| 1. |
- Friberg, Peter, et al.
(författare)
-
Public and global engagement with global health
- 2013
-
Ingår i: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 381:9883, s. 2066-2066
-
Tidskriftsartikel (refereegranskat)abstract
- Global health is widely regarded as being grounded in public and global engagement. But much of the process of global health is dominated by Northern institutions, expert groups, think-tanks, high-level meetings, and the like. Indeed, the exponential growth of global health in the past decade may soon turn into terminal decline unless truly global and broad-based ownership of the concept can be achieved.
|
|
| 2. |
- Hang, Hoang Minh, 1959-
(författare)
-
Epidemiology of unintentional injuries in rural Vietnam
- 2004
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main objective of this epidemiological study was to assess the incidence of unintentional non-fatal injuries, together with their determinants and consequences, in a defined Vietnamese population, thus providing a basis for future prevention. A one-year follow-up survey involved four quarterly cross-sectional household injury interviews during 2000. This cohort study was based within a demographic surveillance site in Bavi district, northern Vietnam, which provides detailed, longitudinal information in a continuous and systematic way. Findings relate to three phases of the injury process: before, during and after injury. The study showed that unintentional non-fatal injuries were an important health problem in rural Vietnam. The high incidence rate of 89/1000 pyar reflected almost one tenth of the population being injured every year. Home injuries were found to be most common, often due to a lack of proper kitchens and dangerous surroundings in the home. Road traffic injuries were less common but tended to be more severe, with longer periods of disability and higher unit costs compared with other types of injury. The leading mechanisms of injury were impacts with other objects, falls, cuts and crushing. Males had higher injury incidence rates than females except among the elderly. Elderly females were often injured due to falls in the home. Being male or elderly were significant risk factors for injury. Poverty was a risk factor for injuries in general and specifically for home and work related injuries, but not for road traffic injuries. The middle income group was at higher risk of traffic injuries, possibly due to their greater mobility. Injuries not only affected people’s health, but were also a great financial burden. The cost of an injury, on average, corresponded to approximately 1.3 months of earned income, increasing to 7 months for a severe injury. Ninety percent of the economic burden of injury fell on households, only 8% on government and 2% on health insurance agencies. Self-treatment was the most common way of treating injuries (51.7%), even in some cases of severe injury. There was a low rate of use of public health services (23.2%) among injury patients, similar to private healthcare (22.4%). High cost, long distances, residence in mountains, being female and coming from ethnic minorities were barriers for seeking health services. People with health insurance sought care more, but the coverage of health insurance was very low. Some prevention strategies might include education and raising awareness about the possible dangers of injury and the importance of seeking appropriate care following injury. To avoid household hazards, several strategies could be used: better light in the evening, making gravel paths around the house, clearing moss to avoid slipping, wearing protective clothing when using electrical equipment and improving kitchens. Similarly, improving road surfaces, having separate paths for pedestrians and cyclists and better driver training could reduce road accidents. In Vietnam, and especially in a rural district without any injury register system, a community-based survey of unintentional injuries has been shown to be a feasible approach to injury assessment. It gave more complete results than could have been obtained from facility-based studies and led to the definition of possible prevention strategies.
|
|
| 3. |
- Minh, Hoang Van, et al.
(författare)
-
Smoking epidemics and socio-economic predictors of regular use and cessation : Findings from WHO STEPS risk factor surveys in Vietnam and Indonesia
- 2006
-
Ingår i: Internet Journal of Epidemiology. - 1540-2614. ; 3:1
-
Tidskriftsartikel (refereegranskat)abstract
- A population-based surveys were carried out in two demographic surveillance sites (DSSs) in Vietnam and Indonesia using the WHO STEPS approach to surveillance of non-communicable disease risk factors in order to characterize smoking epidemics in rural communities of Vietnam and Indonesia by identifying associations between socio-economic status and changes in smoking status among adult populations. The paper reveals that the prevalence of smoking among people aged 25-54 years was higher in Indonesia than in Vietnam. Indonesian men started smoking regularly earlier and ceased less than Vietnamese men. While low income was found to be a significant predictor of becoming regular smokers in Vietnam, old birth cohort and low education significantly increased the probability of being a regular smoker in Indonesia. Economic status was also found to be a significant predictor of smoking cessation in Vietnam while education and occupation played an important role in Indonesia
|
|
| 4. |
- Ng, Nawi, et al.
(författare)
-
Combining risk factors and demographic surveillance : potentials of WHO STEPS and INDEPTH methodologies for assessing epidemiological transition.
