Seasonal and geographical distribution of bacillary dysentery(shigellosis)and associated climate risk factors in Kon Tum Province in Vietnam from 1999 to 2013

Background:Bacillary dysentery(BD)is an acute bacterial infection of the intestine caused by Shigella spp.,with clinical symptoms ranging from fever to bloody diarrhoea to abdominal cramps to tenesmus.In Vietnam,enteric bacterial pathogens are an important cause of diarrhoea and most cases in children under 5 years of age are due to Shigella strains.The serogroups S.flexneri and S.sonnei are considered to be the most common.The main objective of this study was to,for the first time,assess the seasonal patterns and geographic distribution of BD in Vietnam,and to determine the climate risk factors associated with the incidence of BD in Kon Tum Province,where the highest rate of bacillary dysentery was observed from 1999 to 2013.Methods:The seasonal patterns and geographic distribution of BD was assessed in Vietnam using a seasonaltrend decomposition procedure based on loess.In addition,negative binomial regression models were used to determine the climate risk factors associated with the incidence of BD in Kon Tum Province,from 1999 to 2013.Results:Overall,incidence rates of BD have slightly decreased over time(except for an extremely high incidence in 2012 in the north of Vietnam).The central regions(north/south central coast and central highlands)had relatively high incidence rates,whereas the northwest/east and Red River Delta regions had low incidence rates.Overall,seasonal plots showed a high peak in the mid-rainy reason and a second smaller peak in the early or late rainy season.The incidence rates significantly increased between May and October(“wet season”)across the country.In Kon Tum Province,temperature,humidity,and precipitation were found to be positively associated with the incidence of BD.Conclusions:Our findings provide insights into the seasonal patterns and geographic distribution of BD in Vietnam and its associated climate risk factors in Kon Tum Province.This study may help clinicians and the general public to better understand the timings of outbreaks and therefore equip them with the knowledge to plan better interventions(such as improving water,sanitation,and hygiene conditions)during peak seasons.This can,in turn,prevent or reduce outbreaks and onwards transmission during an outbreak.

Ecohealth research in Southeast Asia: past, present and the way forward

Ecohealth is a comprehensive approach to understanding health at its human,animal and environmental interface in a socio-ecological systems context.This approach was introduced widely in Southeast Asia(SEA)by the Canadian International Development Research Centre(IDRC)in the late 2000s.Aimed at addressing the problem of emerging infectious diseases(EIDs),numerous such projects and activities have been generated throughout the region.Ecohealth is increasingly converging with the One Health approach,as both movements emphasise a holistic understanding to health.We conducted a scoping review by considering all of the Ecohealth programmes,initiatives and projects that have been implemented in SEA since the introduction of the approach,and also gathered information from peer-reviewed literature.The objective of this paper is to review Ecohealth activities within SEA over the last 10 years to address the lessons learned,challenges faced and the way forward for Ecohealth in the region.Activities range from those focusing purely on capacity,projects focusing on research and projects covering both.Achievements to date include,for example,research contributing to the field of infectious diseases in relation to social ecological factors and associated urbanisation and agricultural intensification.Challenges remain at the project design and implementation level,in the available capacity and coordination to develop Ecohealth research teams in the countries,gauging teams’assimilation of Ecohealth’s underlying tenets and their translation into sustainable disease prevention and control,as well as in the ability to scale up Ecohealth projects.We suggest that the way forward for Ecohealth should be from a regional perspective in terms of research,training and policy translation using Ecohealth in combination with the One Health approach.

Identifying the impediments and enablers of ecohealth for a case study on health and environmental sanitation in Hà Nam, Vietnam

Background:To date,research has shown an increasing use of the term“ecohealth”in literature,but few researchers have explicitly described how it has been used.We investigated a project on health and environmental sanitation(the conceptual framework of which included the pillars of ecohealth)to identify the impediments and enablers of ecohealth and investigate how it can move from concept to practice.Methods:A case study approach was used.The interview questions were centred on the nature of interactions and the sharing of information between stakeholders.Results:The analysis identified nine impediments and 15 enablers of ecohealth.Three themes relating to impediments,in particular-integration is not clear,don’t understand,and limited participation-related more directly to the challenges in applying the ecohealth pillars of transdisciplinarity and participation.The themes relating to enablers-awareness and understanding,capacity development,and interactions-facilitated usage of the research results.By extracting information on the environmental,social,economic,and health aspects of environmental sanitation,we found that the issue spanned multiple scales and sectors.Conclusion:The challenge of how to integrate these aspects should be considered at the design stage and throughout the research process.We recommend that ecohealth research teams include a self-investigation of their processes in order to facilitate a comparison of moving from concept to practice,which may offer insights into how to evaluate the process.

Food safety in Vietnam:where we are at and what we can learn from international experiences

Food-borne diseases are attracting a lot of attention in Vietnam as a result of repeated episodes of adulterated and unsafe food.In this paper,we provide some perspectives on food safety in Vietnam from the point of view of an international research institution working on food safety with partners in the country.We argue that one of the key issues of food safety in Vietnam is that certain food value chain stakeholders lack ethics,which leads to the production and trading of unsafe foods in order to make profits irrespective of adverse health effects on consumers.In turn,the shortfall in ethical behaviours around food can be attributed to a lack of incentives or motivating factors.Although food safety causes panic in the population,it is unclear how much contaminated food contributes to the burden of food-borne diseases and food poisonings in Vietnam.However,globally,the biggest health problem associated with food are infections from consuming food contaminated with viruses,bacteria or parasites.A major food safety challenge is the inappropriate way of communicating food risks to the public.Another key constraint is the inherent difficulty in managing food in wet markets and from smallholder production.On the other hand,local foods,and local food production and processing are an important cultural asset as well as being essential to food safety,and these aspects can be put at risk if food safety concerns motivate consumers to purchase more imported foods.In this paper,we also discuss good experiences in food safety management from other countries and draw lessons learnt for Vietnam on how to better deal with the current food safety situation.