Although HIV (human immunodeficiency virus) testing for all women has been promoted by Vietnam’s Ministry of Health since 2000, test acceptance rates in this country were reported to be less than 30% in the community. This country has been facing the barriers to approach the national services towards transmission prevention from mother to child including HIV testing during antenatal care (ANC) towards mothers. Here, we aim to assess the socioeconomic inequalities in HIV testing during ANC among Vietnamese women. This study used available data from the Vietnam Multiple Indicator Cluster Survey 2014. Overall, the prevalence of HIV testing during antenatal care was 30% and the concentrate index (CCI) was 0.1926. There was significant inequality between women classified as poor and rich, and when stratified by social characteristics, inequality was found in women aged 15–49 years (CCI: 0.4), living in rural areas (CCI: 0.3), belonging to ethnic minorities (CCI: 0.5) and having primary or less education (CCI: 0.4). In the multivariate logistic regression analysis, ethnicity and socioeconomic status were significant factors associated with HIV testing during ANC. We found the prevalence of HIV testing during ANC was low, and its inequalities were associated with age, living area, ethnicity, education, and economic status.

The Society for Cardiovascular Angiography and Interventions (SCAI) shock classification has been shown to predict mortality in acute myocardial infarction (AMI). However, data on the transition of SCAI stages and their association with mortality after AMI are limited. All patients with AMI admitted to Vietnam National Heart Institute between August 2022 and February 2023 were classified into SCAI stages A, B, and C/D/E at admission and were reevaluated in 24 hours. We used Kaplan–Meier estimate and multivariable Cox regression analysis to assess the association between SCAI stages transition and 30-day mortality. We included 139 patients (median age 69 years, 29.5% female). On admission, 50.4%, 20.1%, and 29.5% of patients were classified as SCAI stage A, B, and C/D/E, respectively. The proportion of patients whose SCAI stage improved, remained stable, or worsened after 24 hours was 14.4%, 66.2%, and 19.4%, respectively. The 30-day mortality in patients with initial SCAI stages A, B, and C/D/E on admission was 2.9%, 21.4%, and 61.0%, respectively (P < .001). The 30-day mortality was 2.4% for patients with baseline SCAI stage A/B who remained unchanged or improved, 30.0% for patients with baseline SCAI stage C/D/E who remained unchanged or improved, and 92.6% for patients with SCAI stage B/C/D/E who worsened at 24 hours after admission (log-rank P < .001). In patients with AMI, evaluating the SCAI stage shock stage on admission and reevaluating after 24 hours added more information about 30-day mortality.

Absent contractility is a rare esophageal motility disorder defined by high-resolution manometry which remains poorly understood in pathogenesis and management. We investigated the clinical symptoms, upper gastrointestinal endoscopy findings, and lower esophageal sphincter (LES) characteristics in adult patients diagnosed with absent contractility on high resolution manometry and factors associated with erosive esophagitis that were found on endoscopy in these patients. A cross-sectional study was conducted in patients with absent contractility who were examined at the Institute of Gastroenterology and Hepatology, Vietnam between March 2018 and December 2020. Clinical symptoms, endoscopic findings, and LES metrics were collected and compared between individuals with and without erosive esophagitis. Logistic regression analysis was used to examine a variety of factors associated with erosive esophagitis. Among 7519 patients who underwent high resolution manometry, 204 (2.7%) were diagnosed with absent contractility. The mean age of the study sample was 45.9 years, 65.7% were women, and none had systemic sclerosis. The most common symptoms were regurgitation, belching, epigastric pain, and bloating. On endoscopy, 50% had erosive esophagitis, mostly Los Angeles grade A (42.9%). On manometry, 44.6% of the patients had LES hypotension and 68.1% had low integrated relaxation pressure in 4 seconds (IRP4s). Male sex (adjusted odds ratio = 2.01, 95% confidence interval: 1.04–3.89) and an IRP4s < 5 mm Hg (adjusted odds ratio = 2.21, 95% confidence interval: 1.12–4.37) were significantly associated with erosive esophagitis. Absent contractility was present in many patients without known systemic diseases. Erosive esophagitis was common and associated with male sex and low IRP4s.

