Effect of Health Expenses on Household Capabilities and Resource Allocation in a Rural Commune in Vietnam

Background

Significant health expenses can force households to reduce consumption of items required for daily living and long-term well-being, depriving them of the capability to lead economically stable and healthy lives. Previous studies of out-of-pocket (OOP) and other health expenses have typically characterized them as “catastrophic” in terms of a threshold level or percentage of household income. We aim to re-conceptualize the impact of health expenses on household “flourishing” in terms of “basic capabilities.”

Methods and Findings

We conducted a 2008 survey covering 697 households, on consumption patterns and health treatments for the previous 12 months. We compare consumption patterns between households with and without inpatient treatment, and between households with different levels of outpatient treatment, for the entire study sample as well as among different income quartiles. We find that compared to households without inpatient treatment and with lower levels of outpatient treatment, households with inpatient treatment and higher levels of outpatient treatment reduced investments in basic capabilities, as evidenced by decreased consumption of food, education and production means. The lowest income quartile showed the most significant decrease. No quartile with inpatient or high-level outpatient treatment was immune to reductions.

Conclusions

The effects of health expenses on consumption patterns might well create or exacerbate poverty and poor health, particularly for low income households. We define health expenditures as catastrophic by their reductions of basic capabilities. Health policy should reform the OOP system that causes this economic and social burden.     

Pleistocene genetic connectivity in a widespread,open‐habitat‐adapted mosquito in the Indo‐Oriental region

Aim The environmental effect of Pleistocene climatic change in the Indo‐Oriental region has resulted in allopatric fragmentation and the generation of diversity in forest‐associated species. The aim of this study was to determine the extent to which Pleistocene climatic change has resulted in the fragmentation and speciation of an open‐habitat‐adapted mosquito, Anopheles vagus s.l., across its range. Location Anopheles vagus s.l. was sampled across the Indo‐Oriental region. Methods We generated 116 mitochondrial cytochrome c oxidase subunit I (COI) and 121 nuclear internal transcribed spacer 2 (ITS2) DNA sequences from 18 populations. Relationships between mitochondrial haplotypes were reconstructed using minimum spanning networks, and population structure was examined using analyses of molecular variance. The population history, including lineage divergence times, population expansion and gene flow, was inferred using beast and the isolation with migration (IM) model. Results There was no evidence to support the presence of the endemic Philippines species, A. limosus; instead, Philippine populations were closely related to, and derived from, A. vagus on the eastern Southeast Asian mainland. The most distinct populations were those from Java and East Timor, which differed from all other populations by all individuals having a 4‐bp insertion in the ITS2 sequence. The corresponding mitochondrial haplotypes had an estimated divergence time of 2.6 Ma [95% confidence interval (CI) 1.9–3.6 Ma]. Haplotype networks and analysis of molecular variance for COI supported western (Sri Lanka, India and Myanmar) and eastern (Thailand, Singapore, Cambodia, Vietnam and the Philippines) population groupings. This grouping structure results from the divergence of an eastern and a western mitochondrial lineage, estimated to have occurred 0.37 Ma (95% CI 0.26–0.55 Ma). Subsequent migration from the east to the west (0.16 Ma) is inferred to have created an admixture zone in Myanmar and Thailand. Main conclusions With the possible exception of populations from Java and East Timor, A. vagus appears to be one widespread genetically diverse taxon across its extensive range. The abundance of grassland during long interglacial periods may have facilitated population connectivity and range expansion across the Oriental and western Australasian regions.     

In Vitro Characterization of a Recombinant AHL-Lactonase from Bacillus cereus Isolated from a Striped Catfish (Pangasianodon hypophthalmus) Pond

aiiA gene encoding AHL-lactonase was isolated from Bacillus cereus strain N26.2, originating from a striped catfish (Pangasianodon hypophthalmus) pond in Vietnam. This gene, abbreviated as aiiA(N26.2), was cloned and expressed in a competent Escherichia coli strain BL21(DE3)pLysS. The resulting protein, abbreviated as AiiA_N26.2, was highly active in the pH range of 6–8 and could retain 80 % of the maximum activity under storage for 5 days at 4 °C or for 3 days at 20 °C. These properties of AiiA_N26.2 protein confers its future application via feed supplementation, with the purpose of controlling aquaculture pathogens which regulate the virulence via a quorum sensing system.     

A poroviscohyperelastic model for numerical analysis of mechanical behavior of single chondrocyte

The aim of this paper is to use a poroviscohyperelastic (PVHE) model, which is developed based on the porohyperelastic (PHE) model to explore the mechanical deformation properties of single chondrocytes. Both creep and relaxation responses are investigated by using finite element analysis models of micropipette aspiration and atomic force microscopy experiments, respectively. The newly developed PVHE model is compared thoroughly with the standard neo-Hookean solid and PHE models. It has been found that the PVHE can accurately capture both creep and stress relaxation behaviors of chondrocytes better than other two models. Hence, the PVHE is a promising model to investigate mechanical properties of single chondrocytes.     

