| 1. |
- Tran, Ngoc Hieu, et al.
(författare)
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Genetic profiling of Vietnamese population from large-scale genomic analysis of non-invasive prenatal testing data
- 2020
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- The under-representation of several ethnic groups in existing genetic databases and studies have undermined our understanding of the genetic variations and associated traits or diseases in many populations. Cost and technology limitations remain the challenges in performing large-scale genome sequencing projects in many developing countries, including Vietnam. As one of the most rapidly adopted genetic tests, non-invasive prenatal testing (NIPT) data offers an alternative untapped resource for genetic studies. Here we performed a large-scale genomic analysis of 2683 pregnant Vietnamese women using their NIPT data and identified a comprehensive set of 8,054,515 single-nucleotide polymorphisms, among which 8.2% were new to the Vietnamese population. Our study also revealed 24,487 disease-associated genetic variants and their allele frequency distribution, especially 5 pathogenic variants for prevalent genetic disorders in Vietnam. We also observed major discrepancies in the allele frequency distribution of disease-associated genetic variants between the Vietnamese and other populations, thus highlighting a need for genome-wide association studies dedicated to the Vietnamese population. The resulted database of Vietnamese genetic variants, their allele frequency distribution, and their associated diseases presents a valuable resource for future genetic studies.
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| 2. |
- Tran, Dien M., et al.
(författare)
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High prevalence of colonisation with carbapenem-resistant Enterobacteriaceae among patients admitted to Vietnamese hospitals : Risk factors and burden of disease
- 2019
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Ingår i: Journal of Infection. - : Saunders Elsevier. - 0163-4453 .- 1532-2742. ; 79:2, s. 115-122
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundCarbapenem-resistant Enterobacteriaceae (CRE) is an increasing problem worldwide, but particularly problematic in low- and middle-income countries (LMIC) due to limitations of resources for surveillance of CRE and infection prevention and control (IPC).MethodsA point prevalence survey (PPS) with screening for colonisation with CRE was conducted on 2233 patients admitted to neonatal, paediatric and adult care at 12 Vietnamese hospitals located in northern, central and southern Vietnam during 2017 and 2018. CRE colonisation was determined by culturing of faecal specimens on selective agar for CRE. Risk factors for CRE colonisation were evaluated. A CRE admission and discharge screening sub-study was conducted among one of the most vulnerable patient groups; infants treated at an 80-bed Neonatal ICU from March throughout June 2017 to assess CRE acquisition, hospital-acquired infection (HAI) and treatment outcome.ResultsA total of 1165 (52%) patients were colonised with CRE, most commonly Klebsiella pneumoniae (n=805), Escherichia coli (n=682) and Enterobacter spp. (n=61). Duration of hospital stay, HAI and treatment with a carbapenem were independent risk factors for CRE colonisation. The PPS showed that the prevalence of CRE colonisation increased on average 4.2 % per day and mean CRE colonisation rates increased from 13% on the day of admission to 89% at day 15 of hospital stay. At the NICU CRE colonisation increased from 32% at admission to 87% at discharge, mortality was significantly associated (OR 5•5, P < 0•01) with CRE colonisation and HAI on admission.ConclusionThese data indicate that there is an epidemic spread of CRE in Vietnamese hospitals with rapid transmission to hospitalised patients.
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| 3. |
- Phu, Vu Dinh, et al.