Background: Vietnam has high rates of antimicrobial resistance (AMR) but limited capacity for genomic surveillance. This study used whole genome sequencing (WGS) to examine the prevalence and transmission of three key AMR pathogens in two intensive care units in Hanoi, Vietnam. Methods: A prospective surveillance study of all adults admitted to intensive care units (ICUs) at the National Hospital for Tropical Diseases (NHTD) and Bach Mai Hospital (BMH) was conducted between June 2017 and January 2018. Clinical and environmental samples were cultured on selective media, characterised using MALDI TOF MS, and illumina sequenced. Phylogenies based on the de novo assemblies (SPAdes) were constructed using Mafft (PARsnp), Gubbins and RAxML. Resistance genes were detected using Abricate against the NCBI database. Findings: 3,153 Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii isolates from 369 patients were analysed. Phylogenetic analysis revealed predominant lineages within A. baumannii (global clone [GC]2, sequence types [ST]2, ST571) and K. pneumoniae (ST15, ST16, ST656, ST11, ST147) isolates. Colonisation was most common with E. coli (88.9%) followed by K. pneumoniae (62.4%). Of the E. coli , 91% carried a bla CTX-M variant, while 81% of K. pneumoniae isolates carried bla NDM (54%) and/or bla KPC (45%). Transmission analysis using single nucleotide polymorphisms (SNPs) identified 167 clusters involving 251 (68%) patients, in some cases involving patients from both ICUs. There were no significant differences between the lineages or AMR genes recovered between the two ICUs. Interpretation: This study represents the largest prospective surveillance study of key AMR pathogens in Vietnamese ICUs. Clusters of closely related isolates in patients across both ICUs suggests recent transmission prior to ICU admission in other healthcare settings or in the community. Funding: This work was funded by the Medical Research Council Newton Fund, United Kingdom; the Ministry of Science and Technology, Vietnam; and the Wellcome Trust, United Kingdom. Research in context: Evidence before this study: Globally, antimicrobial resistance (AMR) is projected to cause 10 million deaths annually by 2050. Ninety percent of these deaths are expected to occur in low- and middle-income countries (LMICs), but attributing morbidity and mortality to AMR is difficult in the absence of comprehensive data. Whilst efforts have been made to improve AMR surveillance in these settings, this is often hampered by limited expertise, laboratory infrastructure and financial resources. Added value of this study: This is the largest prospective surveillance study of three key AMR pathogens ( E. coli, K. pneumoniae and A. baumannii ) conducted in critical care settings in Vietnam. Sampling was restricted to patients who were colonised or infected with extended spectrum beta-lactamase (ESBL) producing and/or carbapenem-resistant organisms. Colonisation with more than one organism was very common, with multidrug-resistant (MDR) E. coli being predominant in stool samples. A small number of predominant lineages were identified for K. pneumoniae and A. baumannii , while the E. coli isolates were highly genetically diverse. A large number of genomic clusters were identified within the two ICUs, some of which spanned both ICUs. There were no significant differences between lineages or AMR genes between the two ICUs. Implications of all the available evidence: This study found high rates of colonisation and infection with three key AMR pathogens in adults admitted to two Vietnamese ICUs. Whilst transmission was common within ICUs the finding of similar lineages and AMR genes in both ICUs suggests that dissemination of AMR occurs prior to ICU admission, either in referral hospitals or in community settings prior to hospital admission. Strategies to tackle AMR in Vietnam will need to account for this by extending surveillance more widely across hospital and community settings.

Background/Objectives: Antimicrobial resistance (AMR) poses a disproportionate mortality risk to older adults, yet this demographic is often overlooked in stewardship interventions compared to the general population or other at-risk/vulnerable groups. While awareness campaigns exist, it remains unclear how knowledge gaps influence antibiotic usage behaviors among the elderly in lower middle-income settings like Vietnam. This study evaluates antibiotic literacy and usage patterns among older adults (aged ≥ 60 years) in Hanoi, identifies sociodemographic predictors of these domains, and determines whether knowledge deficits predict inappropriate practices. Methods: A descriptive cross-sectional study was conducted on 177 retired individuals aged 60-86 years (44% male, 56% female) in Gia Lam Commune, Hanoi, via face-to-face interviews. A structured questionnaire, adapted from World Health Organization and validated regional studies, assessed demographics, knowledge, AMR awareness, and practices. Multivariable linear regression identified independent predictors of these outcome scores. Results: Usage prevalence was high; 60% of participants reported taking antibiotics in the past year. Although 91% acknowledged the personal threat of "antibiotic resistance", profound functional misconceptions persisted: 58% failed to distinguish antibiotics from analgesics (paracetamol), and 67% incorrectly believed antibiotics are effective for treating fever. Of concern, 95.5% mistakenly thought that the human body develops resistance to the medication, and 55% perceived AMR as a foreign issue irrelevant to Vietnam. Regression analysis revealed that advanced age (≥ 78 years) was a strong negative predictor of knowledge (β = -2.0; p < 0.001), while higher knowledge scores were significantly associated with better adherence to safe practices (β = 0.15; p = 0.045). Conclusions: Older adults in Vietnam demonstrate high superficial awareness of AMR but harbor critical misconceptions, particularly conflating antibiotics with analgesics and falsely believing the human body develops resistance. Furthermore, advanced age emerged as a significant vulnerability factor for low health literacy. Since greater knowledge directly predicts safer usage practices, interventions must move beyond general warnings to correct specific mechanistic misunderstandings, thereby mitigating self-medication and resistance in this highly vulnerable population.