Human Taeniasis and Cysticercosis and Related Factors in Phu Tho Province,Northern Vietnam

Several factors presumed to facilitate the transmission of Taenia spp. were reported in Vietnam. We conducted a cross-sectional study taking questionnaires from 1,185 participants, and collecting 1,151 sera and 1,036 stool samples in northern Vietnam. Sera were examined for circulating antigens of Taenia solium cysticerci using ELISA, stools for Taenia eggs by Kato-Katz smear, and copro-antigens by ELISA. Ag-ELISA revealed 4.6% antigen positivity, indicating infection with viable cysticerci. Taenia eggs were detected in 1.5% of participants. Copro-antigens were found in 2.8% of participants. Eating raw meat and/or vegetables was significantly associated with the presence of copro-antigen (OR=8.6, 95% CI: 1.16–63.9, P=0.01). Considering the high taeniasis prevalence and the associated threat, public health attention should be given to treat the tapeworm carriers in the projected areas.     

Prevalence and Risk Factors for Tuberculosis Infection among Hospital Workers in Hanoi,Viet Nam

Background

Transmission of tuberculosis (TB) to health care workers (HCWs) is a global issue. Although effective infection control measures are expected to reduce nosocomial TB, HCWs'' infection has not been assessed enough in TB high burden countries. We conducted a cross-sectional study to determine the prevalence of TB infection and its risk factors among HCWs in Hanoi, Viet Nam.

Methodology/Principal Findings

A total of 300 HCWs including all staff members in a municipal TB referral hospital received an interferon-gamma release assay (IGRA), QuantiFERON-TB Gold In-Tube^TM, followed by one- and two-step tuberculin skin test (TST) and a questionnaire-based interview. Agreement between the tests was evaluated by kappa statistics. Risk factors for TB infection were analyzed using a logistic regression model. Among the participants aged from 20 to 58 years (median = 40), prevalence of TB infection estimated by IGRA, one- and two-step TST was 47.3%, 61.1% and 66.3% respectively. Although the levels of overall agreement between IGRA and TST were moderate, the degree of agreement was low in the group with BCG history (kappa = 0.29). Working in TB hospital was associated with twofold increase in odds of TB infection estimated by IGRA. Increased age, low educational level and the high body mass index also demonstrated high odds ratios of IGRA positivity.

Conclusions/Significance

Prevalence of TB infection estimated by either IGRA or TST is high among HCWs in the hospital environment for TB care in Viet Nam and an infection control program should be reinforced. In communities with heterogeneous history of BCG vaccination, IGRA seems to estimate TB infection more accurately than any other criteria using TST.     

Enhancing the luminescence of Eu3+/Eu2+ ion‐doped hydroxyapatite by fluoridation and thermal annealing

This paper reports a novel way for the synthesis of a europium (Eu)‐doped fluor‐hydroxyapatite (FHA) nanostructure to control the luminescence of hydroxyapatite nanophosphor, particularly, by applying optimum fluorine concentrations, annealed temperatures and pH value. The Eu‐doped FHA was made using the co‐precipitation method followed by thermal annealing in air and reducing in a H₂ atmosphere to control the visible light emission center of the nanophosphors. The intensities of the OH^? group decreased with the increasing fluorine concentrations. For the specimens annealed in air, the light emission center of the nanophosphor was 615 nm, which was emission from the Eu³⁺ ion. However, when they were annealed in reduced gas (Ar + 5% H₂), a 448 nm light emission center from the Eu²⁺ ion of FHA was observed. The presence of fluorine in Eu‐doped FHA resulted in a significant enhancement of nanophosphor luminescence, which has potential application in light emission and nanomedicine.     

Microbial production of astilbin,a bioactive rhamnosylated flavanonol,from taxifolin

Flavonoids are plant-based polyphenolic biomolecules with a wide range of biological activities. Glycosylated flavonoids have drawn special attention in the industries as it improves solubility, stability, and bioactivity. Herein, we report the production of astilbin (ATN) from taxifolin (TFN) in genetically-engineered Escherichia coli BL21(DE3). The exogenously supplied TFN was converted to ATN by 3-O-rhamnosylation utilizing the endogeneous TDP-l-rhamnose in presence of UDP-glycosyltransferase (ArGT3, Gene Bank accession number: At1g30530) from Arabidopsis thaliana. Upon improving the intracellular TDP-l-rhamnose pool by knocking out the chromosomal glucose phosphate isomerase (pgi) and d-glucose-6-phosphate dehydrogenase (zwf) deletion along with the overexpression of rhamnose biosynthetic pathway increases the biotransformation product, ATN with total conversion of ~49.5?±?1.67% from 100 µM of taxifolin. In addition, the cytotoxic effect of taxifolin-3-O-rhamnoside on PANC-1 and A-549 cancer cell lines was assessed for establishing ATN as potent antitumor compound.     

A protocol for the cryoconservation of breeds by low-cost emergency cell banks - a pilot study

A protocol was developed for collection and storage of somatic cell samples under adverse conditions with little infrastructure, for somatic-cell banks as a backup for endangered livestock breeds. The procedure, which is uniform across species, includes sample collection with ear taggers with an integrated tag/vial system, and recording of global positioning system (GPS) coordinates, digital images and breed information. In a pilot study, the procedures were tested on six local Vietnamese populations of pigs, sheep and goats. Initial investment was around €3000, while the total variable cost for sampling one breed with 25 females and 25 males was less than €1000. With support from local organisations, the sampling of six breeds with 300 animals was carried out in 2 months. The protocol and the complete workflow for setting up a somatic-cell bank, together with data collection, are described. The procedure has proved practicable and exceedingly cheap relative to the cryopreservation of semen or embryos.