Drug use and health-seeking behavior for childhood illness in Vietnam—A qualitative study

Hoa, Nguyen Quynh; Öhman, Ann; Lundborg, Cecilia Stålsby; Chúc, Nguyễn Thị Kim

doi:10.1016/j.healthpol.2006.10.005

Cited by 27 publications

(23 citation statements)

References 12 publications

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“…Antibiotic use was not related to carriage which we cannot explain. Antibiotic use in the community was high, but comparable to previous studies that assessed community antibiotic use in Vietnam [21], [22], [23]. Interestingly, we found two cases who carried carbapenem resistant K. pneumoniae strains, which were found to be NDM-1 positive.…”

Section: Discussionsupporting

confidence: 87%

Klebsiella pneumoniae Oropharyngeal Carriage in Rural and Urban Vietnam and the Effect of Alcohol Consumption

et al. 2014

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IntroductionCommunity acquired K. pneumoniae pneumonia is still common in Asia and is reportedly associated with alcohol use. Oropharyngeal carriage of K. pneumoniae could potentially play a role in the pathogenesis of K. pneumoniae pneumonia. However, little is known regarding K. pneumoniae oropharyngeal carriage rates and risk factors. This population-based cross-sectional study explores the association of a variety of demographic and socioeconomic factors, as well as alcohol consumption with oropharyngeal carriage of K. pneumoniae in Vietnam.Methods and Findings1029 subjects were selected randomly from age, sex, and urban and rural strata. An additional 613 adult men from a rural environment were recruited and analyzed separately to determine the effects of alcohol consumption. Demographic, socioeconomic, and oropharyngeal carriage data was acquired for each subject. The overall carriage rate of K. pneumoniae was 14.1% (145/1029, 95% CI 12.0%–16.2%). By stepwise logistic regression, K. pneumoniae carriage was found to be independently associated with age (OR 1.03, 95% CI 1.02–1.04), smoking (OR 1.9, 95% CI 1.3–2.9), rural living location (OR 1.6, 95% CI 1.1–2.4), and level of weekly alcohol consumption (OR 1.7, 95% CI 1.04–2.8).ConclusionModerate to heavy weekly alcohol consumption, old age, smoking, and living in a rural location are all found to be associated with an increased risk of K. pneumoniae carriage in Vietnamese communities. Whether K. pneumoniae carriage is a risk factor for pneumonia needs to be elucidated.

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Section: Discussionsupporting

confidence: 87%

Klebsiella pneumoniae Oropharyngeal Carriage in Rural and Urban Vietnam and the Effect of Alcohol Consumption

et al. 2014

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“…In six of the seven comparisons measuring waiting time, the time was shorter in the private sector. Qualitative data in five studies indicated that the private sector provided more personalised, respectful [39],[40],[46],[47], listening [43], and client-centred service, as well as service that was more convenient [48] and quicker and easier to access [47],[49].…”

Section: Resultsmentioning

confidence: 99%

Quality of Private and Public Ambulatory Health Care in Low and Middle Income Countries: Systematic Review of Comparative Studies

et al. 2011

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“…The frequent inappropriate practices of prescribers and drug sellers regarding antibiotic use for treatment of acute respiratory infections may be one explanation for the high level of antibiotic use and resistance in the area [13]. Other explanation might involve patients' misperceptions and self-medication with antibiotics [12]. …”

Section: Discussionmentioning

confidence: 99%

“…This study is part of a larger project conducted among the population of a rural area in northern Vietnam where data on health care providers and consumers' knowledge as well as their use of antibiotics has been obtained [12,13]. The aim of this paper is to estimate the prevalence of S. pneumoniae carriage, to assess its antibiotic susceptibility, and to investigate possible associations to antibiotic use, demographic factors of children aged 6 to 60 months and households' economic status.…”

Section: Introductionmentioning

confidence: 99%

Decreased Streptococcus pneumoniae susceptibility to oral antibiotics among children in rural Vietnam: a community study

et al. 2010

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BackgroundStreptococcus pneumoniae is the most significant bacterial cause of community-acquired pneumonia among children under five years worldwide. Updated resistance information of S. pneumoniae among children is essential to adjust the recommendations for empirical treatment of community-acquired pneumonia, which will have immense implications for local and global health. This study investigated the prevalence of antibiotic resistance in isolated strains of S. pneumoniae and relationship with antibiotic use and demographic factors of children under five in rural Vietnam in 2007.MethodsIn Bavi district, 847 children 6 to 60 months were selected from 847 households. The main child-caregivers in the households were interviewed weekly using structured questionnaires to collect information of daily illness symptoms and drug use for the selected child over a four-week period (from March through June 2007). In the 3rd week, the children were invited for a clinical examination and to collect nasopharyngeal samples for S. pneumoniae identification. Etest and disk diffusion were used to test antibiotic susceptibility.ResultsOf 818 participating children, 258 (32%) had ongoing respiratory infections, 421 (52%) carried S. pneumoniae, and 477 (58%) had used antibiotics within the previous three weeks. Of the 421 isolates, 95% were resistant to at least one antibiotic (401/421). Resistance to co-trimoxazole, tetracycline, phenoxymethylpenicillin, erythromycin and ciprofloxacin was 78%, 75%, 75%, 70% and 28%, respectively. Low resistance was noted for amoxicillin (4%), benzylpenicillin (4%), and cefotaxime (2%). The intermediate resistance to amoxicillin was 32%. Multidrug-resistance was seen in 60%. The most common pattern was co-resistance to co-trimoxazole, tetracycline and erythromycin. The proportion of children carrying resistant bacteria was higher among the children who had used antibiotics in the previous three weeks.ConclusionsResistance to commonly used antibiotics and multidrug-resistance of S. pneumoniae in the area is remarkably high. High-dose amoxicillin is the only investigated oral antibiotic that can possibly be used for treatment of community-acquired pneumococcal infections. Strategies to promote appropriate prescribing and dispensing of effective antibiotics should be immediately implemented for the benefit of local and global health.

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Drug use and health-seeking behavior for childhood illness in Vietnam—A qualitative study

Cited by 27 publications

References 12 publications

Klebsiella pneumoniae Oropharyngeal Carriage in Rural and Urban Vietnam and the Effect of Alcohol Consumption

Klebsiella pneumoniae Oropharyngeal Carriage in Rural and Urban Vietnam and the Effect of Alcohol Consumption

Quality of Private and Public Ambulatory Health Care in Low and Middle Income Countries: Systematic Review of Comparative Studies

Decreased Streptococcus pneumoniae susceptibility to oral antibiotics among children in rural Vietnam: a community study

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