Hanoi, Vietnam

Hanoi Medical University

Hanoi, Vietnam

Hanoi Medical University is the oldest university of Vietnam located in Hanoi. HMU was found in 1902 by French during the French colonisation under the name Indochina Medical College. The first headmaster of HMU was Alexandre Yersin who was the co-discoverer of the bacillus responsible for the bubonic plague or pest, which was renamed in his honour . Wikipedia.

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Agency: European Commission | Branch: FP7 | Program: CSA-CA | Phase: HEALTH.2011.3.4-2 | Award Amount: 2.20M | Year: 2011

This project will add new research training capacity at low and middle-income countries (LMICs) in Asia, for promoting research on social determinants of health (RSDH). The focus is doctoral and post doctoral training, institutional strengthening for education, financial and administrative research management, and LMICs-based network building. Novel capacity building approaches will reduce brain drain, be more climate friendly and encourage gender equity with LMICs-based training. Internet mounted downloadable modules in related disciplines, like epidemiology, anthropology, economic methods, etc., will support excellent interdisciplinary courses. Addressing social determinants of health and tackling health inequity are research intensive, incremental improvement to measurement and understanding, implementation and evaluation. Therefore LMICs need to grow their own capacity to strengthen RSDH: interdisciplinary, rigorous and relevant. ARCADE-RSDH will support evidence informed decision making by producing a stream of well-trained young RSDH scientists, the next generation of health system leaders and researchers in LMICs. Activities will be aimed at individuals, institutions and the network. Tongji Medical College of HUST (TJMC, China), CBCI Society of Medical Education (SJNAHS, India) and Public Health Foundation of India (PHFI, India) are strong Asian Universities with RSDH focus. They will act as hubs in a network including TJMC, SJNAHS, PHFI, Beijing Normal University (BNU, China), Zhejiang University (ZJU, China), Indian Institute of Health Management Research (IIHMR, India), Ruxmaniben Deepchand Gardi Medical College (UCTH, India) and initially Sultan Qaboos University (SQU, Oman), Hanoi Medical University (HMU, Vietnam), working with strong European RSDH institutions (Karolinska Institutet KI, Sussex University Institutet for Development Studies IDS and University of Tampere UTA). This region-wide approach will draw skills, resources and students to a new LMICs-based RSDH capacity development network.

Agency: European Commission | Branch: FP7 | Program: CP-SICA | Phase: HEALTH-2007-2.3.2-12 | Award Amount: 3.88M | Year: 2008

India is a nation of contrasts. The economy is modernizing, but the culture is traditional. Different provinces experience the HIV epidemic differently; even in high-prevalence areas, the epidemic reflects diverse social, cultural, religious, & sexual practices. This proposal focuses on 2 high prevalence provinces. As the antiretroviral (ART) program is scaled up, adherence is a key issue that needs to be addressed (as it is a key determinant of resistance, which has public health consequences). With limited affordable second-line regimens & restricted laboratory monitoring in low-income settings, optimal adherence to first-line regimens is essential. The study is a randomized controlled trial of an approach using a contextually relevant intervention (mobile telephones) to influence ART adherence in 600 ART nave, HIV\ Indian patients eligible for ART, in Karnataka and Tamil Nadu. The conventional existing approach (as in the national guidelines) will be compared with an intervention in which the patient is provided adherence support using a mobile telephone interface. The study besides assessing the effect of intervention on adherence, will also provide data on the proportion of Indian patients failing first line ART. A study of factors associated with adherence, hitherto unstudied in India will be done. In addition the incidence and manifestations of opportunistic infections, immune reconstitution syndrome & adverse drug events will be described. The use of validated low-cost tests that optimize monitoring, are necessary here. Viral load is rarely used to monitor treatment because it is expensive. Instead falling CD4 counts are used. This usually occurs months/years after virological failure (increasing load); patients could have accumulated enough resistant mutations in this time to render other drugs useless. Using an affordable load test (evaluated in this study) will allow earlier detection of failure in this setting, thus having public health implications. Cost effectiveness will be studied. The project has policy implications for India and other low income settings.

