Objective: This study aims to explore the associated impairments of cerebral palsy (CP) and their correlates among children with CP in Vietnam.Design: Descriptive cross-sectional study using hospital-based surveillance.Setting: National Children’s Hospital, Hanoi, Vietnam between June and November 2017.Participants: 765 children with CP were recruited.Outcome measures: We assessed clinical characteristics of CP, associated impairments (epilepsy, intellectual, visual, hearing, speech impairments) and their correlates. We performed descriptive analyses (median, IQR and proportion). χ²test and Fisher’s exact test were used for categorical variables. Univariate logistic regression and multivariate logistic regression models were established and associated impairments were included as independent variables.Results: The median age of children was 1.7 years (IQR=2.7). Quadriplegia was the predominant subtype (69.5%) and 46.5% were at Gross Motor Function Classification System level IV–V. Of children, 76.3% had ≥one associated impairment, most commonly speech or intellectual impairments (59.1% and 57.8%, respectively). Severity of motor impairment, type of CP, maternal and perinatal factors (eg, gestational age, perinatal asphyxia, timing of injury causing CP) were associated with greater risk of associated impairments.Conclusion: Children with CP have a high burden of associated impairments. Findings from our study will inform the development and implementation of appropriate screening and interventions and reduce the long-term adverse effects of these impairments on individuals with CP and their socioeconomic impact.

Background: The model of trauma in Vietnam has changed significantly over the last decade and requires reforming medical education to deal with new circumstances. Our aim is to evaluate this transition regarding the new target by analyzing trauma and the medical training system as a whole. Objective: This study aimed to establish if medical training in the developing country of Vietnam has adapted to the new disease pattern of road trauma emerging in its economy. Methods: A review was performed of Vietnamese medical school, Ministry of Health, and Ministry of Education and Training literature on trauma education. The review process and final review paper were prepared following the guidelines on scoping reviews and using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart. Results: The current trauma training at the undergraduate level is minimal and involves less than 5% of the total credit. At the postgraduate level, only the specialties of surgery and anesthesia have a significant and increasing trauma training component ranging from 8% to 22% in the content. Trauma training, which focuses on practical skills, accounts for 31% and 32% of the training time of orientation courses for young doctors in “basic surgery” and “basic anesthesia,” respectively. Other relevant short course trainings, such as continuing medical education, in trauma are available, but they vary in topics, facilitators, participants, and formats. Conclusions: Medical training in Vietnam has not adapted to the new emerging disease pattern of road trauma. In the interim, the implementation of short courses, such as basic trauma life support and primary trauma care, can be considered as an appropriate method to compensate for the insufficient competency-related trauma care among health care workers while waiting for the effectiveness of medical training reformation.

Aim: To describe the immunization status of children with CP in Vietnam and identify factors associated with vaccine non-uptake in this group. Methods: We conducted an active prospective case ascertainment of children with cerebral palsy (CP) attending the National Children’s Hospital in Hanoi between June to November 2017, following the model proposed by the Paediatric Active Enhanced Disease Surveillance system in Australia. All children were assessed by trained paediatricians at the hospital and their immunization history was recorded. Results: Data were collected from 765 children with CP (median age = 1.7 years, IQR = 2.7 years). Of these children, 82.7% were fully immunized for their age (compared to 96.4% of the general child population) according to the Vietnamese Expanded Programme on Immunization (EPI) schedule. A BCG vaccination scar was present in 94.0% of children with CP, and 95.9% of eligible children had received the measles-rubella vaccine as part of the national campaign (compared with 96.0% and 98.2% of the general population respectively). Incomplete vaccination according to the EPI was associated with younger age, living in an earth/sand house, homebirth, low-level maternal education, being diagnosed with CP before the age of three, having bilateral CP, having associated impairments (i.e., epilepsy, intellectual, visual, speech), being at level IV-V on the Gross Motor Function Classification System, and being undernutrition. Conclusion: This is the first study to document the immunization status of children with CP in Vietnam. A large proportion had not received the measles-rubella vaccine and 17.3% were not fully immunized. To increase vaccination coverage, interventions and strategies are required to ensure that all children with CP have equitable access to early diagnosis, immunization, health education programs, outreach programs, and frequent follow-up. Early diagnosis and focused intervention in early life could further improve vaccination coverage in children with CP.

