BackgroundTuberculous meningitis in adults is well characterized in Vietnam, but there are no data on the disease in children. We present a prospective descriptive study of Vietnamese children with TBM to define the presentation, course and characteristics associated with poor outcome.MethodsA prospective descriptive study of 100 consecutively admitted children with TBM at Pham Ngoc Thach Hospital, Ho Chi Minh City. Cox and logistic regression were used to identify factors associated with risk of death and a combined endpoint of death or disability at treatment completion.ResultsThe study enrolled from October 2009 to March 2011. Median age was 32.5 months; sex distribution was equal. Median duration of symptoms was 18.5 days and time from admission to treatment initiation was 11 days. Fifteen of 100 children died, 4 were lost to follow-up, and 27/81 (33 %) of survivors had intermediate or severe disability upon treatment completion. Microbiological confirmation of disease was made in 6 %. Baseline characteristics associated with death included convulsions (HR 3.46, 95CI 1.19–10.13, p = 0.02), decreased consciousness (HR 22.9, 95CI 3.01–174.3, p < 0.001), focal neurological deficits (HR 15.7, 95CI 1.67–2075, p = 0.01), Blantyre Coma Score (HR 3.75, 95CI 0.99–14.2, p < 0.001) and CSF protein, lactate and glucose levels. Neck stiffness, MRC grade (children aged >5 years) and hydrocephalus were also associated with the combined endpoint of death or disability.ConclusionsTuberculous meningitis in Vietnamese children has significant mortality and morbidity. There is significant delay in diagnosis; interventions that increase the speed of diagnosis and treatment initiation are likely to improve outcomes.
Purpose Little is known about the effect of COVID-19 pandemic on public health and preventive medicine students, particularly in resource-limited countries. This study evaluated stress level in this population in Vietnam and their coping strategies during the COVID-19 pandemic. Patients and Methods A cross-sectional study was conducted in April 2020 among 563 public health and preventive medicine students. A structured questionnaire included background information, the level of stress measured by the Perceived Stress Scale (PSS) and coping strategies evaluated by the Brief COPE. To compare the PSS score and Brief COPE score among participants with different characteristics, two-sided t tests or ANOVA tests were used when appropriate. Results Most participants were females (71.4%), and the mean age was 21.6 years old (SD = 2.1). Almost all had moderate to high levels of knowledge, attitude and skill toward COVID-19 prevention and protection. The mean PSS score was 17.02 (SD 4.06), and more than 80% had a certain level of stress. The mean score of approach coping strategies was higher than avoidant coping strategies (2.74 and 1.84). Students with a high level of stress had a higher preference for avoidance coping strategies. Conclusion Although students reported relatively good knowledge, attitude and skill as well as the preference for adaptive coping strategies, they experienced a high level of stress during the COVID-19 pandemic.
BackgroundSocial support plays a crucial role in the treatment and recovery process of patients engaging in methadone maintenance treatment (MMT). However, there is a paucity of research about social support among MMT patients, possibly due to a lack of appropriate measuring tools. This study aimed to evaluate the psychometric properties of the Vietnamese version of the Medical Outcomes Study: Social Support Survey (MOS-SSS) among MMT patients.MethodsA cross-sectional survey of 300 patients was conducted in a methadone clinic in Ho Chi Minh City, Vietnam. MMT patients who agreed to participate in the study completed a face-to-face interview in a private room. The MOS-SSS was translated into Vietnamese using standard forward-backward process. Internal consistency was measured by Cronbach’s alpha. The intra-class correlation coefficient was used to determine the test-retest reliability of the MOS-SSS in 75 participants two weeks after the first survey. Concurrent validity of the MOS-SSS was evaluated by correlations with the Multidimensional Scale of Perceived Social Support (MSPSS) and the Perceived Stigma of Addiction Scale (PSAS). Construct validity was investigated by confirmatory factor analysis.ResultsThe MOS-SSS had good internal consistency with Cronbach’s alpha from 0.95 to 0.97 for the four subscales and 0.97 for the overall scale. The two-week test-retest reliability was at moderate level with intra-class correlation coefficients of 0.61–0.73 for the four subscales and 0.76 for the overall scale. Strong significant correlations between the MOS-SSS and the MSPSS (r = 0.77; p < 0.001) and the PSAS (r = − 0.76; p < 0.001) indicated good concurrent validity. Construct validity of the MOS-SSS was established since a final four-factor model fitted the data well with Comparative Fit Index (0.97), Tucker-Lewis Index (0.97), Standardized Root Mean Square Residual (0.03) and Root Mean Square Error of Approximation (0.068; 90% CI = 0.059–0.077).ConclusionsThe MOS-SSS is a reliable and valid tool for measuring social support in Vietnamese MMT patients. Further studies among methadone patients at different stages of their treatment and among those from different areas of Vietnam are needed.Electronic supplementary materialThe online version of this article (10.1186/s13011-018-0147-4) contains supplementary material, which is available to authorized users.
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