Tran B.X.,University of Alberta | Tran B.X.,Hanoi Medical University
PLoS ONE | Year: 2012

Objective: This study assessed health-related quality of life (HRQOL) and its related factors in HIV/AIDS patients taking antiretroviral treatment (ART) in Vietnam. Methods: A cross-sectional study was conducted with 1016 patients (36.2% women, mean age = 35.4) in three epicenters of Vietnam, including Hanoi, Hai Phong, and Ho Chi Minh City. HRQOL was assessed using the Vietnamese version of the WHOQOL-HIV BREF. Factor analysis classified measure items into six HRQOL dimensions, namely Physical, Morbidity, Social, Spirituality, Performance, and Environment. Tobit censored regression models were applied to determine associations of patient's characteristics and HRQOL domain scores. Results: Internal consistency reliability of the six domains ranged from 0.69 to 0.89. The WHOQOL-HIV BREF had a good discriminative validity with patient's disease stages, CD4 cell counts, and duration of ART. In a band score of (4, 20), six domains were moderate; "Environment" had the highest score (13.8±2.8), and "Social" had the lowest score (11.2±3.3). Worse HRQOL were observed in patients at provincial and district clinics. Those patients who were male, had higher educational attainment, and are employed, reported better HRQOL. In reduced regression models, poorer HRQOL was found in patients who had advanced HIV infection and had CD4 cell count <200 cells/mL. Patients reported significantly poorer Physical and Social in the 1st year ART, but moderately better Performance, Morbidity, Spirituality, and Environment from the 2nd year ART, compared to those not-yet-on ART. Conclusion: Strengthening the quality of ART services at the provincial and district levels, gender-specific impact mitigation, and early treatment supports are recommended for further expansion of ART services in Vietnam. Regular assessments of HRQOL may provide important indicators for monitoring and evaluating HIV/AIDS services. © 2012 Bach Xuan Tran.

Toan T.T.,Hanoi Medical University
Global health action | Year: 2013

Dengue fever (DF) in Vietnam remains a serious emerging arboviral disease, which generates significant concerns among international health authorities. Incidence rates of DF have increased significantly during the last few years in many provinces and cities, especially Hanoi. The purpose of this study was to detect DF hot spots and identify the disease dynamics dispersion of DF over the period between 2004 and 2009 in Hanoi, Vietnam. Daily data on DF cases and population data for each postcode area of Hanoi between January 1998 and December 2009 were obtained from the Hanoi Center for Preventive Health and the General Statistic Office of Vietnam. Moran's I statistic was used to assess the spatial autocorrelation of reported DF. Spatial scan statistics and logistic regression were used to identify space-time clusters and dispersion of DF. The study revealed a clear trend of geographic expansion of DF transmission in Hanoi through the study periods (OR 1.17, 95% CI 1.02-1.34). The spatial scan statistics showed that 6/14 (42.9%) districts in Hanoi had significant cluster patterns, which lasted 29 days and were limited to a radius of 1,000 m. The study also demonstrated that most DF cases occurred between June and November, during which the rainfall and temperatures are highest. There is evidence for the existence of statistically significant clusters of DF in Hanoi, and that the geographical distribution of DF has expanded over recent years. This finding provides a foundation for further investigation into the social and environmental factors responsible for changing disease patterns, and provides data to inform program planning for DF control.

While there is accumulated evidence showing the rapid rise of the burden caused by non-communicable diseases (NCDs) in Vietnam, information on the extent to which households in the country suffer financial catastrophe or impoverishment caused by the diseases is still largely lacking. This paper aims to examine the self-reported prevalence of major chronic diseases among a population in rural Vietnam and to analyse the household financial burden associated with these diseases. A cross-sectional survey of 800 randomly selected households was carried out in Vo Nhai District, Thai Nguyen Province, in 2010. Face-to-face interviews were conducted with key informants of selected households on diagnosed chronic NCDs, health care utilization and health expenditure of all household members. The World Health Organization's definitions of catastrophic expenditure and impoverishment were used. Both descriptive and analytical statistics were applied. The prevalence of chronic NCDs in households and individuals was 29.3 and 33.4%, respectively. The catastrophic health expenditure and impoverishment rates among the households who have at least one member with a chronic disease were 14.6 and 7.6%, respectively. These rates were significantly higher than the corresponding figures among the households whose members were free from the diseases (4.2 and 2.3%, respectively). The odds of experiencing catastrophic health expenditure and impoverishment among the household with NCD patients were 3.2 and 2.3 times greater than that of other households. Findings from this study indicate that the epidemiological and household financial burdens caused by chronic diseases in Vietnam are now substantial and need immediate mitigation measures.