- 2006
-
Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 34:2, s. 199-208
-
Tidskriftsartikel (refereegranskat)abstract
- AIMS: Demographic surveillance systems (DSSs) create platforms to monitor population dynamics. This paper discusses the potential of combining the WHO STEPwise approach to Surveillance (STEPS) within ongoing DSSs, to assess changes in non-communicable disease (NCD) risk factors. METHODS: Three DSSs in Ethiopia, Vietnam, and Indonesia have collected NCD risk factors using WHO STEPS, focusing on self-reported lifestyle risk factors (Step 1) and measurement of blood pressure and anthropometric parameters (Step 2). RESULTS: DSSs provide sampling frames for NCD risk factor surveillance, which reveals the distribution of risk factors and their dynamics at the population level. The WHO STEPS approach with its add-on modules is feasible and adaptable in DSS settings. Available mortality data in the DSSs enable mortality assessment by cause of death using verbal autopsy, which is relevant in estimating the impact of NCDs. DSSs as well as risk factor surveillance data may potentially be a lever for hypothesis-driven research to address specific a priori hypotheses or research questions. CONCLUSION: Combining DSSs with the WHO STEPS approach can potentially address basic epidemiological questions on NCDs, which can be used as a powerful advocacy tool in public health decision-making for NCD prevention.
|
|
| 5. |
- Nguyen, Ngoc Quang, et al.
(författare)
-
Cardiovascular disease risk factor patterns and their implications for intervention strategies in Vietnam
- 2012
-
Ingår i: International Journal of Hypertension. - : Hindawi Limited. - 2090-0384 .- 2090-0392.
-
Tidskriftsartikel (refereegranskat)abstract
- Background. Data on cardiovascular disease risk factors (CVDRFs) in Vietnam are limited. This study explores the prevalence of each CVDRF and how they cluster to evaluate CVDRF burdens and potential prevention strategies. Methods. A cross-sectional survey in 2009 (2,130 adults) was done to collect data on behavioural CVDRF, anthropometry and blood pressure, lipidaemia profiles, and oral glucose tolerance tests. Four metabolic CVDRFs (hypertension, dyslipidaemia, diabetes, and obesity) and five behavioural CVDRFs (smoking, excessive alcohol intake, unhealthy diet, physical inactivity, and stress) were analysed to identify their prevalence, cluster patterns, and social predictors. Framingham scores were applied to estimate the global 10-year CVD risks and potential benefits of CVD prevention strategies. Results. The age-standardised prevalence of having at least 2/4 metabolic, 2/5 behavioural, or 4/9 major CVDRF was 28%, 27%, 13% in women and 32%, 62%, 34% in men. Within-individual clustering of metabolic factors was more common among older women and in urban areas. High overall CVD risk (≥20% over 10 years) identified 20% of men and 5% of women—especially at higher ages—who had coexisting CVDRF. Conclusion. Multiple CVDRFs were common in Vietnamese adults with different clustering patterns across sex/age groups. Tackling any single risk factor would not be efficient.
|
|
| 6. |
- Nguyen, Ngoc Quang, et al.
(författare)
-
Effectiveness of community-based comprehensive healthy lifestyle promotion on cardiovascular disease risk factors in a rural Vietnamese population : a quasi-experimental study
- 2012
-
Ingår i: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261 .- 1471-2261. ; 12:article nr 56
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Health promotion is a key component for primary prevention of cardiovascular disease (CVD). This study evaluated the impact of healthy lifestyle promotion campaigns on CVD risk factors (CVDRF) in the general population in the context of a community-based programme on hypertension management. Methods: A quasi-experimental intervention study was carried out in two rural communes of Vietnam from 2006 to 2009. In the intervention commune, a hypertensive-targeted management programme integrated with a community-targeted health promotion was initiated, while no new programme, apart from conventional healthcare services, was provided in the reference commune. Health promotion campaigns focused on smoking cessation, reducing alcohol consumption, encouraging physical activity and reducing salty diets. Repeated cross-sectional surveys in local adult population aged 25 years and over were undertaken to assess changes in blood pressure (BP) and behavioural CVDRFs (smoking, alcohol consumption, physical inactivity and salty diet) in both communes before and after the 3-year intervention. Results: Overall 4,650 adults above 25 years old were surveyed, in four randomly independent samples covering both communes at baseline and after the 3-year intervention. Although physical inactivity and obesity increased over time in the intervention commune, there was a significant reduction in systolic and diastolic BP (3.3 and 4.7 mmHg in women versus 3.0 and 4.6 mmHg in men respectively) in the general population at the intervention commune. Health promotion reduced levels of salty diets but had insignificant impact on the prevalence of daily smoking or heavy alcohol consumption. Conclusion: Community-targeted healthy lifestyle promotion can significantly improve some CVDRFs in the general population in a rural area over a relatively short time span. Limited effects on a context-bound CVDRF like smoking suggested that higher intensity of intervention, a supportive environment or a gender approach are required to maximize the effectiveness and maintain the sustainability of the health intervention.
|
|
| 7. |
- Nguyen, Quang Ngoc, et al.
