Knowing the cause of death (CoD) plays an important role in developing strategies and interventions to prevent early mortality. In Vietnam, the CoD of the majority of patients who acquired infectious diseases remains unknown. While there are challenges that hinder the use of complete diagnostic autopsy (CDA) in practice, minimally invasive autopsy (MIA) might be a promising alternative to establish CoD in Vietnam. The current study aims to explore knowledge of and attitudes toward CDA and MIA in the wider population in Vietnam. The study was cross-sectional, using structured questionnaires that were disseminated electronically via several websites and as paper-based forms in a national level hospital in Vietnam. Descriptive analyses were performed and where appropriate, comparisons between the healthcare workers and the general public were performed. We included 394 questionnaires in the analysis. The majority of participants were under age 40, living in major cities and currently practicing no religion. 76.6% of respondents were aware of CDA and among them, 98% acknowledged its importance in medicine. However, most participants thought that CDA should only be performed when the CoD was suspicious or unconfirmed because of its the invasive nature. For MIA, only 22% were aware of the method and there was no difference in knowledge of MIA between healthcare workers and the wider public. The questionnaire results showed that there are socio-cultural barriers that hinder the implementation of CDA in practice. While the awareness of MIA among participants was low, the minimally invasive nature of the method is promising for implementation in Vietnam. A qualitative study is needed to further explore the ethical, socio-cultural and/or religious barriers that might hinder the implementation of MIA in Vietnam.

Background: Case-based surveillance of antimicrobial resistance (AMR) provides more actionable data than isolate- or sample-based surveillance. We developed A Clinically Oriented antimicrobial Resistance surveillance Network (ACORN) as a lightweight but comprehensive platform, in which we combine clinical data collection with diagnostic stewardship, microbiological data collection and visualisation of the linked clinical-microbiology dataset. Data are compatible with WHO GLASS surveillance and can be stratified by syndrome and other metadata. Summary metrics can be visualised and fed back directly for clinical decision-making and to inform local treatment guidelines and national policy. Methods: An ACORN pilot was implemented in three hospitals in Southeast Asia (1 paediatric, 2 general) to collect clinical and microbiological data from patients with community- or hospital-acquired pneumonia, sepsis, or meningitis. The implementation package included tools to capture site and laboratory capacity information, guidelines on diagnostic stewardship, and a web-based data visualisation and analysis platform. Results: Between December 2019 and October 2020, 2294 patients were enrolled with 2464 discrete infection episodes (1786 community-acquired, 518 healthcare-associated and 160 hospital-acquired). Overall, 28-day mortality was 8.7%. Third generation cephalosporin resistance was identified in 54.2% (39/72) of E. coli and 38.7% (12/31) of K. pneumoniae isolates. Almost a quarter of S. aureus isolates were methicillin resistant (23.0%, 14/61). 290/2464 episodes could be linked to a pathogen, highlighting the level of enrolment required to achieve an acceptable volume of isolate data. However, the combination with clinical metadata allowed for more nuanced interpretation and immediate feedback of results. Conclusions: ACORN was technically feasible to implement and acceptable at site level. With minor changes from lessons learned during the pilot ACORN is now being scaled up and implemented in 15 hospitals in 9 low- and middle-income countries to generate sufficient case-based data to determine incidence, outcomes, and susceptibility of target pathogens among patients with infectious syndromes.

Objectives: The aim of this study was to evaluate clinical and laboratory features related to mortality rate of blood stream infection patients admitted to National hospital for Tropical Diseases. Subjects and methods: A cross - sectional study was conducted among patients diagnosed blood stream infection from 7/2017 to 6/2010 in National hospital for Tropical Diseases. A total of 200 patients with clinical sign, symptoms of sepsis and positive blood culture were included in the study. Univariate and multivariate logistic regressions were used to identify independent prognostic factors for mortality. Results: Of 200 blood stream infection patients, 131 patients were male (65.5%); 150 patients (75%) had comorbidities, the most common diseases are cardiovascular diseases (26%), diabetes mellitus (23.5%), hepatic diseases (18.5%) and alcoholism (13%). E. coli (32%), S.aureus (28.5%) are the most frequent causes indentified in blood culture. There were 44 died (22%) and 156 survived (78%). Platelet < 100G/L (OR = 3.61), rAPTT > 1.25 (OR = 6.26), shock (OR = 71.99), the number of organ dysfunctions ≥ 3 (OR = 4.06) were independent prognostic factors. Conclusion: Septic shock, multiple organ failure and thrombocytopenia are the prognostic factors for mortality of blood stream infection. It should be early detected in blood stream infection for intervention.

Objectives: To evaluate the results of treatment of patients with chronic hepatitis C with Sofosbuvir/Velpatasvir regimen and adverse effects of the regimen. Subjects and methods: A cross sectional descriptive study with follow up 12 weeks after the end of treatment. 46 patients confirmed diagnosis of chronic hepatitis C according to 2016 Guidelines for diagnosis and treatment of hepatitis C virus of Ministry of Health. They received Sofosbuvir 400mg/Velpatasvir 100mg combination once daily for 12 weeks. Patients were followed up six months after the start of therapy. Hepatitis C viral load was assessed at baseline, at week 4 and after 24 weeks following the start of the treatment. Result: 34 patients without cirrhosis (97.1%) and 10 patients with compensated cirrhosis (90.9%) achieved RVR. A total of 100% of patients without cirrhosis and 90.9% of patients with compensated cirrhosis achieved SVR 12 weeks after the end of therapy. Patients with compensated cirrhosis experienced more adverses events (45.5%) than patients without cirrhosis (8.57%). None of the patients without cirrhosis or with compensated cirrhosis experienced any serious adverse event. A few patients complained about some symtoms such as fatigue (6/46, 13.0%), ichy/rash (2/46, 4.3%), insomnia (2/46, 4.3%), jaundice (1/46, 2.1%) - which appeared after received Sofosbuvir/Velpatasvir therapy. Most certain laboratoty abnormalities were seen in patients with compensated cirrhosis. Conclusion: The therapy of sofusbuvir/velpatasvir combination daily for 12 weeks is safe and efficacious in hepatitis C patients without cirrhosis or with compensated cirrhosis, irrespective of the genotype.