To investigate the molecular epidemiology of pneumococcal nasopharyngeal carriage in Hanoi, Vietnam, we studied 84 pneumococcal strains retrieved from children with upper respiratory tract infections. Serotypes 23F (32%), 19F (21%), 6B (13%), and 14 (10%) were found most often. A significant number of strains were antibiotic resistant. Fifty-two percent of the strains were (intermediate) resistant to penicillin, 87% were (intermediate) resistant to co-trimoxazole, 76% were resistant to tetracycline, 73% were resistant to erythromycin, and 39% were (intermediate) resistant to cefotaxime. Seventy-five percent were resistant to three or more classes of antibiotics. A high degree of genetic heterogeneity among the penicillin resistance genes was observed. In addition, the tetracycline resistance gene tet(M) and the erythromycin resistance gene erm(B) were predominantly observed among the isolates. Molecular analysis of the 84 isolates by restriction fragment end labeling (RFEL) revealed 35 distinct genotypes. Twelve of these genotypes represented a total of eight genetic clusters with 61 isolates (73%). The two largest clusters contained 24 and 12 isolates, and the isolates in those clusters were identical to the two internationally spreading multidrug-resistant clones Spain 23F-1 and Taiwan 19F-14, respectively. The remaining RFEL types were Vietnam specific, as they did not match the types in our reference collection of 193 distinct RFEL types from 16 countries. Furthermore, 57 of the 61 horizontally spreading isolates (93%) in the eight genetic clusters were covered by the seven-valent conjugate vaccine, whereas this vaccine covered only 43% of the isolates with unique genotypes. According to the serotype distribution of the nasopharyngeal pneumococcal isolates, this study suggests a high potential benefit of the seven-valent pneumococcal conjugate vaccine for children in Hanoi.

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Background Levels of STIs and teenage pregnancy among Aboriginal and Torres Strait Islander populations are significantly higher than among non-Indigenous populations. However, recent research has shown few differences in the sexual behaviour of young Indigenous and non-Indigenous Australians. We conducted a systematic review to examine the multi-dimensional and socially constructed nature of adolescent sexuality with a view to developing meaningful STI and pregnancy reduction programmes for young Indigenous Australians. Methods Following standard guidelines for systematic reviews we searched eight relevant databases for published studies. We focused on publications since January 2003 using search terms: adolescent, youth, sexual, Australia, Indigenous, Aboriginal and Torres Strait. Given the limited amount of literature available we included all study designs and studies of broader age ranges or populations, but where Indigenous and adolescent populations were disaggregated in study results. Results We identified an initial 2,718 citations through the database search. After removing duplicates and citations that were not peer-reviewed or research articles, we screened 2,266 articles and excluded 2,158. The remaining 180 articles were reviewed in full: 93 did not meet inclusion criteria. Our review finally comprised 15 research papers, representing eleven distinct studies. Across the literature included in the review a number of key social determinants of poor sexual health were identified. These included alcohol, poverty, gender inequalities, intergenerational trauma, limited access to education and employment, shame, constrained adult role models and aspirations and restricted access to (sexual) health services. We examine the role of these factors with regard to adolescent Indigenous sexual health. Conclusions International research argues that promoting good sexual health requires a broader focus on sexuality. The sociocultural and historical contexts of Indigenous communities suggest that focusing on strengths-based approaches to sexual health with peer or community facilitation might be acceptable and effective for young Indigenous Australians.