To examine rehabilitation service use and associated factors among children with cerebral palsy (CP) in Vietnam. This study uses data from hospital-based surveillance of children with CP who attended the National Children's Hospital, Hanoi between June and November 2017 using methodology modeled on the Pediatric Active Enhanced Disease Surveillance system in Australia. Descriptive statistics, exact tests, and logistic regression were used. Of 765 children with CP, 92.6% received rehabilitation services. The median age at first receipt of rehabilitation service was nine months. Physiotherapy (94.3%) was the most common service, followed by advice on treatment (21.5%), rehabilitation childcare, psychological counseling for parents and assistive devices (11.5%). Among children who received rehabilitation services, the majority (88.8%) received them at home.Lack of awareness of rehabilitation (98.2%) was the main barrier to service access. In univariate analysis, younger age (p < 0.01), no intellectual impairment (p < 0.001), Gross Motor Function Classification System levels IV-V (p < 0.05), and wasted weight-for-height (p < 0.05) were significantly associated with limited service use. In multivariate analysis, no intellectual impairment and wasted weight-for-height remained significant (p < 0.05). While most children accessed rehabilitation services, younger age, severe motor impairment, and malnutrition were associated with limited access to these services.

BACKGROUND The model of trauma in Vietnam has changed significantly over the last decade and requires reforming medical education to deal with new circumstances. Our aim is to evaluate this transition regarding the new target by analyzing trauma and the medical training system as a whole. OBJECTIVE This study aimed to establish if medical training in the developing country of Vietnam has adapted to the new disease pattern of road trauma emerging in its economy. METHODS A review was performed of Vietnamese medical school, Ministry of Health, and Ministry of Education and Training literature on trauma education. The review process and final review paper were prepared following the guidelines on scoping reviews and using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart. RESULTS The current trauma training at the undergraduate level is minimal and involves less than 5% of the total credit. At the postgraduate level, only the specialties of surgery and anesthesia have a significant and increasing trauma training component ranging from 8% to 22% in the content. Trauma training, which focuses on practical skills, accounts for 31% and 32% of the training time of orientation courses for young doctors in “basic surgery” and “basic anesthesia,” respectively. Other relevant short course trainings, such as continuing medical education, in trauma are available, but they vary in topics, facilitators, participants, and formats. CONCLUSIONS Medical training in Vietnam has not adapted to the new emerging disease pattern of road trauma. In the interim, the implementation of short courses, such as basic trauma life support and primary trauma care, can be considered as an appropriate method to compensate for the insufficient competency-related trauma care among health care workers while waiting for the effectiveness of medical training reformation.

Introduction: Cerebral palsy (CP) is the most common physical disability in childhood. Although an estimated 60 000 children live with CP in Vietnam, there is no national register to systematically collect data on the prevalence, risk factors or clinical profile of CP or service access. This paper outlines the protocol for establishing the Vietnam Cerebral Palsy Register (VCPR), a national register which will be co-designed by researchers and clinicians in collaboration with the Cerebral Palsy Family Association of Vietnam (CPFAV). The VCPR aims to inform service planning, policy and research through comprehensive, community-informed data collection. Methods and analysis: The VCPR will be developed by a consumer-clinician-researcher partnership. Initially, the VCPR will harmonise and pool data from two sources: (1) a hospital-based cohort of 765 children with CP identified at the National Children’s Hospital in Hanoi (NCH) in 2017, and (2) members of the CPFAV, comprising over 4300 children with CP aged <18 years from 63 CPFAV hubs across Vietnam. Subsequently, standardised data for inclusion in the VCPR will prospectively be collected on children newly diagnosed with CP at NCH and other healthcare settings and on children newly referred to CPFAV. Data will be collected using an adapted version of the Australian CP register questionnaire through a combination of structured caregiver interviews, clinical assessments using validated tools and medical record review. Key demographic variables and information on CP type, motor severity—using the Gross Motor Function Classification System or Manual Ability Classification System, associated impairments (eg, vision, hearing, intellectual disabilities), condition at birth, congenital or other infections, vaccination, educational and nutritional status of the child, access to rehabilitation and family-related factors such as monthly household income, parental education and occupation and maternal health during pregnancy will be collected. The VCPR will contribute data to the Global Low- and Middle-Income Country Cerebral Palsy Register. Ethics and dissemination: Ethics approval has been obtained from Vietnamese and Australian institutions, whose role is to provide ethical oversight and research governance for the PhD project supporting the VCPR. Written informed consent will be obtained from primary caregivers for data collection, secure storage, access to relevant health records, verification with health professionals and future research contact, with no identifiable data disclosed. Involvement of people with lived experience of CP is central to the VCPR and leaders and members of the CPFAV will contribute to co-design, governance, participant engagement and dissemination. Findings will be shared regularly with families, clinicians, policymakers and researchers through CPFAV communications, peer-reviewed publications, national and international conferences and the VCPR website to inform equitable service planning, policy and future research.