(författare)
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Burden of Hospital Acquired Infections and Antimicrobial Use in Vietnamese Adult Intensive Care Units
- 2016
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Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Vietnam is a lower middle-income country with no national surveillance system for hospital-acquired infections (HAIs). We assessed the prevalence of hospital-acquired infections and antimicrobial use in adult intensive care units (ICUs) across Vietnam. Methods Monthly repeated point prevalence surveys were systematically conducted to assess HAI prevalence and antimicrobial use in 15 adult ICUs across Vietnam. Adults admitted to participating ICUs before 08: 00 a.m. on the survey day were included. Results Among 3287 patients enrolled, the HAI prevalence was 29.5% (965/3266 patients, 21 missing). Pneumonia accounted for 79.4% (804/1012) of HAIs Most HAIs (84.5% [855/1012]) were acquired in the survey hospital with 42.5% (363/855) acquired prior to ICU admission and 57.5% (492/855) developed during ICU admission. In multivariate analysis, the strongest risk factors for HAI acquired in ICU were: intubation (OR 2.76), urinary catheter (OR 2.12), no involvement of a family member in patient care (OR 1.94), and surgery after admission (OR 1.66). 726 bacterial isolates were cultured from 622/1012 HAIs, most frequently Acinetobacter baumannii (177/726 [24.4%]), Pseudomonas aeruginosa (100/726 [13.8%]), and Klebsiella pneumoniae (84/726 [11.6%]), with carbapenem resistance rates of 89.2%, 55.7%, and 14.9% respectively. Antimicrobials were prescribed for 84.8% (2787/ 3287) patients, with 73.7% of patients receiving two or more. The most common antimicrobial groups were third generation cephalosporins, fluoroquinolones, and carbapenems (20.1%, 19.4%, and 14.1% of total antimicrobials, respectively). Conclusion A high prevalence of HAIs was observed, mainly caused by Gram-negative bacteria with high carbapenem resistance rates. This in combination with a high rate of antimicrobial use illustrates the urgent need to improve rational antimicrobial use and infection control efforts.
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| 4. |
- Son, Hoang Nghia, et al.
(författare)
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Effects of simulated microgravity on the morphology of mouse embryonic fibroblasts (MEFs)
- 2020
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Ingår i: Romanian Biotechnological Letters. - Bucharest : University of Bucharest. - 1224-5984 .- 2248-3942. ; 25:6, s. 2156-2160
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to assess the effects of simulated microgravity on mouse embryonic fibroblast (MEF) morphology. The results showed that the area of MEFs under simulated microgravity was 7843.39 +/- 551.31 mu m(2) which was lower than the control group (9832.72 +/- 453.86 mu m(2)) (p < 0.001). The nuclear area of MEFs under simulated microgravity (290.76 +/- 4.58 mu m(2)) and the control group (296.8 +/- 4.58 mu m(2)) did not statistically differ. In addition, the nuclear shape value of the MEFs under simulated microgravity and the control group did not statistically differ (0.86 +/- 0.006 vs. 0.87 +/- 0.003, respectively). The nuclear intensity of MEFs under simulated microgravity (19361 +/- 852) was higher than the control group (16997 +/- 285) (P <0.05). Moreover, the flow cytometry analysis indicated the reduced GO/G1 phase cell ratio and the increased S phase and G2/M phase cell ratio in MEFs under simulated microgravity. Simulated microgravity also induced a decrease in diameter of actin filament bundles of the MEFs under simulated microgravity (1.61 +/- 0.33 mu m) compared to the control group (1.79 +/- 0.32 mu m) (P <0.01). These results revealed that simulated microgravity is capable of inducing the morphological changes of mouse embryonic fibroblasts.
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| 5. |
- Berg, Håkan, et al.
(författare)
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An ecological economic comparison between integrated rice-fish farming and rice monocultures with low and high dikes in the Mekong Delta, Vietnam
- 2023
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Ingår i: Ambio. - 0044-7447 .- 1654-7209. ; 52:9, s. 1462-1474
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Tidskriftsartikel (refereegranskat)abstract
- This study makes an ecological economic comparison between three different rice farming strategies in the Mekong Delta. Interviews were made with 30 farmers with two crops of rice and low dikes (2RLd), 30 farmers with three crops of rice and high dikes (3RHd) and 18 farmers with two crops of rice and one crop of fish (2RF). 2RF farmers had the highest annual net income and benefit cost ratio, because of low production costs and high yields of rice and fish. 2RLd farmers had the lowest annual net income. 3RHd had the highest annual rice yield, but also used the highest amount of rice seeds and agrochemicals, generating the lowest benefit cost ratio. Most farmers (70%) preferred two crops because of a higher production efficiency. High dikes and frequent use of pesticides and fertilizers were seen to decrease the water and rice quality, connectivity and biodiversity in farms with three crops. It is concluded that rice farming with two crops, and especially if integrated with fish and applying IPM, provides a sustainable alternative to rice farming with three crops and high dikes, because it makes use of the high connectivity within the rice-field ecosystem for an efficient production of healthy food through increased recycling of nutrients and natural pest control mechanisms.