(författare)
-
Implementing a hypertension management programme in a rural area : local approaches and experiences from Ba-Vi district, Vietnam
- 2011
-
Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 11, s. 325-
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Costly efforts have been invested to control and prevent cardiovascular diseases (CVD) and their risk factors but the ideal solutions for low resource settings remain unclear. This paper aims at summarising our approaches to implementing a programme on hypertension management in a rural commune of Vietnam. METHODS: In a rural commune, a programme has been implemented since 2006 to manage hypertensive people at the commune health station and to deliver health education on CVD risk factors to the entire community. An initial cross-sectional survey was used to screen for hypertensives who might enter the management programme. During 17 months of implementation, other people with hypertension were also followed up and treated. Data were collected from all individual medical records, including demographic factors, behavioural CVD risk factors, blood pressure levels, and number of check-ups. These data were analysed to identify factors relating to adherence to the management programme. RESULTS: Both top-down and bottom-up approaches were applied to implement a hypertension management programme. The programme was able to run independently at the commune health station after 17 months. During the implementation phase, 497 people were followed up with an overall regular follow-up of 65.6% and a dropout of 14.3%. Severity of hypertension and effectiveness of treatment were the main factors influencing the decision of people to adhere to the management programme, while being female, having several behavioural CVD risk factors or a history of chronic disease were the predictors for deviating from the programme. CONCLUSION: Our model showed the feasibility, applicability and future potential of a community-based model of comprehensive hypertension care in a low resource context using both top-down and bottom-up approaches to engage all involved partners. This success also highlighted the important roles of both local authorities and a cardiac care network, led by an outstanding cardiac referral centre.
|
|
| 8. |
- Nguyen, Quang Ngoc, 1976-
(författare)
-
Understanding and managing cardiovascular disease risk factors in Vietnam : integrating clinical and public health perspectives
- 2012
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Vietnam, like other low-income countries, is facing an epidemic burden of cardiovascular disease risk factors (CVDRFs). The magnitude and directions of CVDRF progression are matters of uncertainty. Objectives: To describe the epidemiological progression of CVDRFs and the preventive effects of community lifestyle interventions, with reference to the differences in progression of CVDRF patterns between men and women. Methods: The study was conducted during 2001-2009 in nationally representative samples and in a local setting of rural areas of Ba-Vi district, Ha-Tay province. Both epidemiological and interventional approaches were applied: (i) a population-based cross-sectional survey of 2,130 people aged ≥25 years in Thai-Binh and Hanoi; (ii) an individual participant-level meta analysis of 23,563 people aged 24-74 years from multiple similar surveys in 9 provinces around Vietnam; (iii) a 17-month cohort study of 497 patients in a hypertension management programme; (iv) a quasi-experimental trial on community lifestyle promotion integrated with a hypertension management programme, evaluated by surveys of 4,645 people in both intervention and reference communes before and after a 3-year intervention. Main findings: (i) in the general adult population ≥25 years, CVDRFs were common, often clustered within individuals, and increased with age; (ii) the Vietnamese population is facing a growing epidemic of CVDRFs, which are generally not well managed; (iii) it is possible to launch a community intervention in low-resource settings within the scope of a commune-based patient-targeted programme on hypertension management; (iv) community health intervention with comprehensive healthy lifestyle promotion improves blood pressure and some behavioural CVDRFs. Conclusion: Alarming increases in CVDRFs in the general population need comprehensive multi-level prevention strategies, which combine both individual high-risk and population health approaches. The commune-based hypertension-centred management programmes integrated with community health promotion are the initial but essential steps towards comprehensive and effective management of CVDRFs and should be part of an integrated and co-ordinated national program on the prevention and control of chronic diseases in low-resource settings like Vietnam.
|
|
| 9. |
- Pham, Son Thai, et al.
(författare)
-
Prevalence, awareness, treatment and control of hypertension in Vietnam : results from a national survey
- 2012
-
Ingår i: Journal of Human Hypertension. - : Nature Publishing Group. - 0950-9240 .- 1476-5527. ; 26, s. 268-280
-
Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to estimate mean blood pressure (BP), prevalence of hypertension (defined as BP 140/90 mm Hg) and its awareness, treatment and control in the Vietnamese adult population. This cross-sectional survey took place in eight Vietnamese provinces and cities. Multi-stage stratified sampling was used to select 9832 participants from the general population aged 25 years and over. Trained observers obtained two or three BP measurements from each person, using an automatic sphygmomanometer. Information on socio-geographical factors and anti-hypertensive medications was obtained using a standard questionnaire. The overall prevalence of hypertension was 25.1%, 28.3% in men and 23.1% in women. Among hypertensives, 48.4% were aware of their elevated BP, 29.6% had treatment and 10.7% achieved targeted BP control (<140/90 mm Hg). Among hypertensive aware, 61.1% had treatment, and among hypertensive treated, 36.3% had well control. Hypertension increased with age in both men and women. The hypertension was significantly higher in urban than in rural areas (32.7 vs 17.3%, P<0.001). Hypertension is a major and increasing public health problem in Vietnam. Prevalence among adults is high, whereas the proportions of hypertensives aware, treated and controlled were unacceptably low. These results imply an urgent need to develop national strategies to improve prevention and control of hypertension in Vietnam.
|
|
| 10. |
|
|