Hanh N.T.,Hanoi Medical University
BMC public health | Year: 2011

HIV testing for pregnant women is an important component for the success of prevention of mother-to-child transmission of HIV (PMTCT). A lack of antenatal HIV testing results in loss of benefits for HIV-infected mothers and their children. However, the provision of unnecessary repeat tests at a very late stage of pregnancy will reduce the beneficial effects of PMTCT and impose unnecessary costs for the individual woman as well as the health system. This study aims to assess the number and timing of antenatal HIV testing in a low-income setting where PMTCT programmes have been scaled up to reach first level health facilities. A cross-sectional community-based study was conducted among 1108 recently delivered mothers through face-to-face interviews following a structured questionnaire that focused on socio-economic characteristics, experiences of antenatal care and HIV testing. The prevalence of women who lacked HIV testing among the study group was 10% while more than half of the women tested had had more than two tests during pregnancy. The following factors were associated with the lack of antenatal HIV test: having two children (aOR 2.1, 95% CI 1.3-3.4), living in a remote rural area (aOR 7.8, 95% CI 3.4-17.8), late antenatal care attendance (aOR 3.6, 95% CI 1.3-10.1) and not being informed about PMTCT at their first antenatal care visits (aOR 7.4, 95% CI 2.6-21.1). Among women who had multiple tests, 80% had the second test after 36 weeks of gestation. Women who had first ANC and first HIV testing at health facilities at primary level were more likely to be tested multiple times (OR 2.9 95% CI 1.9-4.3 and OR = 4.7 95% CI 3.5-6.4), respectively. Not having an HIV test during pregnancy was associated with poor socio-economic characteristics among the women and with not receiving information about PMTCT at the first ANC visit. Multiple testing during pregnancy prevailed; the second tests were often provided at a late stage of gestation.

Job satisfaction among health workers is an important indicator in assessing the performance and efficiency of health services. This study measured job satisfaction and determined associated factors among health workers in 38 commune health stations in an urban district and a rural district of Hanoi, Vietnam. A total of 252 health workers (36 medical doctors and 216 nurses and technicians; 74% female) were interviewed. A job satisfaction measure was developed using factor analysis, from which four dimensions emerged, namely 'benefits and prospects,' 'facility and equipment,' 'performance,' and 'professionals.' The results demonstrate that respondents were least satisfied with the following categories: salary and incentives (24.0%), benefit packages (25.1%), equipment (35.7%), and environment (41.8%). The average satisfaction score was moderate across four domains; it was the highest for 'performance' (66.6/100) and lowest for 'facility and equipment' (50.4/100). Tobit-censored regression models, constructed using stepwise selection, determined significant predictors of job satisfaction including age, areas of work and expertise, professional education, urban versus rural setting, and sufficient number of staff. The findings highlight the need to implement health policies that focus on incentives, working conditions, workloads, and personnel management at grassroots level.