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| 6. |
- Dao, Trong Tuan, et al.
(författare)
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Resveratrol suppressed lps-induced cox-2 VIA miR-146a-5p inhibition in raw246.7 cells
- 2017
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Ingår i: Farmacia. - 0014-8237. ; 65:2, s. 214-218
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Tidskriftsartikel (refereegranskat)abstract
- Trans-resveratrol (Res) is a well-known natural stilbene frequently found in grapes which have been reported to possess antioxidant, anti-cancer activities and inhibited COX-2 expression. MicroRNAs (miRNAs) are short endogenous non-coding RNAs involved in the regulation of mRNA stability and protein synthesis. In our research, resveratrol isolated from Vitis heyneana Roem. & Schult Vitis heyneana was observed to suppress lipopolysaccharides (LPS)-induced COX-2 expression in Raw264.7 cells in a dose dependent manner. Using qPCR it was revealed that LPS induced the expression of miR-25, miR- 125a, miR-125b, miR-146a-5p, miR-146a-3p and miR-455. However, we only observed miR-146a-5p expression significantly decreased in resveratrol compared to untreated-control group. In addition, resveratrol abrogated the effect of miR-146a-5p mimic induced-COX-2 expression in Raw264.7 cells. Taken together, this study demonstrated for the first time the involvement of miR-146a-5p in resveratrol inhibited LPS-induced COX-2 expression in Raw264.7 cells.
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| 7. |
- Eriksson, Leif, 1971-, et al.
(författare)
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Secular trend, seasonality and effects of a community-based intervention on neonatal mortality : follow-up of a cluster-randomised trial in Quang Ninh province, Vietnam
- 2018
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Ingår i: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 72:9, s. 776-782
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Tidskriftsartikel (refereegranskat)abstract
- Background: Little is know about whether the effects of community engagement interventions for child survival in low-income and middle-income settings are sustained. Seasonal variation and secular trend may blur the data. Neonatal mortality was reduced in a cluster-randomised trial in Vietnam where laywomen facilitated groups composed of local stakeholders employing a problem-solving approach for 3 years. In this analysis, we aim at disentangling the secular trend, the seasonal variation and the effect of the intervention on neonatal mortality during and after the trial.Methods: In Quang Ninh province, 44 communes were allocated to intervention and 46 to control. Births and neonatal deaths were assessed in a baseline survey in 2005, monitored during the trial in 2008–2011 and followed up by a survey in 2014. Time series analyses were performed on monthly neonatal mortality data.Results: There were 30 187 live births and 480 neonatal deaths. The intervention reduced the neonatal mortality from 19.1 to 11.6 per 1000 live births. The reduction was sustained 3 years after the trial. The control areas reached a similar level at the time of follow-up. Time series decomposition analysis revealed a downward trend in the intervention areas during the trial that was not found in the control areas. Neonatal mortality peaked in the hot and wet summers.Conclusions: A community engagement intervention resulted in a lower neonatal mortality rate that was sustained but not further reduced after the end of the trial. When decomposing time series of neonatal mortality, a clear downward trend was demonstrated in intervention but not in control areas.Trial registration number: ISRCTN44599712, Post-results.
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| 8. |
- Berg, Håkan, et al.
(författare)
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Stakeholders assessment of status and trends of ecosystem services in the Mekong Delta for improved management of multifunctional wetlands
- 2023
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Ingår i: Journal of Environmental Management. - 0301-4797 .- 1095-8630. ; 338
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Tidskriftsartikel (refereegranskat)abstract
- Increased agriculture and aquaculture production in the Mekong Delta during the last two decades has improved farmers' income, national export earnings and reduced poverty, but has also impacted on the environment and ecosystem services (ES) of importance to peoples' livelihoods and well-being. Through group discussions, interviews and questionnaires, this study assesses stakeholders’ perceptions of the status and trends of ES in the Mekong Delta and how these have been influenced by agriculture development. 15 of 24 ES were assessed to be impacted negatively by agriculture intensification, and especially supporting and regulating ES (SRES). Only a few provisioning ES (PrES), related to farming, were assessed to be in a good and stable supply, because of human interventions to create favorable conditions for these ES. Among the ten highest ranked ES, eight belonged to PrES and two belonged to SRES. There was a positive correlation between rank and awareness of ES. The supply of most SRES was perceived to be in a low and declining status and assessed to be in a high need for improved management. Some ES, such as pest-control had been complemented with human-made substitutes, such as pesticides, which however sometimes weakened rather than strengthened the ES. Cultural ES (CES) were often ranked lower and of less management concern than the other groups of ES. It is concluded that future agriculture strategies need a more balanced management of ES for a long-term production of healthy food and increased resilience of the Mekong Delta to cope with future challenges, such as climate change and upstream dams.
