The pharmacokinetics of artemisinin after administration of two different suppositories to healthy Vietnamese subjects.
Eight healthy Vietnamese male subjects received 400 mg artemisinin formulated into fatty suppositories (FS), and six different subjects received 500 mg of artemisinin formulated in polyethylene glycol suppositories (PEGS). Plasma concentrations were measured by high-performance liquid chromatography with electrochemical detection; concentration versus time curves were analyzed with nonparametric methods. No statistically significant differences were found between the two formulations. The maximum concentration (Cmax) was 100 +/- 102 microg/L (mean +/- SD, range = 24-330) microg/L (FS), the pharmacokinetic lag time (Tlag) was 1.3 +/- 1.0 hr (range = 0-3) (FS), and the time of the maximum concentration (Tmax) was 7.1 +/- 2.1 hr (range = 3-10) hr (FS). Because artemisinin is not available for intravenous dosage, absolute bioavailability cannot be assessed. However, compared with a previous study on oral artemisinin in healthy Vietnamese subjects, bioavailability relative to oral administration was estimated to be approximately 30%. We conclude that therapeutic blood concentrations of artemisinin can be reached after rectal dosage. The dose after rectal administration should probably be higher than after oral administration; doubling or tripling the oral dose might be necessary, which would imply a rectal dose of at least 20 mg/kg of body weight given twice a day. (+info)
Prevalence of enteric hepatitis A and E viruses in the Mekong River delta region of Vietnam.
A study of antibody prevalence for hepatitis A virus (HAV) and hepatitis E virus (HEV) was carried out in southwestern Vietnam in an area adjacent to a known focus of epidemic HEV transmission. The purpose of this investigation was first to provide a prevalence measure of hepatitis infections, and second to determine the outbreak potential of HEV as a function of the susceptible population. Blood specimens collected from 646 persons in randomly selected village hamlets were examined by an ELISA for anti-HEV IgG and anti-HAV IgG. The prevalences of anti-HEV IgG and anti-HAV IgG were 9% and 97%, respectively. There was a significant increase (P < 0.01) in age-specific anti-HEV IgG. A notable increase in anti-HAV IgG prevalence (P < 0.0001) occurred between child populations 0-4 (64%) and 5-9 (95%) years of age. No evidence of familial clustering of anti-HEV IgG-positive individuals was detected, and household crowding was not associated with the spread of HEV. Boiling of water was found to be of protective value against HEV transmission. A relatively low prevalence of anti-HEV indicates considerable HEV outbreak potential, against a background of 1) poor, water-related hygiene/sanitation, 2) dependence on a (likely human/animal waste)-contaminated Mekong riverine system, and 3) periodic river flooding. (+info)
Identification of a novel genotype of hepatitis G virus in Southeast Asia.
Hepatitis G virus (HGV) isolates obtained from 20 Myanmarese and 10 Vietnamese subjects were analyzed. A cluster of isolates not belonging to any known genotype of HGV was found in five Myanmarese subjects and three Vietnamese subjects by phylogenetic analysis, and we classified this new genotype as type 4. These results revealed that the HGV genome can be classified into at least four major genotypes. (+info)
Revolving drug funds: a step towards health security.
The establishment of a revolving drug fund project in Viet Nam is described and the factors responsible for its success are considered. As well as being a tool for cost recovery a revolving drug fund can serve as an entry point for strengthening health care and improving health security at local and district level. (+info)
Childbirth customs in Vietnamese traditions.
OBJECTIVE: To examine and understand how differences in the cultural backgrounds of Canadian physicians and their Vietnamese patients can affect the quality and efficacy of prenatal and postnatal treatment. QUALITY OF EVIDENCE: The information in this paper is based on a review of the literature, supplemented by interviews with members of the Vietnamese community in Edmonton, Alta. The literature was searched with MEDLINE (1966 to present), HEALTHSTAR (1975 to present), EMBASE (1988 to present), and Social Sciences Abstracts (1984 to present). Emphasis was placed on articles and other texts that dealt with Vietnamese customs surrounding childbirth, but information on health and health care customs was also considered. Interviews focused on the accuracy of information obtained from the research and the correlation of those data with personal experiences of Vietnamese community members. MAIN MESSAGE: Information in the texts used to research this paper suggests that traditional Vietnamese beliefs and practices surrounding birth are very different from the biomedical view of the Canadian medical system. The experiences and beliefs of the members of the Vietnamese community support this finding. Such cultural differences could contribute to misunderstandings between physicians and patients and could affect the quality and efficacy of health care provided. CONCLUSIONS: A sensitive and open approach to the patient's belief system and open and frank communication are necessary to ensure effective prenatal and postnatal treatment for recent Vietnamese immigrants and refugees. Education and awareness of cultural differences are necessary for physicians to provide the best and most effective health care possible. (+info)
Introducing health insurance in Vietnam.
Like many other countries Vietnam is trying to reform its health care system through the introduction of social insurance. The small size of the formal sector means that the scope for compulsory payroll insurance is limited and provinces are beginning to experiment with ways of encouraging people to buy voluntary insurance. Methods of contracting between hospitals and insurance centres are being devised. These vary in complexity and there is a danger that those based on fee for service will encourage excessive treatment for those insured. It is important that the national and provincial government continue to maintain firm control over funding while also ensuring that a substantial and targeted general budget subsidy is provided for those unable to make contributions. (+info)
Serum dioxin and cancer in veterans of Operation Ranch Hand.
We studied cancer prevalence and exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (dioxin) in veterans of Operation Ranch Hand, the Air Force unit responsible for the aerial spraying of herbicides in Vietnam from 1962 to 1971. A comparison group of Air Force veterans who served in Southeast Asia during the same period and who were not involved with spraying herbicides was included. Comparison veterans were matched to Ranch Hand veterans on age, race, and military occupation. We measured dioxin in 1987 or 1992, extrapolated the result to the time of service in Southeast Asia, and assigned each Ranch Hand veteran to Background, Low, or High exposure categories. This study had low power to detect an effect for specific or rare cancers. The risk of cancer at sites other than the skin within 20 years of service was increased in the Low (odds ratio (OR) = 3.4, 95% confidence interval (CI) 1.5-8.0) and High (OR = 2.7, 95% CI 0.9-8.0) categories, but the pattern was inconsistent with another study, suggesting that the excess risk may not have been caused by dioxin exposure. Overall, we found no consistent evidence of a dose-response gradient and no significant increase in cancer risk in the High dioxin exposure category, the subgroup of greatest a priori interest. (+info)