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Hattasingh W.,Mahidol University | Pengsaa K.,Mahidol University | Thisyakorn U.,Chulalongkorn University | An P.N.,Hanoi University | And 9 more authors.
Vaccine | Year: 2016

The 1st Workshop on National Immunization Programs and Vaccine Coverage in Association of Southeast Asian Nations (ASEAN) Countries Group (WNIPVC-ASEAN) held a meeting on April 30, 2015, Pattaya, Thailand under the auspices of the Pediatric Infectious Diseases Society and the World Health Organization (WHO). Reports on the current status and initiatives of the national immunization program (NIP) in each ASEAN countries that attended were presented. These reports along with survey data collected from ministries of health in ASEAN countries NIPs demonstrate that good progress has been made toward the goal of the Global Vaccine Action Plan (GVAP). However, some ASEAN countries have fragile health care systems that still have insufficient vaccine coverage of some basic EPI antigens. Most ASEAN countries still do not have national coverage of some new and underused vaccines, and raising funds for the expansion of NIPs is challenging. Also, there is insufficient research into disease burden of vaccine preventable diseases and surveillance. Health care workers must advocate NIPs to government policy makers and other stakeholders as well as improve research and surveillance to achieve the goals of the GVAP. © 2016.


Phongsavan K.,Karolinska Institutet | Phongsavan K.,Sethathirath Hospital | Phengsavanh A.,Health Science University | Wahlstrom R.,Karolinska Institutet | Marions L.,Karolinska Institutet
International Journal of Gynecological Cancer | Year: 2010

Background: Cervical cancer is the second most common cancer of women in the world, and it becomes a major cause of cancer mortality in low-income countries. Currently, little is known regarding cervical cancer incidence in Laos, although it is anticipated to be high like in neighboring countries. To be able to develop a screening program in the country, it is essential to explore women's perception of the disease. The purpose of this study was therefore to describe knowledge, awareness, and attitudes regarding cervical cancer among rural women of Laos. Methods: In a descriptive cross-sectional study, women were interviewed using a structured questionnaire covering sociodemographic factors, knowledge of the disease and its risk factors, awareness, and attitudes toward cervical cancer and its prevention. Results: Eight hundred women were included in the study, and 58% claimed to know about cervical cancer. Approximately one third (38%) considered themselves to be at risk, but less than 5% had ever had a Papanicolau test. Sixty-two percent believed it was possible to prevent cervical cancer and that vaccination may be a suitable method, but only 14% know about risk factors. Another method for prevention was frequent vaginal douching, which was suggested by 70% of the women. Symptoms like bleeding and discharge were correctly identified as possible indicators of cervical cancer, but only 57 women (7%) knew that an early stage of the disease could be symptom-free. Lack of subjective symptoms was the main reason for women to refrain from gynecological examinations. Conclusions: This study indicates that rural women in Laos have limited knowledge about cervical cancer and even less about screening and prevention. There is a need to educate the general community about the disease and its prevention. Copyright © 2010 by IGCS and ESGO.


Phongsavan K.,Karolinska University Hospital | Phongsavan K.,Sethathirath Hospital | Phengsavanh A.,Health Science University | Wahlstrom R.,Karolinska Institutet | Marions L.,Karolinska University Hospital
International Journal of Gynecology and Obstetrics | Year: 2011

Objective: To assess the safety, acceptability, and feasibility of visual inspection with acetic acid (VIA) followed by immediate treatment with cryotherapy as a single-visit approach for the prevention of cervical cancer among women in rural Laos. Methods: In 2009, women from 2 provinces in Laos were recruited for cervical cancer screening using VIA. If the inspection of the cervix showed a well-defined acetowhite lesion close to the os, immediate cryotherapy was offered. Results: Of the 1926 women who were included, 134 (7.0%) tested positive on VIA. Of these, 113 (84.3%) underwent immediate cryotherapy and none declined treatment. One year after immediate cryotherapy, 77 (68.1%) women returned for a follow-up assessment and 68 (88.3%) were now VIA-negative. There was no report of a major complication during or after treatment. The acceptance of both VIA and cryotherapy was high. Conclusion: Visual inspection with acetic acid is a simple test that requires minimal infrastructure and expenditure. Integration of VIA with cryotherapy at the primary care level may constitute a feasible program for the prevention of cervical cancer in Laos. © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.