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| 9. |
- Bergström, Anna, 1983-, et al.
(författare)
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A facilitated social innovation : stakeholder groups using Plan-Do-Study-Act cycles for perinatal health across levels of the health system in Cao Bang province, Vietnam
- 2023
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Ingår i: Implementation Science Communications. - : BioMed Central (BMC). - 2662-2211. ; 4:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundUniversal coverage of evidence-based interventions for perinatal health, often part of evidence-based guidelines, could prevent most perinatal deaths, particularly if entire communities were engaged in the implementation. Social innovations may provide creative solutions to the implementation of evidence-based guidelines, but successful use of social innovations relies on the engagement of communities and health system actors. This proof-of-concept study aimed to assess whether an earlier successful social innovation for improved neonatal survival that employed regular facilitated Plan-Do-Study-Act meetings on the commune level was feasible and acceptable when implemented on multiple levels of the health system (52 health units) and resulted in actions with plausibly favourable effects on perinatal health and survival in Cao Bang province, northern Vietnam.MethodsThe Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework guided the implementation and evaluation of the Perinatal Knowledge-Into-Practice (PeriKIP) project. Data collection included facilitators’ diaries, health workers’ knowledge on perinatal care, structured observations of antenatal care, focus group discussions with facilitators, their mentors and representatives of different actors of the initiated stakeholder groups and an individual interview with the Reproductive Health Centre director. Clinical experts assessed the relevance of the identified problems and actions taken based on facilitators’ diaries. Descriptive statistics included proportions, means, and t-tests for the knowledge assessment and observations. Qualitative data were analysed by content analysis.ResultsThe social innovation resulted in the identification of about 500 relevant problems. Also, 75% of planned actions to overcome prioritised problems were undertaken, results presented and a plan for new actions to achieve the group’s goals to enhance perinatal health. The facilitators had significant roles, ensuring that the stakeholder groups were established based on principles of mutual respect. Overall, the knowledge of perinatal health and performance of antenatal care improved over the intervention period.ConclusionsThe establishment of facilitated local stakeholder groups can remedy the need for tailored interventions and grassroots involvement in perinatal health and provide a scalable structure for focused efforts to reduce preventable deaths and promote health and well-being.
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| 10. |
- Bich, Tran Huu, et al.
(författare)
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Father's involvement and its effect on early breastfeeding practices in Viet Nam.
- 2016
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Ingår i: Maternal and Child Nutrition. - : Wiley. - 1740-8695 .- 1740-8709. ; 12:4, s. 768-777
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Tidskriftsartikel (refereegranskat)abstract
- Fathers have an important but often neglected role in the promotion of healthy breastfeeding practices in developing countries. A community-based education intervention was designed to mobilize fathers' support for early breastfeeding. This study aimed to evaluate an education intervention targeting fathers to increase the proportion of early breastfeeding initiation and to reduce prelacteal feeding. Quasi-experimental study design was used to compare intervention and control areas located in two non-adjacent rural districts that shared similar demographic and health service characteristics in northern Viet Nam. Fathers and expectant fathers with pregnant wives from 7 to 30 weeks gestational age were recruited. Fathers in the intervention area received breastfeeding education materials, counselling services at a commune health centre and household visits. They were also invited to participate in a breastfeeding promotion social event. After intervention, early breastfeeding initiation rate was 81.2% in the intervention area and 39.6% in the control area (P < 0.001). Babies in the intervention area were more likely to be breastfed within the first hour after birth [odds ratio (OR) 7.64, 95% confidence interval (CI) 4.81-12.12] and not to receive any prelacteal feeding (OR 4.43, 95% CI 2.88-6.82) compared with those in the control area. Fathers may positively influence the breastfeeding practices of mothers, and as a resource for early childcare, they can be mobilized in programmes aimed at improving the early initiation of breastfeeding.
