical interventions.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
International air travel plays an important role in the global spread of SARS-CoV-2, and tracing of close contacts is an integral part of the public health response to COVID-19. We aimed to assess ...the timeliness of contact tracing among airline passengers arriving in Vietnam on flights containing COVID-19 cases and investigated factors associated with timeliness of contact tracing.
We included data from 2228 passengers on 22 incoming flights between 2 and 19 March 2020. Contact tracing duration was assessed separately for the time between the date of index case confirmation and date of contact tracing initiation (interval I), and the date of contact tracing initiation and completion (interval II). We used log-rank tests and multivariable Poisson regression models to identify factors associated with timeliness.
The median duration of interval I and interval II was one (IQR: 1-2) and 3 days (IQR: 2-5), respectively. The contact tracing duration was shorter for passengers from flights where the index case was identified through mandatory testing directly upon arrival (median = 4; IQR: 3-5) compared to flights with index case detection through self-presentation at health facilities after arrival (median = 7; IQR: 5-8) (p-value = 0.018). Cumulative hazards for successful tracing were higher for Vietnamese nationals compared to non-Vietnamese nationals (p < 0.001).
Contact tracing among flight passengers in the early stage of the COVID-19 epidemic in Vietnam was timely though delays occurred on high workload days. Mandatory SARS-CoV-2 testing at arrival may reduce contact tracing duration and should be considered as an integrated screening tool for flight passengers from high-risk areas when entering low-transmission settings with limited contact tracing capacity. We recommend a standardized risk-based contact tracing approach for flight passengers during the ongoing COVID-19 epidemic.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The Singapore Lecture is designed to provide an opportunity for distinguished statesmen and leaders of thought and knowledge to reach a wider audience in Singapore. The presence of such eminent ...personalities allows Singaporeans, especially younger executives and decision-makers in both the public and private sectors, the benefit of exposure to leading world figures who address topics of international and regional interest. The 38th Singapore Lecture was delivered by His Excellency Tran Dai Quang, President of the Socialist Republic of Vietnam, on 30 August 2016 under the distinguished Chairmanship of Mr Teo Chee Hean, Deputy Prime Minister and Coordinating Minister for National Security, Singapore.
We describe the status of the COVID-19 epidemic in Vietnam, major response successes, factors that prompted implementation of certain public health actions, and the impact of these actions. In ...addition, information for three case studies is reported, with crucial learnings to inform future response. Findings from this study suggest that as early as 20 January 2020, Vietnam held a national risk assessment, established a national COVID-19 Response Plan and Technical Treatment and Care Guidelines, and prepared public health laboratories to accurately diagnose cases and hospitals to effectively treat patients. The first COVID-19 case was detected on 23 January. As of 30 September, there had been three waves of the COVID-19 epidemic totalling 1095 cases, and resulting in 35 deaths all among people with underlying health conditions. Evidence of potential transmission of SARS-CoV-2 from a commercial passenger flight inbound to Vietnam was reported. This study also highlights the importance of early technical preparedness, strong political commitment, multisectoral and multilevel efforts, increased resourcing and coordination towards an effective COVID-19 response. Controlling outbreaks in settings, such as crowded public places (bars and hospitals), within certain villages and over cities, required early detection, aggressive trace-test-quarantine efforts, a geographically extensive lockdown area and an adoption of several non-pharmaceutical interventions. Many low-income and middle-income countries have experienced their second or third wave of the COVID-19 epidemic, and they can learn from Vietnam’s response across the three epidemic waves. Swift governmental action, strict border control measures, effective communication of health promotion measures, widespread community engagement, expanded testing capacity and effective social measures to slow the spread of SARS-CoV-2, are highly important in these locations.
The importation of SARS-CoV-2 through air travel poses substantial risks to generate new COVID-19 outbreaks. Timely contact tracing is particularly crucial to limit onwards transmission in settings ...without established community transmission.
We conducted an in-depth analysis of the response to a big flight-associated COVID-19 outbreak in Vietnam in March 2020 that involved contact tracing, systematic testing and strict quarantine up to third generation contacts.
183 primary contacts from the flight as well as 1000 secondary and 311 third generation contacts were traced, tested, and quarantined across 15 provinces across Vietnam. The protracted confirmation of the index case at 3 days and 19 h after arrival resulted in isolation/quarantine delays of 6.8 days (IQR 6.3–6.8) and 5.8 days (IQR 5.8–7.0) for primary and secondary cases, respectively, which generated 84.0 and 26.4 person-days of community exposure from primary and secondary cases, respectively. Nevertheless, only 5 secondary cases occurred.
A large flight-related COVID-19 cluster was successfully contained through timely, systematic and comprehensive public health responses despite delayed index case identification. Multiagency collaboration and pre-established mechanisms are crucial for low and middle income countries like Vietnam to limit community transmission after COVID-19 importation through air travel.
•Successful control of large flight-imported COVID-19 outbreaks is possible.•Delayed index case confirmation complicates response measures.•A combination of contact tracing, systematic testing and quarantine is key.•Mandatory testing at arrival might be justified for certain settings.•A whole-of-government approach and pre-established protocols are important.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
To examine the effects of socioecological factors on multiple communicable diseases across Vietnam.
We used the Moran's I tests to evaluate spatial clusters of diseases and applied multilevel ...negative binomial regression models using the Bayesian framework to analyse the association between socioecological factors and the diseases queried by oral, airborne, vector-borne, and animal transmission diseases.
The study found that oral-transmission diseases were spatially distributed across the country; whereas, the airborne-transmission diseases were more clustered in the Northwest and vector-borne transmission diseases were more clustered in the South. Most of diseases were sensitive with climatic factors. For instance, a 1°C increase in average temperature is significantly associated with 0.4% (95CI, 0.3-0.5), 2.5% (95%CI, 1.4-3.6), 0.9% (95%CI, 0.6-1.4), 1.1% (95%CI), 5% (95%CI, 3-.7.4), 0.4% (95%CI, 0.2-0.7), and 2% (95%CI, 1.5-2.8) increase in risk of diarrhoea, shigellosis, mumps, influenza, dengue, malaria, and rabies respectively. The influences of socio-economic factors on risk of communicable diseases are varied by factors with the biggest influence of population density. The research findings reflect an important implication for the climate change adaptation strategies of health sectors. A development of weather-based early warning systems should be considered to strengthen communicable disease prevention in Vietnam.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Two series of sulfonylureas derivatives including 24 compounds (
,
,
,
), among them 17 new derivatives, have been synthesized and evaluated for their
-glucosidase inhibitory activity. Compounds
,
...and
showed significant
-glucosidase inhibition with IC
values of 5.58, 79.85 and 213.36 µ
, respectively, comparing with the standard compounds acarbose (IC
= 268.29 µ
and glipizide (IC
= 300.47 µ
). The preliminary structure-activity relationships (SARs) of the synthesized compounds were also investigated.
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