Background Treatment eligibility and the accuracy of its simplified criteria have been poorly documented in patients with chronic HBV infection worldwide, especially in low-and-middle-income countries. Methods From a cohort of HBV-infected patients in Vietnam, we assessed the proportion of patients eligible for treatment using the national guidelines based on reference tests (HBV DNA quantification and FibroScan); and the accuracy of simplified treatment criteria free from HBV DNA and FibroScan (TREAT-B score and simplified WHO criteria) to select patients for antiviral therapy using the national guidelines as a reference. Results We analysed 400 consecutive treatment-naïve HBV-monoinfected patients: 49% males, median age 38 years (range: 18-86), 32% HBeAg-positive, median HBV DNA 4.8 log10 IU/ml (undetectable-8.4), median FibroScan 5.3kPa (3.0-67.8), 25% having significant liver fibrosis including 12% with cirrhosis. Of them 167 (42%) fulfilled treatment criteria according to the national guidelines. Using the national criteria as a reference, the performance of TREAT-B to select patients for treatment was high (AUROC: 0.89 (95%CI: 0.87-0.92)) with a sensitivity of 74.3% and a specificity of 88.4%. In a subset of patients with two ALT measurements over a 6-month period (n=89), the AUROC of TREAT-B was significantly higher than that of the simplified WHO criteria (p<0.001). Conclusion Our study suggests that a large proportion of patients with chronic HBV infection require antiviral therapy in Vietnam. Compared to the simplified WHO criteria free from HBV DNA quantification, TREAT-B is a better alternative to easily indicate treatment eligibility and might help scale-up treatment intervention in Vietnam.
Few point prevalence surveys (PPS) have been conducted in Vietnam on Surgical Site Infections (SSI) or antimicrobial use in surgery. The objective of this study was to evaluate the PPSs of SSI before and after implementation of antibiotic stewardship programs (ASP) and infection control (IC) in a Vietnamese tertiary care hospital. ASP and IC practices were implemented in operating rooms and the orthopedic department, including antibiotic training, skin preparation, hand hygiene, gloves and sterile instruments, and SSIs risk factors. A PPS of SSIs and antimicrobial use was performed in January 2016 according to methods from the Centers for Disease Control and Prevention, before ASP and IC, and in December 2019. Information recorded included surgical data, antibiotic prophylaxis, microorganisms, and SSI risk factors. Skin preparation compliance assessed preoperative washing and antisepsis. SSI prevalence was 7.8% in 2016 versus 5.4% in 2019 (p = 0.7). The use of prophylactic antibiotics decreased from 2016 to 2019. A third-generation cephalosporin was prescribed more than 48 h after surgery for most patients. Skin preparation compliance increased from 54.4% to 70.5% between assessments. The decreased SSI, although non-statistically significant, warrants continuing this program. Vietnamese hospitals must provide comprehensive IC education to healthcare workers to address the prevention of SSI and establish IC policies.
• The use of CGM are beneficial in glycemic control, reduction of hypoglycemia and hyperglycemia events, HbA1c reduction and improvement of quality of life in patients with diabetes.
Background Few point prevalence surveys (PPS) have been conducted in Vietnam on SSIs or antimicrobial use in surgery. We performed PPSs of surgical site infection (SSI) before and after antibiotic stewardship programs (ASP) and infection control (IC) in a Vietnamese tertiary-care hospital. Method ASP and IC practices were implemented in operating rooms and the orthopedic department including antibiotic training, skin preparation, hand hygiene, gloves and sterile instruments, and SSIs risk factors. A PPS of SSIs and AMS was performed in January 2016 according to Center Disease Control methods, before ASP and IC, and in December 2019. Information recorded included surgical, antibiotic prophylaxis, microorganisms and SSI risk factors. Skin preparation compliance assessed preoperative washing and antisepsis. Results SSI prevalence was 7.8% in 2016 versus 5.4% in 2019 (p = 0.7). Significant differences were found for diabetes mellitus, NNIS score, scheduled surgery and prophylactic antibiotics. A third-generation cephalosporin was prescribed more than 48 hours after surgery for most patients in both periods. Skin preparation compliance increased from 54.4–70.5% between assessments. Conclusions The decreased SSI, although non-statistically significant, warrants continuing this program. Vietnamese hospital must provide comprehensive IC education to healthcare-workers addressing standard precautions and establish IC policies.
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