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| 11. |
- Brauckhoff, Michael, et al.
(författare)
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Long-term results and functional outcome after cervical evisceration in patients with thyroid cancer.
- 2006
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Ingår i: Surgery. - : Elsevier BV. - 0039-6060 .- 1532-7361. ; 140:6, s. 953-9
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Surgical strategy in patients with thyroid cancer (TC) infiltrating the aerodigestive system is controversial. This study was undertaken to examine the long-term results of cervical evisceration (CE).PATIENTS AND METHODS: Since 1995, 14 consecutive patients with advanced TC underwent total laryngectomy (LE, n = 6) or esophagolaryngectomy (ELR, n = 8). Patients with unusual thyroid neoplasms or metastases to the thyroid (n = 3) were excluded. For esophageal reconstruction, free jejunal grafts (n = 6) and gastric tubes (n = 2) were used.RESULTS: Procedure-related morbidity and mortality were 42% and 14%, respectively. ELR was associated with a significant higher frequency of complications and reoperations compared with LE. Twelve-month and 30-month survival rates were 73% and 55%, respectively; 85% of the patients were satisfied with the surgical results. There were no long-term problems concerning food intake in the ELR patients. Two ELR patients were able to learn a substitutive voice.CONCLUSIONS: Cervical evisceration in patients with TC is associated with significant perioperative morbidity and mortality requiring careful patient selection. Regarding long-term survival, local tumor control, and patient's satisfaction, however, CE should be taken into account in suitable patients with advanced TC.
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| 12. |
- Dupret, Vincent, 1977-, et al.
(författare)
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The skull of Hagiangella goujeti Janvier, 2005, a high-crested acanthothoracid (Vertebrata, Placodermi) from the Lower Devonian of northern Vietnam
- 2011
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Ingår i: Journal of Vertebrate Paleontology. - : Informa UK Limited. - 0272-4634 .- 1937-2809. ; 31:3, s. 531-538
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Tidskriftsartikel (refereegranskat)abstract
- The acanthothoracid Hagiangella goujeti Janvier, 2005, has been described exclusively on the basis of isolatedthoracic plates from the Lochkovian (Lower Devonian) Khao Loc Formation of Tung Vai, Ha Giang Province, northernVietnam. It is characterized by a very high, triangular median crest on the median dorsal plate, and has been referred to theAcanthothoraci on the basis of the morphology of its fused anterolateral, spinal and anterior ventrolateral plates, and thecharacteristic stellate ornamentation of the group. Isolated plates of H. goujeti are relatively abundant at Tung Vai and noother placoderm taxon from this locality seems to share the same type of ornamentation. However, the skull of this speciesremained elusive. Here we report two well-preserved skull roofs from Tung Vai, which we refer to H. goujeti. They display thesame stellate ornamentation and small size as the previously described plates of the thoracic armor of this species. This newmaterial shows that the head of H. goujeti is surprisingly short (i.e., possibly lacking dermal rostral and pineal elements), incontrast to the elongate and narrow skull of all other acanthothoracids. The combination of unique characters (e.g., presenceof two pairs of posterior pit lines, two pairs of central and paranuchal plates, etc.) suggests a possible sister group relationshipto the placoderm assemblage Petalichthyida + Ptyctodontida + Arthrodira.
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| 13. |
- Gimm, Oliver, et al.
(författare)
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Intra-operative quick insulin assay to confirm complete resection of insulinomas guided by selective arterial calcium injection (SACI).