Phongsavan K.,Karolinska University Hospital | Phongsavan K.,Sethathirath Hospital | Gustavsson I.,Uppsala University | Marions L.,Karolinska University Hospital | And 3 more authors.
International Journal of Gynecological Cancer | Year: 2012

Background: Persistent infection with high-risk (HR) human papillomavirus (HPV) is a well-recognized cause of cervical cancer, but little is known about the situation in Laos. The aims of the study were to determine the prevalence of HR-HPV among Lao women and to evaluate the use of a filter paper card (FTA Elute Micro Card) for collection of cervical cells in the humid tropical climate. Methods: This is a cross-sectional study including 1922 women from 3 provinces in Laos. During a gynecological examination, cervical cellswere collected and applied to the FTA card followed by HPV typing using a real-time polymerase chain reaction (PCR)-based assay. Results: Overall, 213 of the 1922 women were positive for HR-HPV (11%). The most common type was the group HPV33/52/58 (3%), followed by the single type 16 (2%) and the group 18/45 (1%), respectively. Only 11 cards (0.6%) did not contain a sufficient amount of genomic DNA for polymerase chain reactionYbased analysis. Conclusions: The prevalence of HR-HPV infections in Laos is similar to other Asian countries, and 40% of the women with an HR-HPV infection will be target of the present HPV vaccines. The FTA card is suitable for collection of cervical cells for HR-HPV typing in tropical conditions. This information is important for planning and establishing primary and secondary prevention of cervical cancer in Laos. © 2012 by IGCS and ESGO.


Sychareun V.,Health Science University | Phongsavan K.,Sethathirath Hospital | Hansana V.,Health Science University | Phengsavanh A.,Health Science University
BMC Health Services Research | Year: 2010

Background. The Ministry of Health (MOH) launched the National Reproductive Health Policy in 2005, which included recommendations regarding the use of emergency contraceptive pills (ECP). However, ECP have not yet been introduced officially in the public sector of the Lao PDR. Thus, their availability is limited. Understanding the knowledge of ECP and attitudes about their provision, barriers to use, and availability among health providers and policy makers is essential to successfully incorporate ECP into reproductive health services. Methods. Qualitative research methods using in-depth interviews were employed to collect data from policy makers and health providers (auxiliary medical staff, nurses, and medical doctors). Altogether, 10 policy makers, 22 public providers, and 10 providers at private clinics were interviewed. Content analysis was applied to analyze the transcribed data. Results. The majority of policy makers and health care providers had heard about ECP and supported their introduction in the public sector. However, their knowledge was poor, many expressed inconsistent attitudes, and their ability to meet the demand of potential users is limited. Conclusions. There is a need to train health providers and policy makers on emergency contraception and improve their knowledge about ECP, especially regarding the correct timing of use and the availability of methods. In addition, the general public must be informed of the attributes, side effects, and availability of ECP, and policy makers must facilitate the approval of ECP by the Lao Food and Drug Administration. These interventions could lead to increased access to and demand for ECP. © 2010 Sychareun et al; licensee BioMed Central Ltd.


Sychareun V.,Health Science University | Hansana V.,Health Science University | Phengsavanh A.,Health Science University | Phongsavan K.,Sethathirath Hospital
BMC Women's Health | Year: 2013

Background: Emergency Contraception is not officially available to the public sector in Laos. The potential of emergency contraception to prevent unwanted pregnancies is well documented in developed countries, but in Laos no studies of ECPs exist. This study aimed to assess knowledge of and attitudes towards emergency contraceptive pills (ECPs) in Vientiane, the capital city of the Lao PDR.Methods: A cross-sectional survey was conducted among 500 young adults in entertainment venues by using the convenience sampling between May to July, 2007. Data were obtained through face-to-face interview. Participants were asked about socio- demographic characteristics, knowledge, attitudes related to ECPs, and source of information about ECPs. Data analysis was performed with chi-square test and logistic regression (p < .05).Results: Only 22.4 percent of respondents had heard of ECPs and of these only 17.9 percent knew the correct time-frame for effective use. Most of the respondents (85%) agreed on the need for ECPs to be available in Laos and 66.8 percent stated that they would use them should the need arise, if they were available. Among those who said they would not use ECPs, 63.8 percent were concerned about possible health effects, or other side effects. Awareness of ECPs was associated with increasing age (OR = 2.78, p = .025) and male sex (OR = 2.91, p = .010).Conclusions: There is needed to provide effective health education about the method, timing of use, and how to obtain ECPs through both informal, peer channels, and also through formal channels such as health care providers. © 2013 Sychareun et al.; licensee BioMed Central Ltd.

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