Objective Willingness to pay for methadone maintenance treatment (MMT) in three Vietnamese epicentres of injection-drug-driven human immunodeficiency virus (HIV) infection was assessed. Methods A convenience sample of 1016 patients receiving HIV treatment in seven clinics was enrolled during 2012. Contingent valuation was used to assess willingness to pay. Interviewers reviewed adverse consequences of injection drug use and the benefits of MMT. Interviewers then described the government's plan to scale up MMT and the financial barriers to scale-up. Willingness to pay was assessed using double-bounded binary questions and a follow-up open-ended question. Point and interval data models were used to estimate maximum willingness to pay. Findings A total of 548 non-drug-users and 468 injection drug users were enrolled; 988 were willing to pay for MMT. Monthly mean willingness to pay among non-drug-users, 347 drug users not receiving MMT and 121 drug users receiving MMT was 10.7 United States dollars [US$] (35.7% of treatment costs), US$ 21.1 (70.3%) and US$ 26.2 (87.3%), respectively (mean: US$ 15.9; 95% confidence interval, CI: 13.6-18.1). Fifty per cent of drug users were willing to pay 50% of MMT costs. Residence in households with low monthly per capita income and poor health status predicted willingness to pay less among drug users; educational level, employment status, health status and current antiretroviral therapy receipt predicted willingness to pay less among non-drug-users. Conclusion Willingness to pay for MMT was very high, supporting implementation of a co-payment programme.

Giang K.B.,Hanoi Medical University
Global health action | Year: 2013

Alcohol use and alcohol-related problems are on the rise in low- and middle-income countries. Expenditure on alcohol is an important problem for families and communities and needs to be assessed. Aim: This study examines level of alcohol consumption and expenditure on alcohol in a district in Vietnam. A cross-sectional survey was conducted in a rural district in northern Vietnam. Multi-stage sampling was employed to randomly select participants from 20 communities and a town in the same district. One thousand five hundred and sixty-four adults (765 males and 799 females) aged 18-60 years were interviewed. Information about alcohol use as well as expenditure on alcohol consumption four weeks prior to the interview was gathered. Non-parametric tests and log-linear regression were employed to compare expenditure on alcohol consumption across socioeconomic groups. The prevalence of alcohol use one month prior to interview was 35% (66% among men and 5% among women). The median alcohol consumption among those who reported use of alcohol in the week prior to the interview was 7.9 standard drinks. Excessive drinking (more than 14 standard drinks per week for men and more than seven standard drinks per week for women) occurred among 35% of those who used alcohol. Median expenditure for alcohol consumption during one month by those who drank alcohol was USD 3.5, accounting for 4.6% of household food expenditure, 2.7% of total household expenditure, and 1.8% of household income. The differences in alcohol consumption and expenditure between sexes and between socioeconomic groups are also presented. Our study confirms that alcohol consumption and alcohol-related problems are common among men in Vietnam. The share of alcohol expenditure in total household expenditure is substantial, especially among poor households. This should be considered an important public health issue, which needs to be taken into account in the alcohol policy debate.

Diep P.B.,Hanoi Medical University
Global health action | Year: 2013

This study examines the prevalence of and risk factors for alcohol-related harm and types of harm among medical students from Hanoi Medical University (Vietnam). Risk factors include aspects of drinking patterns and relevant socio-demographic variables. A cross-sectional study involving 1st to 6th year students (N=1216; response rate 96.5%). Of these, 210 students from each academic year were randomly selected from a sampling frame covering all students from each academic year. Data were collected using a questionnaire distributed in class by researchers. Drinkers completed 23 questions on alcohol-related harm categorized into: 1) 'negative influence on daily activities'; 2) 'social conflict'; 3) 'loss of control, acute consequences, and withdrawal'; 4) 'mental health conditions'; and 5) 'physical and medical health problems'. Logistic and Poisson regression models were used to identify the predictors of alcohol-related harm and the amount of harm, respectively. The prevalence of alcohol use associated with at least one or more of the five types of harm was higher in men (81.8%) than in women (60.4%). In female and male students, the most common harm category was 'loss of control, acute consequences, and withdrawal' (51.8 and 75.6%, respectively), followed by 'negative influence on daily activities' (29.4 and 55.8%, respectively). Age, living away from home, and average number of standard drinks per occasion among male drinkers, and age and frequency of drinking per week among female drinkers were associated with alcohol-related harm. These data suggest that alcohol-related harm represents a serious public health problem among young educated individuals in Vietnam. The risk factors indicate that prevention should be aimed at aspects of drinking patterns and specific subpopulations defined by gender, age, and (for men only) type of living situation.

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