- 2007
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Ingår i: Langenbeck's archives of surgery (Print). - : Springer Science and Business Media LLC. - 1435-2443 .- 1435-2451. ; 392:6, s. 679-84
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Insulinomas are rare endocrine disorders. Pre-operatively, conventional imaging techniques often fail to localise the tumor. In addition, due to the lack of quick insulin assays, intra-operative confirmation of complete resection was impossible until recently.MATERIALS AND METHODS: Six patients with biochemical evidence of an insulinoma underwent pre-operative localisation studies and selective arterial calcium injection (SACI). In addition, insulin was measured before surgery and every 10-15 min after resection of the tumor using a quick insulin assay.RESULTS: Pre-operative localisation studies identified the tumor correctly as follows: endosonography: three of four, magnetic resonance imaging: two of four and SACI: six of six. Tumors in the head and body were enucleated while those in the tail were resected (n = 2, each). Those three patients, in whom magnetic resonance imaging and/or endosonography could localise the tumors pre-operatively, underwent laparoscopic surgery while the remaining three patients underwent open surgery. Intra-operatively, insulin dropped to normal levels within 20 min in all cases. After a follow-up of 0.8-3 years, all patients remained biochemically cured.CONCLUSIONS: Pre-operatively, SACI appears to be a very sensitive localisation technique and may be most helpful in guiding the surgeon if conventional imaging techniques fail to localise the tumor. Complete removal of an insulinoma can be reliably predicted using a quick insulin assay.
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| 14. |
- Lorenz, Kerstin, et al.
(författare)
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Riedel's thyroiditis : impact and strategy of a challenging surgery.
- 2007
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Ingår i: Langenbeck's archives of surgery (Print). - : Springer Science and Business Media LLC. - 1435-2443 .- 1435-2451. ; 392:4, s. 405-12
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: No surgical standard for Riedel's thyroiditis (RT) is established. Salvage surgery follows severe cervical and compressive airway symptoms or strong suspicion of malignancy. Obscured planes and multi-infiltrative extension prevent sufficient surgery with considerate complications. No alternative definitive treatment is available. In failing conservative treatment, the role of surgery in RT remains unclear.MATERIALS AND METHODS: Clinical manifestation, treatment, outcome and follow-up in a unique series of eight consecutive patients with RT are presented.RESULTS: Seven female patients and one male patient with cervical tumor growth or thyroiditis underwent four total and three sub-total thyroidectomies, respectively, one patient declined remedial surgery. Complications were one bilateral laryngeal nerve palsy and one transient hypoparathyroidism. Histology confirmed RT with perithyroidal extension and excluded malignancy in all. Symptomatic relief of cervical and airway obstruction was achieved in all. Follow-up revealed two extensive mediastinal RT recurrences 1 and 6 years after surgery.CONCLUSION: Favourable symptomatic outcome and alleviation of steroids in the majority render surgery for RT valuable when conservative treatment fails. However, more radical procedures show no advantages and recurrences are not prevented. The demanding technique in RT requires special surgical expertise and highly recommends intra-operative neuromonitoring.
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| 15. |
- Målqvist, Mats, 1971-, et al.
(författare)
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Ethnic minority health in Vietnam : a review exposing horizontal inequity
- 2013
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Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 6, s. 1-19
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Forskningsöversikt (refereegranskat)abstract
- Background:Equity in health is a pressing concern and reaching disadvantaged populations is necessary to close the inequity gap. To date, the discourse has predominately focussed on reaching the poor. At the same time and in addition to wealth, other structural determinants that influence health outcomes exist, one of which is ethnicity. Inequities based on group belongings are recognised as 'horizontal', as opposed to the more commonly used notion of 'vertical' inequity based on individual characteristics.Objective:The aim of the present review is to highlight ethnicity as a source of horizontal inequity in health and to expose mechanisms that cause and maintain this inequity in Vietnam.Design:Through a systematic search of available academic and grey literature, 49 publications were selected for review. Information was extracted on: a) quantitative measures of health inequities based on ethnicity and b) qualitative descriptions explaining potential reasons for ethnicity-based health inequities.Results:Five main areas were identified: health-care-seeking and utilization, maternal and child health, nutrition, infectious diseases, and oral health and hygiene. Evidence suggests the presence of severe health inequity in health along ethnic lines in all these areas. Research evidence also offers explanations derived from both external and internal group dynamics to this inequity. It is reported that government policies and programs appear to be lacking in culturally adaptation and sensitivity, and examples of bad attitudes and discrimination from health staff toward minority persons were identified. In addition, traditions and patriarchal structures within ethnic minority groups were seen to contribute to the maintenance of harmful health behaviors within these groups.Conclusion:Better understandings of the scope and pathways of horizontal inequities are required to address ethnic inequities in health. Awareness of ethnicity as a determinant of health, not only as a covariate of poverty or living area, needs to be improved, and research needs to be designed with this in mind.
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| 16. |
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